Daniel Silver

I’m open to any questions or conversations about health care staffing/recruiting in CA or manufacturing in Tijuana.

@megbasham Moore didn't say "we need more mosques". He advocated for the legal right to build mosques, ie freedom of religion. Moore said at the time - if we try to curtail freedom of religion, there will be churches that won't be built in San Francisco. This is the right position.

Given that I have been critical of the pope in the last few days, including on his self-described communion with Muslims, I do want to take a minute to remind Southern Baptists that our leadership has taken similar stances. The former president of the Southern Baptist Convention, JD Greear, wrote in his book Breaking the Islam code that Muslims and Christians worship the same God. And the former head of our lobbying arm, Russell Moore, argued that we must advocate for the building of mosques in the United States. So this strange promotion of Islam within Christianity is happening all over. Both Catholics and Protestants should be asking why their leadership is doing this.

@MatznerJon I've exited the recruitment business but man. I'm not saying there are no ways to cleverly interview. But especially for run of the mill roles - skip the interview or just say hello for a few minutes and then check references and then hire the people with good references.

we got a job request from a broccoli hair remote cleaning bro that had 11 steps and an 4 assessments for an entry level position. lol

@skylarromines I knew a therapist who worked with kids coming out of childhood trauma - he told me once that often the most intelligent kids have the hardest time recovering from it.

Having a high IQ is one of those things with a relatively low ceiling and a very low floor. Outside of extreme outliers, being smarter doesn’t make you more successful. It often has the opposite effect. Most people would be happier if they were a little more attractive & a little dumber. If you want to create a life worth living, you must be excellent at doing. Thinking is actually optional in most cases. The other guy isn’t winning because he’s smarter than you. He’s winning because you’re still thinking about the other guy instead of doing the thing.

@uroreql @northwoods1980 Not better because it is an APP clinic. It is better than not getting care at all. We are not talking about neurosurgery - APPs obviously must stay within their scope of practice. I really don't think we probably disagree on this.

@danjonsilver @northwoods1980 So you are arguing it is better to get PROCEDURES at at a APP run clinic, in the middle of nowhere, with limited to 0 physician oversight…

Honest question. Is it fair to a pt to schedule appt thinking they’re seeing a board certified orthosurgeon, ER doc, urologist, neurosurgeon or whoever… only to find out later they actually saw a mid-level? Nobody explicitly disclosed that. And yet they were charged nearly same rate as if a physician saw them. Should that be stated upfront when booking? Should patients receive a legitimate discount? Most patients oblivious to this. My wife always explicitly requests a board certified pediatrician or OB for every visit. It usually creates an awkward phone convo w scheduling but she does it every single time.I genuinely appreciated our last pediatric surgery consult for my daughter. She was automatically scheduled with actual surgeon. Not PA or NP. A seasoned board certified pediatric surgeon. I never would have agreed to anything less.

@uroreql @northwoods1980 Ok - I get your point. My point is that specialty experience matters in addition to education. We have an NP-led clinic treating most causes of lower extremity edema, vein disease, veinous wounds, and I know of no physician within 100 miles of us doing the same.

@danjonsilver @northwoods1980 No counterpoint identified. Both should be addressed at the primary care level AND/or are extremely routine. Further, an orthopedics doctor or vascular surgeon would wipe the floor with any APP offering either given they can actually manage the complications if they arise.

@uroreql @northwoods1980 Counterpoint: experience and education both matter. You go to an urgent care with trigger finger. Doc has never done that injection. NP has. Who do you want? You go to a vein clinic for GSV ablation, NP has done 1000 of these, doc has done 10. Real examples.

@northwoods1980 As a urologist, if you have to see every new onset UTI consult… you would die. NP/PAs visits fall into 2 categories 1) Extremely routine consults 2) Should have been managed at primary care level That said-you will ALWAYS be seen by a “good” surgeon before surgery is planned

@shawngorham It's possible that it changes nothing but at minimum it gives people who care about something a chance to visibly say their piece. If a person is worried or anxious about something it's very mentally healthy to take an appropriate action that doesn't hurt anyone else.

Regardless of Politics... I cannot imagine choosing to spend my time on the corner protesting "No Kings" What a waste of time, it changes nothing

@moseskagan @hitsamty @RichardHanania Let me challenge you: not saints, just putting one foot in front of the other like everyone else. Everyone has things they deal with. Foster/Adopt can be a big learning experience but people who think (kindly) "I could never do that" are wrong.

