Two Thought Leaders and a Newsmaker Recognized as “Hirsch’s Heroes” for 2017

Drs. Vinay Prasad, Jen Gunter, and Edward Hu are recognized for their efforts in 2017.

As we approach the end of another eventful year, it is time for “Hirsch’s Heroes” of 2017. And this year I am going to do something a little different.

One of my heroes is someone whose name may be familiar to you, but those of the other two may not be. So, why would I pick two people who may not be known to the RACmonitor family? Because I want listeners and readers to know who is out there in the broader world of medicine making a difference for our patients, our families, and ourselves.

So my first hero is Dr. Vinay Prasad, an oncologist at Oregon Health and Sciences University in Portland. He is a world-renowned expert in evidence-based medicine and medical reversals.

We have all heard of evidence-based medicine, but what is a medical reversal? That is when a commonly accepted medical practice is found to be worthless or even dangerous. Remember when we used to give Procardia under the tongue for elevated blood pressure? Why don’t we do it anymore? Because it harmed more people than it helped. Remember the furor over insurance companies refusing to pay for bone marrow transplants for metastatic breast cancer? Why did that disappear? Because the treatment never worked.

Dr. Prasad’s book, “Ending Medical Reversal:  Improving Outcomes, Saving Lives,” is a must-read. He goes through many of these reversals and also proposes changes intended to  stop harming patients needlessly. He also writes, speaks, and tweets a lot about the many new treatments being introduced for cancer and the lack of proper review of their true effectiveness. Many of these expensive, toxic drugs are being approved based on what are called surrogate measures, which are outcomes that do not necessarily help a patient live any longer or any better, but allow a pharmaceutical company to sell more drugs while giving patients false hope. So I’d urge you to read his book and follow him on Twitter at @vinayprasad82.

My second hero is also a Twitter star, Dr. Jen Gunter. She is an OB/GYN specialist who is also board-certified in pain management and practices in San Francisco. What did she do that got my admiration? There are almost too many things to discuss, but let’s start with her tireless efforts to debunk the many people out there who take advantage of the public by selling quackery.

Her main target is a company run by Gwyneth Paltrow called Goop. Goop bills itself as a modern lifestyle brand, but what it does is play on Paltrow’s fame to sell worthless and potentially dangerous treatments. You may have heard about the jade egg sold by Goop for $66. Women are supposed to place that in their vagina to increase their sexual energy.

What Dr. Gunter points out is that what this really does is potentially increase the risk of toxic shock syndrome, as there is no data supporting any positive effects on a woman’s “energy.” But Dr. Gunter does not just go after Goop. If you are out there trying to convince people that turmeric can cure diabetes, she’s going to go after you. And if you are a man trying to tell her how a vagina should look, feel, or smell, she is going to target you as well, as she did in a recent New York Times article titled “My Vagina Is Terrific. Your Opinion About It Is Not.” So for standing up to quacks and snake oil salesmen and mansplainers, I name Dr. Jen Gunter as one of my heroes. She’s on Twitter at @DrJenGunter and blogs at

And my third hero is Dr. Eddie Hu. Dr. Hu is the president of the American College of Physician Advisors and system executive director of physician advisor services at UNC Healthcare System. He’s my hero because he is so darn smart. He knows Medicare regulations; he knows ICD-10 and CPT® and HCPCS. He keeps up on the medical literature and the changes to the coverage guidelines.  But that’s not enough to make the list.

So, what else has Dr. Hu done? He has successfully gone from being the physician advisor at a single non-academic hospital to the executive director of physician advisor services at a multi-hospital health system that includes a large academic medical center.

He also is doing an amazing job as president of the American College of Physician Advisors (ACPA). He has transitioned ACPA to a new web-based platform, including writing some of the actual computer code to optimize the site. He has greatly strengthened the clinical documentation integrity activities of the organization and is working with Dr. Lisa Banker and Dr. Nick Ullmer on the upcoming spring National Physician Advisor Conference in Greenville, which is the premier physician advisor conference in the nation. So for his expertise at multitasking and his advocacy for physician advisors and case management, I honor Dr. Hu.

Once again, I am honored that I am able to report to you every week on what is happening in the medical world, be it talking about another injustice doled out by a payor, a little-noticed regulatory change that might have been missed, or doing a deep dive into fun topics like the two-midnight rule, observation, or the inpatient-only list. I hope you enjoy my musings as much as I enjoy preparing them for you.


Ronald Hirsch, MD, FACP, CHCQM, CHRI

Ronald Hirsch, MD, is vice president of the Regulations and Education Group at R1 Physician Advisory Services. Dr. Hirsch’s career in medicine includes many clinical leadership roles at healthcare organizations ranging from acute-care hospitals and home health agencies to long-term care facilities and group medical practices. In addition to serving as a medical director of case management and medical necessity reviewer throughout his career, Dr. Hirsch has delivered numerous peer lectures on case management best practices and is a published author on the topic. He is a member of the Advisory Board of the American College of Physician Advisors, a member of the American Case Management Association, and a Fellow of the American College of Physicians. Dr. Hirsch is a member of the RACmonitor editorial board and is regular panelist on Monitor Mondays. The opinions expressed are those of the author and do not necessarily reflect the views, policies, or opinions of R1 RCM, Inc. or R1 Physician Advisory Services (R1 PAS).

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