husband, dad, vascular medicine/cardiology, baker of challah and other treats, STL sports
Nashville, TN
Joined December 2009
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coby grand retweeted
Peripheral arterial disease (PAD) affects more than 300 million people worldwide—yet it remains under-recognised, underdiagnosed, and undertreated.
A new Editorial discusses a Lancet Series aiming to address this major health burden: spkl.io/60177pLLF
coby grand retweeted
Dr. James O'Leary on nonprofit hospital tax exemptions:
"If you can afford to sponsor LSU and do all these things, you don't need a nonprofit tax exemption."
His proposal: go back to the pre-1969 definition — nonprofit status tied strictly to charity care.
No more exemptions beyond that.
Tax the rest. Keep that money in a dedicated charity care fund.
"You are actually, for the first time, a charitable hospital. You just didn't want to do it — but we're helping you."
🎧 Full episode: xitter.cf/DRsLoungePod/status/21…
Real Doc Speaks: Bureaucracy, Bad Incentives, and the Fight to Keep Doctors in Charge
Episode Summary
In this special add-on episode, Anish Koka and Anthony DiGiorgio welcome Dr. James O'Leary — a Mayo-trained OB-GYN with forty years of experience, former department chairman, ACO board member, and host of the Real Doc Speaks podcast — for a wide-ranging conversation on the erosion of physician-led care. The trio dissects a tragic Nashville case in which four outpatient knee-replacement patients were injected with potassium phosphate instead of bupivacaine after a multi-step, multi-person medication-verification process failed at every checkpoint, using it as a jumping-off point to discuss "kludgeocracy," alert fatigue, surgical-timeout mission creep, and how doctors who raise safety concerns get labeled disruptive. From there the conversation moves through OB-GYN malpractice and nuclear jury verdicts, Florida's no-fault birth-injury compensation fund as a possible national model, the maze of state-by-state Medicaid reimbursement and its perverse incentives, and nonprofit hospitals' use of stadium sponsorships as a possible anti-kickback violation, before closing with a rapid-fire "hot seat" round covering ACOs, private equity, scope of practice, physician unionization, and single-payer healthcare.
Chapters
00:00 Cold open — why isn't Medicaid money reaching physicians?
00:34 Welcoming Dr. James O'Leary (Real Doc Speaks)
02:34 Why physicians need a voice on social media
03:14 The Nashville potassium phosphate medication error
09:52 Would a physician-owned hospital have prevented this?
10:17 "Kludgeocracy" and getting labeled disruptive
14:30 The surgical timeout's mission creep
19:35 EMR alert fatigue and lost safety signals
22:50 Replacing pharmacy techs with better safeguards
24:34 Anish's shift from hospital to outpatient practice
30:19 Malpractice, nuclear verdicts, and OB-GYN
33:50 Florida's no-fault birth-injury compensation model
39:16 Medicaid reimbursement and state-by-state variation
50:33 Nonprofit hospitals, sports sponsorships, and the anti-kickback statute
55:46 Five hot-seat questions for Dr. O'Leary
1:01:51 Direct referrals vs. large health systems
1:03:23 Closing thoughts and where to find Dr. O'Leary
Co-Host Handles
@anish_koka and @drdigiorgio
Guest Handle
Dr. James O'Leary — @realdocspeaks
Show Handle
@drsloungepod
Subscribe Links:
Spotify: open.spotify.com/show/44vw8e…
Apple Podcasts: podcasts.apple.com/us/podcas…
YouTube: youtube.com/@TheDoctorsLoung…
coby grand retweeted
The death of Senator Lindsey Graham (R-S.C.) has been preliminarily attributed to aortic dissection — the same condition that took the life of actor John Ritter. His passing underscores the urgent need for aortic dissection awareness.
coby grand retweeted
Just published in JAHA; GLP‐1 RAs were associated with lower rates of mortality, major amputation, revascularization, and hospitalization in PAD and type 2 diabetes patients ahajournals.org/doi/10.1161/…
coby grand retweeted
SVM Member Special!
Get the Online Board Review Course & Question Bank Bundle for just $300 as an SVM member, a savings of $565.
Designed to help you prepare for the ABVM Vascular Medicine or Endovascular Medicine Exam with confidence.
vascularmed.org/board-review…
#SVM #ABVM #VascularMedicine #BoardReview
@DKadiandodov @EstherSHKimMD @sthomas013s
coby grand retweeted
When I was with the St. Louis Cardinals, we had a team meeting about hitting with two strikes.
Albert Pujols was leading it.
At the time, he was hitting something ridiculous with two strikes.
I want to say it was around .265.
Naturally, everyone wanted to know how.
So somebody asked:
"What's your two-strike approach?"
Albert's answer surprised me.