@hitsamty @RichardHanania Oh man that continued for me for a long time :) That's exactly why I regard people who can do it w/o the genetic imperative as saints

Having kids and seeing how much work it is has made the decision to adopt even more incomprehensible to me. No offense to those who do it, but I couldn’t imagine putting up with all the screaming and crying for someone else’s child.

@OurShallowState @JHoffman011171 X full of people making "MOM! SHE HIT ME FIRST" arguments and thinking they are making a point when they are actually just begging the question. Why do so many of us believe the supposed hypocrisy of others has any purchase as a moral argument?

@JHoffman011171 I've always supported restrictions on elected officials trading equities. Term limits, too. But of course, this has zero to do with my post.

A number of reputable financial sites have reported that just a few minutes before Trump posted that he was recanting his threats of attacking Iran based on negotiations that had been progressing, somebody placed a $1.5B bet on stocks rising, which of course they did. And if you listen to Iran, the progressing negotiations are a fabrication. This is massive market manipulation. This needs to be investigated. At minimum, THIS NEEDS TO BE A BIGGER STORY. It's not the first a suspicious trade was made right before news dropped - tariff reversals come to mind. Come on now. GRIFT can't be the sole determinant of every policy and announcement. Can it?

@moseskagan @amisraelhigh The spiritually pitiable "means justify the ends" crowd doesn't recognize the greatness of conscientious public servants (of course imperfect) like McCain, Mueller, Coney Barret, Mike Pence.

@amisraelhigh You are utterly wrong Read the article

Try to look past whatever your politics are & see him for what he was: A patriot nytimes.com/2026/03/21/us/…

@IraGilligan Good Faith Estimates are only required by law for people paying cash (opting out of using insurance) or who don't have insurance. I bet they are just having everyone sign them but they are not filling them out for insured folks maybe?

Does anyone else get asked to sign things at the doctor's office that aren't true? This is the second time. J is getting allergy shots, and the nurse says "I need you to sign this." I read it, and it says "I confirm we are leaving the premises despite being advised against doing so." I say "but we aren't leaving. You just told me we should wait here for 20 minutes, and we are." At the pediatrician: "we need you to sign this Good Faith Estimate. " Me: "I don't see the Estimate." Receptionist: "That is the Good Faith Estimate" Me: "... there is no number. If I sign this, you can charge whatever you want and I have to pay it. That seems contradictory to the purpose of GFE" Receptionist, now annoyed because how dare I read: "do what you want but they won't treat her if you don't sign and you'll pay a cancelation fee" How is this legal?

@DKThomp You're missing the point. They really want credit for someone making up a power point deck about this, multiple times, in the past.

Okay good, let's say the WH planned for Iran to close the Strait of Hormuz following the attack. 1. The U.S. sold off its helium reserve before waging a war that they knew would disrupt helium exports to allies, which make computer chips we rely on. Weird decision. 2. The U.S. let oil stockpiles fall to a multi-decade low before waging a war they knew would disrupt oil shipping. Why? 3. The U.S. didn't build any kind of coalition to assist tankers coming under attack in the region, and two weeks into the war they're only now asking allies to reinforce the US Navy. But they knew they'd need to do this for ... "years"? If this is what "a plan" looks like, god forbid we see what unplanned operations look like.

@TimSheehyMT "nothing to see here, it's all part of the plan" is really going to be a hard thing to sell to the public unless they really do manage to fix it in a reasonable way and a reasonable timeline.

I received a classified briefing from the administration. It is categorically false that they did not plan for Iran closing the Strait of Hormuz. Lawmakers and national security officials have known for years that this was Iran’s plan once their backs were against the wall.

@mhp_guy Counterpoint: Claude enterprise version that requires an investment in at least 20 seats is the only one currently offering HIPPA compliance if I'm not mistaken. That size may or may not work for independent physicians.

