Adam Brown, MD MBA

A message from the president of the United States:

To every kid with a learning disability: don’t let anyone — not even the President of the United States — bully you. Dyslexia isn’t a weakness. It’s your strength.

Washington, D.C., has the highest unemployment rate in the nation, hitting Black workers hardest. Learn more about the impact on the labor market. washingtoninformer.com/racial-unemplo…

Private equity firms bought 500 hospitals. Death rates in their emergency rooms went up 13%. They fired 12% of the staff. Then they paid themselves billions in dividends. A Harvard study just confirmed what doctors already knew: people are dying so investors can hit quarterly targets. Exactly what happens. A PE firm buys a hospital using debt. The debt gets placed on the hospital's balance sheet, not the firm's. Now the hospital owes hundreds of millions it never borrowed. To service that debt, the hospital cuts costs. Costs mean nurses. The numbers from the Harvard/University of Chicago study are horrifying. After PE acquisition, emergency department salary spending dropped 18.2%. ICU salary spending dropped 15.9%. Hospital-wide employees were cut 11.6%. Emergency department deaths rose 13%, seven additional deaths per 10,000 visits. A separate study found patients undergoing surgery at PE-acquired hospitals had 17% higher odds of dying within 90 days. Steward Health Care, owned by Cerberus Capital, filed bankruptcy with $9 billion in debt after closing hospitals across Massachusetts. The CEO lived on a $40 million yacht while emergency rooms went dark. Eight hospitals serving 2 million people nearly disappeared because a PE fund extracted more cash than the system could survive. The private equity industry has poured over $1 trillion into healthcare. They operate a quarter of ERs nationwide. This isn't going away. The investing angle nobody talks about. Non-PE hospital operators like HCA Healthcare (HCA) and Tenet (THC) are the direct beneficiaries. Every time a PE hospital closes or deteriorates, patients flow to the nearest competitor. HCA has returned 1,200% since 2011. Patient volume from PE closures is a structural tailwind nobody's pricing in. Medical staffing firms (AMN Healthcare, Cross Country) charge premium rates specifically because PE hospitals cut staff. The staffing shortage IS the business model for these companies. The disruption play: outpatient surgical centers (SCA Health, now part of UnitedHealth) are pulling profitable procedures out of hospitals entirely. PE-owned hospitals lose their highest-margin surgeries to outpatient, and the death spiral accelerates. Pull up tradevision and monitor healthcare M&A alerts, hospital closure filings, and patient volume migration data. When a PE-owned hospital announces "restructuring," the patient volume shift to competitors like HCA starts within 30 days. That 30-day window is when the competitor's earnings revisions haven't updated yet. Free to try. (a private equity firm bought your local hospital. borrowed $500 million in the hospital's name. fired 12% of the nurses. emergency room deaths rose 13%. then they paid themselves dividends. nobody went to prison. they're currently buying another hospital.)

Mackenzie Scott, ex-wife of Amazon founder Jeff Bezos, has donated $42 million to HBCU Elizabeth City State University, which has about 2,100 students, making it the largest donation per student enrolled

A fifth of Americans reside in rural areas. On average, they live three years less than their urban counterparts, largely due to heart disease and strokes. That disparity is widening, according to research. nbcnews.com/health/heart-h…

"Are we comfortable letting a single vendor or a small handful of vendors define the rules of engagement for interoperability, AI innovation, and clinical documentation?" Read the latest #OpEd from emergency physician and entrepreneur @ERDocBrown: medpagetoday.com/opinion/prescr…

Kristi Noem spent $220 MILLION on a 60-second ad. Pete Hegseth spent $93 BILLION in one month. Trump just gave four Big Tech companies a $51 BILLION tax break. And you’re worried about a single mom getting a few bucks from SNAP to feed her kids? Wake up, people.

BREAKING: As Trump continues to deploy US troops to the Middle East to fight a foreign war with Iran, as gas prices shoot through the roof, and as we are seeing horrific job losses, Donald Trump is playing golf with his billionaire friends in the comfort of his own home, while the Epstein files remain hidden.

Acetaminophen orders in emergency rooms for pregnant patients fell in the weeks after a White House briefing last year linked its use during pregnancy to an increased risk of autism, a new analysis finds. abcnews.link/y0wSBVh

Breaking: In an unexpected downturn, the U.S. lost 92,000 jobs last month. The unemployment rate rose to 4.4%. on.wsj.com/40NdyUl

In the 13 months since Trump took office, the economy has created a net total of 198,000 jobs compared with 1.4 million created in the last 13 months of the Biden administration. data.bls.gov/pdq/SurveyOutp…

We are seeing a nationwide nursing shortage, and the U.S. Department of Education’s proposed rule to exclude nursing degrees from the definition of professional degreescould exacerbate this issue in North Carolina. By 2038, North Carolina will need an additional 25,710 nurses to meet the demands of our rapidly growing state. Right now, we should be doing everything we can to attract health care workers. Instead, this proposed rule will impede our efforts to expand nursing education across NC.  NC is committed to creating more pathways to health care careers, and I urge the Department of Education to reconsider.

And just like that we are no longer a nation divided by left and right, we are now a nation divided be those who want to fight wars for Israel and those who just want peace and to be able to afford their bills and health insurance.

If you look at history or current events, nearly every country that becomes increasingly authoritarian and/or moves from democracy to a general loss of freedom, this always happens… Americans may be rattled or perhaps skeptical of this story in their deep sense of “American exceptionalism” but truly, why should we be in any different? fyi cc @morgfair

The number of US nationals applying for British citizenship hit an all-time high in the first year of President Donald Trump’s second term in the White House bloomberg.com/news/articles/…

Breaking News: The Justice Department did not release key records in the Epstein files about a woman who made an unverified accusation against Donald Trump, in which she said Trump assaulted her in the 1980s when she was a minor. nyti.ms/4ryf4W7

Thomas Massie just went nuclear on Trump’s DOJ for bringing zero “charges, arrests, or investigations” over the Epstein files. “Who should be investigated?” “I’ll name them right here.” “Leon Black.” “Jes Staley, accused of terrible things.” “Leslie Wexner.” “Why did the FBI list him as a co-conspirator in their own documents in a child sex trafficking case, and then tell him that they had no questions for him?” “Over 3 million documents describing horrible things, unspeakable things, much of it redacted.” “Over two dozen people have resigned, CEOs, members of government worldwide.” “But I haven’t seen any arrests or investigations here in the United States.” “Prince Andrew, Duke of York, who has since been stripped of his royal titles due to his affiliation with Jeffrey Epstein, has been arrested.” “Peter Mandelson, who previously served as UK’s ambassador to the United States, resigned in disgrace from UK’s House of Lords and the Labour Party, and he’s been arrested.” “Former Prime Minister of Norway, Thorbjørn Jagland, has been charged.” “But we don’t see any charges, arrests, or investigations in the United States.” “What do we see?” “We see our FBI director celebrating in the locker room at the Olympics overseas.” “We need justice.” @RepThomasMassie @MassieforKY

Donald Trump’s second term has roiled medical care in America. The result will be a lasting impact on people’s health economist.com/united-states/…

How the Epstein Files have frustrated the Trump White House and continued to metastasize on.wsj.com/3MnXo0j