Wednesday’s Senate confirmation hearing wasn’t the first time much of the American public met Dr. Nicole Saphier and heard her perspective; President Donald Trump’s nominee for US surgeon general is a health and wellness influencer who has amassed hundreds of thousands of followers through her podcast and social media platforms
In some ways, the surgeon general position – often referred to as the nation’s doctor – is the original health influencer, tasked with translating science into terms that are easy to understand and guiding the public on ways to improve their health
“For a decade, I have specialized in translating complex, fast-evolving medical information on various media platforms into content that millions of Americans can understand and use, including during the uncertainty of the global pandemic,” Saphier, a radiologist and Fox News contributor, said in Wednesday’s hearing
“I realized then how badly this country needs public health communication that is straightforward and grounded in the best evidence available,” she said. “My years of communicating directly with the public have prepared me to explain complex topics in a way that they can understand.”
But experts say that social media has changed how people receive health information, with increasingly blurred lines as to who is considered to have authority and expertise – and that bringing an influencer into the role of surgeon general presents both opportunities and challenges
Dr. Jerome Adams, who served as surgeon general during Trump’s first term, says the distinction between the role of an influencer and the role of the surgeon general matters more than the overlap
“An influencer builds a brand and an audience. The surgeon general speaks for the nation (and not just ‘followers’), leads the Public Health Service Commissioned Corps, and has a duty to follow evidence even when it is politically inconvenient,” Adams said in an email to CNN. “Influence is a tool, but it is not the job.”
The Pew Research Center said in a report published this year that a significant share of the American public – 4 in 10 adults overall and half of those under 50 – now get their health and wellness information from social media influencers and podcasts
But the center’s analysis of thousands of influencer profiles found a wide range of backgrounds, with less than half describing themselves as some kind of health professional. About 1 in 8 cite their personal experience in their social media bios, and nearly 1 in 6 do not mention anything about their background or expertise
“Now, when a healthcare provider sees a patient, any number of other individuals and platforms and messengers have that patient’s ears and eyes,” said Eileen Yam, director of science and society research at Pew. “The ballgame is changing so quickly as far as where people hear health information, wellness information, beyond that kind of mainstream white coat expertise.”
Influencers presenting information from a clinical perspective may take a very different approach from those who base their content around personal experience, experts say, and there may be friction between the two approaches on the same topic
“On the internet, there’s a lot of anecdotal information that gets generalized, but not everything is generalizable,” said Amanda Yarnell, senior director of the Center for Health Communication at Harvard’s T.H. Chan School of Public Health
“I think some of the most successful creators, both in audience and in providing good information and making people connect with it, are people who have blended their personal experience with other expertise,” said Yarnell, whose center launched a program in 2023 that works directly with creators to use their social media platforms to counter health misinformation online and to spread evidence-based science.
Surgeon general nominee Saphier presents herself as someone who can balance that line between personal and professional experience. To her nearly 360,000 followers on X, she identifies herself as a “full time wife, mom and doctor.”
Her Instagram profile, where she has 147,000 followers, includes the same line – but also indicates that she is the “creator of Drop Rx,” a brand of liquid herbal supplements
Her bio page on the Drop Rx site says she wanted to create “clean, thoughtfully crafted tinctures that support focus, calm, balance, and overall wellness” that are inspired by “traditional herbal wisdom and modern scientific insight.” The site notes that “statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease.” Many of the products are currently unavailable online. Some sell for $24.99 for 2 fluid ounces.
Business interests like this are part of what has challenged influencer credibility, experts say, especially as more traditional information e also lost some of the public’s trust around evidence-based recommendations
“There is often financial gain involved with (social media influencing), so that can influence the content that is delivered as well,” said Dr. Anne Cappola, a physician and executive director of the Penn Medical Communication Research Institute. “It’s not always transparent to those who are absorbing that information. It’s all getting muddy.”
Generally, Pew found that only about 10% of US adults say they trust all or most of the information they get from influencers, while a quarter said they trust not much or none at all
“The lion’s share of these audiences say that they trust some of the information. So there’s some healthy skepticism that people are using when they’re seeing information from health and wellness influencers overall,” said Galen Stocking, an associate director of research at Pew and lead author of the recent report
As the public parses all of the health and wellness information that is available to them online, experts say that trust in the messenger becomes one of most important aspects of who they decide to listen to
“Authority, benevolence and integrity are three pillars of how people have long thought about trust models,” Yarnell said. “The way (these pillars) show up on the internet is quite specific, and they can be used for good or bad.”
Former Surgeon General Adams said the trust Saphier has gained as a health influencer could serve her well as surgeon general, but maintaining that trust in a government role under the current administration will present new challenges
He said he isn’t concerned about Saphier’s ability to communicate, but he is concerned about whether “the environment she would enter will let her tell the truth about what’s actually harming Americans, and how best to protect them” – particularly around vaccine-preventable diseases
Saphier will have to work harder to establish credibility with those who are skeptical about her “prior association with a network and movement that many see as increasingly against science and vaccines,” he said. But she has an opportunity to reach groups “who have tuned out traditional public health voices” and to “raise trust among people who currently distrust ‘the establishment.’”
She’ll need a “clear, independent voice,” he said
When asked about her views on vaccines in Wednesday’s hearing, Saphier said that the measles, mumps and rubella vaccine is “our greatest tool for combating measles,” and she said she does not believe that childhood vaccines cause autism
But when Sen. Bill Cassidy directly asked her “Should a parent be vaccinating their child with the MMR?” she didn’t reply with a yes or no
“I think that the recommendation is to combat what we are seeing right now – the best tool we have to combat these infections, to save the most lives and to also create population herd immunity – is vaccination against the MMR,” Saphier replied
In a podcast episode in February, Saphier reflected on the role of surgeon general after a prior nominee – author, Stanford medical graduate and wellness influencer Casey Means – faced her Senate confirmation hearing
“The biggest skill that this person needs is they need to be able to effectively communicate with the public, public health messaging,” Saphier said on her podcast
“But even more important than that, they need the respect of not only the people, the American people that they are communicating to, but they also need the respect of the administration for which they are working together with to get that research and put out the messaging, and also the medical professionals, the medical organizations, they need to make sure that she is a trusted messenger.”
Trump withdrew Means’ nomination in April after the vote stalled in the Senate, replacing her with Saphier. (Trump had previously withdrawn the nomination of another surgeon general candidate, Dr. Janette Nesheiwat, a New York family physician and former Fox News medical contributor.)
Within days of her nomination, Saphier deleted numerous social media posts in which she broke publicly with Trump and US Department of Health and Human Services Secretary Robert F. Kennedy Jr. on some of the administration’s most politically sensitive health issues, including vaccines and autism
Saphier changed her X profile to private soon after
“A preexisting following is useful only if she uses it to defend science, not to soften it,” Adams said. “Trust in this role has never come from celebrity. It comes from consistency with evidence, and a willingness to speak out on behalf of health, even when it may be unpopular.”
