Hospitals don’t want the truth they want the leverage. They hire consultants and pay them millions so they can have the veneer of impartiality, the consultants tell their clients what they want to hear

Someone asked me for an example of how physicians have ceded their power. There are innumerable examples, but here's my favorite. Do you know who state licensing agencies, CMS, and accrediting bodies defer to for rulemaking on surgery? Not the American College of Surgeons. They use, almost exclusively, the Association of periOperative Registered Nurses (AORN). Full hair coverage. Long-sleeved jackets for circulators. The ban on home-laundered scrubs. All have limited, and some say no, demonstrated link to actual science. AORN concedes as much inside its own massive tome of stupid rules. Compliance costs American hospitals an estimated $540 million a year (for the jacket mandate alone). And the American College of Surgeons, along with every medical staff in the country, just capers and prances. There is an actual cost to being placed in the hospital's cuck chair, and it's not just moral injury.

Hey @wais4100 You guys keep having presenters screenshot my blog posts, but never once mention my name. 5 years in a row. I got eyes everywhere. At least give me some credit if you are going to keep using my content. Looking at you @dotter_IR

Very nice demonstration

Well said. Again, this isn’t politics. These are facts. Another regulatory capture mechanism in the making. Hospitals are loving this.

I hate PE in healthcare as much as the loudest virtue signalers on social media, but we have to be intellectually honest and understand the driving factors first.

The death of on-site private practice DR, IR/DR and the future of IR only practice. We must evolve or go extinct. Addition by subtraction. This will not be a popular take, but keep your receipts. More on the blog soon. @SIRspecialists @MStempniak

Congrats to Sid Padia and the UCLA team for the first positive level 1 data for GAE versus best medical management t in the USA 🇺🇸 #irad #GRAVITY

AMCs are far from benign. The worst offenders in my opinion.

It’s too bad engagement on this platform has declined. Consistency matters.

Your crystal ball is as cloudy as mine, but the way I see it is most IR procedures are low complexity low wrvu procedures that no one wants to do. Very little incentive for most other physicians (who are largely employed with wrvu incentives) to pick up this work. Hence APPs

Milking the hospital cow 🐄 Factors explaining this: more hospital financial support, huge supply demand imbalance and the death of IR/DR private practice. What the future will hold? Many current IR jobs being replaced by APPs. Bookmark this and tag me 10 years from now,

This system absolutely needs to be dismantled—but what will it be replaced with? 🧐

Healthcare has prices everywhere and price discovery nowhere. Take one procedure performed in one hospital on one morning. The hospital has a chargemaster price. Every insurer has negotiated another price. Medicare has an administered price. The hospital may offer a cash price. The patient may receive an estimate that resembles none of them. Which one tells an employer what the procedure is worth? None of them can. The chargemaster is a sticker price. The negotiated rate records the bargaining power of two organizations. Medicare reflects a government formula. The estimate comes wrapped in qualifications. Money changes hands, but no open market establishes the price. That distinction becomes unavoidable when an employer tries to contract directly with a physician, surgery center, imaging center, laboratory, or pharmacy. The employer asks a simple question: What should we pay? Most direct contracts eventually fall back on a percentage of Medicare. Not because Medicare discovered the value of the service, but because healthcare has no trusted market price of its own. That is the infrastructure we never built. Price transparency can reveal what hospitals and insurers negotiated in private. Price discovery allows qualified buyers and sellers to establish an executable price through trade. Healthcare does not need another portal filled with downloadable files. It needs a market that can answer the employer’s first question.

What I have learned: I’m over the structure of American healthcare. There will be fewer physicians in the future, not more. There will be less incentive to do medicine. It is simply a trade and that is what it is treated like. The best leave. @BKRBusinessMin @DrCorriel

One can spend decades and not understand how this game works. Or you do and know what you’re getting into, but don’t act like it’s the norm. Far from it. Employment is fine if that’s what you want. We can’t all be entrepreneurs, but entrepreneurship is essential to advance IR.

Case 162: with @BhaveshPopat7 @DrAntariksh @shubhamvanshi07 @DrVaibhavThakur . Revascularizing both Below the Ankle (BTA) Pedal Vascular Loops . YouTube Link: piped.video/azF3wYE89Rg?si=tx7p… . #irad #virad #endovascular #meded #medx #medtwitter #cardiotwitter @SIRspecialists @SIR_ECS

benwhite.com/medicine/hospit… Thanks for the shoutout @benwhitemd

Hospital employment is evil. The level of financial engineering to make a physician look lazy is insane. These C student administrators need to be kept in check. As is the way of the world, they tend to lead the A students. Know the game. linemonkeymd.com/coming-to-t…

Another reason entrepreneurial and modern #irad is better off not taking hospital employment. linemonkeymd.com/coming-to-t…