Brazenly telling the truth and shining the light on the crisis facing the practice of medicine in the United States...from the inside.
Joined November 2024
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So there are some cowards who like to throw mud and block actual responses.
Although the response below from a post is not on point he or she blocks actual though a dialogue.
Here was my response:
My first oath is Primum non nocere. Do no harm. This is correct. If a patient demands a treatment that in my training and medical judgment would delay care to try depending on the urgency of the situation, it would be harmful for me to treat a patient demanding something that would delay appropriate care.
Shockdoc retweeted
AUBURN HASNT WON IN 9 YEARS
KIRBY IS 65-0 vs unranked teams
KIRBY DOESNT LOST WITH A 14+ POINT LEAD
AUBURN HASNT WON THERE SINCE 2005
INSERT HATER NARRATIVE, IT WAS THERE!!!!
AUBURN BEAT THAT ASS IN THERE CRIB
WAR DAMN EAGLE!!
Shockdoc retweeted
🚨 WARNING TO NEW OPTIONS TRADERS! 🚨
If you see someone posting options calls on a random ticker with little to no liquidity, STAY AWAY!
These plays can be pump and dumps. The person posting may already be positioned and will sell into the buying pressure while YOU are left holding the bag.
⚠️ Stick to highly liquid options like SPX, AAPL, TSLA, etc., where there is strong volume, open interest, and tighter bid-ask spreads.
If you don’t understand options liquidity, you have NO business chasing random tickers.
I’ve seen too many inexperienced traders lose money this way.
Protect your capital. Don’t become someone else’s exit liquidity.
Not every alert is an opportunity. Sometimes YOU are the opportunity. 🎯
Shockdoc retweeted
I don’t think the libertarian party is the key to saving America. I think libertarian ideology is.
Shockdoc retweeted
Do y’all remember, before the internet, that people thought the cause of stupidity was the lack of access to information?
Yeah. It wasn’t that. 🤦♂️
Our good “Dr.” is lying to the community on X. She not medically trained, she is a therapist. Stay in your lane doc. You are using a credential to attempt to come across as something your are not.
Disgusting.
Perhaps understanding that in standard NFL mechanics for 7!man officiating crew each official has a designated key when the ball is snapped. The deep three (FJ/BJ/SJ) each have a receiver and it is based on the formation. The field and side judge always has the widest receiver in his side and the back judge has the 2nd widest receive to the strong side. When the formation is balanced strength is declared to the line judges side.
It is exactly because on open field plays that get into the second level the receivers or offensive players will either have the ball or become blockers and therefore may commit any number of illegal acts to include offensive holding, OPI, illegal crack back blocks illegal cut blocks to name a few.
It becomes a matter of time and space of where the flag comes from and when it arrives. The flag will not be thrown until the foul has a material impact on play. For example an offensive hold is called in three circumstances, the hold occurs on the initial charge, at the point of attack or against a defender in pursuit to the ball. For a holding call to be flagged the calling official must observe a material restriction and is usually indicated by an unnatural athletic movement by the offended player (shoulder twist, sudden deceleration).
Instead of always assuming the official for it wrong, perhaps understanding they by design the officials are trained to not be looking at the player closest to him or follow the play. That is not where fouls by the offense most often happen. They happen before the runner or intended receiver get there.
It is pretty easy to know the foul if you know which official threw the flag and when it was thrown. And for the deep three the flag is specially weighted and called a long toss flag because they often have to throw 15 or 20 yards.
Officials work by published mechanics not by following the play.
I am going to add a very unpopular opinion here but bear with me.
One of the problems with the health care system is the wide notion that health care should be free. Stop and think about your car. Can you imagine how expensive it would be if every gas tank fill, oil change, and tire change were charged to insurance? Insuring the first dollar of everything makes it way too expensive. Same with health care and now we have data around it. It is less expensive for we physicians to take a private pay patient then run things through insurance. Everyone saves money and time.
We should understand that if we used insurance for what it is which is to cover major or catastrophic costs, the price pressure on the system would fall dramatically and this would make health care cheaper. Add to it tort reform and making corporate practice of medicine illegal and within six months we would be well in the road to affordability.
