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Sunday, April 9, 2023

How Much Do Doctors Bill Commercial Insurers?

 Doctors bill commercial insurers an average of $3.8 million per year, a figure well in excess of their pay, according to a new report from AMN Healthcare

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In an analysis of commercial health insurer claims from 2021, general surgeons billed the most -- an average of $11.7 million per year -- while pediatricians billed the least -- an average of $1.3 million per year.

The figures don't include public payer claims; nor do they take into account the downstream revenue generated by physicians, the report noted. And although claimed amounts don't reflect the revenues that ultimately come in, even at an estimated 50% return, the average income generated by a doctor is $1.9 million, it stated.

"Doctors directly generate 20% of healthcare revenues, but the other 80% they have influence over as well," Linda Murphy, president of revenue cycle solutions at AMN Healthcare, told MedPage Today. "You can't get an ultrasound without having a physician order. You can't get labs without having a physician order. They are the gatekeepers in patient care."

Doctors who practice in diagnostic, surgical, and internal medicine subspecialties generated higher billing than primary care doctors, the report found. The average billing for specialists was $4.65 million, compared with $1.77 million for primary care doctors.

That's because surgical, diagnostic, and other procedures performed by specialists are typically compensated at higher levels than the consultation services typically performed by primary care doctors, the report stated.

The top 10 specialties with the highest average annual billing to commercial payers were:

  • General surgery: $11.7M
  • Orthopedic surgery: $9.8M
  • Critical care: $6.7M
  • Urology: $5.9M
  • Gastroenterology: $5.5M
  • Otolaryngology: $4.2M
  • Ob/gyn: $3.8M
  • Rheumatology: $3.4M
  • Cardiology: $3.4M
  • Anesthesiology: $3.3M
Including claims submitted to Medicare and other government payers would significantly increase average billing amounts for most healthcare providers, Murphy said.

For instance, rheumatologists, oncologists, and other specialists who treat a large number of older patients could double their total claim amounts, the report stated. Including public payer claims would have a smaller impact on pediatricians and other specialists who treat fewer older patients.

AMN Healthcare is working on a separate report assessing public payer claims, Murphy said.

Advanced practice providers (APPs) also generate significant revenues, the report found. Certified registered nurse anesthetists (CRNAs) submit an average of $1.75 million in claims each year, while nurse practitioners (NPs) submit around $777,000 on average each year.

"Advanced practice professionals are playing a greater role in healthcare delivery due to state policies that have expanded their scope of practice and due to the physician shortage," Murphy said in a statement. "Their role as revenue generators has expanded correspondingly."

Murphy emphasized that the report is a benchmark, and not a holistic look at the revenues generated by doctors and other healthcare providers.

"We don't want physicians' employers to look at this and say, 'You're not doing enough, you need to work harder,'" Murphy said.

Often, there are other issues at play when money is left on the table, such as making sure to capture the right code for a specific visit. A previous AMN Healthcare study found that $107 billion was lost through the revenue cycle, either because it wasn't captured, or claims were denied, or penalties were assessed, Murphy said.

"The work is being done, it's just not being captured appropriately," Murphy said. "The goal is not to say, 'Hey, you need to see more patients.' It's to look at the way patients are treated, the way you're capturing the information in the patient chart, and understand there's a holistic view. Its not just asking the doctors to do more."

Murphy acknowledged that despite efforts to move the U.S. healthcare system to one that's more grounded in value-based care, performance-based metrics still rule the day. Physician compensation is still tied to production as measured by outcomes such as relative value units (RVUs), the number of patients seen, or claims submitted.

"Quality-based physician payments remain largely aspirational," Tom Florence, president of AMN Healthcare's physician solutions division, said in a statement. "We are still in a system where physicians are rewarded on volume of services they provide or revenue they generate."

The "2023 Physician Billing Report" from AMN Healthcareopens in a new tab or window assessed commercial insurance claims representing about 95% of the commercial claims submitted by doctors, NPs, and CRNAs in 2021. Claims were analyzed for 18 specialties, and in addition to averages, AMN Healthcare calculated the 25th and 75th percentiles for each specialty, noting that amounts will vary by a host of factors including geography.

