Dr. J Bones

God, Father, & America. Hip and Knee Reconstruction Surgeon.

[Dr. J Bones @JBteamUSA]

@realEstateTrent Solid truths in this one

[Dr. J Bones @JBteamUSA]

@FluentInFinance They were doing great work. Until half the country couldn’t handle DOGE. Now it seems to have stalled

[Dr. J Bones @JBteamUSA]

@TheNotoriousMMA @Cernovich Hang in there champ!

[Dr. J Bones @JBteamUSA]

@KanekoaTheGreat Pec strain may have helped some vs natural recovery and modified training regimen.
Stopped because I started to notice some increase skin spots growing with a history of basal cell removed. And one now looking like a squamous that I’m having checked next week.

[Dr. J Bones @JBteamUSA]

@realEstateTrent How about once under contract, and then during due diligence receive actual historical financials and banks underwriting comes back with we will only finance 40% vs 20% based on dscr. Pro forma was way overstated. Is this grounds for an honest retrade and not to be blacklisted?

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

This ridiculous statistic keeps appearing: medical errors are the third leading cause of death.

It is a powerful narrative that has spawned a massive quality-control bureaucracy.

It is also completely wrong.

Taking care of sick patients is not like flying an airplane. Pilots fly machines that have been maintained and cleared for takeoff. Doctors often take over when the plane is already on fire and heading toward a mountain.

Also, not every airplane is destined to crash. Yet, every patient is destined to die eventually.

When reviewers judge bad outcomes backward, they routinely classify the brutal, inevitable tradeoffs of medicine as preventable errors. Critically ill patients have more interventions and higher mortality. That does not mean an adverse event killed them, or that a new bureaucratic rule would have saved them.

The two papers often cited, one by the Institute of Medicine, another by Marty Makary, have substantial flaws. They often struggled to determine whether an adverse event actually caused the death. Shojania and Dixon-Woods, writing in BMJ Quality & Safety, criticized the “third leading cause” claim for exactly this reason. They argued that the estimate combined prior studies too simplistically, failed to follow accepted standards for quantitative synthesis, and did not adequately address whether the adverse events detected by review tools actually contributed to death.

In my latest essay, I explore how the exaggeration of preventable error has actively harmed patient care. The safety movement did not stop at identifying clear, recurring failures. It became a governing philosophy that gave administrators a moral language to control the clinical encounter.

Today, physicians spend hundreds of hours a year feeding quality metrics, hospitals game the data to manage their mortality statistics, and independent practices are crushed under the fixed costs of compliance.

When the metric becomes the target, institutions optimize for the metric. In some cases, like the push to reduce hospital readmissions, that optimization has actually caused more patients to die.

The honest path to patient safety begins by admitting that medical care involves dangerous tradeoffs, not deterministic guarantees. Read the full essay in the reply below.

[Dr. J Bones @JBteamUSA]

@SalaryDr That seems high. But intriguing. What do you think orthopedic surgery rates average or potential is?

[Dr. J Bones @JBteamUSA]

@nickmmark You care that much about his physical?

[Heather Mac Donald @HMDatMI]

Parents of white male students are waking up to the fact that their children are the last to be chosen for medical school, law school, and other graduate programs.

MCAT scores that would be disqualifying for a white or Asian medical school applicant are close to an automatic admit if submitted by a black student.

Of course blacks should seek postgraduate training—but on the same basis as everyone else. It does them no favors to be catapulted into academic environments for which they are not prepared.

[Dr. J Bones @JBteamUSA]

@elyasandkhoy @CMichaelGibson PE is destroying young docs

[Dr. J Bones @JBteamUSA]

@JJjessup1 @selinaai_ Good questions

[Dr. J Bones @JBteamUSA]

@USA_Polling Yay Kamala!

[Dr. J Bones @JBteamUSA]

@RepJeffries Thanks Biden

[Dr. J Bones @JBteamUSA]

@Timcast lol cya later

[Dr. J Bones @JBteamUSA]

@RepJeffries @joncoopertweets Actual clown tho

[Dr. J Bones @JBteamUSA]

@realEstateTrent Valid

[Dr. J Bones @JBteamUSA]

@realEstateTrent @boondockmillion Nothing about ego. Not trying to sell. Just want a prepared serious discussion

[Dr. J Bones @JBteamUSA]

@realEstateTrent Would agree rent roll is important

[Dr. J Bones @JBteamUSA]

@realEstateTrent Screaming is not appropriate. But if you had interest that’s probally something that could have been found out prior to that call. Doesnt seem serious asking how big the building is.

[Dr. J Bones @JBteamUSA]

@boondockmillion @realEstateTrent I get those calls all the time on my multifamily properties. The first question is easily found online. Hard to take this buyer serious. They call asking the questions slow as they appear to be responding to an email in the background. Call prepared