Patrick T O'Leary

🇺🇸husband and father of three, enjoys golf and tennis, Buckeye parent

[Robert Berry, DO @txsportsdoc]

I love this and that more of our colleagues are betting on themself. This is what all doctors used to do before we were convinced we had to be hospital employees. Yes I get that the INS co have decimated professional fees but spoiler alert: Most hosp employees have productivity models ie you work to get paid. Those are usually RVU based. After that guarantee period most will never see those numbers again and you are now hamstrung by your employer. They’ll prevent u from marketing/promoting yourself. If you don’t get enough referrals and can’t make enough on your employee model…you are stuck. No doctor chose the easy path to get where they are. We had to be top students,score well on boards,hard workers. Apply that same effort to practice. If you don’t want to be the one running the practice simply join a private practice. We are stronger together. Don’t tell me I don’t want to work for some “senior partner” and make him money, but you’ll make some “senior admin” millions who’s not a colleague? This is the way doctors. Be like Adrian😃👊

[Karoline Leavitt @karolineleavitt]

Serving as the White House Press Secretary over the past year and a half has been the honor and adventure of a lifetime. I am incredibly grateful to President Trump for granting me so many extraordinary opportunities, such as working in the West Wing and spending countless hours in the Oval Office, flying around the world and meeting foreign leaders, and traveling across our beautiful country and meeting Americans from all walks of life.

Most of all, I am thankful to the President for entrusting me with the distinct privilege of speaking on his behalf at the White House podium. I have spoken with great pride about the many historic accomplishments of this Administration, and I have relished holding the liberal media accountable and ensuring the American people hear the truth about President Trump’s successes.

Being a mother and welcoming a new baby while working in one of the most demanding jobs in the world has been the most rewarding yet challenging season of my life, to say the least. The truth is since returning to the White House after the birth of my daughter, I have felt in my heart that I cannot be the best mom my two young children deserve while devoting the constant time, energy, and attention required of the White House Press Secretary — and that is why I have ultimately made the bittersweet decision to depart the White House and embark on a new chapter in my life.

President Trump has asked me to continue serving as a top advisor to him on the outside, and I will always remain a vocal advocate for MAGA and the Republican Party.

Our country is facing an existential threat from an increasingly extremist Democrat Party that seeks to destroy everything great about America, and I believe it is incumbent upon all of us who care about this country to fight back against that threat. My fight is entering a new phase, but it is far from over.

Thank you again to the President, the First Lady, and the entire Trump family for your kindness and generosity over the years. Thank you to our amazing Chief of Staff Susie Wiles for empowering me since the day she hired me on the campaign, and to the President’s cabinet, my staff, colleagues, and friends at the White House who work so hard on behalf of our nation. It has been a privilege to serve alongside so many accomplished and impressive people, and I look forward to cheering them on over the next two and a half years.

And of course, thank you most especially to my loving and supportive husband and family for the sacrifices they made for me to serve in this role. ♥️🇺🇸

[𝚁𝚒𝚌𝚑𝚒𝚎 𝙱𝚞𝚌𝚔𝚎𝚝𝚜 @RichieBucketsUK]

Might legit be the best throw I’ve ever seen from any baseball player ever. Hell it might be the best throw in ANY sport that involves throwing.

[Eric Daugherty @EricLDaugh]

🚨 WOW. This brave Christian migrant from Iran walked up and WENT BERSERK on the proposed Islamic Center in McKinney, TX — straight to the council's face

The whole building ERUPTED after his dire warning:

"I'm a Sharia law survivor from Iran."

"I'm TELLING YOU, this is a BAD idea and you're going to REGRET not listening to people like us who lived under Sharia law!"

"I'm here to tell you this is a DANGEROUS ideology you're allowing in your country. Every country that is Islamic now, it used to be a Christian country and we were soft Christians."

"And we allowed these people to come in, bring their Sharia law into our countries and slowly k*ll us off left and right!"