The report illustrates the central role of physicians as revenue-generators in today's healthcare system, and how they remain "key catalysts" of how dollars are spent in healthcare.

"You have to look at the full scope of physician activity in order to understand the value that they bring to healthcare, but more importantly, to the patients they care for," Murphy said.

https://www.medpagetoday.com/special-reports/features/103863

U.S. searches for source of highly-classified intel leak

 Highly classified military and intelligence documents that appeared online, with details ranging from Ukraine's air defenses to Israel's Mossad spy agency, have U.S. officials scrambling to identify the leak's source, with some Western security experts and U.S. officials saying they suspected it could be someone from the United States.

Officials say the breadth of topics addressed in the documents, which touch on the war in Ukraine, China, the Middle East and Africa, suggest they were leaked by an American rather than an ally.

"The focus now is on this being a U.S. leak, as many of the documents were only in U.S. hands," Michael Mulroy, a former senior Pentagon official, told Reuters in an interview.

U.S. officials said the investigation is in its early stages and those running it have not ruled out the possibility that pro-Russian elements were behind the leak, which is seen as one of the most serious security breaches since more than 700,000 documents, videos and diplomatic cables appeared on the WikiLeaks website in 2013.

The Russian embassy in Washington and the Kremlin did not respond to requests for comment.

The Russian Embassy is seen in Washington, Thursday, Feb. 24, 2022, following the invasion of Ukraine on the order of Russian President Vladimir Putin. (AP Photo/J. Scott Applewhite)
The Russian Embassy is seen in Washington, D.C. (AP Photo/J. Scott Applewhite)

Following disclosure of the leak, Reuters has reviewed more than 50 documents labeled "Secret" and "Top Secret" that first appeared last month on social media websites, beginning with Discord and 4Chan. While some of the documents were posted weeks ago, their existence was first reported on Friday by the New York Times.

Reuters has not independently verified the authenticity of the documents. Some giving battlefield casualty estimates from Ukraine appeared to have been altered to minimize Russian losses. It is not clear why at least one is marked unclassified but includes top secret information. Some documents are marked "NOFORN," meaning they cannot be released to foreign nationals.

Two U.S. officials told Reuters on Sunday that they have not ruled out that the documents may have been doctored to mislead investigators as to their origin or to disseminate false information that may harm U.S. security interests.

One of the documents, dated Feb. 23 and marked "Secret," outlines in detail how Ukraine's S-300 air defense systems would be depleted by May 2 at the current usage rate.

Such closely-guarded information could be of great use to Russian forces, and Ukraine said its president and top security officials met on Friday to discuss ways to prevent leaks.

WATCHING ALLIES

Another document, marked "Top Secret" and from a CIA Intel update from March 1, says the Mossad intelligence agency was encouraging protests against Israeli Prime Minister Benjamin Netanyahu's plans to tighten controls on the Supreme Court.

The document said the U.S. learned this through signals intelligence, suggesting the United States had been spying on one of its most important allies in the Middle East.

In a statement on Sunday, Netanyahu's office described the assertion as "mendacious and without any foundation whatsoever."

Another document gave details of internal discussions among senior South Korean officials about U.S. pressure on Seoul to help supply weapons to Ukraine, and its policy of not doing so.

A South Korean presidential official said on Sunday the country was aware of news reports about the leaked documents and it plans to discuss "issues raised" with Washington.

The Pentagon has not addressed the contents of any specific documents, including the apparent surveillance of allies.

Two U.S. officials, speaking on condition of anonymity, said that while there was concern about the leak at the Pentagon and intelligence agencies, the documents showed a snapshot in time from more than a month ago, rather than more recent assessments.

The two officials said the military and intelligence agencies were looking at their processes for how widely some the intelligence is shared internally.

The White House referred questions to the Pentagon.

The Pentagon on Sunday reiterated it was reviewing the matter and had made a formal referral to the Department of Justice asking it to investigate the incident.

The U.S. Justice Department said on Friday it was in touch with the Defense Department and began a probe into the leak. It declined further comment.

Officials are looking at what motivations a U.S. official or a group of officials would have in leaking such sensitive information, said one of the officials who spoke to Reuters.

The official said investigators were looking at four or five theories, from a disgruntled employee to an insider threat who actively wanted to undermine U.S. national security interests. 

https://finance.yahoo.com/news/u-searches-source-highly-classified-203425543.html

White House plans support for drugstores, pharma in abortion pill battle

 

The White House is re-upping discussions with abortion pill manufacturers and U.S. pharmacy chains on ways to push back against efforts to ban mifepristone, two sources with knowledge of the matter said, as it gears up to appeal a Texas court ruling suspending the approval of the drug.

U.S. District Judge Matthew Kacsmaryk in Amarillo, Texas, on Friday suspended approval of mifepristone, which will essentially make sales of the pill illegal in the U.S., while a legal challenge proceeds. A conflicting Washington state ruling on Friday blocks changes to pill sales in 17 states.

In January, the Food and Drug Administration made a regulatory change that made it possible for retail pharmacies to offer abortion pills in the country for the first time, but more than a dozen states have passed laws limiting such sales.

"We are discussing ways to offer them legal support," one of the sources said of manufacturers and retail pharmacies.

Options being discussed include having the U.S. Department of Justice back any legal challenges brought against manufacturers and pharmacies, and providing legal advice on how they can continue dispensing the pills, the sources said. The DOJ is separately seeking an emergency stay of the Texas order.

It was not immediately clear which companies were involved in the discussions. The White House declined comment.

Major U.S. manufacturers of abortion pills include GenBioPro Inc and Danco Laboratories. Pharmacy chains dispensing such pills include Walgreens Boots Alliance Inc , CVS Health Corp and Rite Aid Corp.

The companies did not immediately respond to a request for comment on any discussions with the White House.

Walgreens said in March it would not dispense abortion pills in the 20 states where it risked breaking the law.

The White House's Gender Policy Council, Inter Governmental Affairs and the vice president's office have been holding strategy calls for nearly two months on how to make medical abortion available after the Texas judge ruled, anticipating Friday's outcome.

Discussions between the Biden administration and pill manufacturers and pharmacies over the issue have been ongoing for months, sources said, but Friday's decision brings fresh urgency.

It is unclear whether the administration is considering following in California Governor Gavin Newsom's footsteps by withholding federal contracts from chains that suspend abortion pill sales.

RELIEF FROM WASHINGTON STATE

A flurry of White House strategy calls on Friday and Saturday also focused on "immediate, short-term" relief offered by the conflicting order from Washington state , three sources said.

Minutes after Texas judge Kacsmaryk's order, U.S. District Judge Thomas Rice in Spokane, Washington, an Obama appointee, ordered the FDA not to make any changes to mifepristone access in some Democrat-led states.

The administration believes that the Washington ruling gives it more time to respond legally to Texas's final decision. It could "expedite review of Texas, encourage an immediate stay on it and puts a huge question mark over it," one of the sources said.

Politically, the sources said, it makes it easier for the White House to make its case to the public that the FDA approval of the drug was accurate, mobilize activists and supporters to turn the issue into one that resonates with voters ahead of the 2024 presidential elections.

President Joe Biden and Vice President Harris said on Friday the administration will fight the Texas ruling.

"We're going to fight it. The Attorney General has announced @TheJusticeDept will file an appeal and seek an immediate stay of the decision," Biden tweeted.

The legal battle is likely to work through multiple levels of appeals courts over a period of months or years before it is resolved.

The administration is seeking an emergency stay of Kacsmaryk's order from the New Orleans-based 5th U.S. Circuit Court of Appeals.

The path forward discussed during the White House strategy calls touched on how the DOJ will wait for a decision from the 5th Circuit, which has a conservative reputation, the sources said.

If it does not stay the ruling, the department will seek an expedited review by the Supreme Court, they said.

https://www.marketscreener.com/quote/stock/WALGREENS-BOOTS-ALLIANCE-19356230/news/White-House-plans-support-for-drugstores-pharma-in-abortion-pill-battle-sources-43457318/

Biden Invites Expelled Tennessee Democrats To Visit White House

 by Caden Pearson via The Epoch Times (emphasis ours),

President Joe Biden on Friday invited the three Tennessee Democrats who faced expulsion for protesting on the state House floor to visit the White House.

