Trump taps radiologist Nicole Saphier for surgeon general, pulls Casey Means' nomination; medical malpractice trends; AMA and Congress vs. AI chatbots — Morning Medical Update Weekly Recap – Medical Economics

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The top news stories in medicine this week.
The U.S. has not had a confirmed surgeon general in 15 months.
President Trump withdrew the nomination of Casey Means, M.D., Thursday and announced radiologist Nicole Saphier, M.D., as his third surgeon general nominee of his second term.
Means, a Stanford-educated functional medicine physician and wellness influencer, had faced a contentious February confirmation hearing where senators from both parties pressed her on vaccines and her decision to leave her surgical residency before completing it. Republican Senators Susan Collins and Lisa Murkowski left the hearing with unresolved concerns, stalling her path forward. Trump blamed Senate HELP Committee Chair Bill Cassidy, M.D., for blocking the nomination, calling him "a very disloyal person" and urging Louisiana Republicans to vote him out. Saphier — director of breast imaging at Memorial Sloan Kettering Cancer Center’s Monmouth, New Jersey, campus, a frequent Fox News contributor, podcaster and best-selling author — is now Trump's pick to fill a post that has sat vacant since he took office.
Diagnostic Imaging has more on Saphier.
Claim frequency is declining — but premiums and nuclear verdicts are still climbing.
The rate at which U.S. physicians face malpractice claims has declined over the past decade, but the cumulative career risk remains substantial, according to new data from the American Medical Association (AMA). In 2024, 1.8% of physicians were sued in the prior year — down from 2.3% in 2016 — and 28.7% reported having been sued at least once in their career, compared to 34% eight years ago. Surgical specialties carry the highest lifetime risk, with nearly 60% of OB-GYNs and 53% of general surgeons reporting at least one career claim; among those specialties, physicians 55 and older approach a 75% lifetime rate.
Primary care physicians sit close to the overall average, at roughly 27%. The AMA was explicit that being named in a suit is not evidence of wrongdoing — 65% of claims are dropped or dismissed without payment — but noted that malpractice insurance premiums have risen for seven consecutive years, and that the growing frequency of nuclear verdicts continues to drive up costs across the entire system. Read more.
New legislation and physician group advocacy signal federal action may be coming.
The AMA and a bipartisan group of senators are pushing for federal guardrails on AI chatbots, with particular concern about their growing use in mental health support. The AMA sent letters to congressional AI and digital health caucuses late last week calling for mandatory disclosures that users are interacting with a machine, FDA review when chatbots cross into diagnosis or treatment, built-in crisis detection for self-harm risk and bans on targeted advertising to minors.
Days later, Senators Ted Cruz, Brian Schatz, John Curtis, and Adam Schiff introduced the CHATBOT Act, which would require AI companies to offer family accounts giving parents access to their children's chat logs, time limits, and controls to disable addictive engagement features — with kids under 13 required to have a family account to use a chatbot at all.
The two efforts target different problems — the AMA is focused on patient safety in clinical contexts, while the CHATBOT Act is squarely aimed at protecting minors — but together they represent the clearest signal yet that federal action on AI and mental health is on the table.

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Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP; Anders Carlson, MD; Jennifer B. Green, MD
Nihar R. Desai, MD, MPH; Martha Gulati, MD, MS, FACC, FAHA, MASPC, FESC, FSCCT (hon), FRCP Edin
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