Rob Gray🧢

✋ & Microsurgeon. Mayo Clinic, Rush & Brown. “I treat it like it’s my own hand” Opinions my own & this isn’t medical advice

[Rob Gray🧢 @robgraymd]

@gothburz This is the best one in a while. Paging @ramit

[Rob Gray🧢 @robgraymd]

But the problem is the brakes have to come from somewhere. They're definitely not coming from the schools, and the students that you speak of are particularly susceptible to predatory loans, so they are not putting the brakes on. Someone has to protect these people from themselves.

[Rob Gray🧢 @robgraymd]

@MichaelGalvezMD @drharrislakers Allowing disadvantaged students to go $500k into debt isn’t helping them. It traps them. They must either go into super lucrative fields or seek employment that offers loan forgiveness. There is no other way.

[Rob Gray🧢 @robgraymd]

@MichaelGalvezMD @drharrislakers But that only limits physician pay. It certainly hasn’t helped slow overall price inflation.

[AtlasMD @AtlasMD]

@Jason We’re fixing healthcare, I’d rather have 1 minute of your time :-)

[Rob Gray🧢 @robgraymd]

@olsonplanner It was a wild time

[Adrian Sosenko @DrDadBuilder]

I never share reviews, but this one is long and definitely worth the read.

I went independent to have time to listen, take responsibility, and make sure patients get the care they deserve.

Grateful to this patient, and to my staff for making it possible every day.

[Rob Gray🧢 @robgraymd]

@HandSurgeonMD @z1856z Wrong. Greatest lie the devil ever told. You need to visit every PT, OT, immediate care and primary care office in 20 miles. Do 2/week and it’ll take 3 years. Then circle back. Bring coffee and give everyone your cell number.

[Brent A. Williams, MD @BrentAWilliams2]

Well if socialism is so great then why does it need capitalism to fund it?

[Rob Gray🧢 @robgraymd]

@shailinthomas Winner

[Rob Gray🧢 @robgraymd]

@9Nylon Pay for call

[Rob Gray🧢 @robgraymd]

Not everyone has a spine. Ortho ain’t for everybody.

[Paul Sufka, MD @psufka]

Everyone has cytokines, so everyone should rotate through rheumatology.

[Scott Becker @BKRBusinessMin]

If hospital reimbursement goes up net of inflation and physician reimbursement goes down net of inflation, sooner or later you end up with more buildings and less physicians. This is a bad outcome.

[Adam Bruggeman, MD @DrBruggeman]

Follow up from today’s post

I looked into the group whose video ad is running in the Root post, and what I found is concerning.

The ad is titled "EXPOSED: Double Billing." Its disclaimer reads "Paid for by Patients for Safe and Affordable Health Insurance."

It is a limited liability company. The only place its legal name appears is the website's privacy policy. There is no named executive director, no board, no staff, no spokesperson, and no press release.

Its listed address is 712 H Street NE, Suite 1403, in Washington, DC. That address belongs to a FedEx and UPS shipping store. "Suite 1403" is a mailbox.

Its website launched in January 2025. The files behind it are hosted on a WordPress network that also hosts campaign pages for Republican candidates. Most of its pages were written by an account called "Web Ops," not by anyone at the group. This isn't a patient organization that hired a web designer. It's a political vendor's product with a patient-sounding name on the front.
In 18 months, its campaigns have covered oncology drug vials, out-of-network doctors, upcoding, hospital facility fees, a state-specific attack on a hospital system in Indiana, and now modifier 25. Every single one targets a doctor or a hospital. Not one targets an insurer. Not one mentions prior authorization, claim denials, or the profits of the companies that sit between patients and their care.

Look at who it lets speak. Its "facts" page cites AHIP, the insurance industry's trade association. Its billing campaign is built on a Blue Cross Blue Shield Association report. Its surprise-billing pages repeat the insurer line that arbitration costs too much and doctors win too often. The op-eds it promotes are written by a former Florida Blue executive, a former chief medical officer of Regence Blue Cross, and a former chief medical officer of AmeriHealth Caritas. Not one practicing physician. Not one patient.

A group that says it speaks for patients, has no patients, no leaders, and no address, and only ever points in one direction is suspicious at best.

Notice the timing. The comment period closed September 14. More than 150 medical organizations told CMS to withdraw this proposal. CMS tried the same cut in 2019 and pulled it. The final rule is due within weeks. Nine influencers and a video ad showed up in exactly that window, with the same talking points, thanking the administration for a rule it hasn't finalized yet. That is a pressure campaign not a public awareness campaign.

Why would an insurer care about a Medicare rule? Commercial plans already fight physicians over modifier 25 claims. Physicians push back because Medicare, the benchmark, pays in full. If CMS cuts it, every commercial contract in the country follows, and the cut stops being something a doctor can appeal. The savings won’t ever go to seniors. They will go to the plans and their shareholders.

Who funds this and why are we hearing from a mailbox instead of a person?

If you want to argue that Medicare should pay less for same-day services, make that argument. Put your name on it. Publish your data. Tell us who you work for. Defend it in the comment period and in the open.

What you shouldn't do is fund a video from a mailbox, pay nine accounts to run the same script, and call it a grassroots movement.

Patients do deserve transparency. That starts with knowing who is talking to them.

[Rob Gray🧢 @robgraymd]

Preach. https://t.co/9vOLtujRpC

[Rob Gray🧢 @robgraymd]

@northwoods1980 Are you sure it’s a complete tear?🤪

[Rob Gray🧢 @robgraymd]

@txsportsdoc At one point I did 20. Now back to 5. Seems to have protective effects on cognition. My lifts have gone up and recovery shortened. Could be placebo. Feels legit. I drink a ton of water on it and go to the bathroom constantly

[Rob Gray🧢 @robgraymd]

@MichaelGalvezMD That was supposed to read food service but it holds up either way.

[Rob Gray🧢 @robgraymd]

@northwoods1980 What is this?