Thomas Bottiglieri, D.O.

Excited to share our team's work on ProScope - a new AI-powered diagnostic tool that could transform how we detect concussions. By measuring unconscious head and neck stability patterns, we're able to identify concussions with 80-90% sensitivity in just 3 minutes. This technology addresses a critical gap in sports medicine, where up to half of the estimated 3.8 million annual concussions go unreported. Grateful to collaborate with Dr. Linus Sun, Christopher Driscoll, and the team at NewYork-Presbyterian and Columbia. Read more at nyp.org/advances/artic… #Concussion #SportsMedicine #MedicalInnovation

Back pain is one of the most common problems people face, and lumbar disc herniation is a major cause behind it. In this Sports Medicine Minute, Dr. Bottiglieri explains how spinal discs work, why disc injuries happen, and how pressure on nerves can cause pain that travels down the leg. Watch this quick and simple explanation to better understand lower back pain, sciatica, and spinal disc health. #BackPain #LumbarDisc #Sciatica #SportsMedicine #DiscHerniation #LowerBackPain #SpineHealth #SpinalHealth #Recovery #BodyPain #DrBottiglieri youtube.com/shorts/tBSyyJv…

@RepGregMurphy It’s thanks to our government that medicine is being eroded at the hands of lobbyists so that politicians government’s friends are being enriched. It’s not healthcare dollars that are costing America 20% of its GDP - it’s an insurance scam

Unless our Medical Schools do a better job of screening admission candidates, we won’t have any Doctors. If you don’t want to practice FULL time for at least 20-25 years, pick another profession.

Are you bending and lifting the wrong way? 🤕 Thomas S. Bottiglieri explains why proper hip hinging is essential for protecting your lower back and strengthening the deep spinal muscles that support everyday movement. Avoiding movement may actually make back pain worse — learn how simple hinging exercises can help restore strength, stability, and confidence. #BackPain #SpineHealth #HipHinge #Mobility #PhysicalTherapy #LowBackPain #Posture #FunctionalMovement youtube.com/shorts/Cb9tJX-…

Perverse incentive. The definition of

@DrDiGiorgio @X0_1_7ex @Henry_White1996 “Free” Such an interesting word.

@Henry_White1996 I implore you to learn about second order effects

Look me in my eyes and tell me this wouldn’t be transformative for millions of American families

@grok @DutchRojas Be more specific about assets and debt. How can independant doctors or start up practice keep their costs low and asset appreciation high?

The post means this: Private equity is buying up doctor practices because docs often have weak finances and sell out easily. But instead of just learning to read a profit/loss statement, focus on building a "fortress balance sheet"—strong ownership of assets (like your office, equipment, savings) with low debt. That makes selling unnecessary. You stay independent, keep control, and create lasting wealth to pass to your kids and grandkids. Start now and the corporate takeover problems go away.

I don’t care if physicians know how to read an income statement / profit and loss. I only care about building a fortress balance sheet for physicians in the independent practice of medicine. The balance sheet is what you own. 99% of you wouldn’t ever think about selling if you built your balance sheet. You could pass on permanent capital to your children’s children. All the 💩you complain about has been solved. You just have to take the first step.

California is losing. Why? Communism. Producers flee these environments. California was a hotbed of innovation. But working class through big business tax payers do not want to fund friends of government - AKA legalized extortion pretending that it is in service of the unfortunate. New York and California are losing and will continue to lose until those voting in the commies run out of money. And they will. Nothing is free. In New York it costs 40k per student enrolled in public education. Where does that money go? 🤔 “substantial data from government sources shows that California has experienced significant net out-migration of residents (including tax filers and higher earners) and a net loss of some company headquarters in recent years, though the overall economy and business formation remain robust in key sectors. Domestic Migration and Population Trends U.S. Census Bureau data consistently show California with the largest net domestic out-migration (people moving to other U.S. states) of any state: • July 2024–July 2025: Net loss of approximately 229,000 people domestically.  • California Department of Finance estimates: Net domestic migration loss of about 216,000 in 2024–2025.  This continues a long-term pattern of net domestic outflows (often 100k–400k+ annually in recent years, peaking during the pandemic). Overall state population has been roughly flat or slightly declining recently (e.g., a drop of ~9,500 from July 2024 to July 2025, to about 39.355 million), as international migration has partially offset domestic losses—though international inflows dropped sharply in 2025.  Taxpayer and Income Migration (IRS Data) IRS Statistics of Income migration data, which tracks address changes on tax returns (a proxy for households and income), confirms net losses of tax filers and adjusted gross income (AGI): • 2022–2023: California lost a net of roughly 100,400 income tax filers (largest in the U.S.) and approximately $11.9 billion in AGI.  • Broader IRS figures for recent years (including 2023): Net domestic outmigration of about 200,000 people (filers + dependents), down from pandemic peaks but still elevated compared to pre-2020 levels.  • High earners: Outflows have been notable, with analyses (e.g., Center for Jobs) showing net losses of high-earner households and billions in AGI in years like 2022. Pandemic-era data showed elevated outmigration rates among upper-income groups.  Leavers often move to states like Texas, Florida, Nevada, Arizona, and North Carolina (lower or no state income tax, lower costs). Cumulative income losses in the billions have occurred over multiple years. Business and Headquarters Trends • Headquarters relocations: A Public Policy Institute of California (PPIC) analysis found a net loss of 789 headquarters from 2011–2021 (about 1.9% of CA headquarters at the start), equating to roughly 77,600 headquarter jobs (3.7% of the total). Outflows have trended upward while inflows declined. Most moves involved smaller firms, though larger ones were more likely to relocate proportionally. Many went to Texas, Florida, Nevada, or Arizona.  • High-profile examples include Tesla (to Texas), Chevron (to Houston), and others like Public Storage or In-N-Out in recent years.”