After several hours of debate on Thursday, two of three state Democrats were expelled from the Tennessee General Assembly by the Republican-controlled House of Representatives.

The lawmakers were accused of participating in “disorderly behavior” that brought “disorder and dishonor to the House of Representatives,” according to a resolution introduced by Tennessee Republicans.

State Representatives Justin Jones of Nashville and Justin Pearson of Memphis were expelled. Gloria Johnson of Knox County was the sole member to participate in the protest to escape expulsion after eight Republicans crossed the floor to save her.

During a video conference call from Camp David on Friday, Biden thanked the lawmakers for their act of protest. The president also expressed disappointment over their expulsion from the Tennessee Assembly.

“Earlier, I spoke to Reps Jones, Pearson, and Johnson to thank them for their leadership and courage in the face of a blatant disregard of our nation’s democratic values,” Biden wrote on Twitter. “Our country needs to take action on gun violence—to do that we need more voices like theirs speaking out.”

The White House said in a statement that the trio of Democrats thanked the president for his “leadership in seeking to ban assault weapons and standing up for our democratic values” and for his support as they faced “unprecedented attacks” over their actions.

No official date was given for the White House visit.

The two expelled Democrats can be appointed to their seats by officials in their respective counties. Both members represent Democrat strongholds in Nashville and Memphis. They cannot be expelled again for the same offenses, members said during debate Thursday.

Gun Restriction Protest

In a further statement released by the White House, Biden claimed most Americans want tighter gun control.

“Today’s expulsion of lawmakers who engaged in peaceful protest is shocking, undemocratic, and without precedent,” Biden said in the statement. “Rather than debating the merits of the issue, these Republican lawmakers have chosen to punish, silence, and expel duly-elected representatives of the people of Tennessee.”

Biden also took to Twitter to express his support for the lawmakers.

“Our country needs to take action on gun violence—to do that we need more voices like theirs speaking out,” Biden wrote. He further condemned the expulsion of the lawmakers as “shocking, undemocratic, and without precedent.”

Only two other Tennessee state lawmakers have been similarly expelled since the Civil War. However, those votes were largely bipartisan, while the vote on Thursday was mostly along party lines.

Jones, Pearson, and Johnson had been officially censured for their protest and stripped of their committee appointments on April 3. This came after hundreds of chanting demonstrators crowded the state Capitol and its gallery on March 30.

The protesters called for tighter restrictions on gun rights in the wake of The Covenant School shooting in Nashville, where Audrey Elizabeth Hale, 28, who police said identified as transgender, opened fire at the school, shooting dead three 9-year-old children and three adults.

The three Democrats defied convention by moving to the front of the House chamber with a bullhorn, where they cheered on the crowd in the gallery and led chants, marking a breach of chamber rules as they hadn’t been recognized to speak.

In his statement, Biden urged Congress to ban “assault weapons” and high-capacity magazines, require safe storage of firearms, eliminate gun manufacturers’ immunity from liability, and require background checks for all gun sales. He also called on state officials to do the same.

The president argued that most Americans want lawmakers to enact more restrictions on gun rights and accused Republican officials across America of doubling down on bills that he said make schools, places of worship, and communities less safe.

https://www.zerohedge.com/political/biden-invites-expelled-tennessee-democrats-visit-white-house

Led By "Fat Activists", New York Considering Bill To Ban Weight Discrimination

 As if being overweight wasn't already enough of a virtue in the United States nowadays, New York will soon be looking to approve a bill that would ban "weight discrimination in hiring and housing".

Victoria Abraham, referred to multiple times as a "fat activist" by the New York Times, who reported the story, says her cause isn't to lose weight - but rather to make sure people don't get the wrong perception about fat people.

A proponent for the legislation, she told the Times: “There is a perception that you’re lazy or unable to do the work. People don’t even realize that they have that bias.”

She said she proudly displays her body on her LinkedIn profile, so "prospective employers know whom they are considering hiring."

