Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
yes. I see pics
Utilization review Medicare regulatory nerd. Road cyclist. 3v CAD s/p stenting (see proile pic). Fully vaccinated, still N95 masking on planes. Vote blue. Opinions my own, not those of employer
773 followers 763 following 446 posts
view profile on Bluesky Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
yes. I see pics
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Oh, the Medicare plans have been using AI for a while to prior authorize (or rather deny requests) for nursing home or rehab care.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
More the reason to stay far away from RFK Jr. I’ve heard he bites.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Here are the service categories. But CMS has yet to release a list of the actual procedures. The NCDs and LCDs do not have procedure codes. For example, “diagnosis and treatment of impotence” is a service category, but what the heck types of procedures fall into that?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
The Medicare Recovery Auditors have been paid to deny payment for care since 2009. They denied liberally in the hopes providers would not have the resources to appeal.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Say it- RFK Jr is a serial killer! He has already killed in Samoa and will kill again.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Ability to adjust weather maps with a Sharpie is a must have competency
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Was this a tour of The Gilded Age homes?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Eating breakfast and got to see nature in action
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Can't someone stop RFK Jr from biting people? www.nbcnews.com/health/healt...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
I would pay money for an app that will immediately set off a notification and an alarm when Trump dies so I can stop obsessively checking @cnn.com for that headline. But of course, I don’t want a notification about the next celebrity engagement or the next law that Trump violates.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
RFK murdered over 50 children in Samoa with his anti-vaccine advocacy. His serial killing is all over the world.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
@joho.bsky.social is a national treasure. His book is a masterpiece takedown of the COVID deniers whose actions killed people. redhawkpublications.com/We-Want-Them...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Trump not pay a contractor? Say it ain’t so!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Makary needs to get over it. I’ve got an idea for him- start regulating supplements - demand scientific evidence of clinical benefit just like he wanted with masks and vaccines.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Trip to Party City? Oh wait…
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
It’s a tragedy…that Party City went bankrupt and closed all its stores.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
That is hilarious!!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Beware- men in those six states will have their info entered into AI if they want Viagra -- "diagnosis and treatment of impotence" will require prior auth under WISeR.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Your lawn does not need to look like a golf course. Stop killing nature with toxic lawn fertilizers and weed control. Promote native landscaping - wildones.org
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
HHS/CMS does almost no audits themselves. Everything is outsourced to private companies. Even the OIG contracts Maximus to do their audits. "Pay to deny" started in 2005 with the RAC (and we know how those contractors abused the privilege) Now WISeR will be second program.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
And they will be paying the companies with the AI programs based on “savings,” aka to deny medical care. Will be interesting to see if AI evolves to deny more to help its employer.
Ronald Hirsch, MD (@signaturedoc.bsky.social)
For Republican voters, "right to life" ends at birth. They could care less about protecting, feeding, or educating all children.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
☝️☝️ SERIAL KILLER ☝️☝️
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
How come he was allowed to use his cell phone and I can’t when I fly?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
It appears RFK Jr’s serial killing plan includes our veterans and not just ordinary Americans. Stop him now!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
He is a serial killer.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
He’d be another random NFL tight end if he wasn’t dating, now engaged to, Taylor.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
"Patient has a beating heart. Approved for COVID vaccine"
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Breaking News: Top CDC scientist resigns. Dr. Debra Houry had "a long history of working across seemingly partisan divides." We are all doomed. RFK Jr is a serial killer and determined to kill as many Americans as possible. open.substack.com/pub/insideme...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
A box of Kraft Mac & Cheese cures all!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
On the positive side, our health insurance premiums will go down if insurers no longer have to pay for all that costly chemotherapy, surgery and radiation therapy. Hospice is a whole lot cheaper 🙄
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Life in prison until his family buys a bunch of Trump's cryptocurrency then he will get a pardon and citizenship for his family.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
And that's why I post a pic every time I see it (and so should everyone else)
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
urologist!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Yep! He already is killing children in Samoa and a few in the US
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
You can't call nephrology fast enough!!! They LOVE hyponatremia! @kidneyboy.bsky.social will confirm that!
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Just when you thought United Health Group/UHC/Optum couldn’t get more evil… kffhealthnews.org/news/article...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
He’s attacking @ameracadpeds.bsky.social because they spoke out about starvation of children in Gaza.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Does raw milk treat this condition? 🙄
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
I do miss the robust medical discussions that happened on that other site. Learned so much!
Ronald Hirsch, MD (@signaturedoc.bsky.social)
This is the article you need to read today to cleanse your mind and learn about a fascinating creature.
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Trump has turned the White House into a brothel. What the f**k is wrong with him?!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Sensitive nasal passages in those ED docs — they get nose bleeds if they have to go above the first floor of the hospital.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
South Park repeat of that episode last night crashed the Fortnight server!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Back in the old days, hitting pleural fluid was always a celebration when doing a thoracentesis by percussion and palpation. Heck, even a successful paracentesis was cause for celebration. But you're right -- nothing like the perfect LP.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
@brianhiestand.bsky.social - yes! Why is this still a thing after 2 1/2 years???
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Already written - Coronary www.goodreads.com/book/show/64...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Of course. He was home with his kids for two weeks and begged to get his job back so he don’t have to parent them. That’s why he opposed Covid school closings- too much parenting for his ego.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
The Washington Trials of War Crimes by ICE will rival the Nuremburg Trials after WW II. And hopefully the real Alcatraz will be reopened by then so the ICE agents can be imprisoned there.
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Anyone looking for an Alaska fixer upper? www.zillow.com/homedetails/...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Maxwell was raping children herself, not just helping Trump and Epstein do it!
