Stephen Sauer

[Noah Kaufman, MD @noahkaufmanmd]

Houston, we have a problem…

[Stephen Sauer @StephenSauer18]

@elonmusk The word asylum means a place of refuge and or to protect.

[Rand Paul @RandPaul]

If you ran Washington like a business and had to cut 6% to stay afloat, you'd start with the fraud and duplication, then make even, across-the-board cuts. That’s not radical. That’s how every business survives.

[Rand Paul @RandPaul]

Inflation is not some abstract number. It is why your paycheck buys about 25% less than it did 5 years ago.

The national debt drives inflation. Piling on more debt for a one-time $5,000 check does not fix the affordability crisis. It makes it worse.

[PHA @physicianhosp]

Disruption no longer unfolds over years. It happens in months and even weeks.

These five physician-led healthcare leaders are at the front of all of it.

Grateful to have them with us at PHA's 2026 Leadership Summit these next few days to explore where healthcare is headed.

[Nick shirley @nickshirleyy]

I hate that I have to do this, it’s my least favorite part about my life. I knew my life would get even more dangerous when I announced I am suing California and began accepting invitations to speak on college campuses this semester.

I need to raise money again for security. Doing the right thing and exposing evil now puts your life in danger in today’s society. For example, a UC Irvine “lecturer” (teacher) is insinuating it would be funny to assassinate me and leftist are threatening to kill me constantly.

I will not cower to the radicals or the far left who threaten and plot to kill and destroy our country, yet the $30k–$50k a month it costs me just to stay safe doing my job is unsustainable. I make enough for my needs and my employees, but this added expense produces no return and is unsustainable on my own.

If you can donate, please donate here: https://t.co/t17KpayiXW Donations are tax-deductible and go strictly toward security/operations, anything helps 🙏🏼 If you cannot donate no worries please like and share this so more may see it!

God bless,
Nick

[Wall Street Apes @WallStreetApes]

WOW 🚨 The nonprofit who owns the billing codes used by our medical system and gets paid $300 million per year in royalties ALSO SETS THE PRICE OF MEDICAL SERVICES for those codes

American surgeon “It feels ridiculous because we as healthcare providers have to use those codes according to state and federal government, and the AMA created them, copyrighted them, and charges us, the people that they're representing, to use them.

So let's go one step further.

The CPT code system is meant to be this five-digit code that is a universal language for documenting and reporting for all the things that we do in healthcare back to insurance companies, right and ultimately, that affects reimbursement.

But here's a wrinkle that you might not have known.

The AMA also actually makes a recommendation to the government about a value that's assigned to the CPT codes that they own. That's right. They own the system. They're making money off of that, and then they're also recommending back to CMS and ultimately to insurance companies how much doctors and providers are paid for those codes.

That is quite a lot of power for one organization to hold over the money that's exchanged in this healthcare system.

So they're making that three hundred million dollars a year licensing it, but then they're also influencing what I get paid for everything that I do. Interesting…..”

- US government made using these codes mandatory
- A nonprofit who donates millions to politicians on both sides was able to keep the copyright
- That group collects hundreds of millions a year from the people required to use it
- The same group runs the committee that recommends the dollar values attached to those codes

The people who could change this, our politicians, are being paid off not to change it

This is a racket

[Tim Burchett @timburchett]

Crippling debt.

[Cliff @Cliff_Spectre]

@RepJasonSmith If they US Govt. spends more than it takes in, that puts more money in circulation, making the dollar worth less. The US Govt is the primary driver of inflation. Make a budget, cut spending to balance it, and reduce the debt. Then the cost of living won't be going up so much.

[Matt Van Swol @mattvanswol]

In 1988 Dolly Parton pulled every 7th and 8th grader in Sevier County into a room and told them to pick a buddy.

She made them sign a contract.. if BOTH graduate, she hands you both $500. One fails, nobody gets paid.

The county dropout rate went from 35% to 6%.

She handed out the checks herself.

In 1989 she offered $500 to every kid in the county who wanted to go to the local college.

When Gatlinburg burned in 2016, she sent 900 families $1,000 a month for six months.

You've probably heard that part.

Here's the part you haven't:

The fund raised more than expected, so she showed up in May and handed every one of those families another $5,000 on top.

Then she quietly put $3 million into the recovery group that handles the years after the news trucks leave.

She built her county an entire hospital.

She played a benefit concert in 2007, Dollywood and the Stampede matched it, and LeConte Medical Center opened in 2010 with a birthing unit and a women's center in it.

In 2022 she started covering 100% of tuition, books, and fees for Dollywood employees.

Full-time, part-time, AND seasonal.

In 1991 she paid for a bald eagle sanctuary because the birds couldn't be released back into the wild, no press release.

And when Hurricane Helene came through here in Western North Carolina, she wrote a personal check for $1 million and her companies matched it.

She didn't owe North Carolina anything, but she helped us anyway.

She started the Imagination Library because her daddy couldn't read or write. Before he passed, he told her it was the most important thing she ever did.