My response to another attorney who want to govern the practice of medicine instead of attending to his own profession.
In response to your first assertion I hope you realize why this exists. First according to the CMS conditions of participation the medical staff and the administration are two separate but equal governing authority in the hospital environment. This prevents financial pressure from the enterprise that owns the hospital from spilling over into patient care issues. The administration is more than happy to suggest reduced testing and cheaper medications and procedures to bakqnce their books.
Further, physicians are meant to have autonomous judgment relative to the practice of medicine. Physicians should never be employees especially the over 100,000 physicians employed by optum, a wholly owned subsidiary of United Health. If a physician were to have this kind of relationship with anyone he or she would have to deal with Stark violations and CMS anti-kickback statutes which have criminal provisions (maximum penalty 2 years and $76,250 fine per offense).
As a lawyer if you are in private practice I would assume and you have an office in a building you do not presumably own. But there are a thousand examples of businesses conducting their activity in a building they do not own. Same story. Why do you want physicians employed so badly? Bad for the patient. Hypocritical in practice. I will tell you what counselor, govern your own practice and profession. We don’t need another ambulance chaser to try to govern ours. You only harm patients and the practice of medicine.
Tort reform now.
Shockdoc retweeted
🔥🩺 How your doctor presents to the ER!
🔥 If your field is not featured - just make one yourself!
This appears to be the released actual video and audio beteeen replay official, referee and command center. As you can see and hear the replay system that is hard wired to the instsdiun synchronized clocks is superior and does actually show that when the ball becomes dead by rule there is 0:01 remaining. This was released by the conference.
Actually, by rule, the ball becomes dead whenever it touches something beyond its he boundary lines or the field. In this case, a receiver who is out of bounds is leaping to get the ball. The receiver clearly stars from out of bounds and leaps and touches the ball. At that moment the ball has touched something beyond the boundary of the field and is dead.
Once in a great while on a free kick the ball will be alive in bounds and grounded near the sideline. Usually somewhere between the goal line and 10 yard line. If a player steps out of bounds and touches the live ball in bounds, the ball is dead and the kicking team is penalized for kick out of bounds even though the ball it self was never out of bounds. Same story as this play.
Shockdoc retweeted
American medicine spends more money avoiding malpractice suits than it pays out in them. The doctor in this story won his case and left medicine anyway.
Two-thirds of malpractice suits are thrown out before they reach court. Of the ones that do reach court, eight out of ten find for the physician. On paper that is a system working as designed.
The verdict was never the point.
Jordan Grumet, MD, an internal medicine physician, was home with his kids at eight at night when a process server rang the doorbell. The case was one he barely remembered, a patient he had a glancing role with who died of something nobody was going to stop. It took five years to resolve. Near the end, the lawyer essentially admitted he had never believed Jordan did anything wrong. He was using him as leverage against a nursing home.
Jordan won. He also left clinical medicine.
That is the part the dismissal statistics hide. The best study he could find put defensive medicine at roughly 55 billion dollars a year against about 40 billion actually paid out in claims. By age 55, he says, somewhere between half and 60 percent of physicians have been sued at least once, and the risk concentrates heavily in emergency medicine and the surgical fields. The dominant cost of malpractice litigation lands outside the courtroom, in what a physician does for the rest of a career to make sure the doorbell never rings again.
Grumet's larger argument is that malpractice is one line item in a longer bill. Insurers, pharmaceutical companies, private equity, venture capital, electronic medical record vendors, malpractice attorneys. Every one of them sits between the two parties who actually generate and receive care, and every one of them takes something out on the way through.
The line worth saving from the conversation is this one. When a business entity decides that visits run ten minutes instead of fifteen, or that a given test is too expensive to order, that entity is practicing medicine. And in Grumet's framing, business entities don't take the Hippocratic Oath. They carry a fiduciary duty to shareholders instead. We have handed clinical judgment to organizations whose binding legal obligation runs to someone who is not the patient.
His conclusion is that there are only two real stakeholders in health care, the people who hold the knowledge and the people who need it, and that everyone else is a third party who has learned to bill for standing in the middle.
