Dr. Leo Spaceman, FSIR

Glory holes, but it’s a restaurant with a seasonal tasting menu and that’s how chef prefers diners experience his art. You sit on a communal bench with a wall on the other side. Restaurant is called something classy like “The Pemberton”.

Talking like people have to live in the US, pay taxes in the US, spend money in the US, etc to be employed by US companies, but also complaining about the end of WFH is something else. I suspect the only reason some of these jobs aren’t completely off-shored is politics. BCWYWF.

@EM_RESUS You have posted a variation of this 20x. Are you a huge brown-noser or just engagement farming physicians who are brown-nosers (which is a large percentage). @anals_of_IR

I don’t care what anyone says, when a nurse says “I have a bad feeling about this patient”, the shit is about to hit the fan until proven otherwise.

@VPrasadMDMPH *breasted person. This could also put a transwoman or trans man’s life at risk. You, sir, are a bigot and a bit of a cad.

This study looks at 20 mannequins for CPR and finds that none of them have breasts. But the study doesn't show that if you make a mannequin with breasts, CPR rates go up in women, or that they have better outcomes, or that their lives are saved. And in fact, I doubt it.

@gardengirl125 Latina? Excuse me. LatinX. You bigot.

Listening to a group of old white women at lunch in the booth behind us today. Talking about how happy they were that he won. Someone mentioned Gaetz being the AG and that he was accused of sex trafficking and the friend replied, "all he did was take his girlfriend on a plane ride". Then they moved onto how he'll deport the "illegals"... in a Mexican restaurant w/ a latina waitress. Fuck this fucking place

@AndreaR9Md Hi, radiologist here. Not trying to get in on the larger debate here. But you are wrong. We detect cardiac movement as early as 34 days and most often by 7 weeks.

I do not know why I have to say this repeatedly on Twitter. There is no such thing as a fetal heartbeat at 6 weeks. It is electrical activity from pre-cardiac cells. There is no guarantee that these clump of cells will materialize into a baby. Just get the fuck out of our lives,

@SteveWiesnerSMB This is a lot of effort for a post that will change absolutely no one’s mind. The people that believe in price gouging are *willfully* economically illiterate.

$47.61 for paper towels and TP at Target today. Absolutely insane example of corporate greed and price gouging. In fact, it made me so angry, I decided to do some analysis. Many prices have increased by 50% or more since COVID, so I decided to put on my investment banking hat and spread some financials back to 2018 / 2019. And man, was I ever surprised... I started by looking at Target's annual revenue: 2018: $75.4 billion 2019: $78.1 billion 2020: $93.6 billion 2021: $106.0 billion 2022: $109.1 billion 2023: $107.4 billion Last Twelve Months (LTM): $106.6 billion Couple things I noticed. First, revenue has slipped a bit since 2022 and is continuing to do so in 2024 - not a great sign for the broader economy. Second, there's been big growth since 2018. They must be price gouging! Well, I looked a bit deeper. Let's look at their cost of goods sold over the same period (the price they paid to buy the products they sold you). 2018: $53.3 billion (70.7% of sales) 2019: $54.9 billion (70.2%) 2020: $66.2 billion (70.7%) 2021: $75.0 billion (70.7%) 2022: $82.2 billion (75.4%) 2023: $77.7 billion (72.4%) Last Twelve Months (LTM): $76.8 billion (72%) Wow, so let me get this straight... Target is making less money (28 cents) on every dollar of sales today than they were in 2018 (29.3 cents). Hmmmm. That's weird. Maybe they're not so good at this price gouging thing. So, I decided to dig even deeper. They were prolly being evil and firing all of their employees so they could make up for the money they weren't gouging, right? So, I looked at their operating expenses (the amount they pay to run the stores and the overall business): 2018: $15.7 billion (20.9% of sales) 2019: $16.2 billion (20.8%) 2020: $18.6 billion (19.9%) 2021: $19.8 billion (18.6%) 2022: $20.7 billion (18.9%) 2023: $21.6 billion (20.1%) Last Twelve Months (LTM): $21.7 billion (20.3%) Hmmmm. Very unusual behavior for someone price gouging me. Let's sum this all up by looking at their operating cash flow: 2018: $6.3 billion (8.4% of sales) 2019: $7.0 billion (9.0%) 2020: $8.8 billion (9.4%) 2021: $11.3 billion (10.7%) 2022: $6.2 billion (5.7%) 2023: $8.1 billion (7.6%) Last Twelve Months (LTM): $8.1 billion (7.6%) So, what this all means is that Target's making less overall profit on every dollar of revenue today (7.6 cents) than they were in 2018 (8.4 cents). And revenue has grown at an average (CAGR) of 7.3% per year since 2018 and operating cash flow has grown at 5.1% per year - both of which are pretty much in line w/ the overall rate of inflation during that period. I guess I expected price gouging to be more profitable. ❌ NO PRICE GOUGING AT TARGET ❌ "Well Steve," you may say, "that's all fine and good, but even if Target isn't price gouging, Kimberly Clark and International Paper (both of whom are involved in the manufacture / marketing of paper towels and TP) sure as H3ll must be!" Well Yes! Surely they are! I'll spare you all the numbers, but here's the summary: Kimberly Clark: 5-year avg revenue growth: 2.0% 2018 Gross Margin: 69.7% LTM Gross Margin: 64.0% 2018 EBITDA Margin: 12.1% LTM EBITDA Margin: 15.6% "A-HA! Look at that EBITDA margin!" you say, "They must be gouging!" Well, the gross margin clearly says otherwise, and the five-year EBITDA CAGR is 6.6% - pretty much in line with inflation. Again, management is clearly bad at gouging. ❌ NO PRICE GOUGING AT KIMBERLY-CLARK ❌ "Well ok," you say, "I'm sure International Paper must be capturing all of that extra profit because they're the ones gouging then." Let's take a look: International Paper: 5-year avg revenue growth: 0.8% 2019 Gross Margin: 30.8% LTM Gross Margin: 27.8% 2018 EBITDA Margin: 16.1% LTM EBITDA Margin: 11.6% Wowza, I guess IP is the worst price gouger of all since, well, they've basically been destroying value since before COVID began. You would think price gougers would be gouging to, I don't know, make more money and all. Well, IP made almost $3 billion of EBITDA in 2019, and a little over $2 billion over the last twelve months. Sigh. ❌ NO PRICE GOUGING AT INT'L PAPER ❌ So, maybe this means the inflation we've been dealing with hasn't been about corporate greed and price gouging after all. Maybe it has had something to do with, oh, I don't know, government spending and stimulus run amok or something. So, rather than going on populist rants about implementing price controls for the greedy corporations (which, you know, have never worked out so well in the past), maybe we should consider some price controls for government spending. That's a novel idea. 🤔 p.s. And for those of you who say "Hey, wait a minute, your receipt says "Bounty" - that's not Kimberly Clark, that's P&G! They must be price gouging!" Procter & Gamble: 5-year avg revenue growth: 4.4% 2019 Gross Margin: 48.6% LTM Gross Margin: 51.4% 2019 EBITDA Margin: 20.4% LTM EBITDA Margin: 23.7% Gross margin up? Yep. EBITDA margin up? Yep. Good management? Yep. Price gouging? Nope. ❌ NO PRICE GOUGING AT P&G ❌

