David Miller

It was an honor to present in the plenary session at the #AUA24 alongside @KelliGrossMD and @kat_hwangMD talking about the impacts of COVID on male fertility and sexual health! @AmerUrological @dsui_miami_uro

If this is the end of the Pens Big 3, what a run it’s been. — 3 Stanley Cups — 3,924 games — 3,974 points — 1,365 goals — 3 Conn Smythes — 3 Harts 20 years together. The longest-tenured trio in North American pro sports.

Dr Oliverson is completely right In 1998, the Medicare conversion factor was $36.69 for physicians. In 2025, just with inflationary updates, that number would be $72.61. It was $32.35. The AMA graph shows that hospitals are roughly at consumer inflation What isn’t accounted for is additional facility fees that hospitals make when physicians are employed in their facilities. Those numbers are 3x what a physician makes under Medicare and even greater under private health insurance. @IndeMedAction

College tuition has increased 914% since 1983, per CNBC.

A first-year resident earns less per hour than the Starbucks lead down the street. A first-year MBA at the same hospital earns 3x more. We built a system where the people closest to the patient have the least leverage. That's not an accident. It's a design choice.

Healthcare administration costs should never exceed patient care costs.

Imagine your surgeon preparing for your operation. They see you in pre-op, answer your questions, calm your fears, examine you, confirm the plan, and go get ready for the case. They review the imaging and think through the critical parts of the operation. Then a nurse interrupts them: “Doctor, your pre-op documentation isn’t good enough. You can’t just say you discussed the risks and benefits. You need a full H&P.” The surgeon points out that the H&P was already done in clinic. The note is right there in the chart. “No. That note is 31 days old. It has to be within 30 days. But it’s fine if you just copy and paste that old note.” Think about how insane that is. There is no new clinical information. There is no patient benefit. There is no improvement in safety or quality. The only thing being demanded is duplication. A pointless bureaucratic ritual to satisfy the machine. So now you have a frustrated surgeon, a delayed case, a bloated chart, and one more example of modern medicine confusing clerical box-checking with patient care. This is exactly what is wrong with the system. Endless note bloat. Pointless duplication. Administrative nonsense dressed up as professionalism. If there are no changes, there are no changes. Forcing a doctor to re-paste an unchanged H&P adds absolutely nothing for the patient. And the most insulting part is the tone. That smug, condescending “of course you have to do it this way” attitude, as if this is self-evidently necessary instead of obviously stupid. At this point, a lot of doctors would probably take a substantial pay cut to never touch a computer again. Cut the salary and use the savings to hire people to do the computer garbage. Epic. CDI queries. Coding queries. H&P updates. Order entry. Case booking. Inbox nonsense. All of it. Never touch Epic again. Never answer another coding query. Never update another unchanged H&P. Never place another order that a clerk or protocolized team could enter. Never do another ounce of hospital data-entry cosplay. Just let us be goddamn doctors instead of highly trained documentation technicians.

Every physician knows this feeling: clicking through required modules as fast as possible Not because we don’t care, but because the system values completion over learning. ja.ma/4vvyvBm

This is a stunning new statistic from @IQVIA_global: 70% of new prescriptions are initially rejected by private insurers. Many of those prescriptions are eventually approved, but it can take up to a year, and about one-quarter are still ultimately denied.

Ovechkin. Crosby. Malkin. Letang. This is hockey royalty.

This trio is BACK in the Stanley Cup playoffs 🐧 How far will the Penguins go? 🤔

I had a chat with Sid yesterday. He told me what pushed him most in recent seasons is the thought of hearing the noise of the Pittsburgh crowd when he, Geno Malkin and Kris Letang take the ice in a playoff game again. He will get his wish. The Penguins are headed to the playoffs.

Medicare reimbursement rates for physicians have dropped 29% in real dollars since 2001. Hospital facility fees? Up 60% over the same period. The money didn't disappear. It just stopped going to doctors.

Players with 21 point-per-game seasons: Sidney Crosby. End of list.

The most profitable “nonprofit” in Texas is Houston Methodist hospital. They paid their executives over $47MM in 2024. - CEO Mark Boom $7.25MM - Kevin Burns $3MM - Roberta Schwartz $2.8MM - Mick Cantu (legal) $2.5MM - Dirk Sotsman $2MM - Shlomit Schall $1.4MM 11 more between $900-$1.1MM

Our country is so dumb that we will replace MDs with AI instead of the legions of healthcare rent-seekers.

Indiana. I hope you understand how insane of a sports run you are currently on. Purdue 2024 Championship Game Pacers 2025 Finals Indiana 2026 CFB Championship Purdue 2026 Elite Eight+ Haliburton, Clark, Smith, Mendoza Enjoy every moment.

An article about male fertility that doesn’t include the opinions of any male fertility specialists aka UROLOGISTS is not a good article. This lack of insight highlights how lost we are when it comes to male infertility. The normal layperson (including this journalist) doesn’t know who to ask about male fertility. We urologists are the gatekeepers of men’s health and male fertility and need to be better. We need to be louder and more vocal. Let me be clear - male infertility is treated by urologists, so if you’re having issues or fertility concerns please go see one!

A vasectomy on Opening Day!

Evgeni Malkin's certainly mastered the art of the spinning backhand 🤌 🇺🇸: @espn ➡️ espn.com/watch 🇨🇦: @SportsOnPrimeCA ➡️ primevideo.com/nhl

#EAU26 DRE not recommended for asymptomatic men. What are people’s thoughts on need for routine DRE in era of MRI? @ChapinMD @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @CanesDavid @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy