STEVE INSKEEP, HOST:
All right. Let's get a view from a former surgeon general, Dr. Jerome Adams, who served in that role during President Trump's first term. He's on the line from our state of Indiana. Dr. Adams, welcome.
JEROME ADAMS: Good morning. Good to be with you, Steve.
INSKEEP: I want people to know you were publicly critical of Dr. Casey Means, the previous nominee. How did the credentials of Nicole Saphier - Dr. Saphier compare?
ADAMS: Well, she is at least a practicing physician who has a active medical license, so she meets the minimum criteria. But it's important to note that the nominations have evolved with the political and, I think, public health mood. Dr. Nesheiwat, a Fox News contributor, family physician with a Caribbean medical degree, wellness influencer, was the first nominee but was withdrawn in spring 2025 because she wasn't MAHA enough. Dr. Means was nominated, and she aligns much more with MAHA and RFK. But we see exploding measles cases and, again, a - more of a focus on having someone in the role who actually has credentials.
Dr. Saphier, as you mentioned, is a practicing radiologist at Sloan Kettering, Fox News contributor, Caribbean medical degree, wellness influencer - actually very similar to Dr. Nesheiwat. But that said, she's at a time where Trump appears to be striking a more pragmatic balance between someone with active credentials, great communication skills and who also supports the MAHA prevention and lifestyle reforms that RFK is pushing for.
INSKEEP: I think I'm hearing you saying, Dr. Adams, that over the course of these nominations, the MAHA movement has waxed and waned. It was maybe more popular, more powerful a year ago, and it's a little less popular now. And the administration has to respond to that.
ADAMS: Absolutely. And you have Chris Klomp now, who is an adviser within HHS, who many people feel is having a significant influence on the pick of Dr. Erika Schwartz, the CDC director nominee, and of Dr. Saphier, reflecting a desire to change the narrative going into midterm elections away from vaccines and, again, more to some of the things in MAHA that people like I and others agree with - nutrition, physical activity, let's try to focus on environmental issues. And so I think that's what you're seeing here.
INSKEEP: It is really interesting. We heard from Pien Huang that Dr. Saphier herself, before being nominated, laid out some credentials, some qualifications, some necessities for a surgeon general. She said you need the respect of the public. You need the respect of the administration. You have to have people listening to you within the administration, and you also need the respect of the medical establishment. Does Nicole Saphier have those three things?
ADAMS: She absolutely does. And to be clear, I worked with Dr. Saphier when I was surgeon general and she was a Fox News contributor. And I always thought she was very fair, very even-handed, tries to present both sides, if you will. And I think the medical community at large will respect her.
What's interesting, though, is that she is a cancer doc. She tends to see things through a diagnosis and treatment lens because that's what cancer docs do. And it's clear when you look at her book that she wrote that she does not think of things through a public health and societal lens, the way that someone like I, who've been trained in public health, do. Concrete example. She talks about personal responsibility a lot, but you can't eat healthy if you are having your SNAP benefits cut or if the cost of groceries is going through the roof because of inflation. And so the broader societal context actually matters. And I think that's a place where you have to have respect of the corps, the Public Health Corps, to be able to lead it. And she's going to have to work hard, and I think she will and can, to gain that respect of the Public Health Service Corps, who will see things differently than she has.
You also have to have respect of the secretary. And that's going to be challenging, too, because she has in the past spoken out in favor of vaccines. But again, I think the moment we're in right now is very different than Dr. Nesheiwat. And I think she will be able to thread that needle between supporting vaccines but also not alienating herself with the secretary, who is actually your day-to-day immediate boss when you're the surgeon general.
INSKEEP: I want to dwell on that point that you're making there because, of course, your health is to some extent your personal responsibility - a proper diet, proper exercise and so forth. But you're saying there are broader conditions that the government has to attend to or sometimes fails to attend to that really affect people's health.
ADAMS: Exactly. And I explained this to President Trump, and fortunately, my secretary, Alex Azar, completely understood this the first go round. I 100% believe in personal responsibility, but I also know that the choices people make are dependent on the choices they have around them. If they can't afford food, if their neighborhoods aren't safe for them to go out and exercise in, if they're surrounded by tobacco smoke because of the policies that you have, the governmental policies, they're not going to be able to be healthy and to make healthier choices.
So it's both. It's encouraging personal responsibility, but it's also making sure people have better choices in front of them. And that's where government does come in. And again, I hope and expect that Dr. Saphier will recognize that as she assumes the role, which - I think she will be confirmed and pivot a little bit more towards a balance as opposed to all or none.
INSKEEP: Dr. Jerome Adams was the 20th surgeon general of the United States and is now at Purdue University. Dr. Adams, thanks so much.
ADAMS: Thank you, Steve. Transcript provided by NPR, Copyright NPR.
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