@brianpierce@med-mastodon.com
@brianpierce@med-mastodon.com avatar

brianpierce

@brianpierce@med-mastodon.com

Family doc in #Maine working on simple, affordable #directprimarycare #DPC, also #POCUS, science based med. #SBM, #dermoscopy, USCG and USAF vet, former engineer but fascinated with #cognition, #biases, #MotivationalInterviewing See Meta Specific Data Rights Notice in my post, reply history.

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ashleyspencer, to random
@ashleyspencer@autistics.life avatar

My new ADHD med dose went into prior authorization with my health insurance.

I was told this can take anywhere from 24 hours to 2 weeks and still be denied.

I think they are fighting it because the copay covers 2 pills a day, but he prescribed 4 pills a day to get me to 100mg a day.

If I use GoodRx, I can get a month's supply for less than my insurance copay, and get it tomorrow.

UGH at US health insurance.

brianpierce,
@brianpierce@med-mastodon.com avatar

@ashleyspencer

Like many things in medicine, makes it more expensive, not less.

We can dispense generic for members of our practice for about $14 and up for 30 tabs but Mark Cuban's pharmacy has it for even less (no relationship with them):

https://costplusdrugs.com/medications/atomoxetinehcl-25mg-capsule/

CultureDesk, to animals
@CultureDesk@flipboard.social avatar

New research from South Korea suggests that interacting with dogs can affect brain activity to make people feel relaxed and improve concentration. For the study, 30 participants met, played with, fed, massaged, groomed, photographed, hugged and walked a four-year-old poodle named Aro, as changes in their brainwaves were measured. Here's more from NBC.

https://flip.it/ps1fQr

#Lifestyle #Pets #Animals #DogsOfMastodon #Dogs #MentalHealth #Wellness

brianpierce,
@brianpierce@med-mastodon.com avatar

@CultureDesk
Great timing for this article, I've been bringing our 9 month old #poodle to my #familymedicine practice all this week.
We'll see if she train to be a #therapydog eventually.

dankennedy_nu, to journalism
@dankennedy_nu@journa.host avatar

New at Media Nation: A riveting Boston Globe story about a medical disaster with ties to the local news crisis. The common denominator: the private equity firm Cerberus Capital Management. #journalism https://dankennedy.net/2024/01/29/a-riveting-boston-globe-story-about-a-medical-disaster-with-ties-to-the-local-news-crisis/

brianpierce,
@brianpierce@med-mastodon.com avatar

@dankennedy_nu

Mother dies because #boston #hospital equipment was repossessed for not paying its bills.

https://dankennedy.net/2024/01/29/a-riveting-boston-globe-story-about-a-medical-disaster-with-ties-to-the-local-news-crisis/

#obgyn #MedMastodon #obstetrics #healthcare

brianpierce,
@brianpierce@med-mastodon.com avatar

@dankennedy_nu

Another article that further explains how Steward left this and many other hospitals broke.

Hadn't paid enough attention to know if Steward was a "Boston media darling". Would you agree?

"Erstwhile Boston media darling Steward Health Care has been strip-mining hospitals for a decade now. The power elite may finally be paying attention."

https://prospect.org/health/2024-01-26-massachusetts-hospital-nightmare-steward-health/

#boston #journalism #medmastodon

gpollara, to threads
@gpollara@med-mastodon.com avatar

It's all #Threads news right now!

Yesterday #Fediverse /#Mastodon integration (starting) & today available in #EU

https://press.coop/@TechCrunch/111578435320293016

brianpierce,
@brianpierce@med-mastodon.com avatar

@gpollara Will @med be federating with #threads?
Hopefully it will as some of our former #medtwitter colleagues may be over there.
@nick #medmastodon

TheConversationUS, to Health
@TheConversationUS@newsie.social avatar

A dose of humility for doctors could greatly improve patient care.

The patient is part of the team, writes a social scientist who studies how clinicians collaborate.

Data shows when healthcare professionals work in a collaborative manner, patient satisfaction and outcomes improve.

https://theconversation.com/a-researchers-prescription-for-better-health-care-a-dose-of-humility-for-doctors-nurses-and-clinicians-210175
#health #healthcare #medmastodon

brianpierce,
@brianpierce@med-mastodon.com avatar

@TheConversationUS
Not news. This was stressed when I did my medical training in the #airforce They applied the lessons learned from #aircrew issues which contributed to #aviation mishaps

exchgr, to random
@exchgr@mastodon.world avatar

since amazon bought one medical:

  • my pcp quit
  • the next pcp i chose quit before my first appointment
  • can’t get a prescription sent to the right pharmacy

