Daniel McDevitt MD FACS FSVS

They say laughter is the best medicine. Surgery works pretty good, too.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@realdocspeaks @AmerMedicalAssn Private practice died on their watch.

They created the access problem.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@Bibimboppoo You need to pace yourself. You haven’t even made it to the wood chipper yet.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@OckhamsRazor4 I bet Peds produces the least revenue per sq ft or whatever the metric is.

C-suite bonuses happily unaffected.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@BKRBusinessMin We’ll get all the details when we see it posted on 2ndSwingGolf next month.

Just kidding!

Best wishes for a great round!

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

Everyone citing “evidence” is quoting mostly non-randomized studies where

1. Numbers are limited
2. Not all variables are controlled
3. Follow up is inconsistent, and often short
4. Subjects may be similar but not identical
5. Statistical associations are over-analyzed to identify differences that are not necessarily clinically relevant
6. Reproducibility is difficult to confirm and often not even attempted

Honest authors discuss limitations but the potential errors are often not given the credence they deserve.

We live in an imperfect world. It is extremely difficult to get truly exact measurements and outcomes.

Research is difficult. I have the utmost respect for those trying to answer questions. But there is no possibility we have “peaked” in our understanding of many issues.

There needs to be some grace.

Best available information is fine.

Hardening such data into algorithms begs the question of solidifying fluid situations into formulas that can become the enemy of critical thinking.

Defending actions that are not “mainstream” introduces a level of uncertainty when trying to address complex situations.

Just because payers want VBC or “episodes of care” to fit in neat little boxes is no reason to abandon individualized treatment.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@rginvalpo @dramerling @AmericanMD @GingerBreggin @AAPSonline @drsimonegold @DrSuneelDhand @KathMLee1 @DrSuzanneH7 Sadly true.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@DrAlexUrology @brian_blase You have to make a good faith effort to collect.

You don’t have to be successful collecting. But you must try. It is required.

Individual results vary.

[Society for Vascular Surgery @VascularSVS]

NFL quarterback Jalen Hurts’ blood clot diagnosis is spotlighting vascular health. SVS Vice President Dr. @ShutzeW told @EverydayHealth, “You can often feel the superficial clot in the vein under your fingers, like a really hard worm.” https://t.co/J5MJUKFAx7 #HighwaytoHealth

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@pgipe @CMSGov @RepGuthrie Not sure why you’re complaining.

We have the best government money can buy!

😆

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

I’ll say it again.

Imagine. 1 steak is worth 5 carrots because they are both in the grocery store.

That’s how the RBRVS system was conceived.

The idea that an office visit for asthma and a kidney transplant are mathematically related is completely nuts.

The Medicare payment system was designed to address a financial problem the government was having. It was not a treatise on fair market value.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@DrJMarine Milgram already did the study. There’s nothing new.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

A few things. It depended on the circumstances.

1. Write off small amounts. However, most payers require a good faith effort to collect. It’s in your contract. Just be mindful.

2. For high balances and recalcitrant patients, collections. We didn’t necessarily dismiss them because we’d just end up seeing them in the ER again anyway. Frustrating but watcha gonna do.

It’s a look and feel thing.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@ibrahimkalange_ When you say “good afternoon” in a smug tone to colleagues arriving at 7 am.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

This was another “it’s the best we can do right now” moment for our professional societies when the SGR was just about to blow up.

Always remember that everything wrong with healthcare financing today is the result of all the great ideas that the smartest people in the room came up with.

Yea. The same people with all the NEW great ideas.

Smack my head.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@crismyhrmd Truth

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@CyborgPeds I was on the fence, but I will definitely not be voting for him now.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@DutchRojas Astroturf.

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@noahkaufmanmd Congratulations! Best wishes for a wonderful future together!

[Daniel McDevitt MD FACS FSVS @dtmcdevitt]

@IM_Crit_ They want you to cool the patient. Because that's what the manual says and they are quizzing you on the manual they supplied.

The fact that physicians have to recertify in BLS and ACLS every TWO years is simply a business decision by the AHA.