Dustin Gentry, MD, FAAFP

“Healthcare’s administrative burden did not arrive fully formed, roaring across the landscape. It accumulated quietly—policy by policy, form by form, requirement by requirement—until the atmosphere was primed for a fire. And once lit, it spread faster than anyone was willing, or able, to contain it.” Find the rest on substack (link below) 👇 👇👇👇👇👇

@pgipe @KrutikaKuppalli That’s a bad look. 👀 It’s indefensible.

@KrutikaKuppalli And yet some docs are still on here defending this process.

You know what is even crazier? I am an board certified Infectious Diseases physician and am on my third round of appeals with an insurance company for an antibiotic my patient with a rare infection desperately needs - and I have not even spoken to a person! If we want to appeal any further we must pay a fee. This is infuriating. It’s a waste of time. And it hurts patients.

@pgipe @txsportsdoc I am surprised that the docs agreed to that. Every handoff is another hole in the cheese. I like seeing my own hospital patients, But I realize that isn’t practical these days in large systems.

@txsportsdoc Right. What our hospital also started doing was assigning them to floors/units. So if a patient moved for any reason (staffing, procedure) they’re assigned a different doc-to increase AM discharges and bed turnover at the cost of multiple hand offs.

Discharge follow up this week saw THREE different hospitalists in a 36 hour stay-but sure Mr admin, tell me why your ‘geographical’ rounding is so awesome.

@alexmd2 @sallypipes Medicare for all is up when the pendulum swings back. Monopolies are bad. More forms, less care. Think VA.

@sallypipes I like universal coverage but not a single payer. Monopolies are bad.

Single-payer systems guarantee coverage. They do not guarantee immediate access to specialists, elective surgeries, or the newest treatments. Those depend on budget limits. washingtonexaminer.com/restoring-amer…

@eyorrickd @DrDiGiorgio

@GentryMD @DrDiGiorgio A week is under 4 months, and 6-8 weeks is under a year

The median wait time to get an MRI is under 4 months and the median time to see a specialist is under a year in Alabama. Canada can’t say the same.

Insurance claims denial letters are starting to sound like break-up texts: It's not you, it's us. We just don't find this treatment medically necessary right now. (TBH it's usually more like... It's not you and it's not us... It's your doctor. It's all her fault.)

@mcuban Ouch. 😓 Ai has definitely made me smarter…. it isn’t always right…. But it’s a great place to start

There are generally 2 types of LLM users, those that use it to learn everything , and those that use it so they don’t have to learn anything.

Ai-Generated content is really annoying. 2 and 3 word sentences quietly Not ___, but ____ Vibes overuse of adjectives and adverbs It's really easy to spot, and it's not good writing. The irony is that some champion AI as "efficient prose." If so, I don't like efficient prose. I like Welty and even Grisham.... but don't give me AI to read seriously.

@PedsGeekMD Why would he study anything when he purports to already know the outcome?

You know RFK isn't actually interested in vaccine safety or "gold-standard science" when he's been in office a year and not even announced that they are planning the fully vaccinated vs unvaccinated study he and the antivaccine movement have gone on about for decades.

Prior Authorization Testimony of the Week: After examining a patient, I ordered a CT Abdomen, which was appropriate. AmWORSE argued with me and forced me to order an u/s because it is cheaper... even though I showed them in the guidelines they arbitrarily chose to use that a CT scan was appropriate, citing the page number, paragraph, and quoting from the document. Radiologist described what I knew he would on the ultrasound... and then requested a CT scan. The effect, besides pissing me off, is more direct costs to the patient, more missed time from work for the patient (indirect costs - he owns a business and is the only employee), slowing down my office, and preventing my staff and I from caring for other patients. You still think PA's are worth it? The hidden costs are never discussed. Why? All so the CEO can get a big bonus by delaying and denying your care. And it IS practicing medicine without a license. My patients can't afford to cash pay because they are paying so much in premiums.

👀👀👀👀

@DefiantLs overstated nonsense.

RFK Jr.: "We should have the cure for Alzheimer’s today. We don’t have it PURELY because of corruption at NIH. And we are going to have it quickly."

Most people cannot name even 1 past Secretary of HHS. That's the problem.... RFK Jr. is a consequence.... not the root cause. :)

@DrDiGiorgio It's a mess, man. I think it was last year that a large hospital system advertised during the Super Bowl. Remember? Terrible look.

This place gets millions of dollars in subsidies that aren’t available to independent doctors. Facility fees, 340B, GME, tax free bonds alone give them enough financial leverage to crush any independent doctors who try to compete.

@WSJopinion I skimmed the report when it came out a few weeks ago... and wasn't shocked. But I'm also not privy to the power-play in Washington either between these groups.

MedPAC has been co-opted by progressives who dislike private markets and the Medicare Advantage program for seniors. Why does Washington need one more government health policy shop lobbying for more control over American healthcare? on.wsj.com/3M6tZaO

Nothing defeats common sense faster than dogma

Insurance companies are now denying claims faster than patients are being triaged in the ER.

Breaking: Showdown of the Century: Bobby Tyson vs. Doctor Oz LAS VEGAS, NV – The showdown of the century is scheduled for this Friday night...Full Story 👇👇👇 @CoveragePending for the latest news you can use

Want to know why Costplusdrugs.com doesn't have more brands? With a few exceptions (already has a generic, not on formularies, soon to have a generic), CPD , and every pass through smaller PBM , can't buy branded meds that have a rebate, at a competitive price. No one is asking for rebates equal to the big 3 PBMs. We can't even get a " walk in off the street price." We actually had one brand say in a meeting they would give us a "walk in off the street price", then all the sudden they couldn't I asked the CEO of a best selling branded med how many lives we would need to have covered before they would sell to the GPO we created, or to us in any manner, he said "half". They couldn't sell to us until we covered half the lives the big 3 cover. He would lose placement on formulary tiers merely for offering us rebates. He couldn't afford to do business with us This is not an efficient market. The big PBMs have threatened brands with loss of formulary positioning for their entire portfolios This is why brand pricing continues to be high for employers @PamBondi @AFergusonFTC

I don't care who you are... that's funny.