Private Practice IM doc, UofK alumi, wanna be foodie, college sports, pilot, not as angry as I sound in tweets
KY
Joined June 2009
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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
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.’”
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
Don’t forget this is 65% of a copay that was already probably 300% higher than what it would be at a doctors office.
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
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? 🤮
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
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.
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
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.
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.
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.”
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
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.
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…