"Let me make it very clear to you. Christianity is a personal relationship with God...Islam is Sharia law. Religion and state, which is not even compatible with the American thing and when these people will lie to you, to manipulate you."

"Because whenever Islam is little, they will lie to you and tell you they come in peace. This is level one!"

"Level two is what's happening in UK right now, where you have two-tier policing, where you have the blasphemy laws, Islamophobia, racism, all this nonsense that they talk about."

"Any time you criticize Islam, they will use the race card, but every country has this disgusting ideology inside their country, including my own country, Iran, Russia, Islamophobia is another made up bullsh*t because they don't want you to criticize their death cult!"

"If you question that disgusting book, they're get k*lled over it, just like my friends were apostates imprisoned or dead right now in Iran!"

HE NAILED IT!!!

[Damian Caraballo MD @813JAFERD]

fun fact, the average Senior VP at United Healthcare makes more than the average emergency physician in the US.

CMS just proposed +2.48% raise for Medicare Advantage plans, while cutting PFS for physicians -1.61%

Why is US healthcare expensive again?

[Z @insatiablevine]

My White American privilege means I get to spend 67 years of my live paying into a system that prioritizes foreigners over Americans. They squander away my social security through fraudulent dark money schemes that reward third world invaders and career politicians. It means I’ll pay my own groceries while funding SNAP for low income blacks who hate my existence and call me a bigot as they plunder my income. It means I’ll have to jump through hoops to secure a 30 year mortgage for an overpriced home because the illegals , TPS migrants and H1-B are getting government funded loans while they steal our jobs and crowd our schools. My White American privilege means I will abide by every law and watch illegals rape, stab , murder, kidnap and traffic drugs in my community- receive no bail release and a slap on a risk for felonies. It means I’ll spend my days as a wage slave while criminal third worlders open up fake daycares, drive Bentleys and live in mansions.

White American privilege is a lie. Everyone is benefiting from America except working class White Americans.

[Chicago Tribune @chicagotribune]

Letter to the Editor: We are one of the worst-run states in America: No. 1 in pension debt, with higher than the national average in cost of living, property taxes and unemployment. We are in the bottom half for business climate and job growth. https://t.co/ETnRnBwTzi

[Alex Berenson @AlexBerenson]

From the same story:

"Sharp and wise at critical moments, the product of decades of seasoning, able to rise to the occasion even in the dead of night to confront a dangerous world."

Ahahahahahaha

[God & Country @GodandCountryy]

This isn’t Basketball

[Clay Travis @ClayTravis]

Black WNBA player clotheslines Sophie Cunningham on a lay up attempt. Gets ejected. Tweets “White privilege” from locker room to argue she was ejected because of racism. Identity politics destroys everything, even sports.

[Gad Saad @GadSaad]

Universities do not exist to promote "marginalized voices." They do not exist to promulgate social engineering experiments. They do not exist to engage in social justice activism. A university exists to expand the boundaries of human knowledge, to defend truth, and to create an ecosystem for intellectual enrichment. Once a university optimizes the wrong variables, we end up with the parasitized minds that we now see populating academia, business, politics, journalism, culture, etc. The West in general and the US in particular were founded on a set of key ideals that are unique to human history. Do not presume that these ideals are the default reality. There is always a tsunami of miscreants who are working day and night to end our liberties and freedoms, and destroy these ideals. Be vigilant. Fight for our civilization. Activate your inner honey badger.

[Joey Jones @Johnny_Joey]

Today is my “Alive Day”. On august 6th 2010 I stepped on an IED. I lived and Daniel Greer died. I spend 364 days a year dreading today. The emotions surrounding today are too complex and difficult to explain. I am overwhelmed with a wave of guilt and gratitude that feels inseparable and at times indistinguishable from one another. I wish 1000 times over Daniel Greer had lived and I had died that day. Yet, because he made that sacrifice I’m here and so is my daughter. I’ll spend the first few hours of this bittersweet anniversary in the middle seat of a @delta redeye home from Phoenix… its quite apropos to be reminded that even discomfort is a blessing when you shouldn’t be alive to feel it.

