Listening to @HHSGov Secretary @RobertKennedyJr speak about lack of access to health data in America. It’s a big problem and much has been wasted to secure the data in silos that no one, not even the government can access it. Health data is owned by patients who have the greatest stake in its use. HHS and CMS is solving the problem through an App. No more clipboards in doctors’ offices collecting redundant information, or CDs driven over with MRI scans that can’t be easily viewed. The tools are reducing wasted time by physicians and others filling out forms. Thanks to @ThePatientsSide at @CMSGov some of these problems are being addressed, including empowering patients to have more access and control over their health records. Secretary Kennedy spoke about the importance of AI (now SI) as a tool to go through enormous amounts of data in healthcare. We spend 5.3 trillion annually on healthcare in the US and most is on chronic disease.

Yes I think the key point to understand is that “safe and effective” is a legal standard, not a medical one. If a Pharma product meets the legal definition of “safe and effective,” then the FDA is required to approve it. But that approval does not mean that the product is medically safe and effective for all patients in all circumstances. That is for doctors and patients to determine.

Again. Completely untrue. Residents are workhorses that are incredibly valuable. The $5billion revenue health systems will absolutely pay up. Why you ask? When the University of New Mexico lost its neurosurgery residency accreditation in 2019/2020, the clinical work of 8 resident physicians was replaced by 23 nurse practitioners (NPs) and physician assistants (PAs)

Listened to Bill Gurley's talk at the latest @theallinpod summit "Searching for Feynman"(worth a listen). In it, he decries systemic institutional failure, lack of curiosity, and the dangers of groupthink. I then caught his talk from a few years back titled "2,851 Miles." It has quite a few connotations for healthcare. Gurley argues that regulatory capture lets established companies shape government rules to protect themselves, limiting competition and innovation at the public’s expense. He cites telecommunications, Epic’s electronic health records business, and COVID testing as examples where he believes lobbying and industry ties helped incumbents suppress competitors or sustain higher prices. His central warning is that Silicon Valley—including AI—risks losing its innovative edge as leading companies embrace Washington and seek regulations that entrench their dominance. Healthcare innovation doesn't die from bad ideas; it dies from good regulation and even better groupthink. This happened with telecom in the late 90s. It happened with EHRs in the 2000s and is about to happen with healthcare AI. The regulatory moat is the ultimate defensive strategy for health systems. By imposing hyper-bureaucratic security and interoperability requirements, incumbents successfully tax startups out of existence. Vinod Khosla and CureAI's marketing push clearly shows SV has learned the ropes when it comes to the process. These tools could have a tremendous impact on healthcare. They also represent a significant market opportunity for every interested stakeholder. The bureaucratic barriers are real. The real question becomes: is the compliance moat a siege weapon, a rampart or a cemetery? @DrDiGiorgio @SebastianCaliri @DrBruggeman @SamirUnni @AIHealthUncut @bgurley youtube.com/watch?v=F9cO3-ML…

Seems inflation is simply a tool to keep those already wealthy (more?) wealthy, at the expense of those (deserved) who are looking to close the gap between their status and their wealth. It’s a shitty way to keep the oppressed suppressed….

In its pivotal clinical trial, the GRAIL test to detect early cancer failed its primary endpoint. It detected only 3 early cases per 1,000 people assessed. There were more false negative results (N=196) than true positives (N=133). Reviewed here erictopol.substack.com/p/the… But you wouldn't know any of that if you read today's WSJ editorial! gift link wsj.com/opinion/a-grail-canc…

I make ten million dollars a year. I run a nonprofit. I know. Take a moment. A gentleman at CommonSpirit was paid nearly twenty eight million in a single filing year. He served three days of it before he stepped down. Three days. Some men are simply better at mercy than I am. You have read about places like mine. You read the headline, and you felt something. A little ache. A little pride in your community hospital. Thank you for that. I mean it. You have never seen love until you have seen a town love its nonprofit hospital. I saved their grandparents. I saved their parents. I delivered their babies. Now, when they say that, they do not mean me. They mean the nurse who sat with their father at three in the morning while I was asleep in a house they will never see. They mean her. They say me. I take the credit. All of it. I stand at the gala in a tuxedo and accept a standing ovation for work performed by people I am, at that moment, negotiating against. And I never once had to lie. I never said I did it. I simply never said I did not. Gratitude is the cheapest input in my supply chain. It arrives free. It never unionizes. And it goes directly onto my name. You believe I am a charity. You have believed it your entire life. Your mother believed it. And I have never corrected you. Why would I? It is the nicest thing anyone has ever done for me, and you did it for free. Let me tell you what the word actually means. Nonprofit is not a promise. It is not a vow. It is a tax election. Nine letters and a filing. I did not swear anything. I did not kneel. I filled out a form, and a clerk approved it. Everything else came from you. The holiness. The charity. The sacrifice. I never promised any of that. You did. The word profit appears nowhere in my filings. It would look terrible. So I call it surplus. I run a billion dollar surplus and a portfolio that would make a hedge fund blush, and not one word of it is a lie. I did not hide anything. I changed the noun. I could have done all of this in private equity. The arithmetic is identical. But nobody names a wing after a managing director. So I chose the path with the gala. Same extraction. Better applause. Now look across the street at the for-profit clinic. He pays property tax. It funds your schools. He sues fewer patients than I do. And you despise him. You call him greedy. Then you walk under my cross, accept a bill you cannot pay, and thank me on the way out. I am not a better man than he is. I picked a better tax status. So yes. I love the word nonprofit. I did not take a vow of poverty. I filed a form. Poverty is what I sell. It is not what I practice. -Rojas out.

No matter which side of the aisle you’re on, Trump’s “Right to Try” medical law has saved and extended many patients' lives since it was signed in 2018. Many people don’t know about it until it affects them, someone they know, or their family. 🙏

We understand the human body so well that finding out whether a drug works routinely bankrupts a company.

Having been in academia as the opposite of Arday, I find myself wondering about the fate of those who have been left out of the story. What has become of the those whose works were plagiarized to bring Arday, or Gay, or others of the same ilk to their great “success”? As the scholar whose work-product was usurped to create a create a Dean of a School of Medicine at the self-proclaimed best public university in the land (UCLA), are there others who went through our lives profoundly altered given the juxtaposition of misplaced credit?

ADMIN: “We worry that owning a hospital gives you a financial interest in your patients’ care.” Physician: “So you want to hire me?” ADMIN: “Yes.” Physician: “And your hospital will earn money from my work?” ADMIN: “Yes.” Physician: “Who worries about that financial interest?” ADMIN: “Your orientation starts Monday.”