Value‑based Care: The Healthcare Villain to Scrap
The villain in health care is something called ‘value based care.’ Get rid of it.
Vasectomy Coverage Lags Behind Female Contraception Under ACA
“Despite being one of the safest and most cost-effective permanent contraceptive methods, vasectomy is not guaranteed no-cost coverage under the Affordable Care Act’s preventive services mandate in the same way female contraception is.” Dominick Shattuck digs into vasectomy coverage (an...
New CMS ACO Model Sparks Debate Over MSSP Improvements
1/ A new @CMSinnovates ACO model was released this week In our interview with @AbeSutton on the #ACOshow I teased him about how every new CMMI director seems to believe the world needs yet another primary care model (instead of improving...
Healthcare Needs Humanity Amid Tech Evolution
Sharing Is Caring: #Healthcare Needs Its Own Humanity's Last Exam by @burhansebin @Forbes Learn more: https://t.co/LwritD6vmF #HealthTech #Tech #Technology https://t.co/gmyu9pmFVR
Hospitals Overlook Patients, See Only Bills
Why hospital systems fail to notice the human behind the bill [PODCAST] http://dlvr.it/TRsYCQ Podcast #EmergencyMedicine
Epigenetic Aging Markers Predict Dementia Risk Beyond Age
Epigenetic Clocks of Biological Aging and Risk of Incident Mild Cognitive Impairment and Dementia: The Women's Health Initiative Memory Study 🧠"These findings provide evidence linking epigenetic biomarkers of biological aging with MCI and dementia development, independent of chronological age." https://t.co/GKmn44gsqj
Doctor‑Founded MyReset Launches Malaysia’s Next‑Gen Weight‑Loss Platform
Feels like I’ve talked about everything — weight loss, GLP-1s, founder diaries… But have not formally introduced our platform. So here goes — MYRESET. — A next-generation digital health platform built for weight loss in Malaysia. Founded by doctors (myself + my co-founder), with real experience in telehealth...
Surviving Chronic Illness Highlights Ongoing Healthcare System Failure
I learned that we're seeing above-average premium increases as a company because a few teammates have some chronic issues. I spent 7 years seriously ill during my 20s due to a chronic issue that almost killed me (15% survival rate, I...
Read Books, Not Conspiracies, to Support Low‑cost Vaccines
Ummm, maybe on the day you decide to visit a library and read a book instead of relying exclusively on fake conspiracy sites to spoon feed you disinformation for their political or financial advantage. So likely never. I develop low...
NBTXR3 Surpasses 70% Enrollment, on Track For
$NBTX update: Their lead cancer drug NBTXR3 is now over 70% enrolled in its crucial Phase 3 trial. Target: complete enrollment by end of 2025. With cash into late 2027, they're funded to reach this major milestone. Biotech
Minor Dry Cough Significantly Increases Caregiver Burden
How a minor dry cough amplifies caregiver burden in home health care http://dlvr.it/TRsLZP Conditions #Geriatrics
5‑MeO
I mis-spoke here. This study showed 5-meo-DMT much more effective than psilocybin. This was specifically on treatment resistant depression. A 15 point MADRS reduction there is ~2x psilocybin and ~3x ketamine. 5-meo-DMT really is the most potent antidepressant known to...
NMN and NR Show No Benefit for Elderly Muscle
The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta‐Analysis “… In conclusion, current evidence does not support the use of NMN and NR as effective interventions for improving muscle function and mass...
HHS Undermines U.S. Biotech, Promotes Pseudoscience
Hasn’t HHS already done enough damage to U.S. biomedical science and biotech? Why kill one of the few things that still works in America? ANS: it’s part of a darker dystopian MAHA vision to elevate pseudoscience in its place. My...
AI-Driven Healthcare Coverage: Automating Institutional-Grade Research
I'm building out "AI-native" coverage on my old healthcare coverage (153 healthcare stocks ex-therapeutics that I covered institutionally for ~10 years). I am testing how close I can get to institutional-grade coverage while doing as little as possible manually: ramping...
CZI Biohub Leverages AI to Outpace Funders in Biomedical Research
CZI’s Biohub aims to harness AI for groundbreaking biomedical research, potentially surpassing other leading funders in influence and investment. Wendy Paris Reports: https://tinyurl.com/28f6rnzc Related IP Resources: The Chan Zuckerberg Initiative -https://tinyurl.com/nhhw9a9u Disease Research Grants -https://tinyurl.com/akr4pv9h Grants for Science Research -https://tinyurl.com/mpdstvy2 Tech Philanthropists -https://tinyurl.com/bdewp5v8 Journalism
Intranasal EV Vaccine Delivers Broad, Cross‑protective Flu Immunity
An intranasal vaccine using extracellular vesicles displaying inverted influenza hemagglutinins induced broad, cross-protective immunity in mice, offering a promising strategy for universal flu prevention at the mucosal level. vaccines
Autonomous Clinical Care Scales to 3 Million Conversations
First fully autonomous clinical encounter in the end of 2023, to 3 million autonomous clinical conversations with patients in 2.5 years. The co-pilot to autopilot transition is underway in specialty care, and we're thrilled to deepen our partnership with Insight...
Trump Proposes $5 B NIH Cut; Congress Unlikely to Approve
NIH would get $5 billion cut under Trump’s 2027 budget, but Congress unlikely to go along https://t.co/PPQbrSBwi0 via @statnews
Be the only Specialist, Not Just the Best
🧵 Doctors, don’t try to be the best. Become the only. “Best doctor” is crowded. Every clinic claims it. “Only doctor for this problem” is clear. No comparison. Pick one condition. Own it deeply. Be known for it. Patients don’t remember the best. They remember the specific. Are you just another...
Good AI Diagnoses, Bad Chat Interface Worsens Outcomes
This new Nature paper (using old models) illustrates the point of my latest Substack post on AI interfaces. AI did a good job diagnosing medical issues, but when users had to interact with chatbots the interface led to confusion &...
AI Medical Tools Need Evidence, Not RCTs, to Trust
How can we trust CDS AI like OpenEvidence, DoximityGPT, etc if no one's done studies showing their use improves patient outcomes? While I understand the intent, I think it's ultimately a misguided question. Anytime a new medical textbook comes out, should...
Trump Targets NIH Funding Amid $1.5T War Spend
Trump once again going for draconian cuts to NIH, though not as catastrophic as he sought for the last round (and didn't get). Meanwhile, he wants $1.5T for war. I doubt he'll be any more successful with NIH cuts than...
Health Insurance Waiting Periods: An Unjust, Normalized Scam
Waiting periods for health insurance is such a scam. Where else is it normalized for you to pay for something you can’t actually use for months?
Evidence‑Heavy Statins Still Outpace Unproven Peptides
There is a fascinating op-ed piece in STAT from a doctor whose patient rejected a statin -- one of the most tested drug classes in existence -- but chose to take an untested peptide for cardiovascular risk. "My patient is intelligent,...
AI Drives Value‑Based Care Revolution in Hospitals
Healthcare must be redesigned around early intervention, accountability, and outcomes, and artificial intelligence can help make this a reality. A decisive transition to value-based care, powered by AI, can fundamentally change how hospitals operate and help us reimagine how physicians...
Geography Determines Newborn Screening Access, Not Health
‘Death by ZIP Code’: Newborn Screening and the Geographic Screening Lottery -- Excellent piece by my colleague @GrinsteinJ https://t.co/K0mVN4Ydbk via @Inside_PM
Unstable Jobs and Bureaucracy Push Families Into Health Crises
The latest episode of The Pitt shows how people fall through the cracks. A mom works as a hair stylist with unpredictable income and misses the Medicaid renewal notice when they changed apartments. Her teenaged son ends up in the...
8‑9½ Hrs Sleep, 40‑105 Min Exercise Cuts MACE 57%
https://t.co/IOM6UP2RJ0 "The best combination included sleeping for about 8 to 9.5 hours per night, getting in roughly 40 to 105 minutes of moderate-to-vigorous activity daily, and maintaining a higher-quality diet. This combination had a 57% lower MACE risk." #lifestylemedicine #pavingwellness #health...
Trump's Pharma Tariff Won't Lower Prices, Study Finds
Trump's proposed 100% tariff on pharma imports would have limited impact, analysis says. Why? 68% of U.S. prescription drugs are already made domestically. Prices are driven by patents & rebates, not import costs. Healthcare
Zero Staff, High Marketing Spend Drives Scalable Revenue
Some are saying this Medvi story is fraudulent. What others in the industry are saying is with zero headcount, all the $ can go into marketing (meta, affiliates, etc). All the infra is rented. Operating margins will be extremely low,...
Healthcare Gains While Other Sectors Lose Jobs
Over the past year the US economy has added 680,000 healthcare and social assistance jobs and lost 420,000 jobs in all other industries.
