I'll be attending the amazing TSA Annual Meeting 2026. Let me know if you're planning to attend so that we can say Hi! 👋 Or register now and join me at the event! whova.com/portal/registratio… #TXAnes26 - via #Whova event app whova.com/portal/registratio…

Iran Coverage The headlines abound: Iran Regime doing well, in control Trump under pressure to end war Khomeini son just as tough as Father US responsible for missile on school One headline after another essentially featuring Iranian propaganda as the news. Where are the headlines: 50 Iranian ships sunk Iranian military assets destroyed Leadership tries to put on good showing despite internal chaos Khomeini appointment creates hereditary theocracy War plan progress unprecedented The press is a drumbeat of negativity favoring the Iran regime. It’s puzzling at this point how any success is buried. The reality is likely the regime is being pummeled on all sides and has no ability to provide for its people. Maybe it can put on a good show for another week or two but its leadership is under immense pressure. But that’s not what the American public is getting from mainstream media.

Leadership should be judged on facts and service. @szaafran has dedicated his career to patient care and upholding the mission of the Texas Medical Board. The reporting confirms there is no evidence of wrongdoing, the title of the article draws attention, but ultimately to a non story by @DallasExpress. Texas patients deserve strong physician leadership, and Dr. Zaafran’s record reflects exactly that. @texmed @TSAPhysicians @ASAGrassroots @ASALifeline dallasexpress.com/state/texa…

Same goes for all male mammals

Testimonial Tuesday: “We have roughly 50,000 anesthesiologists in America. If only 20% of them (10,000) would just pick up one legislator as their friend, we would easily beat the billionaire-financed lobbyists.” – H.A. Tillmann Hein, MD, PhD, FASA

@AnthemBCBS, a/k/a @ElevanceHealth or whatever they call themselves this week, has responded to the AHA letter in opposition to Anthem's announcement in Nov. 2025 that beginning 1/1/26 that it "may" reduce hospital reimbursements by -10% for each hospital based group who is out of network (OON) or will become OON. The AHA and Federation letter is here: aha.org/lettercomment/2025-1… In classic Anthem fashion, it is blaming physicians for in essence refusing their low ball offers & unfair/illegal claim adjudication practices, going OON and filing IDRs. Facts are stubborn things. CMS data shows that the plans are losing 85-90 % of the IDRs which means they are paying the clinicians and for the adjudicator's fee in "baseball arbitration." If you were playing sports and losing 90% of the games, wouldn't you say that the system is rigged? Anthem claims that for certain categories the IDR awards are 9X of the initial payment. Is there a suggestion here that if they paid fair in network rates that the volume of IDRs would decline that clinicians want to be in network at fair rates--better for all concerned? Not to Anthem--introspection is not their jam. A warning to the physician and supporting advocacy community: Anthem and other plans including the BCBS Association and AHIP are building the narrative that the IDR process has to be substantially reformed or eliminated entirely or else the consumers will pay for the additional costs. Of course, not a word about their billions in profits which would have been multiples of those profits if the law had been written as they advocated for it--benchmarking to Medicare or other rates determined solely by the health plans with no IDR process (the House Energy and Commerce bill in 2019). @drdanchoi @DrBruggeman @mass_marion @PPA_USA @ahahospitals @DrAlexUrology @AmerMedicalAssn @RadiologyACR @ACEPAdvocacy

'He has a point, but he's too blunt.' From the start, a key tactic of the gender identitarians has been linguistic prescription, and it's proved shockingly successful. Trans activists' shibboleths and euphemisms have been allowed to penetrate the upper echelons of our culture with devastating consequences to freedom of speech and belief. Huge swathes of liberal media, the arts, academia and publishing have thrown themselves with gusto into the defence of a quasi-religious belief causing provable real world harm, and in their arrogance they've been outraged when people they assumed were part of their In Group have refused to march meekly along in lock step. Time and again, I've seen and heard well-educated people who consider themselves critical thinkers and bold truth-tellers squirm when put on the spot. 'Well, yes, maybe there's something in what you're saying, but it's hateful/provocative/rude not to use the approved language/pretend people can literally change sex/keep drawing attention to medical malpractice or opportunistic sexual predators. Why can't you be nice? Why won't you pretend? We thought you were one of us! Don't you realise we have sophisticated new words and phrases these days that obviate the necessity of thinking any of this through?' As the vibe shifts, and a lot of people in the elite professions start trying to reposition themselves, the obvious place to start is, 'it's not that I couldn't see your point, but did you have to say it that way?' We dissenters were supposed to find a way of questioning the chemical castration of children while calling it 'gender affirming care.' We were meant to defend the rights of vulnerable women while also using female pronouns for male rapists. We should have found a way to discuss fairness for women and girls in sport, while pretending that the ineradicable physical advantage men have over women doesn't exist. Either a man can be a woman, or he can't. Either women deserve rights, or they don't. Either there's a provable medical benefit to transitioning children, or there isn't. Either you're on the side of a totalitarian ideology that seeks to impose falsehoods on society through the threat of ostracisation, shaming and violence, or you're not. The alternative to being 'blunt' - using accurate, factual language to describe what was going on - was to surrender freedom of speech and espouse ideological jargon that obfuscated the issues and the harms caused. We've always needed blunt people, but we need them most of all when being asked to bow down to a naked emperor.