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
For physicians who have been through a suit: what changed in how you practiced the week after you were served?
#MedicalMalpractice #ThePodcastbyKevinMD
Shockdoc retweeted
The Constitution does NOT give you rights. You already have them.
The Constitution simply tells the government that it cannot take those s rights away.
I wish more people understood this.
My thought exactly. I have made sure to take both of them off my feed. It boggles the mind how two grown men can degenerate into mean girls junior high school. If these men are the serious traders they proclaim to be, I am left with the inescapable conclusion neither are them deserve another listen. The lack of respect for the entire trading community and the impulsiveness seen is not only likely pathological, how can anyone take either of them seriously when serious traders have their own capital on the line.
I am not only flabbergasted, I am disgusted and call on X to sanction both. How can PW of ICT be taken seriously
Gentlemen i suggest you get a room together because I can only conclude you each are attracted to the other.
Shockdoc retweeted
The World Cup ends today. One game left. By tomorrow most of you visitors will be packing up, heading to the airport, going home.
So before you go, let me say the thing I actually want to say.
A few weeks ago I wrote a silly post about all the things you were discovering here. Free refills. Free water. Ice like civilized people. Chips and salsa before you even order. Air conditioning that is a fact and not a moral debate. Drive-throughs. Ranch by the gallon. The Germans standing in the HEB meat aisle in reverent silence, finally understanding why we do not have trains. Buc-ee’s, for which there are still no words.
It blew up, because it was true, and because you were so delightfully stunned by all of it.
Even the Wall Street Journal caught on. Their headline this week: how the US lost the World Cup and won over the world. We did not lift the trophy. But apparently we lifted something else.
We even learned a few things about ourselves along the way. Like the fact that Elon Musk, the single richest man on the planet, shops at HEB. Just rolls in and queues up for fresh tortillas with everybody else. The man could buy the tortilla company, the state it is in, and the moon it sits under, and instead he is standing in line at the hot-tortilla counter like the rest of us, because that is where the good ones are. Only in America is the wealthiest human alive elbow to elbow with a mom of four at the salsa bar. That is the whole country in one aisle.
And here is the part I want every one of you to hear on your way out the door.
None of it was a show.
We did not roll all this out because you were coming. The ice was always there. The refills were always free. The grocery stores were always the size of aircraft hangars at ten on a Tuesday. The stranger who adopted your whole section, the guy who gave you a ride, the waitress who remembered your order, the family that invited you to the cookout, that is not World Cup America. That is just America. That is Tuesday.
We are exactly like this when nobody is visiting. Loud, generous, ridiculous, overfed, and genuinely thrilled you came. We will still be exactly like this tomorrow when the stands are empty and the flags come down.
So thank you. To everyone who came, who sang in our streets, who cleaned our stadiums, who turned our cities orange and filled our bars and taught us your chants. You were wonderful guests, and you made a country that just turned 250 feel young and seen and loved.
And to everyone who could not make it this time, the door does not close today. We meant all of it. Come whenever. The porch light stays on, the fridge stays full, and there is always room for one more at the table.
You found out who we are these last few weeks.
Good news. We are like this all the time.
Safe travels home.
Y’all come back now, you hear. 🦋
🤖 Made with AI
Shockdoc retweeted
The next great discussion on X is malpractice reform. As we can no longer proceed to improve healthcare without it.
Currently the physician is the center of all blame for not only malpractice but poor outcomes where all has proceeded according to the standard of care.
This must change. 1/
The pager and the hallway conversation ran American medicine for decades. Nobody transcribed the hallway. Nobody archived pages in a vendor database. The law treated transient coordination as what it was: transient.
The same coordination moved to text, and HIPAA decided the conversation about the chart is the chart. Now a compliant platform converts every "bed 4 is crashing" into a centrally stored, permanently logged, legally discoverable record.
Clinicians respond the way anyone responds to friction: they route around it, back to their phones. The rule produces neither security nor compliance. It produces a paper trail for the lawyers and a shadow workflow for the actual work.
