Amit Achhra, MD PhD MPH

#MedTwitter #STI rates are at all time high. Did u know any provider nationally can ask any STI-clinical question on @CDCgov run stdccn.org platform? I'm on their expert team & can confirm they take this seriously & help with a variety of cases simple to complex 1/2

Glad to see #CROI2026 has kept up its bag game :)

@MarkDrazner @UTSWMedCenter @JtThib @HFSA @JACCJournals @ACCinTouch @AHAScience @KhazanieHeart @UTSWInternalMed @utswheart @UTSWCardfellow @UTSWIMchief @hmkyale Is there a link? Thanks

The future of #HFrEF treatment: can we move from a strategy of “Lifetime quadruple therapy for all” to “Personalized GDMT”? Congratulations to @UTSWMedCenter MS4 Michael Pitonak for leading this effort! @jtthib

Incredible piece showing why hospitals are the biggest driver of healthcare spending. Everyone wants to blame pharma but that’s not what’s happening. Hospitals can mark up drugs when they administer them. And those markups can be absurd. Bloomberg found hospitals charging insurers five times, ten times, even over 700 times what Medicare would pay for the same drug. Example from the article: Oxaliplatin. A 20 year old generic cancer drug. Long off patent. The manufacturer barely makes money on it anymore. Medicare pays about $35 per dose. Yet nearly 150 US hospitals billed five times that or more. It is hospital pricing power. This is why premiums are high. This is why out of pocket costs are high. Hospitals are the single largest driver of healthcare spending. Must read from @Bloomberg.

I don't think I've ever seen as much disconnect between doctors and the public as with the excitement (or lack thereof) with whole-body screening MRI. Not a single doctor I know would get (or recommend) a whole-body screening MRI. Everyone speaks of false-positives, but other major issues with WB-MRI 1. Some cancers grow aggressively and some slowly. These are not false-positives, but overdiagnosis. Taking all lumps out means you're undergoing surgery and thinking "wow thankfully this MRI found this cancer or I could've died!" when in reality the thing could've sat there for decades without problems. 2. WB-MRI is limited by the technology. An MRI to evaluate liver tumors, for example, is a specialized triple-phase MRI. A WB-MRI, on the other hand, tries to save time and so is a "crude" scan which will miss many tumors including colon/GI luminal cancers and lung cancers. 3. AI might catch lesions that human radiologists miss, but it cannot characterize tumors beyond what the imaging limitations allow. Many lesions seen on MRI, no matter how much AI you throw at it, will remain ambiguous. The only way to diagnose these lesions is to cut them out, which again leads to unnecessary procedures. And then all the usual issues with cancer screenings (lead-time bias. etc). Vinay Prasad speaks on this at length.

India’s fight against TB is achieving remarkable momentum. The latest WHO Global tuberculosis report 2025 highlights that India has recorded a commendable reduction in TB incidence since 2015 and it is nearly twice the global rate of decline. This is one of the sharpest drops seen anywhere in the world. Equally heartening is the expansion of treatment coverage, the fall in ‘missing cases’ and the sustained rise in treatment success. I compliment all those who have worked towards achieving this success. We remain committed to ensuring a healthy and fit India! pib.gov.in/PressReleasePa… @WHO

@Papa_Heme How’s the EMR and “required training modules” experience?! @Papa_Heme

Deep thoughts on leaving academics… The amount of silly and redundant emails I receive has dramatically decreased since leaving academics. This is nice.

Eye of the beholder No difference in overall mortality Massive overdiagnosis-many medicalized for no reason Screen 400+ men to avert 1 prostate ca death over 20+ years Doesn't include QoL harms of biopsies & treatment If honestly presented, many would say no thanks

@AnilMakam Interesting. This massive NIH trial is in planning fyi clinicaltrials.gov/study/NCT07199…

fascinating trial from 18 public hospitals in Kenya! Steroids work safe to say its driven by severe CAP with hypoxia Rare example where the subgroup analysis is very helpful there is prior evidence of benefit if hypoxic & on oxygen vs not Not flukish

@pash22 @AnilMakam @DrSidMukherjee @NewYorker Excellent thanks for sharing

@AnilMakam Have you read the recent article on this topic by @DrSidMukherjee in @NewYorker Anil ? newyorker.com/magazine/2025/…

Ouch I'd stay away from Grail unless far more convincing evidence emerges

@AnilMakam Yes no surprise there unfortunately

what a coincidence! with next admin change, I would think Peter Marks will be considered to return he did an amazing job approving meds that didn't work and may have even killed young boys with very worrisome early phase data

@AnilMakam See this time and again. Goes to show many physicians don’t feel confident in their ability to read/interpret evidence and feel the need for someone (guidelines) to permit them to change. In fact even after guidelines update, change is slow to be adapted

Guidelines are neither scripture or always evidence-based, and slow to updating Think of all the harm by waiting not to adopt good evidence

@AnilMakam Interesting. Knew about artificially low thresholds but didnt know about lobby influence there! Any reference there? Thanks

None Vit D thresholds to define deficiency were lobbied to be lowered by politics and money, not science Its also one of the best treatments studied No benefit from repletion for virtually any symptom or disease

@drjohnm @MartyMakary @VPrasadMDMPH @US_FDA I hope it doesn’t mean longer ads with more disclaimers!

I am 💯 behind free speech. But pharmaceutical (AND DEVICE) ads are an abomination. I support @MartyMakary @VPrasadMDMPH @US_FDA in their efforts to stop deceptive advertising. Optimism is in short supply these days but new FDA makes me hopeful

@DrOnyemaOgbuagu Wow share pics!

HIV unwrapped at NY fashion week 2025 holds tomorrow and pairs HIV experts and fashion designers to make "statement" lab coat designs that raise awareness around HIV and tackle stigma. Science and fashion blend I will be walking their red carpet tomorrow. instagram.com/reel/DOJ3f8Yks…

@PaulSaxMD @CarlosdelRio7 Agree. And that’s the danger- we might lose public trust in good ones like this one if we push questionable ones too hard (e.g covid vaccine for low risk /young).

@CarlosdelRio7 This is one of the great vaccine success stories of our lives. My wife (a pediatrician) saw this previously live-threatening disease of children disappear after its introduction.

The impact of the HIB vaccine in essentially eliminating a devastating meningitis is infants is simply amazing. #vaccineswork

@DrDamluji @TheLancet Thnx. For how long would u continue? What was the max follow up ?

β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials: @TheLancet 🥸 Data on beta blockers with mild LV systolic dysfunction are mixed (even for normal LVEF)! 😱 Summary 👇👇👇

PEPFAR Commits to Distributing Breakthrough HIV Drug Lenacapavir Demonstrating American Excellence in Science and American Leadership in HIV Prevention - United States Department of State state.gov/releases/the-u…

@MonicaGandhi9 So why not just campaign to insurance or state funds, instead of forcing change in recommendations against evidence (or lack of)?

HHS Secretary hearing this am: Most experts, including FORMER ACIP members, don't think young healthy people need COVID boosters. Issue in US is can't get boosters on insurance without being on CDC guidance which is probably why former ACIP had them on medpagetoday.com/opinion/second…