@raimcsantos Oh. @anals_of_IR

43 yo, ♀︎, severe abdominal pain. CT showed spontaneous dissection of the celiac trunk with progression to the splenic artery and hepatic artery. History of ulcerative colitis. Treated with covered stent - Begraft 5x22 mm: resolution of symptoms.#AortaEd #VascularEd #MedTwitter

3/x recognition for herself (as well as a free trip). She will undoubtedly escape any long-term consequences because she is in the most privileged class there is…white liberal affluent woman. They are beyond reproach.

2/x denounced was the only way she ever rose to the position she did. She also utilized funds that could have been used to actually help the people she purported to help. In the end, she irrevocably harmed the people she claimed to be helping. However, she did succeed in gaining

1/x So a white liberal academic woman took it upon herself to save and help the natives understand themselves, despite being wholly unqualified. The result was that all the attention was focused on her rather than those whom she presumed to be helping. In fact the very privilege,

This ain’t it. They are used to being ruled and OK with mediocrity.

I feel like I need to remind some of you today: They were totally fine with Biden being a demented figurehead. Because they KNEW. Had known forever. There’s no way they didn’t. Covered for it. They ONLY became not ok with the situation once YOU all knew the situation too.

You should ask, who is taking care of you when you go to the hospital and see someone in a white coat or see a primary care provider (most physicians will not call themselves providers) Imagine 96% acceptance rate for medical school. It’s usually closer to the opposite 4%.

Enough already. Stop romanticizing noise pollution and blaring music at 2am to sell a POS magazine/make up yet another way to be a victim. Quiet is racist, ffs.

Scam Medicare Advantage, decreasing RVUs, increasing labor costs, states licensing physicians from foreign countries without US training and this is what we are worrying about. Why are physicians like this?

Been on hold with @Optum for 30 mins to figure out my 7YO daughter’s anti-rejection med she’s been on for a year that NOW requires a PA? She’ll be out of med in a few days. Cash price is ~$350. She needs this med so her kidneys don’t fail. This is inhumane!

@drmcumming Hawkins blunt if you don’t have a varady

When removing a CVC with a cuff the blade/spatual end of a phlebotomy hook works great.

Using phrases like “chop, chop” and “don’t come back until you stop smoking” is 🤢 Doing an AKA for a gangrenous foot because you don’t treat venous dz that made a BKA untenable is not “comprehensive” care. All the PR in the world isn’t going to change this reality.

Instead of inventing ways to convince everyone to that only a vascular surgeon can provide #comprehensivevascularcare, maybe SVS should come to terms with the behavioral issues that make referring docs, patients, and hospital admins choose IR and IC over them? @anals_of_IR

“Front hole” is less offensive than “cervix”? Have we lost our fucking minds.