Nathan K Itoga

tweeting to remember and improve

[Francis Deng, MD @francisdeng]

Med students may be interested to know that physician compensation varies by specialty, as does time worked per year (based on weeks time off a year and hours worked per week on).

[Nathan K Itoga @n_itoga]

I 💯 percent agree with this! There is minimal training for this. I was glad I went to a coding course in training. I am still learning… billing properly (matching icd to cpt, with appropriate modifiers) & resubmission for insurance payment denials sucks the soul out of me.

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

American doctors aren’t rewarded primarily for being good doctors. They’re rewarded for mastering the billing labyrinth. The physician who can recite NCCI edits, apply the right modifier, and know which codes are bundled (or can be unbundled) is the one who thrives.

[Ed Gaines @EdGainesIII]

1/ Additional evidence that the health plans’ #MedicareAdvantage plans are engaged in systemic denials, downcoding &/or prior authorization abuses that drive these hospitals out of network w/ MA. Contrast this to traditional Medicare where denials and prior authorization are a fraction of the MA plans—no wonder.

29 health systems dropping Medicare Advantage plans | 2025 https://t.co/BPsuTkj8n9 #

[Nathan K Itoga @n_itoga]

This is fascinating 🤨

[KFF @KFF]

Health care utilization in the U.S. — from doctor visits to surgeries — is generally lower than in other wealthy countries, but our analysis finds costs across both public and private insurance were consistently higher in the U.S.

See the details: https://t.co/o21uDbKCMp

[Nathan K Itoga @n_itoga]

@AlanLumsdenMD So many options - ecmo, tpa, ac, cdt all options. Can ask same questions for dvt. Come back to Hawaii vascular meeting in a couple years and can discuss more 🤙

[Nathan K Itoga @n_itoga]

@AlanLumsdenMD Need more info for your patient above - right heart strain (can’t see rv in the pre images) elevated biomarkers? The decision is complex and PERT team evaluable is invaluable.

[Nathan K Itoga @n_itoga]

@farkomd @EdjohnHarris @StanfordVasc @elgeorge_vascmd Dr EJ Harris - you da man! Happy retirement 🤙

[Nathan K Itoga @n_itoga]

Best comment of the night. Funding for venous care will now get increased funding by $1 billion bc Trump has venous insufficiency. -Dr Kistner

[Nathan K Itoga @n_itoga]

Hawaii Vascular 2025! Awesome meeting 🤙 At the beautiful Kahala hotel 🌈 @DukeVascular @UWVascsurg @usc_vascular

[Ed Gaines @EdGainesIII]

1/So in patient hospitals will receive a +2.4% in Medicare, SNFs +2.8%, respectively, & the entire list of other entities receiving a couple of positive points on their fee schedule in ‘26. Physicians continue to receive a -2.83% in ‘25 w/ larger potential cuts looming in ‘26.

The current situation is both untenable and unsustainable.

Don’t get mad—get busy with advocacy and let’s get Congress to pass HR 879, to reverse the current cut & add ~+2.0%. There are 155 bi partisan cosponsors in the House.

[Nathan K Itoga @n_itoga]

Took a class from him at Stanford. Brilliant. He took time to meet with the groups to answer meaningful research questions.
Give credit to him for standing up during the pandemic with his thoughtful and thorough analysis.
Tough job ahead - look forward to his leadership. 🤙

[NIH @NIH]

Congratulations to @DrJBhattacharya as he begins his tenure as the 18th NIH Director! A renowned doctor, researcher, & health economist, Dr. Bhattacharya held a tenured professorship at @StanfordMed. https://t.co/DIGJTlZuPi

[Nathan K Itoga @n_itoga]

I watched this twice - brilliant

[Saturday Night Live @nbcsnl]

Dave Chappelle's monologue!

[Neal Taparia @nealtaparia]

Your 40-hour workweek is a scam.

Microsoft Japan proved it:

Their 4-day work week SKY-ROCKETED productivity by 40%.

Here's the 100-year-old lie about work:

[Nathan K Itoga @n_itoga]

Excellent meeting @farkomd in person - just as entertaining and engaging as his Twitter posts. 🤙 see you again on the ⛳️

[Nathan K Itoga @n_itoga]

@farkomd I like your controversial posts but this one doesn’t have too many opinions. Tcar with schockwave - heard about it but haven’t done it - too expensive. See you in Hawaii next week

[Ed Gaines @EdGainesIII]

So per @RANDCorporation hospital in patient reimbursements were over 250% & out Pt over 280% versus Medicare in ‘22. Was there mention that the Medicare physician fee schedule is down over 60% since RBRVS in ‘92? Also, the previous posts here of the @FAIRHealth study showing a 14% reduction in network & ~10% drop in OON reimbursement in the past 4.5 yrs? Context matters!https://t.co/fR8GCrj60y

[Nathan K Itoga @n_itoga]

@farkomd @canuc_57 🤙 looking forward to meet when you make it out to Hawaii 🌊 🏄‍♂️

[Nathan K Itoga @n_itoga]

@canuc_57 @farkomd 🍿private practice vascular surgeon here - this is the stuff I randomly check on Twitter for. I don’t know both surgeons personally, but I learned that it’s ok to think differently and I appreciate both sides being passionate.🤙

[Adam Grant @AdamMGrant]

Novices seek praise. Recognizing strengths builds confidence to keep going.

Experts crave criticism. Seeing shortcomings reveals avenues to keep growing.

Preferring corrections to compliments is a sign of skill. The better you get, the more determined you become to get better.