EP serving the underserved. Mizzou medical school faculty. Medical faculty to the US armed services. Eager student of great ideas from anywhere.

Springfield, MO
Joined August 2011
100% this. The failures of government are being reframed as a crime of the successful.
Replying to @RoKhanna @chamath
why not just raise income tax rates? because your real intent is not to just “provide healthcare”. you’re masking that you are proposing the creation of, for the first time in the 250 years of this American republic, an organized government seizure of private property from citizens. you’re calling it a “wealth tax” or a “billionaires tax” or “millionaires tax” or whatever nom du jour polls well. but at the end of the day, it’s the seizure of private property from citizens by the government. citizens that earned money, paid their fair taxes on those earnings (53% if they live in California) and are now being told they need to hand over after-tax assets because the government has failed to provide promised services with the revenue it’s collected, and are now re-casting their own failure to be a socio-economic inequity that must be justly resolved... a slippery slope that has never gone anywhere good (see economic effects in USSR, Cuba, Venezuela, France and Norway wealth tax etc.) the American founders fled tyranny in Europe and this amazing nation was populated by immigrants (myself and your parents) from around the world not just looking for a “better life” but for a place where they could have freedom from tyrannical governments that can take what they want from private citizens. a great nation borne of property rights, the rule of law, and endowed freedoms to believe, speak, or act. these principles led to the greatest run of innovations, successes, and widespread increase in prosperity, for all citizens, ever seen. the citizens, the individuals, not the institutions, delivered this progress. those who invented, who toiled, who bled, who sacrificed, who took risk and persevered, who led, and who changed the world, are not charlatans, kleptocrats, or oligarchs. they’re what made us all better off. prosperity is a measure of america’s success, not its failure. it is your principle that is so offensive, as evidenced by the broad disdain for your flippant flirtation with the darkest of human fantasy - socialism. you and other neo-socialists have led so many of us to reflect on America’s history and what it is becoming. that now leads so many to consider, so unnecessarily, leaving their homes for a place where everyone stands up to shout down the principle you suggest. because if your ideas are now considered moderate, it’s clear this titanic is sinking. that a “simple tax” of taking assets that have been earned, through toil and tribulation, rightly taxed, and preserved, should now be unjustly seized, is your solution to a problem of obvious government mismanagement and outright fraud, tells us that your true motivation lies not in giving people healthcare but in cutting down success and deleting the system of prosperity and opportunity for all. i don’t care, and neither should anyone else, what the sum total market value of a private citizens private assets might be. it is none of my business and should be none of yours. because, again, once you open that pandora’s box, we might as well study Lord of the Flies … there is literally nothing stopping 51% of citizens demanding that their government go out and seize 100% of the private property of the 49%. want to give healthcare to people in need? do your job and fix healthcare. make it affordable. want to be lazy about it? then do your job lazily and raise income taxes. want to take private property from private citizens who have paid their fair share of taxes and legally earned their property, then honestly declare that it is envy, not inequity, that you strive to resolve…
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He’s not wrong
Y'all said FSD 13 was impressive too. And FSD 12 And FSD 11 And FSD 10 And FSD 9 And FSD 8 And FSD 7 And FSD 6 And FSD 5 And FSD 4 And FSD 3 And FSD 2 And FSD 1 Its been 'impressive' for a decade but yet still cant actually FSD? Its a cult.
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You can’t possibly think that the baby boomer generation with full legislative authority wasn’t going to look after their interest, right?
Forcing the Young to Subsidize the Old and Stifling Entrepreneurship —The ACA’s “Intended Consequence”
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YESSSSS! Go, Joe!
Hopefully they gutted the right things: 1. The Department of Masking Toddlers 2. The Office of Outsourcing School Reopening Guidance to the Teachers Unions 3. The Institute for Producing Inaccurate Covid Tests 4. The Center for Rubberstamping Covid Boosters Based on Antibody Data from 8 Mice If these have been "gutted," we will be better prepared for future infectious disease challenges.
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V for Vendetta was prophetic. And a damn good movie.
The more they try to cover it up, the more it will appear
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It's been 2 months since I subscribed to @Tesla premium connectivity in my Model S. And Spotify is still stuck in the loading wheel of death. Nothing seems to fix this.
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Standby is a PERFECT product-market fit. My main dish is back to paying SpaceX, and my mini still carries its own subscription. Great job, @Starlink.
SpaceX has introduced a new Standby Mode for @Starlink. “Pause now includes Standby Mode, which comes with unlimited low-speed data for $5 per month, perfect for backup connectivity and emergency use.”
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Only an entirely new system fixes this. See a mass will continue cycling through specialties cutting every time. Right, @sgreenbergmd ?
🚨 Imagine waking up tomorrow and your pay was slashed 25% - for doing the exact same work. 🚨 That is, in essence, what CMS is proposing be done to urologists. And if you think your specialty is safe, you’re wrong. Here’s what every doctor needs to know 👇🏻
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The HRS legal advocacy wing needs to keep up their ongoing efforts.