The bill will add weight to the list of protected groups, which also includes race, gender, religion and disability, the report notes, stating that obesity rates are up over the last 2 decades and accelerated during lockdowns, when people were forced to stay home. More than 40% of Americans are obese, the Times writes.

We have to ask, though: if that number breaches 50%, can't obese people no longer be considered a minority? We digress.

Abraham / Photo: NYT

Abraham testified on behalf of the bill, which could be approved as soon as May. “We should never treat people differently because of their weight," Mayor Eric Adams, who famously lost 35 pounds on a plant based diet (and wrote a book about it), said about the bill.

“Even when I was heavier, I was still a good-looking guy,” the Mayor joked last week. 

While the nation continues its incessant and never-ending fight against all types of discrimination - gender, race, sex, etc. - weight has now been added to the discussion. Michigan and Washington State already have similar bills enacted and New Jersey and Massachusetts are considering it. 

The councilman sponsoring the bill, Shaun Abreu, said he gained 40 pounds during the pandemic and "noticed a change in how people treated him".

“What you look like should not impact your ability to get a job. We should embrace body positivity and inclusion. It’s so important for people to feel comfortable,” he told the Times. 

Not everyone is sold on the idea, however. Kathryn S. Wylde, president of the Partnership for New York City, said: “This is another mandate where enforcement will be primarily through litigation, which imposes a burden on employers, regulators and the courts.”

Joseph Borelli, the City Council’s minority leader and a Republican who has documented his weight loss online, said it would “empower people to sue anyone and everything.”

He concluded: “I’m overweight, but I’m not a victim. No one should feel bad for me except for my struggling shirt buttons.”

CDC Partners With 'Social And Behavior Change' Initiative To Silence Vaccine Hesitancy

 by Katie Spence via The Epoch Times (emphasis ours),

Dr. Mary Talley Bowden, a Stanford-educated ear, nose, and throat doctor, isn’t afraid to voice her beliefs. During the height of the COVID-19 pandemic, she repeatedly used her platform on Twitter and TikTok to question the vaccines, promote ivermectin as a treatment, and call out pharmacists for refusing to dispense it.

But her efforts resulted in significant backlash. On Nov. 7, 2021, Dr. Danielle Jones, an OBGYN who posts under the handle @MamaDoctorJones on YouTubeTikTok, and Twitter—and has millions of followers—put out a video accusing Bowden of “grifting,” rejecting science, and profiting from those who questioned the vaccine.

The video received thousands of comments, including from Team Halo members, Dr. Zachary Rubin, a pediatrician, and Christina Kim, an oncology nurse practitioner. Team Halo is a social media influencer campaign formed as part of the United Nations Verified initiative and the Vaccine Confidence Project to increase vaccine uptake.

“That doc is problematic,” Rubin wrote. Kim followed with, “Wow. That ‘doctor’ should have her license revoked.”

On Nov. 12, 2021, five days after the video, Bowden received a text message from the Houston Chronicle, “Hi Dr. Bowden, I’m told you’ve been suspended from Houston Methodist pending further investigation because of your comments on social media. I plan to report that this afternoon but wanted to give you an opportunity to comment.” Stunned, Bowden responded that the text was the first she had heard of the suspension.

The suspension turned out to be the tip of the iceberg. Over the following months, Bowden’s life was thrown into chaos as multiple social media influencers targeted her. However, the most dogged was a pharmacist named Savannah, who posts under the handle @rxOrcist.

“Savannah has over a million followers. She made a video about me because I have been calling out, online, pharmacists that were refusing to dispense ivermectin,” Bowden told The Epoch Times. “The majority of them happen to be Asian. So, she, therefore, concluded that I was racist against Asians and called me a ‘xenophobic, racist [expletive],’ among other things.

“Because she has so many followers, when she makes a video about you, you get an army of people coming after you. A lot of fake people [writing] reviews. That’s one of the biggest things. You can’t get them removed. I’ve tried to get them removed, and I can prove that they’re not my patients.”

Bowden added that she’d been kicked off of TikTok, is on probation on YouTube, had complaints filed against her, and has even had to call security when someone came to her office and threatened her.