The TSA is thrilled to win the Alabama Cup this year for our chapters contributions to the ASAPAC!

So many of us felt the absence of Dr. George Williams at #TXAnes25 this past week/weekend. Though he is no longer with us, his presence and impact are still felt by so many in the anesthesiology community. Wearing a bow tie in his honor is just one way to keep his memory alive. We will forever miss his smiling face and perfectly placed bow tie. Our thoughts are with his family, friends & all who knew him during this difficult time.

New: @JayHardaway, a former Abilene city councilman and once-staffer for @RepArrington & @RepStanLambert, has filed a CTA to run in #HD71. Lambert announced this morning he will not seek re-election next year. #txlege

I'll be attending the amazing TSA Annual Meeting. Let me know if you're planning to attend so that we can say Hi! 👋 Or register now and join me at the event! whova.com/portal/registratio… #TXAnes25 - via #Whova event app whova.com/portal/registratio…

It’s an incredible honor to be the chair of the @TSAPhysicians Education Committee. We have a fantastic CME lineup with amazing speakers from all across Texas. I hope you consider attending the 2025 meeting at the @JWSanAntonio! @CRCook1978 @ZachJonesForTX

Camille, Vivian and I are now reunited with Caroline and Juliana who were evacuated from Camp Mystic. The last day has brought unimaginable grief to many families and we mourn with them as well as holding out hope for survivors. We want to thank the first responders who have come from far and wide to save lives. The TX Division of Emergency Management has been incredible and the White House, DHS, FEMA, DPS and local officials have all been responsive and helpful. Please join us today as we pray for miracles.

Genius move by United…. We already have a hard time getting anesthesia coverage for surgeries. By placing further downward pressure on anesthesiologists we risk losing even more coverage. What does that mean? Less surgery for patients who need it, but more money for shareholders of UHC.

🚨🚨🚨 So @AHIPCoverage @txhealthplans @UHC Slashes Anesthesia Payment at the Expense of Patients w/ Complex Preexisting conditions, These include senior adults, women with complex pregnancies, minority patients & critically ill children. @UnitedHealthGrp is flexing with the leverage they have gained from the #NoSurpisesAct @UHCprovider has issued a sweeping policy change that eliminates payment for ASA Physical Status modifiers—key indicators of patient medical complexity. Effective Oct. 1, @askUHC will also cut 15% from anesthesia services performed by CRNAs using QZ modifier. 📉 Physical Status Modifiers (P3–P5) are vital to documenting & compensating for patients with serious or life-threatening conditions. UHC’s move to zero out these adjustments devalues critical care for the sickest patients. 🧾 This isn’t reform—it’s rationing care to increase profits. 🚫 This policy: •Hurts patients with preexisting conditions •Undermines anesthesiology workforce stability •Forces cost-cutting at the bedside, not in UHC boardroom where the cuts belong. 📢 Defend patients. Demand reversal of this policy from: @askUHC @UHCprovider @UnitedHealthGrp @AHIPCoverage @txhealthplans @UHC 🔗 Learn More: asahq.org/standards-and-prac… @RobertKennedyJr @DrOz @realDonaldTrump 👀 ⬇️ @RepRaulRuizMD @DrKimSchrier @RepHerbConaway @herbconaway @MaxineDexterMD @Morrison4MN @RepBera @RepMMM @RepMarkGreen @RepGregMurphy @RepRonnyJackson @RepJohnJoyce @RepNealDunn @RepAndyHarrisMD @RichforGA @RepDesJarlais @SenJohnBarrasso @SenBillCassidy @RogerMarshallMD @DrRandPaul @MikeKennedyUT @BobOnderMO @GOPDoctors @RepRaulRuizMD @DrKimSchrier @RepHerbConaway @MaxineDexterMD @Morrison4MN @RepBera uhcprovider.com/content/dam/…

My advice to foreign leaders is that if you have not already reached out to President @realDonaldTrump, you need to do so immediately. Trump is, at his core, a dealmaker who sees the world as a series of transactions. Based on his track record to date with foreign governments, law firms, and universities, he is a tough, but fair negotiator. He loves to make deals and he loves to get things done promptly. I expect Trump will reward the early dealmakers with fairer deals than those that wait to sit down at the negotiating table. Countries that respond with additional tariffs on our goods will be severely punished. The carrot and the stick writ large, Big Boy style. The Art of the Deal will soon be sold out on @amazon. But if you are running a foreign country that is now subject to massive tariffs, don't wait to read the book. Just pick up the phone. Call the President, and make a deal. Just some advice from a friend of the global economy.

Democratic party approval rating can't sink lower than 29%. Chuck Schumer: "Hold my Beer..." x.com/greg_price11/status/19…

Schumer mocks "greedy" Americans who want to keep more of their own money: "Their attitude is, 'I made my money all by myself. How dare your government take my money from me?'"

Great panel this morning with @CarolineForTX, @LaceyHullTx, @szaafran, and Dr. Clif Porter at the @TPPF Policy Summit! The @TexasYRs are ready to support legislation to make healthcare more transparent and affordable! #txlege

@szaafran, President of the Texas Medical Board, identifies vertical integration - by both hospital systems and insurers - as having real threats for misaligned incentives in the provision of care to patients. States that the end decision making process needs to be about taking care of the patient, and not someone else's interest.