#enshittification

brianpierce,
@brianpierce@med-mastodon.com avatar

@exchgr
20+ year PCP here- #primarycare has been going down the drain (#enshittification) long before #amazon got involved so (so far) they are more of a symptom than cause.
Plenty of good articles in past few years explaining it but #healthinsurers AND #medicare and #medicaid are big drivers of this so don't kid yourself that nationalizing it will be any better.
#MedMastodon

brianpierce,
@brianpierce@med-mastodon.com avatar

@argv_minus_one @exchgr Good luck with that.

brianpierce,
@brianpierce@med-mastodon.com avatar

@argv_minus_one @exchgr
I'm part of a doc movement separating PCPs from the insurance racket. Don't prepay for routine , otherwise affordable care with the complicated, expensive system we use for emergencies, major illnesses, etc.
It's not the one solution, but it's a step in the right direction and should be part of any solution.
#directprimarycare

brianpierce,
@brianpierce@med-mastodon.com avatar

@argv_minus_one
"Otherwise" meaning it'd be affordable for most (and cheaper for Medicaid) if we didn't prepay for primary care. Prepaying via third parties inflates prices.

We agree that going to a visit and then getting a bill for stuff you weren't expecting is horrible.

Routine primary care costs are actually quite predictable for even small groups of patients. (I have 5-600).

I charge $82/month for a 40-64 year old patient including an annual physical, acute visits etc.

pluralistic, to random
@pluralistic@mamot.fr avatar

Today's threads (a thread)

Inside: Uncle Sam paid to develop a cancer drug and now one guy will get to charge whatever he wants for it; and more!

Archived at: https://pluralistic.net/2023/10/19/solid-tumors/

1/

brianpierce,
@brianpierce@med-mastodon.com avatar

@pluralistic Pertinent to

brianpierce, to maryland
@brianpierce@med-mastodon.com avatar

https://arstechnica.com/health/2023/10/in-the-us-malaria-can-easily-masquerade-as-an-endemic-parasite/
#Maryland first local #malaria case in 40 years initially duped doctors

#MedMastodon #IDMastodon #publichealth

arstechnica, to random
@arstechnica@mastodon.social avatar

Raw milk outbreak sickens 14 in Utah—a state with loose laws, bad track record

The people sickened range in age from 2 to 73.

https://arstechnica.com/health/2023/10/raw-milk-outbreak-sickens-14-in-utah-a-state-with-loose-laws-bad-track-record/?utm_brand=arstechnica&utm_social-type=owned&utm_source=mastodon&utm_medium=social

brianpierce,
@brianpierce@med-mastodon.com avatar

@arstechnica
Raw milk article pertinent to #MedMastodon #IDmastodon #publichealth #utah @sltrib

bleakfuture, to random
@bleakfuture@techhub.social avatar

This is America in 2023.
Women will die.
Babies will die.
Pro Life my ass. This is Gilead. https://hachyderm.io/@genxjamerican/111155747392222269

brianpierce,
@brianpierce@med-mastodon.com avatar

@bleakfuture #ruralmedicine was already tough. More so when all your #obgyn docs leave the state.

thomasfuchs, (edited ) to random
@thomasfuchs@hachyderm.io avatar

Mastodon supports actual real search now! This is great to find interesting people and content from all over, even when people don't tag posts. To be sure people can find your public posts, opt in (your server has to be on Mastodon 4.2 or higher).

⚙️Mastodon settings > "Public profile" > "Privacy and reach". (Don't forget to hit the save button on the bottom of the page!)

brianpierce,
@brianpierce@med-mastodon.com avatar

@thomasfuchs

Thanks for the reminder! Just updated my profile settings to allow search.

arstechnica, to random
@arstechnica@mastodon.social avatar

The history of syphilis is being rewritten by a medieval skeleton

Columbus may not have brought syphilis back to the Old World after all.

https://arstechnica.com/science/2023/09/the-history-of-syphilis-is-being-rewritten-by-a-medieval-skeleton/?utm_brand=arstechnica&utm_social-type=owned&utm_source=mastodon&utm_medium=social

brianpierce,
@brianpierce@med-mastodon.com avatar

@arstechnica

Pertinent to #IDMastodon #medicalhistory #histodon

arstechnica, to random
@arstechnica@mastodon.social avatar

Toddler poisoned after eating deadly plant mislabeled as diet supplement

Nine out of 10 Tejocote Root products tested were actually deadly yellow oleander.

https://arstechnica.com/health/2023/09/toddler-poisoned-after-eating-deadly-plant-mislabeled-as-diet-supplement/?utm_brand=arstechnica&utm_social-type=owned&utm_source=mastodon&utm_medium=social

brianpierce,
@brianpierce@med-mastodon.com avatar

@arstechnica

#supplements #medmastodon #toxicology

erictopol, to ai
@erictopol@mstdn.social avatar

We've seen a cluster of advances in medical #AI in recent days, from randomized trials to making difficult diagnoses. The new Ground Truths gets into it all.

https://erictopol.substack.com/p/all-eyes-on-medical-ai

brianpierce,
@brianpierce@med-mastodon.com avatar

@erictopol
Pertinent to #artificialintelligence #diagnosis #MedMastodon #ai #ophthalmology

petersuber, (edited ) to Insurance
@petersuber@fediscience.org avatar

#Doctors billing for #emails
https://kffhealthnews.org/news/article/email-doctor-visits-new-fees-copays/

Wow. Lots of questions. One is covered in the article itself. Will this hurt patients?

