Daniel

[Daniel @dardeljan]

Friday was my last internal medicine clinic day, culminating 10 years at @HopkinsMedicine @HopkinsMDPhD @OslerResidency. From training as a bench scientist and now a bedside clinician, I can’t believe how much I’ve grown here. Excited for the next phase! @DanaFarber @harvardmed

[Thomas Massie @RepThomasMassie]

@WhiteHouse Can you arrest Epstein’s co-conspirators instead of riffing on a porn site ?

[DataRepublican (small r) @DataRepublican]

🧵 THREAD: Democrats TEACH voter identification and election integrity ... just not in America

The Democratic Party has an international arm called the National Democratic Institute (NDI). It's funded by $181M/year in US tax dollars. Its board includes Stacey Abrams, Donna Brazile, and Tom Daschle.

But in regards to today's SAVE America Act debate... did you know that the NDI has taught and supervised election processes all over the world?

For 40 years, NDI has told every developing country on earth that voter ID is essential for election integrity. They've recommended biometric systems... yes, that's right, NDI recommended biometric systems, which goes way beyond SAVE America Act! They praised fingerprint verification. Tracked ID card issuance rates.

Meanwhile, Democrats call the SAVE Act "Jim Crow 2.0."

Same party. Same people. Opposite positions.

As always, patience as I pull together the thread 👇

[Bloomberg @business]

Residents exiting Massachusetts took a net of $4.2 billion in adjusted gross income with them in 2023, one of the largest totals in the country, after a tax on millionaires took effect https://t.co/6qiRJ02yBh

[Former Congresswoman Marjorie Taylor Greene🇺🇸 @FmrRepMTG]

Dear World,

Americans overwhelmingly do not support going to war. In 2024, we voted to end foreign wars and regime change.

Americans want affordable health, home, and auto insurance and good healthcare.

Americans want rich powerful pedos and rapists strung up on gallows, even if it collapses our own government. They’ve also said wood chippers. (Literally quoting them)

Americans want a good paying job and to be able to buy a nice home.

Americans just want good trade deals and world peace, and we love to travel to many of your lovely countries.

I just thought someone should tell you outside of our ruling class.

[Daniel @dardeljan]

@dgermain21 the obligation is to get everyone in before 3
if the effect size is real. would you tolerate less for your family member?

[Tom Shattuck @tomshattuck]

I cannot stress how big this is but the world is finding out. 18 killed in a mass shooting in Maine. The public raises millions for them and the steering committee steers millions to themselves https://t.co/Rlzn0R0cLJ

[Daily Mail @DailyMail]

The great Polish exodus: The arrival of 100,000s of Poles changed the face of Britain, but now they're returning home in droves for a better life in their low-tax, booming homeland. Could there be a more damning indictment of our decline? https://t.co/Y3PQPV3Ljg

[MAZE @mazemoore]

Incredible clip from 1996. Nancy Pelosi on tariffs and the trade deficit with China.

"On this day, your member of Congress could have drawn the line to say to the President of the United States, do something about this US-China trade relationship that is a job loser for the United States."

Thirty years later and our annual trade deficit is now approximately $300 billion annually with China. Our politicians did nothing to stop this. They sold out America.

Now politicians, including Pelosi, are saying that not only China, but all countries should be able to tariff us and we shouldn't respond in kind.

[Daniel @dardeljan]

@reverendofdoubt probably the ideal is that a hospital has an oncologist available to eyeball a chart and confirm that outpatient workup is ok via such a clinic vs admit to medicine for expedited eval. it's tough at academic centers cuz everyone wants a tissue dx since we're all sub-specialized

[Daniel @dardeljan]

@reverendofdoubt almost none. many systems are starting up cancer diagnostic clinics that a patient can be sent to to get all the scans, biopsies ordered, etc. the question is always whether the patient is actively in distress or there's threat of organ damage

[Daniel @dardeljan]

@SalaryDr 200k actually

[Elon Musk @elonmusk]

Make Europe Great Again!

MEGA, MEGA, MEGA

[Dutch Rojas @DutchRojas]

Healthcare isn’t expensive.
Bureaucracy is.

Physicians, nurses, and clinical staff are underpaid relative to the value they deliver.

The real cost drivers?

Health system monopolies,
bloated administrative salaries,
and vertical consolidation that forces employers and patients into higher premiums and worse care.

Break the monopoly.
Restore competition.
Bring back physician autonomy.

#healthcare

[Daniel @dardeljan]

@EPotterMD the fact that there are distinctions between inpatient admission and observation IS the problem!! the medical fact of needing to keep the pt in the hospital for post op care is all the physician needs to decide. the rest is semantics and bureaucratic nonsense

[Andrea C. Love, PhD @dr_andrealove]

The NIH 15% cap on indirect costs will kneecap biomedical research in the US.

Without essential infrastructure, there will be:

Staff cuts
Lab closures
Fewer research projects
Less scientific progress
Loss of talent

The US will no longer lead scientific & medical innovation.

[Nicholas Fabiano, MD @NTFabiano]

Academics are paid nothing for peer review.

Yet journals made a total of over $8.3 billion on article processing charges alone between 2019-2023.

Make it make sense.

[Nick Sortor @nicksortor]

🚨 #BREAKING: President Trump has just signed an executive order designating drug cartels as foreign terrorist organizations

They can now be targeted with LETHAL FORCE by the U.S. military.

This is HUGE.

[Niels Hoven 🐮 @NielsHoven]

They also noticed that kids in honors classes did better in life, but in this case the response was to get rid of honors classes in order to reduce inequality

[Rich @rich_rdctd]

Why is 1971 such an inflection point in so many data sets?

[Third_Eye_Prophet @Third_i_Prophet]

A media blitz has been going on to demonize Doctor salaries. It's obviously funded by the Healthcare-Pharma Complex, to deflect blame onto Doctors for high Healthcare costs.

It is the worst kind of gaslighting against doctors, because the exact opposite situation is true.

First, doctor pay is 6-9% of all Healthcare costs, so even if they worked for free, it would hardly put a dent in Healthcare spending.

Second, many young doctors may not realize this, but Congress froze Medicare payments to doctors in 1997, and real salary adjusted for inflation decreased 80% since then!

Medicare work-RVU payment-
2000: $36.69
2024: $33.29
Inflation since 2000: 70%

Meanwhile, hospital payments and insurance premiums have OUTPACED INFLATION since 2000. That is where the problem lies.

People will argue that doctors are paid more in the US, but so is every other profession- law, finance, tech, nursing, etc.

Average nurse salary-
USA: $82,750
Germany: $33,000

Also, the US has fewer doctors per capita than Europe, resulting in more office visits and procedures per doctor.

And US doctors have on average $227,000 in debt compared to none in Europe. If you just invested that money in the S&P at it's historical return of 10.26% for 45 years, adjusting for inflation, you get $22.97 Million. That is the opportunity cost of becoming a doctor in America.

Anyone blaming doctor pay, which is down 80% the past 25 years, for our high healthcare costs, needs to read this thread and face the facts.