etherMD

Anesthesiologist. Conservative. Evil prevails when good men do nothing. Make good choices. Cats are the best.

[etherMD @ether_md]

RT @JeromeAdamsMD: I hate to give airplay to misinformation, but the following post is still online - hasn’t been deleted - and it’s from t…

[Jerome Adams @JeromeAdamsMD]

Many of my Republican colleagues champion “merit” - meeting basic standards for a job.
The Surgeon General MUST be a member of the USPHS Commissioned Corps. To serve as a physician in the Corps, you MUST hold an active medical license.

I -and every prior SG- was held to that standard.

If the administration lowers (or creates a back door around) those standards, and the Senate confirms Casey Means (who has let her license go inactive and didn't complete residency), they undermine every argument they've made about merit, standards, and opposing “DEI” shortcuts. 🤷🏽‍♂️

[Handre @Handre]

LASIK eye surgery cost $2,200 per eye in 2000. Today it's around $1,000 per eye despite 24 years of inflation. Meanwhile, an MRI that cost $1,200 in 2000 now costs $3,000+. The difference? LASIK operates in a free market with no insurance interference and minimal regulation.

When patients pay directly, providers must compete on price and quality. LASIK clinics advertise prices, offer financing, and constantly improve technology to attract customers. Compare this to hospital procedures where prices are hidden, patients never see bills, and insurance companies negotiate opaque rates that somehow always increase faster than inflation.

Cosmetic surgery follows the same pattern. Breast augmentation, rhinoplasty, and other elective procedures have become more affordable and safer over decades. Surgeons invest in better techniques and equipment because they must satisfy paying customers, not insurance bureaucrats or hospital administrators focused on maximizing reimbursements.

The lesson is clear: remove third-party payment systems and excessive regulation, and you get Austrian economics in action. Prices fall, quality rises, and innovation accelerates. Healthcare costs aren't rising because of aging populations or new technology—they're rising because we've destroyed the price mechanism that makes markets work.

[Chamath Palihapitiya @chamath]

When idiots admit idiots…

- loss of credibility for the school in the eyes of employers and post grad institutions

- lack of career prospects and student debt that won’t be paid off by admitted students

At a minimum, we should all agree that student loans should not be federal guaranteed if the students receiving them can’t do basic math.

[John Asghar @JahangirAsgha10]

As an independent practitioner, I get no tax breaks. If a patient or insurer doesn’t pay their bill, even when the claim was pre-approved and the care already provided, we have almost no recourse. There’s no legal department, no institutional protection, and no write-off cushion. That’s just income I never receive for work performed.

I can’t claim those losses the way large hospital systems or “non-profits” do. Non-profit hospitals collect billions in tax exemptions under the banner of “community benefit,” while still suing patients for unpaid bills. For-profit systems write off bad debt as an operating expense, backed by legal and billing departments that exist solely to enforce collection. Both are protected and subsidized by policy.

Independent physicians absorb those losses personally. We provide the care, pay our staff, rent, malpractice, equipment, and taxes — all out of the same margin. There’s no safety net, no tax shield, and no regulatory protection when patients can’t or don’t pay — or when insurers simply delay, deny, or underpay.

That’s the irony of American healthcare finance. Hospitals collect billions in tax breaks for “serving the community.” Private physicians are the community — and we’re the ones left holding the bill.

[etherMD @ether_md]

@BKRBusinessMin You can’t have more doctors without increasing residency spots. That is the bottleneck.

[Jake Scott, MD @jakescottMD]

RFK Jr. is misrepresenting a landmark Danish study that followed 1.2 million children over 24 years. The study found no link between aluminum in vaccines and autism or neurodevelopmental harm. Let’s fact-check his claims - using actual data. 🧵

[Astronomer @astronomerio]

Thank you for your interest in Astronomer.

[Nisha Patel, MD MS, Dipl of ABOM, CCMS @DrPlantel]

The worst kind of doctor? The one who thinks they’re better than everyone else because they “treat the root cause,” claim to have “seen the light,” and now preach that modern medicine is toxic. Also they don’t take insurance and charge $1,200 to tell you to cut out gluten and that you have “adrenal fatigue”.

[etherMD @ether_md]

@BKRBusinessMin The problem is not graduating doctors it’s the number of funded residency slots. That is what needs to be expanded first.

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

I love when smug healthcare policy wonks throw out that old “Medicare and Medicaid only have 2–5% administrative costs” line, as if it’s gospel truth and not a completely misleading stat from a 2011 Health Affairs article.

Let’s unpack this nonsense because it violates basic economic logic.

In what world does a centrally planned, government-run bureaucracy more efficient than a private competitive market? True efficiency requires price signals, profit/loss, and competition. This is econ 101. Medicare/Medicaid lack all of these things.

So lets think more about that 2-5% figure that keeps getting thrown about. You know what it's based on?

CMS's administrative budget.

That's it.

