President Donald Trump’s controversial nominee for surgeon general, Casey Means, was expected to be grilled by a Senate health committee Thursday. The confirmation hearing, however, was delayed because Means went into labor with her first child.

That’s just the latest drama over her nomination. Means never completed a residency after graduating in 2014. Her medical license has been inactive, and she’s known more as a wellness influencer than a traditional physician.

Means has questioned mainstream medical views about fertility, accused doctors of overprescribing birth control, and faced pushback from nursing and public health associations for her unconventional vaccine views. Even MAGA influencer Laura Loomer called her a “Witch Doctor.”

But her nomination is a reminder that Congress should ask: Why does the United States have a surgeon general? Does it even need one?

A policy analysis I co-authored at the Cato Institute traces the surprising evolution — and overreach — of the office.

The U.S. Public Health Service Commissioned Corps, of which the surgeon general is the operational and symbolic leader, has come a long way since its inception in 1798, when Congress created the U.S. Marine Hospital Service to care for sick and injured merchant seamen. This service evolved into a national marine hospital system staffed by a corps of physicians overseen by a “supervising surgeon.” In 1889, Congress formally named it the Commissioned Corps, a military branch administered by what eventually became the Office of the Surgeon General.

Yet what started as a civil service role overseeing merchant marine hospitals has transformed from an apolitical supervisor of medical staff to a divisive activist who undermines public health. The surgeon general is second-in-command (the Department of Health and Human Services’ assistant secretary for health is first) of the Public Health Service Commissioned Corps. This roughly 6,000-member uniformed corps of doctors, nurses, veterinarians, pharmacists and other health professionals deploys to an array of federal agencies, some of which address public health emergencies. The corps also duplicates civilian roles and functions outside traditional public health. Our study at the Cato Institute found that more than half of the agencies to which the surgeon general assigns corps staff have little connection to public health, notably the departments of Commerce, Education and Energy.

Our study cites a 2010 Department of Health and Human Services report that found using commissioned corps officers is about 15 percent more expensive than employing civilians in comparable roles. The report estimated that switching to civilian staff could save roughly $1.3 billion annually.

If confirmed, Means would not be the first contentious surgeon general. In recent decades, the office has strayed from its core mission — protecting the public from harm such as infectious diseases and pollution — into areas beyond traditional public health. It has weighed in on media violence, pornography and education, as well as poverty, guns and inequality. More recently, it has waded into parenting, labor, loneliness and social media, often advocating new regulations, subsidies and gun-control laws. In short, an office meant to advocate for “public health” has morphed into little more than a bullhorn for the government’s opinion on everyone’s personal life.

Surgeon general nominee Vivek H. Murthy once assured senators he wouldn’t use the office to push gun control — then, once confirmed, urged Congress to treat guns like cigarettes, calling for universal background checks, tighter restrictions on gun ownership and bans on semiautomatic rifles.

Former surgeons general themselves have warned about the office’s politicization. In 2007, Richard Carmona, C. Everett Koop and David Satcher told Congress that presidents had pressured them to toe the party line and avoid inconvenient topics. Years later, Carmona urged a return to appointing nonpartisan career officers instead of politically connected civilians.

Substantially reforming, or even axing, the surgeon general position would not be unprecedented. In 1968, President Lyndon B. Johnson effectively eliminated the office, folding its duties into the assistant secretary for health. A decade later, however, when Congress split the Department of Health, Education and Welfare into Education and HHS, it revived the role.

The surgeon general’s office and the Commissioned Corps waste taxpayer dollars, blur accountability and do little to advance the health of Americans. Phasing them out and moving essential duties to existing agencies would strengthen public health and fiscal responsibility.

HHS calls the surgeon general “the nation’s doctor.” But as our report shows, the nation doesn’t need a doctor — and it certainly doesn’t need a doctor’s army.