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Dean Cain is no Pat Tillman; Cain's a washed up actor promoting hate and violence, not defending our country. www.cnn.com/2025/08/07/e...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Why is no one talking about the wild ending to this week’s The Gilded Age??!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Ok, I'll play. Why is it so crowded on a Monday? It's usually the weekends with the worst crowds. (And happy to support them even with lines rather than shop at Target!)
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Love when screening works but sad that it shows that once again addressing the social determinants of health has so far to go. And angry that RFK Jr is determined to resist any effort to reduce health disparities or even measure the effects of these disparities and the effects of SDoH.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Politics over data??? No, not the Trump/RFKJr/Bhattacharya/Makary/Means cartel!!!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
I loved the "spend more time with family." He's the guy that opposed shutting down schools in COVID because he did not want to be stuck at home watching his kids.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Let him charge health insurance companies first!! That’s true organized crime- UHC, Aetna, Blue Cross, etc.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Miracles do happen.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
You mean giving Suprep for colonoscopy prep or to avoid constipation?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
And he just officially abolished birthright citizenship www.hhs.gov/guidance/doc...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
It's official- children born in the US are not automatically citizens without a "qualifying parent" per EO from Dictator Trump. www.hhs.gov/guidance/doc...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
"Hey! I know that guy!!!"
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Ethical Obligations to Inform Patients About Use of AI Tools url:https://jamanetwork.com/journals/jama/fullarticle/2836687?utm_source=bluesky&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=072125
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
I wish I could have watched. I was sound asleep then woke up in recovery apparently saying inappropriate things. One patient of mine reportedly started singing Star Spangled Banner during her scope. Talk about no filter… 🤣
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Your article on Makary's blind spots is an absolute masterpiece! Thank you!!!! vajenda.substack.com/p/marty-maka...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
The choreography is superb! Credit to Trump staff. So many moving parts to get that perfect shot!
Ronald Hirsch, MD (@signaturedoc.bsky.social)
We learn Trump is on Aspirin for CAD prevention. USPSTF does not recommend ASA for primary prevention -> RFK Jr shuts down USPSTF to avoid scrutiny.
Ronald Hirsch, MD (@signaturedoc.bsky.social)
We know money changed hands! Our tax dollars! Who got that money and how much? You have to assume their monarch got a nice bribe to accept these ICE kidnapping victims. www.cnn.com/2025/07/17/a...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
They're eating their own!!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
This is RFK Jr's version of doing science right??? Change the study results to fit their narrative? I don't think so... RFK Jr, Oz et al are serial killers.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
I sure hope every one of those parents files fraud and personal injury lawsuits against that doctor!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
It's all about corruption even in HHS with people's lives at stake - All that matters is - What's in it for RFK Jr and his pals? kffhealthnews.org/news/article...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
The corruption and conflicts of interest at HHS are immense with RFK Jr. kffhealthnews.org/news/article...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
So says Robin on Ghosts UK
Ronald Hirsch, MD (@signaturedoc.bsky.social)
#HappyKittenDay to Leopold, survivor of meningioma s/p radiation Just as your children are always kids no matter how old they are, cats are still kittens at any age.
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Does Marjorie Taylor-Greene know they are now using Chinese lasers to kill mosquitoes? (This is actually pretty cool and will buy once price comes down from $600) www.indiegogo.com/projects/wor...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
Now we have MABA- Make America Beautiful Again, with the sec'y with Hegseth, Vought, Wiles, and more MAGAts on the commission to open more public lands to hunting and fishing and recreation. What could go wrong??? public-inspection.federalregister.gov/2025-12774.pdf
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
He can't let his job get in the way of his tee times on his golf courses...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Please ensure FEMA is functioning to help those Americans and all Americans when disaster strikes. Do not let Trump decimate another crucial govt agency for personal ego and financial gain.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Every meal sitting in a chair. If the doctor doesn’t get breakfast in bed, the patient shouldn’t either.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Not sure I'd go on vacation with her to Nepal... www.pbs.org/newshour/wor...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Go Mint Chocolate Chip and Pistaschio!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
If Elon thinks this will convince me to buy a Tesla, he's mistaken. I am waiting for the Chinese electric cars, just like Jim Farley, CEO of Ford www.businessinsider.com/ford-ceo-chi...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Quite the case for term limits. At least for their last term, our elected officials can do what we elected them to do, as Thom Tillis is doing now and not be constantly groveling for money and support for reelection.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Stephen Miller and RFK Jr are both serial killers. And the blood is on Trump’s hands!
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Headline to Read-- Stephen Miller joins RFK Jr as a Trump Administration Serial Killer
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Kuldorff starts by claiming (lying) that one COVID infection gives lifetime immunity to future infection
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Pass. You’ll just be a publicity tool for them and draw more listeners to their crap
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Serial killer RFK Jr.
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
He signs his name to his social media posts!!! Who does that but a demented person who thinks they are dictating a letter?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Can't wait for all the false positives. Watch health care expenditures skyrocket...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
And the federal General Accountability Office agrees the restrictions are harmful! links-2.govdelivery.com/CL0/https:%2...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Hard to know which one is a more telling sign of his worsening dementia...
Ronald Hirsch, MD (@signaturedoc.bsky.social)
In a devious public relation plan, RFK Jr just took away ACA health coverage from all #DACA recipients without anyone noticing by also announcing a deal with insurers to "reform" prior auth. This final rule was released and ignored by the media- urldefense.proofpoint.com/v2/url?u=htt...
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
Why does he sign his name to his posts? Does he think when he writes a post, it gets printed on paper and hand-delivered to the subject of the post?
Ronald Hirsch, MD (@signaturedoc.bsky.social) reply parent
GAO did criticize abortion restrictions...this is typical Republican payback links-2.govdelivery.com/CL0/https:%2...