Where Have All the Heroes Gone?

A popular segment on the long-running Monitor Mondays weekly Internet radio broadcast was a series that ran once a year, around the winter holidays. The segment was created by Ronald Hirsch, MD, a permanent panelist on the broadcast and Vice President of R1-RCM. Hirsch discontinued the series in 2020, as the COVID-19 pandemic was generating an inordinate volume of frontline heroes – too many to name.

Titled “Hirsch’s Healthcare Heroes,” it involved Hirsch selecting three healthcare professionals who, in his opinion, were worthy of honor and recognition for their acts or services.

Notable among them was his 2016 selection of Michael Salvatore, MD, since retired in 2020, but at the time the physician advisor at Beebee Medical Center in Delaware, where he also served as the medical director of palliative care. Here’s what Hirsch said in his introduction:

“Dr. Salvatore practiced for many years as a critical care physician, where he never saw an orifice that didn’t need a tube. But like many physicians, as he gained experience and wisdom, he saw that more is not always better, and became a specialist in palliative care. So as a physician advisor, he uses his training in critical care and palliative care to put things in perspective for patients, families, providers, and especially for other doctors.”

“But the main reason he is named as one of my heroes is his ability to provide levity at the times when frustration is at its worst. Dr. Salvatore is a constant presence on RAC Relief, where he has posted such statements as this: ‘I think what CMS is saying is that the ignorance of their ignorant interpretation of regulation is the only ignorance they are interested in. But this begs the question of whether ignorance of ignorance is ignorance. Using the double negative rule either grammatically or mathematically ignorance of ignorance is understanding, which is why we all understand what is going on here.’”

Here is the full list of honorees, dating back to 2015. We present it today along with welcome word that Hirsch hopes to bring back the segment as the pandemic subsides.

2015

• Guy Higgins at Infirmary Health: called out a RAC for improper practices;
• Dr. Roy Baker at Self Regional: took on the Medicare Advantage plans for their egregious denial processes; and
• Dean Baker, economist: called out UHC for lying about the financial effects of the health exchanges.

2016

• Ian Mattis at Novitas (now at Penn State health): an excellent resource to get accurate Medicare information;  
• Dr. Juliet Ugarte Hopkins at ProHealth: for setting an excellent example as a burgeoning physician advisor; and
• Dr. Michael Salvatore at Beebee Medical Center: for his ability to provide levity at the times when our frustration with the Centers for Medicare & Medicaid Services (CMS) and the payors was at its worst.

2017

• Dr. Vinay Prasad at OHSU: author of Ending Medical Reversal, stressing the importance of evidence proving that a medical intervention actually works;
• Dr. Jen Gunter at Kaiser Northern CA: wielding the lasso of truth, calling out medical quackery; and
• Dr. Eddie Hu at UNC: at the time president of ACPA, and a darn smart guy.

2018

• The International Consortium of Investigative Journalists: produced an amazing expose on the hidden dangers of implanted devices;
• Dr. Erica Remer: a CDI expert who wisely always advises to “just tell the truth;” and
• Chuck Buck: (well, you know why.)

2019

• Dr. Alex Ogedegbe: for asking great questions on the RAC Relief page;
• Nina Youngstrom: writer and editor of an invaluable report on Medicare Compliance; and
• Anita Dunham: the awesome case management leader at Monument Health in South Dakota.

“I am hoping that I will be able to return to naming Hirsch’s Heroes at the end of 2022, if the COVID-19 pandemic subsides,” Hirsch told the Saturday Morning Post. “The sacrifices of every healthcare worker over the last two years can never be forgotten. But changes in healthcare delivery continues on, and acknowledging individuals seems appropriate once again.”