Darrell White retweeted
Bausch + Lomb named Thomas J. Appio interim CEO, replacing Brent Saunders.
@DarrellWhite provides commentary on what the move may suggest about Bausch + Lomb’s future.
Read more on @GoHealio: 🔗
vist.ly/5ntnc
Got news that may not read positive? Most release it late Friday, preferably on a holiday weekend. Not Bausch&Lomb which announced its separation with CEO/ex-Chairman Brent Saunders during biggest annual eye mtg. Here's what I think: healio.com/news/ophthalmolog…
If you are making the choice for yourself please read @anish_koka's post. If you are helping an older loved one make this decision please read Anish's post.
If you don’t lock in Original Medicare + a Medigap supplement during your one-time 6-month window when you first become eligible, you may never be able to get it later. Choose Medicare Advantage instead and, in most states, Medigap insurers can reject you for preexisting conditions (or ones you develop) if you try to switch back.
Seniors I talk to almost universally don’t understand this and are enticed into Medicare Advantage plans with lower monthly premium sales pitch.
They also don’t realize Advantage plans typically have higher medical copays than Original Medicare + Medigap Plan G. MA plans also apply much tighter management (prior auth + step therapy) to Part B drugs like chemo and infusions.
Darrell White retweeted
If you don’t lock in Original Medicare + a Medigap supplement during your one-time 6-month window when you first become eligible, you may never be able to get it later. Choose Medicare Advantage instead and, in most states, Medigap insurers can reject you for preexisting conditions (or ones you develop) if you try to switch back.
Seniors I talk to almost universally don’t understand this and are enticed into Medicare Advantage plans with lower monthly premium sales pitch.
They also don’t realize Advantage plans typically have higher medical copays than Original Medicare + Medigap Plan G. MA plans also apply much tighter management (prior auth + step therapy) to Part B drugs like chemo and infusions.
Every year I'm on this app I remind my readers about Medicare open enrollment. It's often a very confusing process for many. Please be informed. Read the attached for more information.
kff.org/medicare/medicare-op…
10/9 at 8:07. It's easy to remember the details. It's now been 11 years since my Dad bade us farewell. I remember this week in "Sunday musings...: drdarrellwhite.com/another-y…
Right and wrong, good and bad exist and they are definably different from one another. Thoughts about them through the lens of Dale Murphy's career in this Midweek Memory of a Random Thoughts "classic"": drdarrellwhite.com/right-and…
For future post.
Aldeyra to File Formal Dispute with US FDA over Reproxalap Rejection: bit.ly/4AOfHjj
Darrell White retweeted
Bill Henniger is an absolute legend:
- Air Force veteran
- worked at General Motors in ops for 8 years
- noticed CrossFit was starting to take off in the mid-2000's
- founds Rogue Fitness in his Ohio garage in 2006, eventually leaves his GM job to lead it
- becomes the official supplier to the CrossFit Games and the default supplier of CrossFit gyms, not to mention many other gym types
- no PE, not even any outside investors, and no debt
- grows Rogue to ~1,400 employees, with a massive domestic US manufacturing presense
- Now closing on a 1,000,000 sq. ft. facility in Columbus, Ohio that can process up to 250K lbs of steel / day.
- still shutting up idiots on the internet under his own name
Someone commented disbelief on a post I made regarding Rogue Fitness building a 1M+ sq ft gym equipment manufacturing facility in the US and that I was impressed it was owned 100% by one guy started in a garage.
So, the owner of Rogue, Bill Henniger, dropped the hammer with an epic reply and then graciously offered to give the guy a tour of what he’s built.
Living in a time where this sort of exchange is possible and to be able to watch it is amazing.
Better surgery with lower complication rates and more accurate calculations that result in better uncorrected vision. Faster recovery. Superior implant technology even in basic lenses resulting in superior vision quality. 75% decrease in pay; no decrease in liability.
CMS pays physicians less for getting faster.
The fee schedule has always worked this way. A procedure gets quicker, the RUC resurveys it, the work RVU gets cut. Cataract surgery has been revalued downward for thirty years on exactly this logic.
The 2026 rule removed the survey step. A 2.5% "efficiency adjustment" now comes off the work RVU of roughly 7,000 non-time-based codes, recalculated every three years, on the assumption that you got more efficient whether you did or not.
Now run the math from the practice side.
Revenue per unit of efficiency falls, by rule. Cost per unit of efficiency rises, because the cheap gains come first: the next increment needs new capital, new workflow, more staff training. Declining return, rising cost, and the crossover point arrives sooner the better you get.
Budget neutrality closes the loop. Whatever one practice saves in RVUs gets redistributed across the whole pool. The efficient practice funds the inefficient one and keeps nothing.
Soviet planners had a word for this. The ratchet. Beat the quota and the quota goes up, so no factory manager ever beat it by much.
The fee schedule is a ratchet. Physicians learned the same lesson.
Last weekend found us at a family wedding, all missing our parents and grandparents, their history and their stories. Be sure to share your stories with the next generations. We empty the attic in this MidWeek Memory: drdarrellwhite.com/the-famil…
Darrell White retweeted
My controversial take: For the vast majority of outpatients followed by their own doctor, this was a better model.
The inpatient / outpatient silo physicians are now in would not have happened with physicians in charge.
Replying to @UDarnTuten @anish_koka
Yep. And years ago your primary doctor would have admitted you and rounded every day. I did it for years.
Darrell White retweeted
He’s lying.
Medicare For All is an existential threat to the current physician landscape in large part because it defacto outlaws the private payment for medical services.
They need that provision in place so they will have physicians who will take Medicare.
Otherwise everyone of value would escape the system ( just like what’s happening now)
The most blatant flip flop I’ve ever seen.