California found the expandable word in Medicaid: Health. Once “health” includes housing, meals, bikes, scooters, gym memberships, art lessons, music lessons, and student loan repayment, the program stops being a safety net and becomes a vendor factory. Sacramento expands the definition. Taxpayers in the other 49 states cover the bill.

Interesting. It’s happening. Transparency. But there are radicals that don’t believe facts.

@VigilantFox @jaschmd Facts have no place in the communist intifada.

Bill Maher just dedicated the end of his show to throwing his own party under the bus for defending every minority group except Jews. “There is a frothing anxiousness for the literal extermination of this one group. And Democrats, where are you?” “If any other minority group was being talked about this way, you’d break out the Kente cloth and have 10 benefit concerts.” “But because you see that so many of your brainwashed-by-TikTok constituents now have an unfavorable view of Israel, you indulge them when you should be correcting them.” “All the people likely running for president now on the Democratic side want it known they don’t take money from AIPAC, the Israeli lobby… You take money from crypto and factory farmers and big tech, from Diddy and Weinstein and Epstein, but AIPAC is too far?” “Let me just say this to all who ask me, ‘Why are you harder on the Democrats than you used to be?’ Until you fix this whole issue, stop asking me.”

Two wings. One bird. None of them care about American people. They care about their pet projects and protecting the profits of the conglomerates. And we are all too stupid to figure out how to restore order.

The opportunities are there. It is time.

@mcuban @Benefitsguynick @HeathVeuleman @DutchRojas would love to hear your thoughts on this. Should doctors be recommending this program?

Costpluswellness.Com is changing how employers think about their healthcare costs. Now you can carve out for direct contracts with providers and cut your healthcare costs. And it’s all transparent beckersasc.com/asc-coding-bil…

@Benefitsguynick Excellent information. So much of the insurance industry is an outright scam. It seems more like a tax than actual share risk. It’s Not just health insurance. The whole concept is broken.

A conversation was had today that might bring you value, it was around rate guarantees on medical stop loss insurance. Here's the facts. A rate guarantee typically comes as a promise to not raise your rates at renewal by more than 30-50%. The finance charge typically runs 5-10% of total premium. Therefore, if 7.5% finance charge on a $1M premium, you're paying $75k for the promise, but here's the rub for me. 1. A group that is well managed typically isn't going to see stop loss rates increase anywhere near 30%. If that's you, you bought an expensive insurance policy on your insurance policy. 2. A group that is anywhere near or above that 30-50% threshold has some serious issues on it and likely is not being managed. If that's you, you bought an expensive insurance policy on a dumpster fire. I'm not saying rate cap guarantees aren't worth consideration in some scenarios, but more often they are premium paid and no value in return. P.s. the rider premium is commissionable, so if it costs you $75k, your broker probably just made $7500 for getting you to check the box yes.

The post by DutchRojas argues that most generalist VCs don't understand real clinical workflows (e.g., how doctors actually use EHR systems). They pour billions into digital health tools that physicians ignore, which is why Series B funding has collapsed (30 deals through Q3 2025 vs. 63 three-year avg). PhyCap (PhysiciansCap) is a physician-led fund filling that gap—doctors diligence deals with clinical insight that pure capital can't match. Fund I closes May 31. Read more via DutchRojas daily threads or PhysiciansCap.

The joy of discovery. That’s the big why. @chris_driscoll1

@DutchRojas I need to Understand this better. @grok please explain the post above. Where can I read more?

Most generalist VCs can’t tell you what an EHR workflow actually looks like. They’re allocating billions on tools physicians will never touch. US digital health Series B raises through Q3 2025: 30. Three-year average: 63. The middle of the funding stack collapsed because generalist capital can’t underwrite what it can’t read clinically. That gap is the entire PhyCap thesis. Physicians who diligence companies before they fund them have a structural edge capital alone can’t replicate. Fund I closes May 31, 2026.

@realdocspeaks @DutchRojas @HeathVeuleman @KaufCare Direct specialty care? Examples?

@DocBottsNY @DutchRojas @HeathVeuleman Direct care is the answer and this can be DPC,DSC, or DAC. DAC is personified by @kaufcare!

We are holding on and holding onto hope. But they are destroying our profession. We will either advocate and save ourselves or the profession will go the way of the dinosaurs. 🦖 @DutchRojas @realdocspeaks @HeathVeuleman

One of the world`s most common knee surgeries does not help and may even be harmful . docbotts.com/healthcare-new…