Today @cmsgov announced another significant cut for electrophysiologists (as well as our interventional colleagues), this time for left atrial appendage closure. Starting in 2026, reimbursement will be cut by 27%. This just a few years after the draconian cardiac ablation cuts. While industry and hospitals continue to see increases in reimbursement, the physicians are, once again, hung out to dry. Who helps make these decisions? The @AmerMedicalAssn RUC committee who sends out convoluted surveys that only focus on how long a procedure takes while crosswalking to completely unrelated codes. No intensity, complexity, or long term healthcare savings taken into account. The absolute laziest form of evaluation one could think of to evaluate physician work. Even worse, those who sit on the RUC committee recommend the 25th percentile to CMS. What kind of physicians find the 25th percentile acceptable in anything we do? A clear cut case of Stockholm Syndrome. While budget neutrality remains the underlying issue, the AMA RUC needs total reform. @HeartRhythmAdvo @HRSonline @ACCinTouch @SCAI @DutchRojas
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Scrubs was always the most realistic healthcare show. We will see if it stays that way.
Did they expand the cast to show the growth in administrators? 30 more cast members playing chief experience officers, CDI teams, HR administrators, 340B compliance officers… Meanwhile JD and Turk have their offices taken away and have to sleep in their cars on call.
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John Garner, MD retweeted
🚨BREAKING: 12 states have now passed resolutions to add term limits for Congress to the U.S. Constitution. 34 are needed: Florida Alabama Missouri West Virginia Oklahoma Wisconsin Tennessee Louisiana North Carolina South Dakota Indiana South Carolina
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This is a great story, but you lost your job because you made a Twitter post advising people to quite quit and said you had already dropped productivity.
I got fired today. I'm not sure why, I personally don't think there is a reason, or that it's important. When I joined twitter, I joined because of the engineers I met in SF. They seemed happy. They were having fun. Engineers at play. Engineers that were enabled. It was good!
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It was a bunch of democrats trying to slow the company. Tesla doesn’t HAVE to do anything… the letter just asks them to.
🚨BREAKING: Texas lawmakers urge Tesla to delay robotaxi launch in Austin until new AV rules take effect Sept 1. But Tesla is not required to halt its June 22 launch they can proceed if they show vehicles meet the upcoming legal standards
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60 patients, people. Settle down. Hypothesis generating only.
Carvedilol as Single Therapy for HF Improved EF : A Randomized Clinical Trial (CATHEDRAL-HF) Withdrawal of HF treatment maintaining carvedilol vs usual treatment led to similar rates of worsening of left ventricular function at 52 weeks jacc.org/doi/10.1016/j.jchf.…
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I think this about almost everything Apple does.
Steve Jobs would have fired everyone
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Or, you know, accuse him of being a p*do on the Epstein list. Either way 🤷🏽
The Trump administration should recognize Elon’s point about the budget & build a bridge with him — & the majority of Americans — who want to see us cut spending. Here’s what they admin should say/do: “we hear you Elon, we are going to sharpen our pencils and iterate on BBB to address the Americans people’s concerns over the debt” Take the off ramp!
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This is probably the charge/expense @garyblack00 ought to model for a bear case.
Replying to @Tesla
How much longer will HW3/FSD owners be forced to be second-class citizens without full V13(+) functionality? What's the status of the HW4 CPU upgrade @elonmusk promised, since it's clear by now that HW3 *can't* support the current model?
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Yeah, this rings true.
I think the ultimate fertility-killer has not been secularization, or the Sexual Revolution, or really even the pill. The primary culprit seems to have been the way 'parenting' has morphed into a kind of suite of ever-changing, high-pressure social obligations that seem to be almost 'moral' in character. I say this because in earlier times, there was none of this business about constant sports practices, extracurriculars, SAT prep, constant doctor's visits, college funds, expensive Christmases, and on and on and on. Children weren't considered tiny princes and princesses -- they were just kids, and you fed them, kissed them goodnight, taught them to read and to work, and otherwise left them to their own devices out in the yard or in the woods. Childhood was not some kind of a high-drama summer camp, nor was it a status symbol for public display among the parents. Once the neurotic, consumerist, status-obsessed mentalities of the bourgeois types became mainstreamed in parenting -- and a massive avalanche of expensive, time-consuming, high-stakes 'stuff' was suddenly shoehorned onto 'parenting', people began to (somewhat rightfully) think of having kids as a kind of expensive, anxiety-inducing prison sentence. If I had to guess, the solution to the fertility crisis is to look at parenting since the 90's as a regrettable chapter that must now end; and to return to a more casual, less obsessive kind of parenting. To relax a little.
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Life in a society without accountability
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This is VERY common.
every time a dentist tells me i have cavities i switch dentists and the next one says i have no cavities
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