Patient Centered Endocrinologist. My opinions are my own.

Williamsburg, VA
Joined October 2020
Traditional Medicare used to skip prior auth. In 6 states, including New Jersey, a pilot called WISeR put AI-assisted prior auth back in. On Oct 15, a CMS deputy administrator said "there are a lot of things about WISeR that are not working." It's bad for independent practices. Hospitals can absorb the unpaid admin time. A solo office can't. The House spending bill would cut off its funding. The Senate voted 46-50 against ending it. Current funding runs out Dec 11. Doctors, residents, med students: ask your House member and both senators to keep the WISeR funding ban in the final bill. Template below.
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"Over the last 25 years, Medicare reimbursement to physicians has declined by 33 percent after accounting for inflation, while the cost of running a medical practice has continued to rise unabated." rollcall.com/2026/10/23/here…
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Kate Roberts MD retweeted
While this is behind a paywall and some of you might not be able to see it, the encouraging part is that both sides of the aisle can see some of the common sense solutions. I would have loved to see @ZekeEmanuel and @brian_blase add in physician owned hospitals and 340B reform, but we can’t get everything! Site neutrality and Medicare Advantage reform are the two main issues that need to be resolved from this list.
We disagree about politics. But we see the same problems in health care. NEW from Brian Blase (@brian_blase) & Zeke Emanuel (@ZekeEmanuel) in @washingtonpost ⬇️
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Kate Roberts MD retweeted
Healthcare consolidation has a lovely vocabulary. Buying your competitors is integration. Charging more is sustainability. Asking taxpayers to cover the difference is protecting access.
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Kate Roberts MD retweeted
I'm shocked that The Economist was willing to publish this!
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The classic Motte & Bailey. People insist that the Democrats just want universal coverage, like other countries. But their prized plan, Medicare for All, isn't like Switzerland, Germany, Singapore, Australia, or even France. It's a plan that totally eliminates private health insurance. It essentially puts all healthcare spending under the control of the federal government. If you're a doctor, you're forced to take Medicare rates and abide by Medicare rules. If you're a patient, you have the federal government deciding what is covered, and how long you need to wait to get it. That's more radical than the healthcare plans of nearly every country on earth. They'll insist they just want healthcare coverage. Then they'll nationalize 20% of the US economy.
This is why I argue the United States has the most powerful propaganda machine in the world. And frankly, I don’t think there’s another country that even comes close. A perfect example is this Vietnamese immigrant family proudly announcing that they’re voting Republican because they believe in freedom, democracy, and the need to defeat the evils of communism. Let’s examine the irony here. First, communism is not a threat to the United States. The Democratic Party is not communist. Supporting universal healthcare, something virtually every other developed country provides, does not make someone a communist. But Republicans have spent decades convincing Americans that any policy designed to help ordinary working people is somehow a step toward communism. It’s one of the oldest scare tactics in American politics, and remarkably, it still works. Second, you’re celebrating freedom and democracy while supporting Donald Trump, a man who has repeatedly attacked democratic institutions, entertained the idea of a third presidential term, undermined America’s international alliances, and dragged the country into a disastrous war with Iran. This is the same man who promised to end America’s endless wars. And here’s the greatest irony of all. You’ve been convinced that voting Republican means defending freedom from communism, when the far more immediate threat to American democracy comes from politicians who believe the Constitution should only apply when it’s convenient for them. That’s what makes American propaganda so extraordinarily effective. It convinces ordinary people to fear an imaginary communist takeover while ignoring the very real erosion of democratic institutions happening right in front of their eyes. And the people who have been most successfully manipulated are often the ones most convinced they’re thinking for themselves.
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Kate Roberts MD retweeted
$28,303 a year for family health insurance. Up 387% since 1999. And after paying that, families still face deductibles, copays, prior authorizations, and a 7-minute visit with a doctor who's staring at a screen. You're not paying for care. You're paying for the middlemen.
BREAKING: The average cost of a family’s annual health insurance premium in the US is up +$1,303 YoY, or +5%, to a record $28,303. This marks the 4th consecutive annual increase of at least +$1,300. Over this period, the average annual premium for family coverage has surged +$5,884, or +26%. To put this into perspective, CPI inflation has risen +13% over the same period, or half as much. Since 1999, the average health insurance premium for a family has soared +$22,494, or +387%. This represents an average annual growth rate of +6.1%, well above CPI inflation at +2.6% over the same period. Health insurance has never been more expensive.
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The biggest U.S. insurer also employs or contracts with tens of thousands of doctors. It collects the premium, pays the claim, and its own doctors give the care. If I sent my Medicare patients to an imaging center I owned, federal law would step in. Why is one a conflict and the other "integration"?
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Kate Roberts MD retweeted
In a new randomized study, adults with type 2 diabetes were assigned to either: 1) A high-fiber diet 2) Metformin After 12 weeks, the high-fiber group had better blood sugar control and greater weight loss.
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Kate Roberts MD retweeted
CURED OF SICKLE CELL DISEASE Now THAT'S science! No ivermectin in sight
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Kate Roberts MD retweeted
🇮🇹 Italian PM Giorgia Meloni: “The Left predicted that I would destroy Italy, but they were wrong. Employment is at a Record High, our Economy is Growing, Illegal Immigration has decreased by 60%, and we are expanding freedom in every aspect of Italians’ lives.” 🔥🔥🔥
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1/ I built a free, open-source lab notebook that lives in your own GitHub. Created using @claudeai Lab Notes for All: numbered, dated, signed pages that sync across phone, tablet and laptop, saved to your own private repo. 🧵
🤖 Made with AI
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Kate Roberts MD retweeted
When I was a kid, everyone wore poppies in November Now, hardly anyone seems to It's a shame. Never forget those who gave their lives for our freedom
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I disagree the milk is best it gives sugar and protein to bring the blood sugar up and keep it stable
If your diabetic mother collapses at home and she's still able to talk but very weak, which first aid can you do at home before rushing to the ER? A. Nothing! Just wait it out. B. Give her a glass of milk. C. Give a cup of water. D. Give a bottle of Coke. Why?
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BREAKING: The average cost of a family’s annual health insurance premium in the US is up +$1,303 YoY, or +5%, to a record $28,303. This marks the 4th consecutive annual increase of at least +$1,300. Over this period, the average annual premium for family coverage has surged +$5,884, or +26%. To put this into perspective, CPI inflation has risen +13% over the same period, or half as much. Since 1999, the average health insurance premium for a family has soared +$22,494, or +387%. This represents an average annual growth rate of +6.1%, well above CPI inflation at +2.6% over the same period. Health insurance has never been more expensive.
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Hospital owned doctors
Let me start with screw the @washingtonpost they are crap journalists. These are hospital-owned clinics. The hospital controls the billing and collects the facility fee. Yet the Washington Post puts “doctors’ offices” in the headline, leaving readers with the impression that their physician is behind the markup. Misleading BS Patients deserve to know who sets these charges and who collects the money. If the hospital is charging the fee, put the hospital in the headline. Physicians shouldn’t have to answer for a billing policy their employer controls. washingtonpost.com/business/…
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When a hospital buys the primary care practice down the street, its referrals get a new boss. Now they point inside the system. Independent doctors should do the same for each other. Refer your patients to independent specialists and independent primary care. Every patient kept out of the system helps keep another independent practice open.
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Kate Roberts MD retweeted
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MedPAC is discussing letting NPs and PAs bill Medicare directly instead of under a supervising physician. Hospitals push NP independence because it's cheaper than employing doctors. Cheaper for the hospital isn't safer for the patient. And it squeezes employed doctors again.
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