shrivatsa nadiger

Internal medicine, Infectious disease.

[Shreedhar Manek @blueringtail]

TLDR - join this WA group: https://t.co/7rijxtCrwN

We will make plans to show up in Indiranagar to oppose the horrible flyover(s) that will cut the neighbourhood in half https://t.co/hyUkBi2zPt

[shrivatsa nadiger @snadiger]

Disappointed again by @ridetheferry . After the show at radiocity we were tracking the ferry bus and the bus took a left on 49th street! And cut short the route. I had to take a cab to the ferry terminal . there was nobody to take the complaint at terminal.

[shrivatsa nadiger @snadiger]

@AndrewAPrice ooh. which store?

[Adam Bruggeman, MD @DrBruggeman]

CRITICAL UPDATE:

Medicine is at a crossroads. Physicians are now moving to employment over private practice due to overburdensome regulations and financial incentives to do so. Facilities can pay doctors significantly more than they make in private practice and this increased pay gap widens every day while we fail to increase payment in private practice with inflation (hospitals get inflationary updates).

All of this costs consumers more money. One example shows that Medicare pays a doctor $250 for an injection in the office in private practice but a doctor employed by their health system costs $750 for the same procedure. Given that many of these healthcare systems have insurance contracts that are 3x or more of Medicare, that gap widens dramatically.

Meanwhile, United Healthcare is continuing its meteoric rise (along with others in the health insurance sector). One profit scheme is through upcoding and cherry picking patients in the Medicare Advantage program, which is now estimated to cost taxpayers $80B annually above what it would have cost through Medicare. Much of the money to cover that $80B is coming from Medicare Part B, the fund used to pay physicians.

Dr. Oz just testified in front of the Senate Finance Committee and committed to attacking these payment schemes. Senator Cassidy referenced a bill he is working on to prevent upcoding. Others on both sides of the aisle agree that something must be done.

What do we need to do? Return that money to Medicare Part B and use those savings to pay for the permanent fix, putting physicians on par with all others in healthcare by giving them mandatory annual inflationary updates. Investing in our physicians will ultimately save the healthcare system money by encouraging more self-employed physicians.

This can all be done with our upcoming reconciliation process. Leadership in both the Senate and House have committed to doing “something” about physician pay in the reconciliation. It’s time we speak up and demand we don’t just do something…. Let’s do something BIG! Let’s fix the fee schedule once and for all. Let’s do it on the backs of insurance companies that have been stealing from American taxpayers through various Medicare Advantage schemes. Let’s invest in the future of our healthcare system by supporting small businesses (physician practices), which are the backbone of our economy.

All of this takes effort and money.

1) Support your favorite medical PAC
2) Call your Members of Congress and tell them how important these changes are

The stars have aligned to make a big change, but it only happens if EVERYONE in medicine pulls together and demands the change. Decide to be a change agent. Fight for your patients. Fight for your profession. Fight for your colleagues.

[Brian Stelter @brianstelter]

By the way: "Fifteen peer democracies spend an average of $70 per person on public media. In this country, we spend a measly $3 per person." That's counting various state funding sources as well as federal. https://t.co/YPjOd76W8Z

[Dr. Angela Rasmussen @angie_rasmussen]

On Data Purge Eve, many people stayed up late to save the CDC website. @charles_gaba downloaded the whole thing. 👑

A group of us are working to make these preserved data an accessible & publicly available resource. More to come, but get started here 👇🏻

https://t.co/cljgv1U9lP

[Robert Oubre, MD | The Doctor of Documentation @Dr_Oubre]

I asked, “What do you like to see on discharge summaries?”

I received 100+ responses.

6 tips on writing the ideal discharge summary (and improving patient care):

[shrivatsa nadiger @snadiger]

@TimesAlgebraIND @theliverdoc

[Vincent Rajkumar @VincentRK]

Great table on the decrease in insulin prices that happened Jan 1 this year. @AbarcaHealth https://t.co/26kupRMTLI

Advocacy works.

[Bishal Gyawali, MD, PhD, FASCO @oncology_bg]

I am disappointed at a system where for a 85 year old man who has progressed on 3 lines of therapy but lives alone, I can easily prescribe 4th line of treatment at the click of a button that costs the system 15K a month, but can’t arrange for a social support worker who can cook him food, bathe him, buy him groceries etc. that’d hardly cost the system 1K a month!

[Anil Makam @AnilMakam]

2 days on service

Ordered
-1 AM CBC

Stopped
-TTE for incidental finding
-SSI x2 peeps
-metformin/sglt2i/statin in person dying
-glargine->glipizide
-PPI x2
-BP med in bad dementia
-mucomyst inh for aspiration
-many I/Os & freq vitals

Focused on
-treating illness
-symptoms
-GOC

[Adam Bruggeman, MD @DrBruggeman]

Going to say it again…

1998 conversion factor for doctors - $36.68

2024 conversation factor for doctors - $33.29

1999 Insurance premiums - $6k

2024 Insurance premiums - $24k

When you pay more for healthcare, it’s not coming from private, independent doctors no matter what the insurers, politicians, or news stories say. Physicians are paid less in absolute terms over the last 25 years while insurers are up 314% and inflation is up 83%

We need a long term solution to ensure physicians are paid commensurate with their cost of doing business. Our country is on an unsustainable path in healthcare where all of the profits are going to insurers and hospitals, leaving physicians no choice but to vertically integrate, which drives costs even higher.

[Peter Stewart @PeterCNStewart]

This is breathtaking: almost all Latvian classrooms' CO2 levels can be checked online. This is what world-leading actually looks like. More info: https://t.co/PjwoiaTx1p

[shrivatsa nadiger @snadiger]

@VincentRK Pls amplify

[Vincent Rajkumar @VincentRK]

To my followers who wonder what MOC is, and why many doctors are tweeting about it. Thread.

1) Maintenance of Certification (MOC) is a redundant requirement thrust on US physicians by a private organization. We resent it.

[Dhruv Rathee @dhruv_rathee]

Happy Ram Navmi 🚩

All sensible Hindus need to unite and save Ram from Nathuram 🙏

[Jonathan Haidt @JonHaidt]

One of the more cruel things we do to students is give them 20 minutes for lunch, at some schools. Those at the end of the line sometimes have 0 minutes to eat.

Peter Gray says: lets return to "lunch hour" with time for play!
https://t.co/ums2UUsh7Q

[John Burn-Murdoch @jburnmurdoch]

NEW 🧵:

American politics is in the midst of a racial realignment.

I think this is simultaneously one of the most important social trends in the US today, and one of the most poorly understood.

[Jeremy Corbyn @jeremycorbyn]

Why is there always money to bomb people, but never any money to feed, house or care for people?

[Shivam @imrozed]

A message from Pakistan -

“Tum bilkul ham jaise nikle”
- Fehmida Riaz