"Many health care professionals share the fear that billing for [emails] will adversely affect medically and socially vulnerable patients. Even a relatively small copay could discourage patients from emailing their clinicians for medical advice in appropriate situations."

#Insurance #Medicine

🧵

brianpierce,
@brianpierce@med-mastodon.com avatar

@petersuber

Much of this is due to #feeforservice billing paradigm and prepaying for routine care via #healthinsurance

For #primarycare, it's simpler to dump both. That makes primary care efficient enough that we can provide it (and free phone calls and messages) for $44 to $99/month when the hospital clinic down the street is charging $173 to $351 per visit.

Save the insurance for big , expensive problems.

#costsofcare #directprimarycare #dpc #healthreform

erictopol, to random
@erictopol@mstdn.social avatar

Covid and the heart in today's NYT Science Times
https://www.nytimes.com/2023/09/07/well/live/covids-heart-health.html?searchResultPosition=1

brianpierce,
@brianpierce@med-mastodon.com avatar

@erictopol
#covid and the heart in #nytimes today.

#medmastodon #cardiology #covid19 #myocarditis

petersuber, (edited ) to twitter
@petersuber@fediscience.org avatar

To share with friends who moved from to :

" acknowledged…to The Washington Post that Threads is intentionally blocking the search terms ["covid" and "long covid"] and said that other terms are being blocked, but the company declined to provide a list of them. A search by The Post discovered that the words…“coronavirus,” “vaccines” and “vaccination” are also among blocked words."
https://www.washingtonpost.com/technology/2023/09/11/threads-covid-coronavirus-searches-blocked/
()

brianpierce,
@brianpierce@med-mastodon.com avatar

@petersuber

#scicomm #publichealth #medmastodon

jeffjarvis, to random
@jeffjarvis@mastodon.social avatar

This story says less about Silicon Valley than America, where health is a privilege....

Silicon Valley’s quest to live forever now includes $2,500 full-body MRIs https://wapo.st/3PHFftf

brianpierce,
@brianpierce@med-mastodon.com avatar

@jeffjarvis

All those false positives ("indidentalomas") from full body #MRI will get expensive workups, follow up studies that will be paid by the rest of us via higher insurance premiums and taxes.

Get some data first please.

#medmastodon #costsofcare #radiology #evidencebasedmedicine #ebm #sbm #sciencebasedmedicine

fulelo, to random
@fulelo@journa.host avatar

Deadliest #legionella strain found onboard #BibbyStockholm

https://www.theguardian.com/uk-news/2023/sep/08/legionella-found-onboard-the-bibby-stockholm-is-most-deadly-strain?CMP=Share_AndroidApp_Other

brianpierce,
@brianpierce@med-mastodon.com avatar

@fulelo #IDMastodon

PieterPeach, to random
@PieterPeach@mastodon.social avatar

These combined SARS-CoV-2 and Influenza A/B home lateral flow tests could be quite useful.
How would it change management?
How well might it facilitate early detection for those in which antivirals such as Oseltamivir are indicated and treatment needs to be started within 48hrs of symptom onset?
Could false -ves delay treatment where people avoid seeking better diagnostic tests?
#Influenza #infectiousdisease #IDMastodon

brianpierce,
@brianpierce@med-mastodon.com avatar

@PieterPeach You're assuming that #Oseltamivir is effective in treating #influenza

ProPublica, to Insurance
@ProPublica@newsie.social avatar

How Health Insurers Have Made Appealing Denials So Complicated

"I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals.

"Nearly everyone said the same thing: Great idea. But almost impossible to do."

#Insurance #HealthCare #Health Hospitals #Patients #Doctors #Medicare #Medicaid

https://www.propublica.org/article/how-to-appeal-insurance-denials-too-complicated?utm_medium=social&utm_source=mastodon&utm_campaign=mastodon-post

brianpierce,
@brianpierce@med-mastodon.com avatar

@ProPublica
Thanks for another great #healthinsurance article.

We're a #directprimarycare #familymedicine practice but still run into this frequently with insurers, i.e. automatic denials, followed by complicated time consuming online forms and phone calls, even "peer to peer" for tests that meet their criteria.

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