Nadim

@VCUHealth Orthopaedic Surgery Res'30 || @MedicineUVA'25 || @UVA’20 || KFHS'17

[Arthroplasty Today @ArthroToday]

🚨 YOU’VE BEEN CITED. 🚨

What makes an arthroplasty RCT rack up citations?

This study investigated 566 hip and knee arthroplasty RCTs published from 2014–2023 to find out. 👮‍♂️📄

https://t.co/U6lKQutP0Y

[The Journal of Arthroplasty @JArthroplasty]

Have we been lied to? This study would suggest it.

Until there is stronger evidence to establish a causal link between cement use and BCIS, avoidance of BCIS does not appear to be a strong argument against cementation.

https://t.co/sMJEaY2m0o

[Nadim @nbarakat98]

Somebody called me Dr Barakat today, and I had to tell them to calm down

[John Asghar @JahangirAsgha10]

Everyone talks about physician compensation.
Almost no one talks about overhead.

We debate how much CMS pays.
Why procedural specialties are paid more.
How physicians are reimbursed.

But that misses the real driver of dysfunction:
The single most expensive, least addressed force in U.S. healthcare is overhead.

Since 2000, the cost to run a medical practice has exploded—not because of waste, but because of structural demands:
•Labor inflation: Support staff wages up 20–30%
•IT requirements: EHR systems cost $100K+ to implement, plus ongoing fees
•Administrative burden: Prior auths, audits, quality metrics, and regulatory reporting—all requiring more staff and more unpaid physician hours

Today, 60–70% of practice revenue goes to overhead.
And that’s just at the practice level.

At the national level?
Administrative costs now exceed $1.4 trillion—about 25% of all U.S. healthcare spending.

Let that sink in.

Compare that to peer nations:
•Germany: 5%
•France: 6.5%
•Switzerland: 6.2%
•Canada: 3.8%
•U.K.: 3.5%

When we spend 3-5x more on bureaucracy than comparable countries, it’s no wonder we’re struggling.

And yet, the federal government continues to pour tax dollars and subsidies into hospital systems—without addressing the underlying cost drivers.

Now combine that with revenue trends:
•Medical Economic Index (MEI): +76%
•General Inflation (CPI): +70%
•Practice Overhead: +100% or more
•Medicare Conversion Factor: –5.5% (nominal)
•Inflation-adjusted CMS payments: ~26% decline

Rising costs. Flat and falling revenue.

This is the math problem that’s breaking medicine:
•Independent practices are disappearing
•Physician burnout is soaring
•Access in underserved communities is collapsing

This is what I mean when I say Medicare, Medicaid and healthcare need structural reform.

[Melina Kibbe @kibbemr]

Yesterday was an exciting day for the UVA School of Medicine graduates! I am so proud of our students and the faculty and staff who supported them through their journeys.

[Nadim @nbarakat98]

So weird to think of myself as no longer being a medical student

[UVA School of Medicine @MedicineUVA]

They did it! MD graduates officially hooded and celebrated at the historic @cvilleparamount #UVA2025

[UVA @UVA]

Status update: #UVAAlumni 🎓

[UVA School of Medicine @MedicineUVA]

Congratulations to the Class of 2025!

Watch live as we honor our newest Doctors of Medicine: https://t.co/Tyt9qX0eKv

#UVAMed2025

[UVA School of Medicine @MedicineUVA]

This morning, before the official ceremonies began, we gathered in front of the historic Old Medical School to honor the next generation of physicians and scientists. Here’s to the class of #UVA2025 and the bright future ahead of them🥂

[UVA School of Medicine @MedicineUVA]

The Virginia Journal of Medicine is back with a new vision that reaches beyond UVA! Led by Aaron D. Smith and Catherine Lyons, submissions are now open to medical students nationwide.

📗 Read the Spring 2025 issue: https://t.co/YiBvbqX5sd

[Nadim @nbarakat98]

@SalaryDr Is the year with respect to application or matriculation?

[John Coogan @johncoogan]

Tariffs up 50%. Stocks down 5%.

You know what hasn’t changed?

What benching 225 for reps feels like.

Time to visit the church of iron boys.

[VCU Health @VCUHealth]

👏🎉💛

[UVA @UVA]

Graduating @uvamedicine student Krystyna Cios Phillips celebrates with her fiancé after learning she’ll do her residency in neurology at the @MayoClinic. “I’m feeling so much joy, love and appreciation. My time here was phenomenal. This community is phenomenal. Just great friends, great people and I’ve learned so much.” https://t.co/jm2Fy9t16A
#MatchDay #UVA25

[UVA @UVA]

Congratulations to @uvamedicine Class of 2025 on your #MatchDay yesterday!

#UVA25 matched into 21 different specialties across 34 different states. 19 matched here at UVA Health. We are so proud of this incredible group. Their journeys as doctors begin now, and we can’t wait to see the impact they’ll make. 💙🧡

[Nadim @nbarakat98]

@sofihida @HSpecialSurgery Congrats Sofia !

[Nadim @nbarakat98]

Super excited to have matched into Orthopaedic Surgery @VCUHealth, the next five years are going to be crazy!
757 -> Cville -> RVA; A VA boy through and through
@iss96 @jbrettgoodloe @MedicineUVA @VCUHealth
#Match2025 #orthotwitter #orthomatch

[J. Brett Goodloe @jbrettgoodloe]

The future is bright @VCUHealth

[UVA Urology @uvaurology]

Spreading the #MATCH2025 love through one more day... we are so proud of our @MedicineUVA students and our Bill Steers Research Fellow, all of whom matched yesterday! @OHSUurology, @UPMCUrology, @brady_urology, @VCUUrology - you are welcoming amazing doctors into your programs!