Blake Harp

50 years ago yesterday the Texas Tech SPORTS INFORMATION DIRECTOR, Ralph Carpenter said near the end of a Texas Tech v A&M basketball game as the Aggies went ahead. ITS NOT OVER UNTIL THE FAT LADY SINGS”. The rest is history. Texas Tech 74 A&M 72. That saying is used all over the world every day in all kinds of sporting events.

Short🧵regarding fascial closure: I had a lot of fun with my 🧵on LOTR last week, but I must now return to my core content. Let us briefly review why it is important to avoid catching too much subcutaneous tissue in our sutures when closing fascia.

Since 2016, Medicare hospital base payment rates have risen—30% for inpatient and 26% for outpatient. Meanwhile, the physician base payment rate has fallen 7%. These uneven updates create distortions and may fuel consolidation. Learn more: t2m.io/xpN3h7X

Unique to America, you have the remarkable opportunity to visit your congressman, congresswoman, or senator's office on the day of the #SOTU2026 to advocate for physicians and patients alike, and you'll be greeted with warmth and open arms. @AmerUrological #AUAsummit26

Trips to the Hill to advocate for @AmerUrological are key to advancing health policy. So glad we have participation from medical students, residents, and faculty at this meeting! @HarpBlake @marawaneltayeb @BSWHTemple_Urol @itsagoodthing_ @UTSWUrology #urosome

Grateful to meet with the team from Rep. Jasmine Crockett’s office to discuss Medicare reimbursement, prior authorization, and the proposed Office of Men’s Health🤝🏛️ An incredible experience seeing advocacy and legislation in action with my fellow Texans 🇨🇱 #AUASummit2026

Medicare is cutting payments to proceduralists because surveys suggest we have become more “efficient.” Under the Physician Fee Schedule, payment is tied to estimated physician work inputs. It’s the Marxist labor theory of value in federal policy. If CMS concludes that a procedure now takes less time or effort, the RVUs are reduced. Time and effort are treated as proxies for worth. Yes your doctor gets paid less for being more efficient. We are treating older and sicker patients. Documentation requirements have exploded and admin burden has grown. Total professional effort has not meaningfully declined. And even if operative time truly falls, why does that automatically justify a pay cut? In a functioning market, if a plumber or mechanic becomes more efficient, he keeps the surplus unless competition drives prices down. Price reflects supply and demand, not a central estimate of minutes spent. Medicare does not operate that way. Payment is periodically reset by formula. If your innovation reduces operative time, the system eventually claws back much of the gain through revaluation. Basic economics still applies. Lower administered prices reduce expected returns. Over time that affects specialty choice, training pipeline decisions, capital investment, and willingness to adopt new technologies. Supply responses in medicine are slow because training is long and capital is sticky, but they are real. You cannot repeatedly cut prices and assume supply and innovation remain unchanged.

Learning to jump through the hoops makes my intern year so hard!

Ironically this is what a doctor needs to do to book an emergency surgery. This isn’t hyperbole. A simple case request for an emergency surgery has about 50 hard stops. A doctor must put in both a CPT code and an ICD code. They must estimate the length of stay and input that. They must input the date of surgery (even when it’s right f***ing now because the patient is dying) and check the “add on” box or else they won’t be able to find the case in the depot. They must indicate if the patient needs a preop risk assessment or if they need a Covid test. They need a full updated H&P. Then, and only then, is the surgeon allowed to actually operate.

@drabhishekbhat @BSWHTemple_Urol @AmerUrological @SCSAUA @marawaneltayeb @patslowry Happy holidays Dr Bhat!

Our wonderful group of residents send out season’s greetings @BSWHTemple_Urol Truly the heart and soul and definitely the faces of any program 🥸 @AmerUrological @SCSAUA

RETWEET IF YOU LOVE THIS TEAM ‼️

@TexasTech POWER!!!!

RAIDER!!!

@TrayPayneLBK @NCAAFootball 100% agree.

I can’t wait to watch the next three @NCAAFootball conference championship games and the announcers talk about the millions of NIL money spent by the respective programs. Or is that only relevant to Texas Tech?

BIG 12 CHAMPIONS 🏆 Congratulations to @TexasTechFB for claiming the 2025 Edward Jones Big 12 Football Championship. #Big12FB | @EdwardJones

@joshabbottband POWER!!!!!!

RAIDER!!!!!!

Wreck em! Locked our coach in too.

Checking in to the Top 4️⃣

Goodness gracious, Gary Clark Jr just SHREDS on this version of Voodoo Child. Woah. youtu.be/cHaQzVqUbCY?si…

After a random drug test two weeks ago, doctors discovered that Broncos LB Alex Singleton had a testicular cancerous tumor that they removed the day after Denver defeated the Raiders on Thursday night football. “The prognosis is excellent for me and my family,” Singleton announced today. “For Broncos fans, I fully expect to return to the field very soon.”