In the video, Savannah showed that she reported Bowden to the Texas Medical Board. The board declined to investigate her specific complaints. Still, they are pursuing two other complaints—one filed by Houston Methodist claiming a violation of patient care and one filed by Texas Health Huguley Hospital for prescribing ivermectin.

In the comments of Savannah’s video, Tyler Kuhk, a nurse and previous Team Halo member according to web archives, and who posts under @thatsassynp, stated, “How these loons still have licenses is beyond me. Why is an ENT even treating COVID?”

Savannah is part of a group called Shots Heard, which calls itself a “rapid-response digital cavalry dedicated to protecting the online safety of health care providers and practices.” Kuhk is also a member. Savannah joined Shots Heard on Aug. 6, 2020, and Kuhk joined on Feb. 13, 2021.

According to its website, Shots Heard is an initiative under The Public Good Projects (PGP), a “public health nonprofit specializing in large-scale media monitoring programs, social and behavior change interventions, and cross-sector initiatives.”

Another of PGP’s  initiatives is the Public Health Communications Collaborative (PHCC), which sits within the CDC Foundation—a nonprofit arm of the Centers for Disease Control and Prevention (CDC) established by Congress.

The goal of the communications collaborative, according to PGP, is to decrease misinformation and increase vaccine demand worldwide. And it’s using social media influencers to silence vaccine detractors.

A Tangled Web

PGP is headquartered in New York and was founded in 2013. Its current CEO is Dr. Joe Smyser, who holds a Ph.D. and master’s in public health and completed his postdoctoral training at the CDC.

The Tennessee Department of Health states about Smyser and PGP, “Dr. Smyser has designed some of the United States’ most influential and impactful health campaigns to date in partnership with the CDC, FDA, Kaiser Permanente, Rockefeller, and Humana.”

According to its website, the CDC Foundation is “the sole entity created by Congress to mobilize philanthropic and private-sector resources to support the Centers for Disease Control and Prevention’s critical health protection work.”

The Emergency Operations Center at the Centers for Disease Control and Prevention in Atlanta, Ga., on March 19, 2021. (Eric Baradat/AFP via Getty Images)

Since its creation, the CDC Foundation has launched over 1,300 “health protection programs” and raised over $2 billion in support for the CDC.

One of those health protection programs is PGP partner PHCC, which according to its website, was formed in August 2020 to “provide unbiased communication about the COVID-19 pandemic.” And one of the ways PHCC accomplishes that is by putting out “Misinformation Alerts,” which are powered by PGP.

For example, on March 23, PHCC posted on its website that a “well-known anti-vaccine physician” claimed that COVID-19 vaccines caused an increase in miscarriages and stillbirths. It labeled it a “high-risk alert” and recommended, “directly addressing and debunking the misinformation.”

That “debunking,” according to PHCC, includes using a “strong, robust social mobilization” to amplify messages from the World Health Organization and UNICEF, encouraging social media organizations to flag “misinformation,” and promoting “trusted pro-vaccine voices.”

Enter, Shots Heard.

Shots Heard and Team Halo

On its homepage, Shots Heard states, “If you stand up for vaccine science, we’ll stand up for you.” It includes a link for people to apply to “sign up to defend vaccine advocates.” It also provides a link to “Alert the Shots Heard Cavalry,” plus a link to a members-only Facebook group, which currently has 1,176 members.

An insider in the group who requested to remain anonymous for fear of being kicked out supplied The Epoch Times with screenshots and messages of the Shots Heard Facebook group.

In one “alert,” a Shots Heard member named Bernadine Huff posted, “It’s important for all of us to stop the insanity and to call out other healthcare workers that don’t believe in science.” She encouraged Shots Heard members to “report” a graduate nurse named Megan to the Ohio Nursing Board for providing information on how to get a medical exemption for the COVID-19 vaccine. The replies from numerous Shots Heard members simply state, “reported.”

In another “alert,” Shots Heard group administrator Jeff Sykes posts, “Hey Shots Heard, it’s been brought to our attention that Dr. Scott Jensen has been using his online platforms to spread misinformation about COVID-19. … We need your help reporting him.”

