Proctalgia Fagux, MD 🇺🇸

Independent. EM trained & burned out. Trying to figure out the rest of my saga. Love animals, birds, wildlife, antiques,historical architecture/fashion/photos🤨

[Forest Park Pharmacy @ForestParkPharm]

My wife and I own Forest Park Pharmacy, and we don't accept insurance. None of it. That decision is exactly why we could fix what happened to a patient today.

A family came in wanting to transfer their kid's antibiotic to us. The child had already STARTED the course. Then, mid-treatment, the insurance company decided the last 14 tablets suddenly needed a "prior authorization" before the other pharmacy could hand them over. A sick kid, halfway through an antibiotic, and the answer was "please hold."

The drug is linezolid. It's a generic. It's been generic for over a decade. It treats serious gram-positive infections — the kind you do NOT want to stop antibiotics in the middle of, because an interrupted course is how you breed resistant bugs and end up right back where you started.

So why the hold-up on a cheap, common generic? Follow the fake math.

Insurance and the PBMs behind them price drugs off a number called AWP — "Average Wholesale Price." People in my industry have another name for it: "Ain't What's Paid." It's a benchmark number, not a real-world cost. On paper, the AWP for just those last 14 tablets is about $2,500.

My cash price for the same 14 tablets? $18.

Read that again. The system that's supposedly "protecting" this family from cost is the same system that inflated an $18 medication into a $2,500 line item, then slapped a prior auth on it to "review the expense" THEY invented. They manufactured the problem, then billed everyone for the privilege of solving it — and made a sick kid wait while they did it.

This is the whole game. When a drug is priced honestly, there's nothing to "manage." When it's priced off a fantasy benchmark, you get spread pricing, PA paperwork, pharmacy phone trees, and delayed treatment — all dressed up as cost control.

Here's the part nobody tells you: roughly 90% of prescriptions are low-cost generics. For the vast majority of what people pick up every day, running it through insurance does two things — raises the real cost and risks delaying your care. That's it. That's the value-add.

That's why we fired the insurance companies. No middleman deciding your kid can't finish their antibiotics on schedule. No fake prices. Just the real number, on the shelf, today.

The medication was always cheap. The insurance was the expensive part.

[Maximus Textoris Pulcher @MaximusTPulcher]

Look, I spent three hours grooming my fur into a perfect ceremonial puff for this state visit. Bart and I show up ready for a Shogun-level fashion moment and the Emperor rolls up like he’s going to a Brussels business lunch. My bad. Even emperors ghost tradition sometimes. 🇯🇵🐈🇧🇪

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@RoKhanna

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

https://t.co/VyBd4hySW2

[Zachary Parker @ZacharyforWard5]

Did my morning run on the Mall, and I can report that the $13M renovated reflecting pool looks about the same. 🤷🏾‍♂️

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@DrLunar @StephenKing 🙄

[EarthCam @EarthCam]

Months of work, condensed into seconds. Watch the transformation of the Lincoln Memorial Reflecting Pool as crews drained, repainted, and refilled one of America's most iconic landmarks ahead of a busy summer season in Washington, D.C.

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@StephenKing @NutlawPete

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@washingtonpost https://t.co/zZKjtvyKZ9 https://t.co/zZKjtvyKZ9

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@Avabelly__ 🙄🙄

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@JohnSimpsonNews I’ll listen to this guy interviewed by ABC- Ebola is “not very contagious”.
Why is it that so many individuals just say crazy things or lie? It’s remarkable.

https://t.co/qxZpMpjOoI

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@reuterspictures @ajlamesa No facetime then??

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@StatisticUrban https://t.co/0CaedETWfD

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@StatisticUrban Delay of 3 weeks is multi-factorial.

2020 publication (link in replies)- median delay of 44 days for outbreaks prior to 2020
West African Ebola (2013-2016) - delay of 86 days
While causation of delays are not identical, 3 weeks is not an outlier

https://t.co/EQ3SpqkPGn

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@BrendanCarrFCC @MattWhitlock Not “bona fide news”

Shrieking, fear mongering, panel of simple minded contrarians.

https://t.co/TBet6Ds5Us

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@Edidem_greek @BernieSanders 🙄🙄

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@chrislhayes

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@lamps_apple @SenLouiseLucas Also is CEO for a business that “runs residences, day programs and transportation services for intellectually disabled adults”. The types of services that now cause one to raise an eyebrow.

https://t.co/XjcUmUN5Hw

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

@SenLouiseLucas Corruption probe initiated under Biden. Previous cannabis store business partner was recently indicted for wire fraud.
She’s the CEO of a business that “runs residences, day programs & transportation for intellectually disabled adults”.

https://t.co/XjcUmUN5Hw

[Proctalgia Fagux, MD 🇺🇸 @FaguxMD]

Is he insinuating that Vessel Sanitation Program staffing has some relationship to Hantavirus outbreak outside of VSP’s jurisdiction-“international voyages with a stop at a U.S. port”?
Why be clear on important matters when you can mislead & limit replies?
https://t.co/B0UrYswSB5

[Jonathan Reiner @JReinerMD]

Last year half of CDC’s Vessel Sanitation Program staff were fired. This is the group responsible for investigating cruise ship outbreaks. The cuts were made despite the fact that US taxpayers don’t pay for this team. The cruise ship industry does.

[Mark Cuban @mcuban]

TrumpRx is not a scam. Is it perfect ? No. That would require them to add all @costplusdrugs meds !

They have done a great job on IVF and GLP1s. If it allows a couple to afford to grow their family or to afford the GLP1 they need, it’s a win.

[Sheldrick Wildlife Trust @SheldrickTrust]

Meet Bumpy!

This enchanting little chap was rescued over the weekend. His mother likely died defending him in a territorial fight and when the Kenya Wildlife Service found him, he was huddled beside her body. They rescued him and placed him in our care.

This was Bumpy's first night with us, snuggled next to Keeper Simon. Simon put his mattress on the ground and the tiny hippo nestled by his side, swaddled in his cherry blanket. After his fraught ordeal, he finally felt at peace and slept soundly in the crook of Simon's arm.

Now, you can become part of Bumpy’s journey — read his full rescue story and support him through an adoption: https://t.co/sR6w4FUvNN