@JermaineCurtis Depends on who else I have on my team. Former of I have power bats elsewhere in the lineup. We're too TTO these days and forget it's 9 in the lineup and options on the bench.
Highly recommend watching this at 2-3x speed. A little because it's long, but a lot because it's modern Abbott and Costello in high def and had me laugh crying.
Evergreen reminder that it doesn't matter where you live. It's what you build, and who builds it with you. Ignore the babbling brooks of insecurity telling you otherwise.
"Living in Dallas is the worst." I moved my business here 12 years ago:
My kids are in a 10/10 school district.
I live on 3 acres with no HOA and I'm only 30 mins from downtown Dallas and 35 mins from DFW airport.
I'm within 45 minutes of a 6 different pro sports teams.
Every band and touring musical travels here.
Countless amazing restaurants.
My property has appreciated by over $1m in a decade
I'm buying more land 30 mins away in the path of growth for only $12k/acre
I can fly direct to Dubai, Bozeman, basically anywhere.
No state income taxes. The more you make, the more you save.
Strong Christian/LDS family values.
Tons of Indians (awesome people BTW).
Cheap contractors.
VERY pro business.
Pretty freaking hot weather but ice cold A/C. :)
Youth sports culture is kinda out of control.
Property taxes will murder you NGL.
Don't like it? Don't move here. I've lived in Houston, too and boy let me tell you...We've got it good here.
@mcuban Also in prior ventures it is impossible to entice docs to adopt new tech with any under table dealings. The hospitals have VAC committees and they hold the power for all new product adoption. One admin said "don't care if this helps patients, incr budget decr my bonus"
@mcuban Built and sold a company with a surgeon a few years ago. Sunshine Act means whether a free pen or an M&A, it's all reported and there are no free vacas. Surgeon was angry I'm not "reported," but I don't have an NPI #. Other than that point, ๐ฏ agree.
The greatest problem in healthcare ? Hospitals, even market dominant hospitals, wonโt walk away from the big ins companies that underpay, late pay, clawback, deny claims, waste their time in denial appeals, and require them to pay up to 8 pct of revenue to RCM consultants so they think they are getting what they are owed.
Here is the crazy part. The ins companies ARE NOT THE ONES ACTUALLY PAYING THEM on commercial plans. Employers are.
60 pct of employees get their insurance from their self insured employers. The ins carrier is just a middleman that pretends to add value.
All the clinical โvalueโ they add, the hospital could do better, for both medical and pharmacy.
Most hospitals have no idea whether they make or lose money with their big ins contracts. They are just afraid to lose patient flow.
But. They actually know which companies their patients are coming from. They actually know or can find out, how much more the employers are paying the ins company, than what the ins company pays them (the spread, just like in pharmacy )
And to make it worse, those ins companies negotiate their rates as a discount from the โcharge master โ, which is like WAC in pharmacy. Just a made up list price.
Because the hospitals are afraid or too uninformed to walk away from these deals, the hospitals use the inflated charge master prices as the basis to charge uninsured , or out of network , or insured but not covered for their care, at charge master rates. Which of course the patients canโt afford. And it crushes their finances or they go without care
Iโll summarize. Employers , and their members , are paying far more than they should to companies they donโt like working with , that effectively rip off both the employer and hospital , and they could eliminate the middlemen if they went directly to to the employer.
Itโs so simple. Sell your services to the employers that use your services at a price that is less than what nine companies charge for your services and you will make MORE money and employers will save a ton
And if they did this, they could dump the chargemaster and reduce the price they bill patients when they are at their most vulnerable
But they donโt want to change. And donโt get me started on how much hospitals over pay for drugs and devices because of the GPO deals they do. Itโs just stupid.
Which in turn leads to the hospital being a bad actor with 340b , facilities fees and afraid of their doctors who demand they pay more for things like glue and implants so they can get vacations.
If you are a politician and reading this. Now you know why this is so fucked up and itโs not about capping rates. The insurance companies are smarter than you. They will just move the money to other places. Itโs not about giving money to patients. You canโt shop for care from hospitals that are too gutless to walk away from the ins companies that distort all of healthcare economics
Go to your local hospitals , particularly those at risk of closing and ask for their profitability by carrier. Fully burdened. Ask how much they spend on RCM and consultants. In many cases they could survive if they ran like a real business and hired execs that could do the work rather than just manage consultants. They could work out contracts in their communities rather than with ins companies and benefit everyone.
The middlemen are not needed. Get rid of them
Watched the transition from lap โก๏ธ robot in real time over 20 years. It's ergo (no scrub, sitting), visualization, and wristed instruments for tight spaces IMHO. Evidence shows = lap so ain't that, but worthy endeavor leveling skill sets and extending surgeon careers.
We need to pause and recognize the amazing adoption on robotic assisted surgery in the USA ๐บ๐ธ
Is it evidence based?
Ergonomics?
Improved skills instrumentation?
Better visualization?
Cool technology?
Preparedness for AI and automation?
Regardless, the future with this technology is unknown and unlimited @IntuitiveSurg
@CoffeeBlackMD This is how I feel about (me and esp my kids) standing on any edge with a sheer drop >= 30 feet. Grand Canyon wasn't my favorite Spring Break trip obviously. Yet I have no problem ski 45ยฐ couloirs ๐คทโโ๏ธ we all bad risk purveyors ๐
@brittanybussemd@CoffeeBlackMD@DutchRojas Great analogy--COGS in the machine, no agency, and importantly, no breathing room or incentive to innovate. The trend to self-pay will continue, fighting that perception myself rn in current role
@Ben13Porter ABS discourse is just the latest episode of people discovering latent expertise they discovered without experience. Good attention for baseball while it lasts the next week or 2 ๐คทโโ๏ธ
@rationalyankee@JM46684231 They are going to have to write an entire GD&T handbook for the strike zone now, are they? If you don't know what I mean, look it up and you'll come back here to tell me dang, you're right!
I hired a local pro to handle the mounting. He quoted $250, I gave him $300. He showed up fast, brought a second guy, and did a flawless job.
A lot of people in the replies completely missed the point. This was never about the physical act of hanging a TV on a wall.
It was about paying for a service that a massive retailer simply refused to fulfill.
@BestBuy took the money and walked away from the job. They will never see another dime from me.