Abdul El-Sayed today on Medicare for All: "If you would like to have a private insurer, you’re welcome to do that."
This man has spent YEARS vowing the exact opposite.
Here are 11 times Abdul promised to ELIMINATE private health insurance plans:
08/04/2018: “Instead of having multiple insurance companies... what you have is the state operating as your insurance company. That's what we want.”
11/18/2019: "Medicare for All guarantees you a public health care plan and eliminates your private one."
11/18/2019: "Under Medicare-for-All, the federal government is the only payer—hence single payer—for healthcare to everybody in the nation."
06/04/2020: "What does Medicare for All do? Medicare for All comes in and says, ‘No more of this insurance industry,’ which costs us far more, whose CEOs make tens of millions of dollars a year, and which creates redundancy in the healthcare system that increases the overall cost for all of us."
07/12/2020: “My issue with private health insurance is that I see it as fundamentally a middleman that we've allowed to persist and exist in our healthcare system for no added value except that a lot of people profit off of it... the best way to do that is cut out the middleman.”
09/29/2020: "The only insurer in town is Medicare"
12/16/2020: “What Medicare for All does is it does away with the private insurance market. It now has one single payer—that's why we call it single-payer, right? One insurance, and that is the government of the United States.”
03/15/2021: “We are going to create one insurer that operates on behalf of the taxpayer, on behalf of the American public, so that we can reduce prices as much as possible and collectivize as much as possible.”
04/13/2021: “Instead of having a whole bunch of payers you have one payer and that is the federal government.”
05/25/2021: “We have an entire industry — the insurance industry — that does not need to exist, that should not exist. There’s a world that’s possible where it didn’t exist. The question becomes are we willing to do the morally right thing as a society?”
04/07/2022: "I advocate for a government takeover of health insurance because health insurance offers no value in the American health care system"
Darrell White retweeted
The “studies” that led to these numbers are incredibly flawed.
For example, say a patient has a small intracranial hemorrhage from a fall. She’s on eliquis, a blood thinner, because she’s at risk of a stroke.
What does the neurosurgery team do with the eliquis?
Say they hold it. Two days later she has a massive stroke and dies. That would count as a medical error in the aforementioned studies.
Say they don’t hold it. The bleeding in her brain progresses and she dies. That would also count as medical error.
Doctors often walk in to advanced disease processes, many of which have no reliable data on the right course of treatment. Many treatment decisions have a potential for bad outcomes either way.
Sometimes you do surgery and the patient has a complication. Sometimes you don’t do surgery and the disease progresses.
We don’t have a crystal ball.
It’s not like piloting an airplane, unless the pilot was taking over the flight while the plane was on fire, one engine was out, and it was heading straight at a mountain.
Doctors do make errors, and egregious ones should be punished, but these numbers are a joke.
Joe Rogan and Andrew Huberman look up how many Americans die from medical error each year, and the answer floors them both.
ROGAN: “Okay, so medical error is responsible for 251,000 deaths a year.”
HUBERMAN: “Whoa, that’s crazy.”
ROGAN: “Do you understand how insane that is? Imagine if that was Pop-Tarts.”
That number comes from a 2016 Johns Hopkins study published in the BMJ. It estimated medical errors kill 251,454 Americans a year, which makes them the third leading cause of death, behind only heart disease and cancer.
And it gets worse. A 2023 Johns Hopkins and Harvard study found that misdiagnosis alone kills an estimated 371,000 Americans a year and leaves another 424,000 permanently disabled.
If an airline killed that many people, nobody would ever board a plane again.
“Maybe we can all be a little less certain about knowing what someone is going through,” Duncan says. “It’s important to be in tune with the notion that you just don’t know."
Grace and peace to the Robinson Family and everyone who knew and loved Eli.
“Eli, God love him, would listen to him.”
Behind Duncan Robinson’s unlikely ascent to the NBA was a hidden second life — a decade spent as a quiet lifeline to his struggling brother.
nyti.ms/4rxzKi4
Darrell White retweeted
And why would an error rate in this procedure have anything to do with the likelihood a 79 year old with a pneumonia who gets admitted to the hospital will die of medical error?
I’ll say again, 250,000 as a medical error death count is a completely made up number.
Sure, but complications are a part of every life saving procedure.
A pericardiocentesis is hundreds of times a day across hospitals around the country. A needle is slipped into the space around your heart to drain fluid that if left untouched would cause your death.
Some small number of times, for a variety of reasons that are beyond the control of the operator, even when the correct protocol is followed death may result when performing the procedure.
There are medical malpractice courts to adjudicate cause of death where medical experts way in on protocol deviations that where outside of standard of care ( separate discussion about that flawed process)
But this doesn’t mean every complication should be regarded as a “medical error”.
You can turn the medical error rate to zero by not going to the hospital when in distress. But that’s probably a bad idea.
Oh, but this is different. Mass General is a non-profit organization. Right Sen Warren?
Mass General has a health plan. It also owns doctors. It also has about $19B in investments.
Is the good Senator from MA coming for them, too?
Joy is the ultimate emotional force magnifier. Get you some in this Midweek Memory of a Random Thoughts "classic" drdarrellwhite.com/joy-is-a-…
It's September and that means we're talking about all things anti-inflammatory in 2026 in my annual review: healio.com/news/ophthalmolog…
Meet the men who helped me become the man I have become, my college teammates, in this week's "Sunday musings..." drdarrellwhite.com/the-good-…
I am who and what I am because of who I knew and what we did together as very young men. Read about us in this week's "Sunday musings..." drdarrellwhite.com/the-good-…
This is the crew that @ByTimLayden and I spent the weekend with @bambam1729. Those were good days. Our today's are better because of them.

















