Steven Bishop, MD

Yes, our long term goal is decentralized saline manufacturing with integrated 503a and 503b compounding capabilities! Been following your journey, it’s a hard road no doubt about it—usually the best medical ideas come from patients living through our systems. Would love to hear about it!

@GenMedDoc Ooh. Decentralizing IV fluids? I've been thinking about an idea, mid way through starting chemo...

Who knows a lot about compounding pharmacies?

@YoungEx20 @CoffeeBlackMD 7 days in the hospital with round the clock Zofran and IV fluids. He turned out ok but man…

@GenMedDoc @CoffeeBlackMD Oh my God how did that end up?

If you chug a whole bottle of methadone syrup, how long will you need to be in the ICU on a narcan infusion? If you said *at least* 4 days!! You’d be correct. But we are still finding out!! Science!!!

@SMB_Attorney I can’t even fathom how they think this would be enforced…

Special interests everywhere are going to work tirelessly to keep AI out of law and medicine. If they succeed, and only doctors and lawyers can use AI for those purposes commercially, doctors and lawyers will make 100x the amount of money they previously made.

@ProjectVirginia They behave as if they are at war and our republican colleagues pretend it’s another day at the club. Wild.

This is why there needs to be a complete, nationwide purge of anyone who shows any signs of being "woke" from American health care. They are harming, even murdering people on purpose.

@AssocAnderson Any thought on the physician assisted suicide bill that’s sure to come back to the GA? Will docs be able to say “no” if a patient comes asking for this if they pass it into law?

Things I am watching and worried about in 2026 - related to the First Amendment and Religious Liberties in Virginia. Religious Exemption for Home-School Families Virginia’s long-standing religious exemption allows parents to educate their children at home based on sincere religious conviction. Democrats have already signaled interest in repealing or tightening this exemption. Expect bills requiring home-schooled children to meet state testing, curriculum, or teacher-qualification mandates — which would effectively erase parental religious autonomy. Nondiscrimination Mandates vs. Religious Autonomy New proposals are likely to expand “protected classes” under Virginia’s Human Rights Act and attach these mandates to all organizations, including religious schools and ministries that receive any public benefit or recognition. Churches could face legal pressure to hire or retain employees whose lifestyles or beliefs contradict doctrine, or to open facilities for activities that violate their faith. Church and Ministry Outreach in Public Schools Public schools are increasingly restricting outside groups — including faith-based mentoring, prayer, and chaplaincy programs. The next session could formalize those limits, imposing “inclusive access” rules that require churches to comply with state diversity or gender-identity training to participate in student programs or after-school events. Faith-Based Social Services and Funding Strings Expect tighter regulations on churches and nonprofits that contract with or receive funds from the Commonwealth — including shelters, counseling centers, or crisis-pregnancy ministries. Future grant rules could condition participation on adopting nondiscrimination statements that directly conflict with biblical teaching. Many ministries will face a choice: compromise conviction or lose state partnership. Redefining Religious Freedom Protections Some lawmakers are discussing a “modernization” of Virginia’s religious-freedom statutes — code for narrowing the scope of what counts as a protected religious exercise. Proposals could raise the bar for claiming conscience protections or add procedural hoops before a church or school can assert a free-exercise defense. This would erode the strength of Virginia’s Statute for Religious Freedom — the same principle authored by Thomas Jefferson.

Want to solve the rural healthcare crisis in America? Just get out of the way and let physicians solve it. You don't need new subsidies that will just be directed by politicians towards their buddies in large consolidated hospital systems. Let physicians build hospitals and solve it. Look at Doctor's Hospital Renaissance in the Rio Grande Valley. Built by physicians, this hospital serves its community, with doctors practicing where they grew up. That's all you need. Doctors desprately want to build new hospitals. They want to serve their communities. They want to provide high quality care at low cost without the administrative bloat that is destroying their profession. Physician ownership of hospitals was outlawed in the Affordable Care Act, and now, for over a decade, physicians have been blocked from solving the the problem of rural healthcare. Just let doctors build. See our latest in @BeckersSpine below

@generalorthomd A relic of a more civilized age…

These “surgeon preference cards” that are reportedly referenced by OR staff to make sure you have all the proper equipment for a surgery… Those are a myth, right?

@AtlasMD Denial is a heck of a drug 😂

dpc hasn't taken off yet :) ... that comes as a surprise to 1000s of direct care docs

@AJA_Cortes Research

I wrote a free Guide to Peptides which explains what they are in layman's terms, answers common questions, AND has a cheat sheet for ALL major peptides used in research today Comment "research" and I will DM it to you

Looks like those of us opting out are right over the target.

Correct

@drmoneymatters The early retirements and transitions to part time will continue until morale improves. Oh and apparently forays into politics…

Take a look at the comments. Doctors are not the problem and other doctors/politicians calling them out doesn’t help.

Tell me you are out of touch without telling me…

@Rick_Pescatore Today is my last clinical day at the current place as well! God speed!

Today is my last shift in academic emergency medicine. After 15 years inside the system, I’m stepping out—not to leave medicine, but to rebuild part of it from the outside.

@BowTiedHRT We homeschool our kids through Northstar and it's a gift. They are not caught up in the hamster wheel of the college admissions hype cycle. I wish more families would go this route...the kids will be just fine and succeed without the $200K in unnecessary debt.

I sure hope so. Especially with the ridiculous cost of education and books these days. I paid over $1000 for a book on more than one occasion for a class that was completely unnecessary for the advance of my education. Just matriculating so that I can finally apply to law school. What a waste.

My wife and I had a similar conversation this week. A lot of people are still in the Matrix on this...

@DrBretEHO @BowTiedHRT @FitDadRx @CoffeeBlackMD (All of which you obviously understand given you are a doc)

100%, the younger docs will come around quicker. They are living in AI fueled research. Despite what many believe medicine is very very complex and you can harm or kill people easily. When you bear the burden of those choices on behalf of others, you have to think twice, or thrice before you act.

This is the nonsense guys are dealing with out in the world of the every day doctor. In shape super healthy guy and this is your suggestion…. @CoffeeBlackMD @BowTiedHRT @DrBretEHO