It’s hard to imagine a federal agency that touches more of our lives—and in more personal ways—than the Food and Drug Administration. It reaches in through our medicine cabinets, regulating everything from our morning pills to makeup—and through our kitchen cupboards, ensuring the safety of most of what we ingest each day, even bottled water. Its purview extends from pet food to microwave ovens to vaccines, pacemakers, and bedpans. And in the year since he has been FDA commissioner, Scott Gottlieb has appeared to have had a direct hand in all of it. Gottlieb, a physician and former VC who served as a deputy commissioner in the administration of President George W. Bush, has earned broad kudos from a constituency that is often beset by bitter argument. He has pushed for creative ways to slow the skyrocketing rise of medicine prices (in part by making it easier for generics to compete), helped speed the development of digital health technologies through clearer regulatory guidance, embraced more efficient clinical trial designs, and aggressively tried to reduce cigarette smoking and contain America’s raging opioid epidemic through sharp policy moves. An avid (perhaps even obsessive) tweeter, Gottlieb has gotten credit for being transparent about FDA steps—and, more important, for using his bully pulpit without being a bully.