He said:
"I think fastball inside and hit it back through the middle."
That was it.
No complicated mechanics.
No secret formula.
Just:
Fastball inside.
Back through the middle.
I remember sitting there thinking:
"Why would you think fastball inside with two strikes?"
So somebody asked him.
And Albert said something I'll never forget.
He said:
"If I can hit a fastball inside back through the middle..."
"I can hit the fastball away."
"I can stay on the changeup."
"I can stay on the slider."
"I can stay on the curveball."
Then he paused.
And said:
"The ball gets deeper."
That's when it clicked for me.
He wasn't trying to pull the inside fastball.
He was using one thought to cover everything.
The more I thought about it...
The more it made sense.
So I started trying it.
And it changed the way I thought about hitting with two strikes.
Instead of worrying about every pitch...
I focused on one.
Fastball inside.
Back through the middle.
See it DEEP.
If you're struggling with two strikes, here's what I'd do tonight:
Round 1: Short Box
(Set the distance somewhere between front toss and batting practice.)
Have a coach throw only fastballs inside.
Your only thought:
"Fastball inside."
Drive the ball back through the middle.
10 swings.
Round 2: Mix Speeds
Now the coach mixes:
- Fastballs
- Changeups
- Breaking balls
- Sliders
But your thought never changes.
You're still looking:
"Fastball inside."
10 swings.
Round 3: Two-Strike BP
Every pitch starts 0-2.
Compete.
Battle.
Use the same approach.
"Fastball inside."
Back through the middle.
10 swings.
That's it.
30 focused swings.
One thought.
One approach.
One goal.
Drive the baseball back through the middle.
One thing I've learned:
Most hitters get worse with two strikes because they add thoughts.
Albert got better because he removed them.
With two strikes, simplicity is a weapon.
Thank you for reading,
Jermaine Curtis
P.S. - If you enjoyed this and thought it was helpful, please share it.
(When you share it, it tells me you want more content like this.)
coby grand retweeted
From the latest issue: Oliveira and colleagues review the emerging role of #ARBs in #Marfan syndrome, highlighting how losartan and its metabolites may modulate TGF-β signaling, improve endothelial function, and slow aortic root dilation.
journals.sagepub.com/doi/10.…
coby grand retweeted
We have an unexpected opening in our @HarringtonHVI vascular medicine fellowship for July start. Come train with our amazing team. DM me if interested and further details 👇🏻 please help spread the word @SVM_tweets
uhhospitals.org/medical-educ…
coby grand retweeted
81 years ago today, the men of Easy Company discover Kaufering IV, a satellite camp of the Dachau concentration camp system in Bavaria.
coby grand retweeted
Is there a conflict of interest when hospitals:
1) design policies to prevent pt “leakage”
2) incentivize intensity of care with RVU targets
3) use 340b arbitrage
There’s an honest convo to be had re: pros & cons of competition from MD-owned hospitals.
The below is propaganda.
There is no issue with physician-led hospitals- the issue is about the conflict of interest when physicians self-refer patients to their own hospitals.
The data is clear: POHs tend to treat more commercially insured and healthier patients than full-service hospitals.
In rural communities, this can leave rural hospitals with a greater financial burden, further threatening their ability to keep their doors open and keep 24/7 care available in their communities.
Read more: fah.org/wp-content/uploads/2…
coby grand retweeted
Gore recently announced the first implantation of the investigational Gore ascending stent graft in the ARISE III trial for the treatment of an acute type A dissection @WLGore vascularnews.com/arise-iii-p…
coby grand retweeted
Dr. @NPatelMD is the winner of the most recent Heart Tank on Interventional Cardiology, presenting a pragmatic bundle to enhance radiation safety for #CathLab staff & interventional cardiologists. 🎥 Watch: bit.ly/3LPjRT9
📍Next stop: #ACC26 finals!
#ACCAcademic #ACCIC
coby grand retweeted
The Princess Bride is as perfect a movie as has ever been made
that’s my pick
@SheaSerrano what’s your go-to Rob Reiner flick?
Mine is A Few Good Men, but Princess Bride is a close second.
coby grand retweeted
If you have questions about our project, please DM or email me at [email protected]. Thank you for your support and please spread the word! @PagingDrSolomon @AlexSullivan_MD @JoshuaBeckmanMD @EstherSHKimMD
coby grand retweeted
With the support of @SVM_tweets, I am conducting a survey of Internal Medicine residents to better understand their knowledge of vascular medicine. We will use this data to develop targeted educational programs and enhance awareness of this vital and expanding field.
With the support of @SVM_tweets, I am conducting a survey of Internal Medicine residents to better understand their knowledge of vascular medicine. We will use this data to develop targeted educational programs and enhance awareness of this vital and expanding field.