Rest in Peace, Dolly 🇺🇸

[Stephen Sauer @StephenSauer18]

@jasonryanmd Thank you for saying that. Med students should only be allowed to select one publication for their application. Quality over quantity.

[Stephen Sauer @StephenSauer18]

@DutchRojas Single payer would work if the patient was defined as the payer.

[Noah Kaufman, MD @noahkaufmanmd]

Looking at our 68 five star reviews after 3.5 months, I honestly feel all the reward I need. The next step will be scaling this nationally and actually making an impact on the American healthcare system. Really appreciate the support everyone and if you love what we’re doing, tell the world! https://t.co/GfaylOTc5r

[Stephen Sauer @StephenSauer18]

@timburchett Disgusting

[James O'Keefe @JamesOKeefeIII]

“Nothing ever happens to these people.”

Something is going to happen. We’re going to make it happen by applying so much force through sunlight that it will be impossible for nothing to happen.

Don’t believe it? Watch…

[Noah Kaufman, MD @noahkaufmanmd]

GOOD NEWS.

@KaufCare has currently saved patients over $240,000 in emergency room costs and over 450 hours waiting in the ER waiting room.

We have a running calculation on our website and we spent a lot of time putting these metrics together against real data.

Oh yeah and we are over fifty heartfelt 5⭐️ reviews. 🤝

LFG!

[Adam Bruggeman, MD @DrBruggeman]

The AMA is in the crosshairs on Capitol Hill this week, and the target is a payment system most of the country has never heard of. Senator Bill Cassidy's HELP Committee is demanding data on CPT licensing fees. CMS's proposed rule for 2027 is openly asking whether Medicare should walk away from CPT and the RUC altogether, and the agency has gone as far as suggesting that reliance on this process helped build a "sick care" system that undervalues prevention. Republican members of Congress are calling it a government backed monopoly.

Independent physicians should care about this fight regardless of where they land on it, because CPT and the RUC are the plumbing behind every claim we submit. Before Congress or CMS moves to blow up a 35 year old system, the history and the facts deserve a real look.

This week I am walking through how the RUC was actually formed and why, how the AMA came to hold the CPT code set, how the committee that values physician work is structured and separated from the committee that writes the codes, and whether the record supports the claim that this system was built to enrich surgeons and proceduralists at the expense of primary care. Tuesday through Thursday are the deep dive. Friday is the fix.

The real driver of the primary care versus specialist tension in Medicare payment is budget neutrality, not who sits in the room of the RUC committee. That point is critical for figuring out solutions.

[Adam Bruggeman, MD @DrBruggeman]

Let’s talk about physician payment for a minute and why that AMA graph just doesn’t feel like it tells the whole story. Here’s why…

Let’s start with how the AMA calculates its graphic. They work on the specified update, which is what Congress set out to do that year… but that’s only half the story

Each year, the conversion factor (CF) is recalculated by multiplying the prior year CF by the statutory update by the budget-neutrality adjustment. When you only go on the statutory update, you miss a big potential gain or loss due to budget neutrality.

@anish_koka has explained why budget neutrality has doomed the physician fee schedule permanently. The AMA has provided Congress with years of bad data that ignores the massive financial trouble that budget neutrality has caused and created a far rosier picture.

When you look at the AMA graph, it appears doctors have seen a 10% increase since 2000. The 2000 CF was $36.6137. The 2027 proposed CF is $32.84. That’s over 10% in the negative direction.

We need truth in advertising. I begged the specialty societies and the AMA to fix their graphs. I spent 3 years asking for it. No one listened.

So, I did what I had to do and I pulled the data together. Below is the work product of that venture and a graph that I think (visually) shows the much more striking reason why doctors are leaving medicine or selling their practices.

The first graph looks at things from the perspective of the 2000 CF. If we just compare how much doctors and hospitals are paid, we see that physician pay via CF has declined 10.3% while hospital pay has increased 97% and inflation (MEI) has increased 71%. That seems pretty stark but I think the second graph uses the same numbers but in a more effective way.

The second graph assumes that MEI is the baseline. In other words, what if doctors just got what they were paid in 2000, updated for the cost of inflation. Now we see what really has happened. Doctors are 81.3% behind inflation while hospitals are 26.8% above inflation. No wonder hospitals are buyers and doctors are sellers in this market.

It’s time for truth in advertising. It’s time Congress and CMS heard the real numbers. 81% behind inflation over 25 years and even worse when compared to HOPDs. Our government created this crisis and they will need to understand the issues they created to get us out. Follow us at @IndeMedAction as we shine the light on issues critical to independent physicians.

[Stephen Sauer @StephenSauer18]

@DrDiGiorgio You’re underselling yourself. Your only thinking of the time it takes to do your day to day tasks. If you looked at your decision making and technical skills then I would say they could do 5% of your job.

[Stephen Sauer @StephenSauer18]

@txsportsdoc Open insurance markets across all states