I just spend a week at a Mexican resort with 150 doctors. And wow. I can now say with 100% certainty that I know what the biggest wealth creation opportunity of 2026 is. These guys are the best of the best, each making $500k - $5m+ per year. I gave a keynote about how to implement AI into their practices, and what I learned kind of shocked me. I asked how many knew what an AI wrapper was. MAYBE 2 hands halfheartedly went up. Vibe coding? Crickets. Replit? Nope. How many have ever uploaded a file to AI? Maybe 20% of people. I couldn't even get through my 2 hour talk because they were asking so many questions. These guys were almost all 35-55 year old wealthy Americans, on the cutting edge in their field. I don't care what size the business is - small, large, medium, it doesn't matter - business owners are DESPERATE for someone to do 3 things for them with AI. 1. Solve problems. 2. Save money. 3. Make money. So what's the opportunity? Get in front of them for free. Any way you can. In your local area, preferably. Rent a freakin' Holliday Inn conference room for an hour if you have to. Promote the event with the FB ads + Eventbrite integration. Have your buddy sign them up for a demo in the back of the room. You will have 5 figures in monthly recurring revenue in a matter of days, not months. You don't have to do an event, but the close rate is stupid. I know of at least 10 people doing this today. X is a bubble. The stuff you see here about OpenClaw, AI wrappers, Claude's capabilities, etc, is all 2-3 years ahead of the general public.

@DutchRojas Add to your list of disadvantages for independent physician practices compared to hospitals/facilities: can't be reimbursed for bad patient debt by medicare. Facilities get 65% reimbursement for bad patient debt after 120 days, independent physicians do not.

@RepBaumgartner I agree with the concern but the GOP is currently in power and not leading by example. You have Tony Gonzalez comfy in his seat, Trump pardoning people he's in business with (Binance), inconsistent tariffs with lobbied carveouts. Tend to the log in your own eye congressman.

I like my country governed by a fair set of rules applicable to all, not whatever totalitarian nonsense this Senator is threatening. This is America, not Animal Farm.🇺🇸

@thatchthoughts @moseskagan @JenniferJJacobs @CBSNews I'm not an expert but I think procedural votes are often unconnected to the merits. Several of these were removal to other courts (contract issues). I assumed you were addressing 2025 because you mentioned a sum total of 24 cases above - I believe there were 24 cases in 2025

@danjonsilver @moseskagan @JenniferJJacobs @CBSNews You’re responding to me lol. I’m talking over all Supreme Court record. Btw you get a stay generally if your case is “likely to win on the merits”

🚨 Pentagon official lashes out at Anthropic as talks break down: "You have to trust your military to do the right thing." Undersecretary Emil Michael spoke with @CBSNews just before he called the Anthropic CEO a "liar" in a tweet.  Asked why the Pentagon will not address Anthropic's red line concerns by putting in contract writing that its AI model can't be used by military for mass surveillance of Americans or to make final targeting decisions without human involvement, Michael said those uses of AI are already barred by the law and by Pentagon policies. "We have humans in the loop in every aspect when we're even thinking about modeling and simulation on these things. So at some level, you have to trust your military to do the right thing," he told me. "But we do have to be prepared for the future. We do have to be prepared for what China is doing," Michael said, referring to how U.S. adversaries use AI. "So we'll never say that we're not going to be able to defend ourselves in writing to a company."  @USWREMichael said Anthropic has been invited to participate in AI ethics board. But: "You can't put the rules and the policies of the United States military and the government in the hands of one private company." Pentagon set deadline for Anthropic for 5 pm tonight. "One thing is for certain, no company is going to take out any software that's being used in this department until we have an alternative," Michael told me. "So I'm working on alternatives." More details here: cbsnews.com/amp/news/penta…

@thatchthoughts @moseskagan @JenniferJJacobs @CBSNews I'm talking 2025. Perhaps 17 of the 20 wins in 2025 are procedural. Sending the case to Federal Claims Court or saying a certain court couldn't issue national injunction for example. So yeah these are procedural wins but not mostly final decisions on actual merits.

@danjonsilver @moseskagan @JenniferJJacobs @CBSNews Sounds like cope. He’s been before scotus going on a decade now. These aren’t all recent cases

@learnsquick @moseskagan @JenniferJJacobs @CBSNews Success in lifting restraining orders is not the same as success on the merits. How many previous admins had this many restraining orders issues by lower courts? (I honestly don't know)

@moseskagan @JenniferJJacobs @CBSNews Much less than other administrations. Trump 2 has one of the highest success rates of any administration ever

@thatchthoughts @moseskagan @JenniferJJacobs @CBSNews Almost all the wins were not decisions on underlying cases but just "benefit of the doubt" removal of stays against Trump's executive action. Decisions on the merits will come and I don't think those decisions will be nearly as deferential to Trump

@moseskagan @JenniferJJacobs @CBSNews Besides Star war names district court judges our record is phenomenal 22-2 at the Supreme Court. Perhaps that should make you do some self reflection, but you won’t