Private Practice IM doc, UofK alumi, wanna be foodie, college sports, pilot, not as angry as I sound in tweets

KY
Joined June 2009
Dr. Gripesalot retweeted
Well done @SECShorts Little ole Kentucky
5
70
8
512
20,032
This. Transparency without choice is worthless.
You can publish every hospital price in America. If the same company owns every practical alternative near you, congratulations. You now know exactly how little choice you have.
1
1
7
434
Dr. Gripesalot retweeted
Its all an upcoding scam. Physicians get a million queries by coders to document it since "severe malnutrition" reassigns a DRG to MCC which adds thousands of dollar per stay. But the diagnosis of malnutrition has little to do with nutritional status since severe illness often looks exactly the same
Has America had a rapid and sudden rise in deaths due to malnutrition? This has become a common anti-American talking point, but is it true? Well, that is what the death certificates say, but that's just because we started writing them differently!
7
7
63
4,496
Dr. Gripesalot retweeted
Ty Bryant, a Lexington native and 4-year Wildcat, on being a part of a Kentucky team that’s sitting at 1st place in the SEC: “It’s amazing. I told Coach Bateman when the clock was winding down ‘I love you man… I’ve been here for 4 years and I’ve never seen anything like this.’”
10
135
5
2,268
42,695
Wow. Did not know this. @CMSGov and Washington really will do absolutely everything they can to put physicians out of business and rob patients and taxpayers of every dollar they can. @RepGuthrie
When a Medicare patient doesn't pay their deductible or coinsurance at a hospital, Medicare pays the hospital back 65% of it. When the same patient doesn't pay my office, Medicare pays me nothing. Why is the hospital's bad debt Medicare's problem and mine isn't?
8
5
35
2,938
Don’t forget this is 65% of a copay that was already probably 300% higher than what it would be at a doctors office.
1
1
115
I’m so sick of @GOP @GOPDoctors pretending to be capitalists or care about the economy or our debt. At least the DSA folks will tell you up front they want to take your money and give it to somebody who hasn’t earned it
1
4
99
I was yesterday years old when I found out PB&J with chili is a thing. Am I the only one who didn’t know about this? 🤮
7
1
8
944
Dr. Gripesalot retweeted
This staggeringly arrogant reply by non doctor "wellness" crank Calley Means in response to an actual doctor warning against his irresponsible promotion of raw milk for kids "We'll take it from here" he said as he joined RFK Jr's circus as an adviser Today, Calley Means quit
60
231
4
1,403
21,926
Dr. Gripesalot retweeted
I complain enough that I have to share this Last week I had a drug denied and required replacement with a me too drug in the same class. Except it was not a good switch for good medical reasons Yesterday while still on call my nurse forwarded me a phone number to call for a peer to peer I’m busy but I know how the game is played. I had to call back even though I was busy. I was expecting to deal with an annoying phone screen and long hold times. So … I call and 1. The doctor immediately answers. It was his personal line! ✅ 2. It’s actually a doctor and actually an oncologist. An actual “peer” ✅ 3. We have a real clinical discussion about the R/B of the choices. Not some script designed to force my hand ✅ 4. At the end he agreed with my reasoning and said he’d get back to me 🤔 5. Today they callsd to tell me the drug was approved!! 🎉🎉🎉 6. Whole thing took less than 5’ ! That’s how it should work! Not only because I got what my patient needed, but it was prompt, professional and respectful of my time. And to be fair, the doc was so reasonable that if he had a reasonable counter I might’ve switched … but I was right and he didn’t.
19
4
74
2,394
Dr. Gripesalot retweeted
Every Top 12 Teams Strength of Schedule: -Miami 58 -BYU 36 -Ohio State 11 -Notre Dame 42 -Georgia 32 -Indiana 24 -Ole Miss 13 -Texas Tech 80 -UCLA 51 -Utah 100 -Tennessee 23 -Kentucky 2
78
181
23
1,853
176,020
Dear specialists: I try my hardest not to send you trash referrals-so please answer your f’n phone when established patients call. The amount of your work we do daily bc we’re the path of least resistance is absolutely exhausting.
8
2
124
10,379
Dr. Gripesalot retweeted
Churchill could have shortened WW2 by years if he had just “done a deal” with Hitler. George Washington could have done a deal to end the American Revolution. Zelenskyy is in good company.
6,250
9,810
906
69,341
3,036,959
Dr. Gripesalot retweeted
“Vice-President Vance said today that whether this ad by Vivek Ramaswamy was appropriate was not really his concern. Seriously? The question for all Republicans is whether this type of attitude is what we want leading our party going forward. For the last decade, our party has been infected by a corrupted moral center. Vance’s acceptance of this campaign ad only breathes life into the disease that we should be seeking to cure.”
219
580
35
3,397
87,243
Dr. Gripesalot retweeted
I find these posts from ‘health system academics’ frustrating and not reflective of the data. As @pgipe can attest, Value-based care is not a proven panacea. The term often obscures a broader goal: modifying and consolidating payment systems into vertically integrated silos which are known to add costs. Payment models encourage consolidation, rely on imperfect or potentially gameable metrics, and impose substantial administrative costs. Even, models that show promise in limited settings often fail to produce consistent savings or better outcomes across the broader health care system. As in this situation, the strongest advocates are large health-system academics who are often incentivized to promote these models. Primary care clinicians already have extensive experience with value-based payment systems. They face ever-expanding documentation and reporting requirements, attribution rules, and other administrative burdens and costs that advocates often overlook. Claims that value-based care is a magical solution are farcical and overstate the evidence. But let’s keep selling that snake oil
14
8
1
27
1,985
If you have trouble sleeping tonight just listen to this Auburn coach give his post game interview.
2
3
613
Dr. Gripesalot retweeted
KENTUCKY BEATS OKLAHOMA 21-13! The Wildcats move to 6-1 (4-1 SEC), and are now tied in the SEC for first place. With the upsets this week, potential to move into the Top 10.
3
82
1
883
8,725
Against this D? Kick was the only play. Cmon.
1
356
Dr. Gripesalot retweeted
Non-profit ASCs has double the profit margin of for-profit ASCs It must be nice to not pay taxes on anything.
Comparison of Ambulatory Surgery Center Operational and Financial Characteristics by Ownership Type Full study in @JAMAHealthForum: jamanetwork.com/journals/jam…
1
3
8
561
Dr. Gripesalot retweeted
Replying to @ZekeEmanuel @KFF
The whole study: support falls to 35% with higher taxes and 24% with delays. People want lower costs, not a government plan. The alternative: site-neutral pay, end MA overpayments, 340B reform, lift the physician-owned hospital ban, & funded HSAs with real prices.
2
7
287