It leaves out the following:
- Physician time on documentation for CPT compliance, ICD coding, and submitting claims.
-Physician compliance with MIPS quality metrics
-Hospital staff requirements for submitting claims, auditing charts for maximum DRG capture, coding queries, quality metrics, star ratings, bundled payment compliance, readmission tracking, etc
- The entire RUC/CPT process which involves four annual meetings a year with hundreds of doctors.
- Licensing fees for CPT
- EMR and meaningful use mandates
- CMMI demo projects

And, last, but most importantly, most of Medicare and Medicaid are now administered by private insurance.

So to claim that Medicare/Medicaid has lower administrative cost than private insurance assumes that these private insurers somehow operate MORE efficiently when taking capitated payments from the government. Not only is this a ridiculous notion, the insurance companies also need to comply with the various regulations, such as quality metric reporting, star-ratings, MLR reporting and the hundreds of other compliance regulations needed to get capitated government payments.

So when people keep saying popping up and saying "well AKSHUALLY it's way more efficient to just have the government run the program."

Remind them it only appears efficient because CMS makes everyone else do the work.

[Garry Kasparov @Kasparov63]

Socialism is like polio, it comes back when people forget about the horrible damage it did last time.

[Dutch Rojas @DutchRojas]

It is one thing to express moral concern.

It is another to understand the implications of what we demand in the name of morality.

Many claim that healthcare is a “human right.”

Yet rights, properly understood, do not require the labor of another person.

You have a right to free speech, not to a printing press or a microphone.

You have a right to worship, not to a church building funded by others.

Healthcare, by contrast, is not an abstraction.

It requires skilled labor, costly equipment, and time, often years of training and millions in investment.

To say that someone has a right to it is to say that someone else has an obligation to provide it, regardless of cost or consent.

The physician in question is free to offer his services at no charge to anyone he pleases. But he does not. And that fact is more revealing than any tweet.

It is not selfishness that leads people to reject the idea of healthcare as a right, it is the recognition that good intentions, untethered from economic reality, have repeatedly produced bureaucracies that ration care, stifle innovation, and punish excellence.

In a wealthy society, we can and must find ways to care for the vulnerable. But let us do so with clarity, not slogans.

The first lesson of economics is scarcity. The first lesson of politics is to ignore the first lesson of economics.

I first wrote this reply in April of 2012.
It seems we have not learned…

[David Frum @davidfrum]

An Iranian missile struck the largest hospital in southern Israel. Unlike in Gaza, there was no military bunker buried below. Still, you know the rules:

Done by Israel, no matter how justified: war crime.

Done to Israel, no matter how atrocious: not a war crime.

[Dutch Rojas @DutchRojas]

Property Tax Exemptions?

Because health systems classified as 501(c)(3) nonprofits, they are exempt from local property taxes, even on massive campuses in prime real estate zones.

While independent practices pay property taxes like any small business, nonprofits can hold vast, tax-free real estate portfolios.

This erodes municipal revenue, shifting the burden to residents and other local businesses.

This allows the health systems to gain real estate leverage with no recurring public cost, allowing land banking and development at scale, while small practices pay into the public pot.

It’s time to end these exemptions…

[Dutch Rojas @DutchRojas]

Your healthcare costs are subsidized twice, and you're being ripped off both times.

While Americans debate healthcare policy, a $1+ trillion wealth transfer is happening right under our noses.

“Nonprofit" health systems use taxpayer subsidies to eliminate competition and inflate the costs those subsidies were meant to reduce.

The math is simple:
- You pay taxes to subsidize hospitals (thinking it will make healthcare cheaper)

- Those same health systems use your subsidies to crush and buy out the competition

- With no competition, they charge you more for worse service.

- You pay twice, get less

And the hits just keep on coming.

[AG @AGHamilton29]

Personal post:

I don’t think people outside the Jewish community understand the extent to which open Jew-hatred has been normalized and encouraged right now.

I can’t share details for security reasons but a woman (white/young) came into a Jewish organization’s building in the Midwest today (where they were holding job interviews) and specifically told a friend of mine that she really just came to let them know she would never work with “Jews” because “you are committing genocide” and that “she does not value Jewish lives”.

The security suspects that she was casing the building for some future action (she took pictures as she left), which obviously has scared the people who work there.

The organization and the building have little to do with Israel. This same building was vandalized last year with “Free Palestine” graffiti.

It’s going to keep getting worse if people don’t speak up.

[etherMD @ether_md]

https://t.co/B6LdVs7a7Q

[etherMD @ether_md]

@AshleyGWinter I wouldn’t call a repeat c-section purely elective. There are inherent risks in a tolac and I don’t think it’s a fair comparison to an elective primary section whatever ones thoughts are on those.

[John Asghar @JahangirAsgha10]

Let’s take a second to understand the scale of the bureaucratic costs of US health care…

If we gave every physician a 10 % raise but cut admin costs by 10%, we would save 100+billion annually

If we gave every physician and nurse a 10% raise and cut the admin costs by 10%, we would still save 60-70 billion annually

Our admin costs(per capita) is 2-3 times any other country