David B. Stewart, MD, MHA, FACS, FASCRS

I went from exposing billions in dirty money… to not being able to afford food. After I blew the whistle, I lost everything. Sleeping on a cot. No safety net. No backup plan. @PFChangs took a chance on me—gave me a job as a waiter and made sure I ate. I’d go home with lo mein just to get by. People don’t forget who shows up when they’re at their lowest. If you’re hungry—go there for lunch.

novo nordisk's semaglutide went off patent today... weight loss drugs that cost $100/month can now, when produced generically, cost $3 a month per patient (insane)

Afroman is the hero we all need right now.

To our Jewish community: This is what’s happening in the West Bank right now. A Palestinian man describes a brutal sexual assault by Israeli settlers amid a wider pattern of escalating terror and impunity allowed by the state. We have to see Palestinians’ humanity – and the reality of their abuse at the hands of other Jews – and ask what kind of country Israel is becoming. Then demand a different path.

1/ In a phase 2 obesity trial, 100% of patients on Retatrutide 8mg and 12mg lost at least 5% of their body weight. Not most. Not the majority. Every. Single. One. In obesity pharmacotherapy, that doesn't happen. Or at least it didn't — until retatrutide. 🧵 substance-over-noise.beehiiv.com/p/the-drug-tha…

Remember - it’s self-referral when a physician does it. If I own the hospital, and employ the physician - they must self-refer to their and its verticals or else they’re not being a team player. And - I’m even going to “legally” induce those referrals by paying a wRVU. The gaslighting is insane. This is why there’s a hospital in every soap opera.

Rapid fire glp-1 med myth busting - no difference from placebo in pancreatitis - medullary thyroid cancer seen in rats not humans (humans don’t have GLP-1 receptors there while rats do) - muscle loss is same as caloric restriction - gastric emptying slows initially but goes closer to normal after months. No strong data for permanent issues other than random lawsuits. - help with weight loss via appetite. They are not metabolism boosters (yet) - they do have multiple benefits beyond weight loss

Dear @AnthemBCBS @Aetna @Cigna @UHC I can tell you guys are feeling it. NSA is here 2 stay. Get with the program & stop the denials for indicated and medically necessary care. Physicians & payers can play in the same sandbox. We certainly r important to a functioning system. RU?

@FAHhospitals You mean like you own the hospital, the clinic, the radiology suites, the doctors, the physical therapy clinics, the outpatient radiotherapy places, and the home health? And you silo out private physicians from accessing your systems? Cry me a river. Tick-tock

@FAHhospitals “Self referral” is what hospitals make their employed physicians do, all the time. If avoiding conflict of interest is so important, we should end hospitals employing physicians and restore physician’s independence Don’t you agree?

I’m sorry you’re dealing with this. But when a university taking in billions in revenue chooses not to buffer even short-term funding delays or prioritize its resources around science, while administrators expand their offices and take in seven-figure salaries, it says everything about the model. Scientists are treated less as scholars to be supported and more as revenue generators for indirect costs, with all the financial risk pushed onto them.

@sammyjoluxton1 @JacksonG36452 Sammy, exactly. There are ways to avoid a slippery slope, while doing better for terminally ill patients who cannot be cured and who are dying in an ignoble manner due to pain and suffering.

@JacksonG36452 I don’t support how broad Canada’s system is. I’m talking about terminal illness as the only exception

My grandad had bowel + prostate cancer - he was so unwell, in agonising pain every day, being fed medication to knock him out 24/7. He begged us to kill him, every day said he couldn’t wait to die. I know he would have loved to have the option to go peacefully on his terms 😅

Reviewer 1: "this is a great piece and I look forward to seeing it in print" Reviewer 2:

What happens to the heart when people stop GLP-1 drugs? The short answer: nothing good. New from our team: a study of 330,000+ people in @BMJMedicine 🧵

The only AI system ever cleared to diagnose a patient without a doctor in the room does one thing: scan a photo of your retina for signs of diabetic eye disease. That was 2018. In the 8 years since, two more systems got cleared for that same single task. That's the full track record of autonomous AI in medicine. The FDA has authorized about 1,450 AI medical devices through the end of 2025. Sounds like a lot. But 76% are radiology tools, and almost all of them just flag something on a scan for a human doctor to review. They don't diagnose. They don't treat. They highlight. A March 2025 study in npj Digital Medicine combined results from 83 separate studies comparing AI with physicians on diagnostic tasks. Overall AI accuracy: 52.1%. Expert doctors were significantly better. And in real-world clinics (not carefully designed test scenarios), AI showed no meaningful edge over standard care. Diagnosis is a sliver of what doctors actually do. The US performs 40 to 50 million major surgeries a year. About 11% of Americans undergo surgery each year. No AI is cutting anyone open. No AI is delivering a baby at 3 am, managing five medications for a patient with four chronic conditions, or sitting across from someone explaining what stage 4 means. And the US has too few doctors, not too many. The AAMC (the Association of American Medical Colleges, which tracks physician supply) projects a shortage of up to 86,000 physicians by 2036. Right now, 74 million Americans live in areas the government classifies as primary care shortage zones. If underserved communities had equal access, the country would need 202,800 more doctors just to meet today's demand. 42% of active physicians are 55 or older. A third of the workforce will retire this decade. There's also a legal wall no one talks about. Under current US malpractice law, if an AI tool contributes to a bad diagnosis, the doctor gets sued. Not the algorithm, not the developer. There is no legal framework for sharing responsibility with AI. A Johns Hopkins study found that surgeons generally accept that final responsibility remains with them even when AI is involved. Until liability law catches up, no hospital is giving clinical authority to software. AI is already useful in narrow spots, like helping a radiologist catch something they might miss on a scan. That's real. But it's closer to spell-check for X-rays than it is to replacing your doctor.

He's a child and has witnessed more horror than millions of individual people will go through in a lifetime.

Jews like me have been speaking out against this genocidal filth bc it's the moral thing to do. How could we not. But I wonder if those Jews who haven't done so but claim to care about Jewish safety will see the need to speak out against this.

The boy who saw seventy bullets pierce through his family in Tammun said: "I asked the soldier, 'Do you love your father and mother?' He replied, 'Yes.' I said to him, 'Then why are you killing my father and mother?' So he slapped me across the face." Noor Abu Salma