Bourbon and smoked meat
Columbus, OH
Joined May 2022
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I took my kids to COSI, the science museum, and you look at the exhibits and it’s all these doctors from just one or two generations ago, who were major philanthropists and pillars of the community.
Our profession has been destroyed.
Basal expectations of a physician entering practice 50 years ago:
-build an independent practice employing other people
-investment and ownership
-stay at home or socialite wife
-nanny/housekeeper
-custom home in best neighborhoods
-top private schools for 2+ children
-country club membership at exclusive club
-second home(s) at beach, lake, ranch, or mountains
-boat and/or plane
-high social standing
Today:
-employee in a large hospital system or PE
-own nothing
-working wife, likely another medical professional
-day care or au pair
-tract home in the suburbs
-public schools
-Lifetime Fitness and public links
-air bnb rental
-Disney cruises and economy class
-nobody knows your name
This is a graph of budget deficits, not of revenues. The revenue does go up after tax cuts. Laffer didn’t lie. The issue is spending.
Here is the actual graph of revenues.
Some more thoughts on AI. Specifically, this explores what has happened to doctors that will eventually allow health execs to replace us with AI. We increasingly are following a script that we didn’t write, making it easy to substitute in the script itself and cut us out.
Nothing is unlimited. There aren’t infinite surgeons and doctors and meds and supplies and beds and rooms. Nothing is unconditional. The only question is who does the economizing, is it a consumer deciding what to and not to buy or is it a bureaucrat deciding what you can have?
Staff bathroom in the ER has single ply, but if you go across the street to the admin building all the bathrooms have Charmin. This upsets me so much.
Scott Cardone retweeted
Private Equity Firm purchases Pennsylvania Hospital, paid all their executives hundreds of millions of dollars, sold their land, then started charging the hospital $35 million per year in rent forcing the hospital to shut down
“The private equity firm that owned and shut down this Delco hospital pocketed hundreds of millions of dollars in the process, while it left its community stranded of emergency services. And it has already ruined lives.
- Prospect Medical Group bought the nonprofit Crozer Hospital System back in 2016, while the hospital system was struggling financially
- 2 years later, in 2018, Prospect took out a $1 billion loan and then paid out investors over $450 million
- The CEO, Sam Lee, pocketed almost $100 million
And obviously, when you take out a loan, you have to pay it back. So Prospect sold all the land and buildings of all the hospitals they owned across the country to a real estate Investment Trust for $1.4 billion. That real estate trust then rents out the land and the buildings back to the hospitals in what's called a sale leaseback agreement.
For the Crozer system in Delco, this now meant that they had to pay $35 million a year in rent to the trust. That's $35 million a year in rent that they didn't have to pay before Prospect took over.
On top of that, Prospect was accused of aggressively cost cutting, reducing quality of care at their hospitals, and got sued multiple times for Medicare fraud. Surprise, surprise. Prospect had to file for bankruptcy back in January, listing debts of more than $400 million, which is also suspiciously similar to the 450 million that was paid out to investors back in 2018.
So Prospect had to shut down two of its hospitals here in Delco, making it much harder for the people in this area to get the proper care they need. Quite literally, some people in emergency situations will now, because of the extra time it takes to get to another hospital.
And mind you, that is not an exaggeration. It has already happened — The Prospect investors basically got away with all of this, and they're now hundreds of millions of dollars richer.”
I don’t like the term burnout. Whatever term we use though, the cause is that simple—we are not happy when subordinated to people we cannot respect.
This includes the people running the AMA, by the way.
Why are doctors so burnt out? What causes burnout in health care? Is there a National Burnout Study? Michael Tutty, PhD, group vice president of Professional Satisfaction and Practice Sustainability at #OurAMA answers these questions and more. spr.ly/60134MiwF
They are turning @elonmusk into Hank Rearden.
Someone pooped on the floor of the staff bathroom today, clearly intentionally, right in front of the toilet. I don’t know what message was being sent but finding it was not my favorite way to begin a shift.
