Another Physician Dissent to CMS MACRA Rule



Good afternoon, Ladies and Gentleman,

My name is Dr. Richard Armstrong. I am a general surgeon who has been in practice for 35 years since completing post-graduate training. I have been in the military, in academics, in private practice and now employed. I have watched the development of the federal medical bureaucracy since 1976 and opposed more government intervention then in public in a letter to the Washington post. I did this as an active duty naval officer and received hundreds of letters of support.

In 2009 after President Obama spoke before a joint session of Congress about health care reform, I wrote to him with a simple specific request. I asked him to please speak with the doctors on the front lines, the dedicated physicians and surgeons who care for all of you and your families day and night…24/7. The fellow human beings who are there for you when…

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Conservative Civility – Episode IV: A New Hope

Conservative Civility – Episode IV: A New Hope

The Collision Blog

Unfortunately, conservative writers and commentators whom I truly respect are beginning to seriously question their activism. I’ve now watched four conservative bloggers close up shop, toss the keys to angry “conservatives,” say their farewells, let Jesus take the wheel, and now have cat memes and dinner recipes filling their timelines. While Republicans in government are not in the uproar we’d like to believe, conservatives themselves are caught in a toxic battle that bears a resemblance to, but is far worse than, the war between the right and the left. Been there, done that. Those who don’t particularly like your opinions quickly look for that button to press, the one we all have. “I’m over it,” and “what good am I doing?” are both theories thrown around by those bombarded with sermons from the pulpit of complacency. “Give me memes or give me death!” is the mantra of the 21st Century. “Agree with me or I’ll…

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The Democrats’ Refugee Crisis

The Democrats’ Refugee Crisis

Black and Red

Democrats, nationwide, face a vexing refugee crisis of their own making: Hundreds of thousands of people have picked up their lives to rescue their families from devastation wrought by liberal incompetence and naive policies. These refugees, numbering nearly 1,000 per day, simply seek a better life, even if that means contending with culture shock and a change of climate. However sympathetic to the refugees’ plight, the people tasked with accepting them fear that the newcomers will bring along a dangerous worldview that can turn their newfound garden spots into the dysfunctional locales they left behind. As observers sift through the data to learn as much as possible about these refugees, one point remains clear, virtually all of them are Americans.

Writing for the Washington Times, Stephen Moore describes the IRS’ findings showing that, liberal blue states continue to hemorrhage people to conservative red states.

“The new Census data…in 2014…

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— Is It Amnesty, Or Is It Anarchy??


K. Pinckney

Alright!  So in the pantheon of topics I didn’t think I’d ever get the urge to engage in, is Illegal Immigration… Yet, here we are! But lets clarify something.  I, as a Libertarian, am not against anyone trying to get into the United States because they believe they can build a better life (without taxpayer help) for themselves and their family.  I’m all in favor of making immigration NATURALIZATION a more simple, predictable, process in which those who follow laws can come to the United States if they choose to do so.  But what I am not willing to do, is patently approve of, surrender, or be forced to cede to, a lawless system that benefits those who are willing to break the law as undocumented immigrants ILLEGAL ALIENS.

The United States has laws against illegal immigration, however, the United States Government (President/Congress) isn’t doing the work it takes to…

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The Joy of Knitting (and Harping)



Let me begin by saying, I truly enjoy knitting. If you read my Twitter timeline you’ve probably noticed that I tweet about knitting often. So, I’d like to share a few thoughts about my knitting hobby.

I’ll start with the reason(s) I started knitting. I took up knitting as a hobby three years ago after my mother died. I needed something productive to do during the throes of grief and for some reason I decided to knit. Not sure how I picked knitting to occupy my mind, but I did. It is a relaxing, peaceful hobby and knitters are very kind people. Also, my mother did knitting, crocheting and needle point. So there’s probably an element of this that brings me thoughts of my mother.

My mother and I shared one main hobby – Harp playing. As in the musical instrument.  We began by taking lessons together and after we became somewhat proficient we began playing in public (along with our instructor) at churches and special events.  Unfortunately, I’ve had no desire to play my harp since my mother died, so I needed something productive to do to replace my Harp playing – enter learning to knit.

I began by taking classes because that’s the quickest way for me to learn. I started with a beginner’s knitting class at a local yarn shop to learn the basics of knitting. Another reason for attending classes was to learn to read knitting patterns. Knitters, just like harpists, are generally very nice people and are a pleasure to be around.

In the first knitting class we learned the basics of knitting and we made what was called a ‘sampler scarf.’ Sampler indicated each section had a different pattern. This was a great first project because it gave me the opportunity to work a number of different stitches within one pattern; plus it was challenging.

Since that first knitting class I’ve probably take at least 10 different knitting classes to learn to make scarves, shawls, hats, totes and sweaters. I’ve given away 75 percent of the projects I’ve knitted. However, I am learning to not give away my knitted projects to people who don’t have an appreciation for the labor involved in knitting these items. Plus, good yarn is very expensive!

A dear friend of mine pointed out that my hobbies are always activities that are good for the spirit. I had never thought about it that way, but she’s right. Harp playing has been proven to bring calm to both the player and the listeners. When a harpist plays the harp it actually rests against your shoulder and when you strum the strings the vibrations reverberate through your body. They have created vibration tables that are used for Harp therapy. A harp is attached to the table and the vibrations from the harp playing are felt by the person laying on the table. It’s an interesting concept. Harp playing has also been used in hospitals during surgeries and in patient’s rooms. It’s the actual harp music vibrations that can make the difference; it’s not simply listening to harp music, however that is very relaxing as well. Choice of music makes a difference as well. A Harp Therapist will always ask if there are any songs that the recipient does not want to hear. The wrong song can have the opposite effect and cause a person discomfort instead of healing and relaxation. (If you’re interested here’s a link for some information on Harp Therapy:

Anyway, back to the topic of knitting. Ultimately I would like to teach knitting classes and to also write knitting patterns. My goal is to write my first pattern during 2014 and to actually get it published. I’ll let you know when I’ve sold my first pattern.

If you’re wondering if I’ll ever play my harp again, the answer is yes. Lately I’m beginning to think about playing my harp instead of just periodically tuning it.

Hope you enjoyed my notes about knitting and harping. Stop back again soon.


Aetna stonewalls then says I’m bound to our agreement; I say I’m not and why



April 2, 2014

Dear Mr. Bertolini and Ms. Smith,

January 30, 2014, I submitted my letter of termination to Aetna. You acknowledged receipt of this letter by email on January 30 and by certified mail on February, 7.

March 25, 2014, I finally received your response, dated March 10, 2014, that I am bound to the agreement until 2015.

I now refer you to our Physician Agreement signed September 1, 2012. “Section 6.2 Termination without cause: This Agreement may be terminated by either Party with at least ninety (90) days prior written notice to the other Party. In addition to the foregoing, Group may terminate this Agreement in accordance with the provisions of Section 5.1.” This letter serves to remind you that ninety days from January 30, 2014, my agreement with you is terminated according to Section 6.2.

While I need no cause to terminate, I will voice what has…

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