As a pediatrician, I care deeply about who helps guide the health of my patients and their families. The Casey Means nomination for U.S. Surgeon General worries me, a lot. This role should be grounded in deep clinical training, service, and evidence-based care. Our patients deserve leadership shaped by years of training, by caring for people across every background, not by selling expensive, unproven “wellness” solutions to the privileged. Public health leadership should put patients first, not