Adam Wheeler

Properly incentivized primary care won’t fix the world, but it will fix health care. I’m open to ideas for what to fix after health care.

[Adam Wheeler @AdamWheelerMD]

We help under-utilized health care providers care for under-cared-for people for an affordable price using tech-enhanced relationships. Join us. We are fixing health care, one friend at a time.

[Adam Wheeler @AdamWheelerMD]

@DutchRojas This is direct primary care. DPC doctors figured out how to lower the cost of care: lower ER utilization, lower specialist utilization, lower pharmacy spend. But insurance companies profits are fixed as a percentage of spend. So they incentivize brokers not to use us. It’s simple

[Adam Wheeler @AdamWheelerMD]

@SeeFisch They are 10x more expensive. Albuterol works. Laba/ics are not fda approved for quick relief. I’m not saying it’s not a better solution. I am questioning whether the average patient should be on a slightly better medicine for 10x the cost.

[Adam Wheeler @AdamWheelerMD]

@JoshJPhilipp Well after walking hundreds of people through this I can say that RFKJrs experience is unique. This sort of fear mongering post will keep thousands of people from a medication that provides real help. Congrats. You made the world a worse place.

[Adam Wheeler @AdamWheelerMD]

@newstart_2024 For sure. A lot of boys should not start school until age 9. It’s not a real option for many. And with 100 years of great safety data, methylphenidate is one of the safest meds we have.

[Adam Wheeler @AdamWheelerMD]

Grok says meth and methylphenidate are not chemically related. And while some children get to satisfactory places with improved diet and exercise, some children, especially boys, do not. So then you are left with a choice, use a medication that has decades of safety data, or let them fail.

[Adam Wheeler @AdamWheelerMD]

@DutchRojas @KatyTalento @HeathVeuleman They have destroyed the independent health care system in central Missouri, then use their network power as leverage against the insurance cos. The insurance cos pass price increases on to the state and employers. MU pinches their own doctors saying they are barely making it…

[Bilal Farooqui @bilalfarooqui]

why do so many mental health providers not accept insurance?

because they are in high demand and insurance doesn't pay well

aetna just announced sessions over 53 minutes will be reimbursed at the same rate as sessions 37-52 mins

yes, they count minutes

[Adam Wheeler @AdamWheelerMD]

@SeeFisch To get adequate T>MIC for treatment of MSSA, you have to do 500 4-5x/d. Just repeating thing multiple times doesn’t make it true.

[Adam Wheeler @AdamWheelerMD]

Which is the greatest? The moon landing, the “like” button or the origami fortune teller?

[Adam Wheeler @AdamWheelerMD]

@himshouse I don’t understand how this was “added.” Hims is not a provider. The clinicians on Hims could not prescribe a medicine if they felt it was appropriate but now they can? How is this not a violation of the corporate practice of medicine laws in relevant states?

[Adam Wheeler @AdamWheelerMD]

This is a nuanced argument, but it demonstrates why doctors can't just listen to FDA indications. Consider two children aged 8 with an ear infection. One is 39kg, one 41kg. The FDA says the smaller child should get twice as much amox-clav as the larger child (based on the FDA label of Amoxi-clav 600). In real life, we face this sort of thing every day. The FDA helps. They are not dealing with real life though. Every doctor would give the same dose to both kids. The FDA would not.

[Adam Wheeler @AdamWheelerMD]

@StillmanMD This is not true. They help millions. We don’t give them to people with no issues. It’s a risk benefit calculation for sure. But “worst scams ever”? Hardly

[Adam Wheeler @AdamWheelerMD]

I am a pediatrician. Half my patients are unvaccinated. They all report being treated differently. They are routinely kicked out of pediatric practices. They are harassed by the health care system. I believe the medical care these people received was probably routine. The shame is real.

[Adam Wheeler @AdamWheelerMD]

And the data says that “recommendations of diet and exercise” have almost no effect on any outcome. Some studies say that the recommendations actually lower the probability that someone will make changes. Chronic disease is not an education deficit. People know what to do. Our society is built to reinforce bad behavior. People like this are a large part of the problem.

[Adam Wheeler @AdamWheelerMD]

And the data says that “recommendations of diet and exercise” have almost no effect on any outcome. Some studies say that the recommendations actually lower the probability that someone will make changes. Chronic disease is not an education deficit. People know what to do. Our society is built to reinforce bad behavior.

[Adam Wheeler @AdamWheelerMD]

@runtraffic The fact they had legit script tells you everything you need to know about legit script

[Adam Wheeler @AdamWheelerMD]

They should be paid by the patient. If they keep the patient happy, they get paid. If they don’t, the patient leaves. It’s called direct primary care. It works.

[Cyborg Pediatrician @CyborgPeds]

Correct. The doctors would fire all their sick patients.

[Adam Wheeler @AdamWheelerMD]

All true, and not even close to the most ironic fact set in Medicine. Doctors can’t own hospitals but private equity can. Most every doctor does things that are not approved by the FDA (dosing, drug combos, indications etc) every day. An intern in a large health system generates many multiples of revenue per visit more than the most well trained private doctor. Etc etc

[Neil Stone @DrNeilStone]

So let me get this straight

You think doctors who advise vaccines are just solely in it for the money but the anti vaccine lawyer who stands to make millions from from anti vaccine lawsuits has the purest of intentions and just has your best interests at heart?

OK then