Ikenna Okpareke

Interventional Pain Medicine. Anesthesiology. Manchester United. Super Eagles. Albany Med, UChicago DACC, Rush Pain

[East Cobb News @EastCobbNewsNow]

Marietta City Council approves data center off Delk Road - East Cobb News https://t.co/7I0p5rqOfh

[Ikenna Okpareke @CooperBott]

More work to do for grok🥴

[𝕯𝖆𝖗𝖐 𝖁𝖊𝖗𝖉𝖎𝖈𝖙 🌑 @Lone_ridder]

Hey @grok, I've been staring at this for 10 minutes... What part of Earth is this?

[𝕯𝖆𝖗𝖐 𝖁𝖊𝖗𝖉𝖎𝖈𝖙 🌑 @Lone_ridder]

Hey @grok, I've been staring at this for 10 minutes... What part of Earth is this?

[Felix Prehn 🐶 @felixprehn]

Private equity firms bought 500 hospitals. Death rates in their emergency rooms went up 13%. They fired 12% of the staff. Then they paid themselves billions in dividends.

A Harvard study just confirmed what doctors already knew: people are dying so investors can hit quarterly targets.

Exactly what happens. A PE firm buys a hospital using debt. The debt gets placed on the hospital's balance sheet, not the firm's. Now the hospital owes hundreds of millions it never borrowed. To service that debt, the hospital cuts costs. Costs mean nurses.

The numbers from the Harvard/University of Chicago study are horrifying. After PE acquisition, emergency department salary spending dropped 18.2%. ICU salary spending dropped 15.9%. Hospital-wide employees were cut 11.6%. Emergency department deaths rose 13%, seven additional deaths per 10,000 visits.

A separate study found patients undergoing surgery at PE-acquired hospitals had 17% higher odds of dying within 90 days.

Steward Health Care, owned by Cerberus Capital, filed bankruptcy with $9 billion in debt after closing hospitals across Massachusetts. The CEO lived on a $40 million yacht while emergency rooms went dark. Eight hospitals serving 2 million people nearly disappeared because a PE fund extracted more cash than the system could survive.

The private equity industry has poured over $1 trillion into healthcare. They operate a quarter of ERs nationwide. This isn't going away.

The investing angle nobody talks about.

Non-PE hospital operators like HCA Healthcare (HCA) and Tenet (THC) are the direct beneficiaries. Every time a PE hospital closes or deteriorates, patients flow to the nearest competitor. HCA has returned 1,200% since 2011. Patient volume from PE closures is a structural tailwind nobody's pricing in.

Medical staffing firms (AMN Healthcare, Cross Country) charge premium rates specifically because PE hospitals cut staff. The staffing shortage IS the business model for these companies.

The disruption play: outpatient surgical centers (SCA Health, now part of UnitedHealth) are pulling profitable procedures out of hospitals entirely. PE-owned hospitals lose their highest-margin surgeries to outpatient, and the death spiral accelerates.

Pull up tradevision and monitor healthcare M&A alerts, hospital closure filings, and patient volume migration data. When a PE-owned hospital announces "restructuring," the patient volume shift to competitors like HCA starts within 30 days. That 30-day window is when the competitor's earnings revisions haven't updated yet. Free to try.

(a private equity firm bought your local hospital. borrowed $500 million in the hospital's name. fired 12% of the nurses. emergency room deaths rose 13%. then they paid themselves dividends. nobody went to prison. they're currently buying another hospital.)

[Markos Mom @Markos_mom]

The Station Nightclub fire happened in 2003. No smartphones. No Instagram.

100 people still died because they stood watching the flames, thinking it was part of the show.

I've retrofitted fire safety for some of the largest property portfolios in the UK post-grenfell.

You are confusing stupidity with biology, physics, and catastrophic design failures.

Here is the actual science of what you are watching:

1. When the music keeps playing and staff don't panic, the human brain overrides flight instincts to fit the threat into a normal context. This is called normalcy bias. These kids froze to process conflicting social cues, not to post for likes. They were likely already filming. They were also likely drunk.

2. We explicitly design buildings to account for this hesitation (pre-movement time). Fire safety codes assume people will wait before running. In a compliant building, you can assume up to a minute or two before egress commences. Sprinklers and detection systems are designed specifically to buy that time.

3. The reason the time buffer didn't exist here is the material. That ceiling is polyurethane foam. It doesn't burn linearly; it hits flashover (1,100°F) in under 90 seconds. It's essentially solid gasoline. The room would have exploded for all intents and purposes. Way before anyone could reasonably evacuate.

4. We calculate exit widths based on how many people can physically pass through a door per minute (flow rate) versus how fast a fire spreads. With foam fires, the available safe egress time drops to almost zero. Even if they had reacted instantly, the crowd density would have choked the exits before the room cleared.

5. In any normal building fire, especially one that starts off small, you expect a responsible adult to put it out, or sprinklers to do the same. When there's a pan fire in a restaurant, you don't run out in case the entire building suddenly explodes. No reasonable person should have expected this unless they were the owner and knew how the building was designed.

Those poor teenagers likely passed out from smoke inhalation soon after this video. If they didn't, they would have been caught in a catastrophic explosion as they crammed into the single tiny exit.

They didn't die because of Instagram.

They died because the physics of the fire moved faster than human bodies can physically squeeze through a door, and a catastrophic disregard of safe design principles meant they never stood a chance.

[Ikenna Okpareke @CooperBott]

@AJamesMcCarthy What!? Congrats!

[Ikenna Okpareke @CooperBott]

@StrangelEdweird @JonHaidt @LetGrowOrg I completely agree with you. Also the demands on kids in 2025 are so different. Good luck getting into a competitive college or landing a decent job if all you did all summer was cruise for chicks in your Camaro.

[Ikenna Okpareke @CooperBott]

@ArunBaksi What a horrible, horrible response.

[Ikenna Okpareke @CooperBott]

@rbarbosa91 Know finance and the business of medicine as thoroughly as you know medicine itself!

[Jeremy Counts @HokiePharmacist]

A friend sent me their GLP-1 profits for the year. -$27k on $562k of medication. They have decided to no longer fill them. How are we supposed to keep our doors open?

#Pharmacy #twitteRx

[Ikenna Okpareke @CooperBott]

@AJamesMcCarthy Who else sees it?

[Ikenna Okpareke @CooperBott]

@drkeithsiau Could look surprisingly different on a patient with dark skin.

[Ikenna Okpareke @CooperBott]

@hjluks Wow. What was the time interval?

[Ikenna Okpareke @CooperBott]

@thefutballboy_1 Sadio Mane. Easy

[Ikenna Okpareke @CooperBott]

@Rheumatology A inferior glenohumeral ligament
B humeral head

[Ikenna Okpareke @CooperBott]

@Rheumatology Triceps brachii long head tendon.

[Ikenna Okpareke @CooperBott]

@AuforGA Very compelling testimony.

[Ikenna Okpareke @CooperBott]

@drkeithsiau *Gasp* Shots fired!

[Ikenna Okpareke @CooperBott]

@drkeithsiau Epstein–Barr virus. Infectious mononucleosis.

[Ikenna Okpareke @CooperBott]

“Is there something going on or is it Friday afternoon.” 😅

[Dr. Glaucomflecken @DGlaucomflecken]

Emergency medicine consults