Patients Favor Peptides over Statins, Exposing Medical Bias
My patient would rather take a peptide than a statin. That reveals an uncomfortable truth in medicine https://t.co/vCtJj2O6vq via @statnews
Trump Backs Cheaper Drugs, but His Approach Is Corrupt
Trump is right that we should pay less for prescription drugs, but he is trying to lower drug prices in the most corrupt possible way https://t.co/hv87kTzMrg
Imaging Volumes Keep Rising, Revealing Unmet Clinical Demand
Interesting perspective. 👇 Real-world practice suggests the opposite: imaging volumes keep increasing, not decreasing. Although there is certainly a lot of unnecessary imaging performed, the fact that it is still carried out indicates that it fulfills a need beyond appropriateness use...
Every “Hassler” Adds ~9 Months to Your Biological Age
Negative relationships may accelerate biological aging. In a new study, each additional “hassler” - someone who often causes problems or makes life difficult - was linked to ~1.5% faster aging and ~9 extra months of biological age. The catch: this showed up...
When Protocols Override Reality: Absurd Medical Billing Errors
You spend years training to make complex clinical decisions, only to spend your days trapped inside a system that refuses to apply basic common sense. We have optimized healthcare for metrics, throughput, and standardized protocols. The goal was to eliminate individual...
Debating Brainless Clones as Personal
Are you pro-bodyoid or anti-bodyoid? For the purpose of this poll, a bodyoid is: a newborn clone of you lacking a cortex, a.k.a. a brainless clone, gestated by a paid surrogate. It's organs are a perfect match (isogenic) to you...
Compact, High-Capacity Stand-Up Aid for Tight Spaces
Molift Raiser Pro: High-Capacity Stand-Up Assistance in Tight Spaces by @gigadgets_ #MedTech #Healthcare #HealthTech #Tech #TechForGood https://t.co/1KHpsFf39p
Japan Approves Conditional Stem‑cell Parkinson’s Replacement Therapy
Woah. I'm slightly embarrassed that I missed this for a few weeks. Finally there is approval, in a Large Nation, for a stem cell-based REPLACEMENT therapy for an age-related condition. The condition is, no surprise, Parkinson's, which I always highlight...
Oral Contraceptives Tolerated by Some; Informed Consent Essential
The oral contraceptive is well tolerated by some women. My point is you need full informed consent.
Personalized NAD Boosting Needed; Redox Fingerprints Reveal Disease
Dynamics of blood NAD and glutathione in health, disease, aging and under NAD-booster treatment “In healthy population (n=299;18-70 year-olds) redox metabolites follow normal distribution in blood and remain unchanged during aging. NAD-boosting increased 4-6 fold the blood NAD+ depending on individual,...
Severe Infections Independently Raise Dementia Risk, Study Shows
The role of noninfectious comorbidities in the association between severe infections and risk of dementia in Finland: A nationwide registry study "These results support the role of severe infections as independent risk factors for dementia..." https://t.co/7gG41XSiy7
Dry Needling Glutes Resolves Misdiagnosed SI Joint Pain
I had three patients on my schedule today with “SI joint pain”; two were evals. After dry needling specific trigger points in the gluteus medius muscle, their symptoms completely resolved with post treatment testing. I think “SIJ dysfunction” is largely...
Empty Hospital Beds Still Incur Full Fixed Costs
Great point. They say they lose money on Medicare and Medicaid. But they know the fixed costs are still going to cost them money when those beds are empty. And they will still be paying doctors , nurses...
Hospitals Blind to Costs, Overreliant on Consultants
Most hospitals don't know their costs. Things I've asked for that made them roll their eyes : A BOM for surgeries P&L for each insurance carrier P&L for Medicaid or Medicare business Why do they need consultants for everything. ...
Advocate for Autism Support Month and Essential Services
I like this idea. How about Autism Support Month? Or maybe Autism Understanding Month? Some things that are desperately needed: -Funding for services -More availability of early parent coaching -More (free)?training for educators -Wider accommodations for adults -Fewer barriers to diagnosis and/or pre-diagnosis therapies -Less preying...
Mono Infection Triples Risk of Developing Multiple Sclerosis
New study has strengthened link between infectious mono and Multiple Sclerosis. By analyzing 2 decades of health records, researchers found people who contracted mono as teenagers or adults were 3x more likely to develop MS later vs those who didn’t https://t.co/6DLZMEWyU6
Doctors as Gatekeepers: 60‑Second Visits Still Matter
A large fraction of the time, doctors are primarily gatekeepers between me and a treatment or test I want prescribed. So yes, a 60 second appointment is great.
Running, Not Coordination, Boosts Brain Neurogenesis
As a medical school professor, I tell students exercise is medicine. But a new study shows the TYPE of exercise determines whether your brain grows new neurons. Researchers compared treadmill running vs. coordination exercises at matched intensity. Published in Frontiers in Neuroscience: ->...