[Kevin Pho, M.D. @kevinmd]

Your two month wait to see an orthopedic surgeon is not a doctor shortage. It is a business model. One surgeon proved it by quitting the model entirely.

Daniel Paull was partway through a hand surgery fellowship, nine years of training behind him, when he quit, moved to Colorado, and built something that is not supposed to exist: a cash only orthopedic surgery practice with no insurance of any kind. No Medicare, no Medicaid, no Tricare, no commercial plans. Two years in, he does surgeries, keeps an office, and runs about half his visits as house calls.

The mechanism is the interesting part.

Taking insurance, by his math, means hiring roughly five full time people just to deal with it. It means more office space to hold them. It means an EMR that every doctor hates because it is built for billing, not note taking. That overhead has to be fed, so the practice sees more patients in less time, and the thing he calls the core of medicine, the relationship with the patient, is what gets squeezed to pay for it.

So he removed the layer instead of feeding it. What is left is a practice where an appointment at a busy orthopedic office can take a month or two, but a call to him gets you seen the same day or the next. Where the visit is not rushed. Where every patient has his phone number and is encouraged to call and text, and he answers, and if he is running late to the next patient he says so himself. Cash at the end of the visit, low overhead, a staff of two. When a patient is an hour and a half away, he drives, with the cost factored in.

He is careful to say the quiet part correctly: doctors inside the system are talented. It is not about the doctor. It is about the business model of delivery.

The origin was not a business plan. It was the moment the training treadmill stopped making sense to him: "there's no light at the end of the tunnel, it's just a series of tunnels."

Some doctors dabble in cash pay on the side. Fully detached from insurance in orthopedic surgery, he does not think anyone else is doing it, and he says he would like to learn about them if they are. Most of his physician referrals come from direct primary care doctors, because a fifteen or twenty minute in-system visit leaves no room to explain cash pay economics to a patient who has never considered it. In his telling, a patient has to understand cash pay before the model can serve them, and that familiarity is the gating constraint on direct specialty care.

Daniel Paull is an orthopedic surgeon, and the full conversation covers how the model works, who it fits, and where it breaks.

Listen to the full conversation on The Podcast by KevinMD. Link in the replies.

What would your specialty look like with no billing department to feed? #ThePodcastbyKevinMD #DirectCare

[Steven Phillips, MD @StevePhillipsMD]

Socialism never opens with force. It opens with smiles & promises. Free food. Free housing.

Venezuela had the world’s largest oil reserves.

But even that couldn’t save it from the destructive force of socialism: Venezuelan’s lost an average of 19 lbs from malnutrition, the murder rate skyrocketed, Caracas became the most violent city on Earth, & 8 million people fled.

Nothing is free. Somebody always pays — in bread, in voice, & in blood.

It’s unforgivable that schools haven’t taught the truth about socialism. An entire generation of young people have been gaslit.

[Stephen Moore @StephenMoore]

Americans now pay more in taxes than they spend on food, clothing, and shelter combined.

Think about that.

Government has become so big and bloated that taxes cost more than life's basic necessities. Every American taxpayer should be outraged.

[Mike Bales 🫡🇺🇸 @MikeBales]

Share if you agree 😌🙏🏻

[Sage Steele @sagesteele]

Really, Wisconsin?? REALLY????

[Clay Travis @ClayTravis]

New York City will require IDs to prove you live in the city in order to shop in the city owned grocery stores. So you need an ID to shop in the city’s stores, but it would be racist to require an ID to vote. Perfection.

[Martina Navratilova @Martina]

How is including males on women’s team inclusive for the female athlete who lost that spot to a male? The ignorance is astounding.

[Ken Gardner @KenGardner11]

One of Ayn Rand's very best observations, which has aged like fine wine:

"Socialism is not a movement of the people. It is a movement of the intellectuals, originated, led and controlled by the intellectuals, carried by them out of their stuffy ivory towers into those bloody fields of practice where they unite with their allies and executors: the thugs."