Shots Heard member Marcia Fiamengo posted this alert, “Need help reporting this group,” and linked to a group promoting ivermectin. Among the many who replied was New York’s Suffolk County Department of Health account, which wrote, “Reported.”

Fiamengo also posted on Dec. 29, 2021, “Fantastic news,” and attached a screenshot of Dr. Robert Malone’s suspended Twitter account. Shots Heard member Angie Anderson states in the comments, “Ooooh, I just reported a few of his posts yesterday. So satisfying when you see real results.”

On March 24, 2022, Fiamengo encouraged Shots Heard members to report Bowden. Again, Suffolk County Health responded, this time with “Done.” On May 2, 2022, Fiamengo again made a celebratory post. This time for an American Frontline Doctor being stripped of all state licenses after prescribing ivermectin. “Wooooo!!!! Another one bites the dust!” she said.

Shots Heard doesn’t limit itself to reporting single healthcare practitioners. On Sep. 12, 2021, Shots Heard member Liz Ditz “reported” a preprint by researchers Dr. Tracy Beth Hoeg, Allison Krug, Josh Stevenson, and Dr. John Mandrola, which found vaccine-induced myocarditis might be worse than COVID-induced myocarditis. Shots Heard members were outraged.

The Twitter sign is seen at their headquarters in San Francisco, Calif., on Oct. 28, 2022. (Constanza hevia/AFP via Getty Images)

Moreover, Shots Heard doesn’t limit itself to simply “reporting.” When Bowden posted on Twitter, “Are Americans supposed to take this [expletive]? We don’t want your shot, and we especially don’t want it for our kids,” her post was flagged and flooded with Shots Heard member comments.

Such tactics are called “gang stalking,” Nicole Sirotek, a registered nurse in Nevada and the founder of American Frontline Nurses, told The Epoch Times. “[Shots Heard members] make videos about [the offending health care worker] saying they need to be delicensed, then [Shots Heard] followers go and hunt down the nurse and swarm the licensing board.”

Sirotek has been the victim of many such attacks from Shots Heard and Team Halo—the two groups share many of the same members.

For example, in December 2022, Team Halo member Jess, who posts under the TikTok handle @jesss2019, doxed Sirotek on TikTok by revealing a previously court-sealed name change. Jess is a “Featured Influencer” for The Health Influencer Council, another PGP project that includes Shots Heard, and This Is Our Shot — a “diverse coalition of health heroes” who engage on social media to combat misinformation and build vaccine trust, according to its website.

An Inside Look

Tyler Hardy, a previous Team Halo member known as “your favorite field epidemiologist” until he ignited a social media firestorm for lying about some of his credentials, told The Epoch Times he’s seen both sides of the social initiates.

I joined Team Halo at the beginning of 2022, in January. I was invited by nurse Jess [@jesss2019],” Hardy said. “I wanted to educate, and that was why I thought Team Halo would be good because it would give me the exposure to do that.

“As I got behind the scenes of these big creators, right, these people like Dr. Cat and Dr. Jon, Jess, @thatsassynp, I learned that they were, pardon my French, just [expletive]. And they let that stardom of being part of Team Halo get to their head.”

During his time at Team Halo, Hardy said Team Halo members communicated over a private WhatsApp chat. Anytime a Team Halo member disagreed with someone online, “You just put it in the chat, and then every single person in Team Halo would instantly jump on them. Get them fired,” Hardy said.

https://www.zerohedge.com/political/cdc-partners-social-and-behavior-change-initiative-silence-vaccine-hesitancy

Israel Strikes Syria After Rare Rocket Attack On Golan Heights

 On the heels of the most intense exchange of fire across the Israel-Lebanon border since 2006, violence erupted on a different front over Saturday night, as a rare rocket attack on the Israel-occupied Golan Heights was carried out by Palestinian militants in Syria. 

The Al Quds Brigade claimed responsibility, according to a Beirut television station. The Palestinian militia headquartered in Damascus said the volley of rockets was an act of retaliation for a brutal Israeli police raid on the Al Aqsa Mosque in Jerusalem earlier in the week.