John Adler

Hey @elonmusk Engineering alone ain't going to get humans to Mars. @SpaceX avoid a crash course in space radiation brain damage. But @neuralink we can work together to re-engineer the human brain non-invasively. cureus.com/articles/41344… #SpaceX #Mars #ElonMusk #Radiation

New publication alert Socio-economic disparities in radiation treatment for patients with metastatic brain tumors. rdcu.be/dofHB Grateful for all the collaboration & support @DYDadey @ARodrigues121 Dr Pollom @JohnRAdler and @AnandMed @StanfordNsurg Stanford AI/ML Lab

beckershospitalreview.com/ehrs/judy-faul… “#Healthcare industry is adrift at sea because of challenges like provider #burnout, staffing shortages, provider satisfaction” etc, but now Epic can fix it. Is Judy Faulkner blind? Epic’s horrible SW app is THE cause of these “challenges”. More Epic will make things worse not better! Time to totally reimagine #EMR before all of US #medicine collapses

prenuvo.com Whole body screening #MRI scans…yikes! With all due respect to celebrity endorser @KimKardashian (ugh) this utterly dumb idea will produce one false positive after the next, merely enriching a few #medical charlatans at the expense of patient well-being. SAD!!

forbes.com/sites/sachinja… Brilliant! Dr. Jain points out that #patient-#physician relationship is the heart of #medicine yet today we have largely "middlemen, actors and sub-actors", companies which promise to fill “gaps” in but instead create a "Frankenstein #healthcare system”. Time to blow it all up!!

beckershospitalreview.com/hospital-manag… Words of wisdom from one of the few people really trying (& able) to fix #healthcare. Moreover, how much of our lives are wasted in useless meeting? We can make society so much more efficient by carefully rationing them…..unfortunately in a regulated industry like healthcare, many meetings are required by regulators?

@BrielmaierL YUP.....I hear repeatedly that democracy is under threat. Maybe democracy doesn't die at the voting booth but under a mindless mountain of powerful bureaucrats. Bureaucracy is the third rail of US politics, & so far only DT has blundered his way into challenging.

@JohnRAdler 757 pages in a single House spending bill, just one of twelve. taxnotes.com/featured-news/…

US #hospitals must survive on 1.4% profit margins…..absolutely crazy! The solution for the past 3 decades is to keep raising prices to what are today by far the highest in the world. When will people wake up and finally realize the answer is to reduce the regulatory burden on hospitals which currently contributes almost 1/3 of the cost of care?? beckershospitalreview.com/finance/hospit…

@KimballCruz1 Show me a system that REALLY works anywhere in the world, and maybe I will start to change my mind!

@JohnRAdler Single payer please :)

#Doctors make a lot more money than nearly all other professions. How is that a surprise? But with such a broad range of #physician abilities, why are all doctors paid the same for a given RVU? Nowhere else in our society is that true. I don’t have an answer, but it reenforces the commonsense observation that all of #physiciancompensation is far removed from market forces which might lower and raise salaries. Speaking for myself, I would be quite willing to pay 2, 3, 10X more than the prevailing reimbursement for many critical physician services to access a better doctor, and so would the authors of the WP article if they were being honest! @washingtonpost beckershospitalreview.com/compensation-i…

@drmoneymatters I TOTALLY AGREE!! Massive doctor ownership of hospitals & outpatients facilities may be the only way out of the current mess we call US healthcare. BTW....I made great (doctor-like) money as a kid working as both bartender & deckhand on fishing boat for others!

@JohnRAdler There are a lot of teachers, pilots, baristas, etc who vary in skill and are paid the same simply because they don’t own the biz. But doctors specifically cannot own the hospitals. Are teachers barred from owning private schools? Pilots from creating an airline co?

@JamesNNY1 YUP......the irony is that the "clowns", mostly coming from academia, that are key to creating quality measures, have spent their lives writing academic treatises and hobnobbing with DC gov types. They have long ago, if ever, stopped being real docs

@JohnRAdler I totally agree but it’s impossible to calculate real quality. The “worst” performing orthopedic surgeon in my hospital was (by far) the best. He took on the most risky, complex patients. Even aggressive attempts to accurately risk stratify outcomes fails.

@KimballCruz1 @drmoneymatters Fair enough! I too believe there is a huge cultural problem everywhere in US society today, & especially medicine. But all the cultural changes I see people advocate seem like we are headed in the wrong direction.

@JohnRAdler @drmoneymatters But you all saw this happening and did nothing. Younger docs saw how f--ked up the system was during undergrad. Instead of running the other way, they said, "Sign me up for this!" We are attracting a different kind of provider to the US HC system. The Culture is the problem now.

@KimballCruz1 I do NOT defend the indefensible & rapacious US healthcare system. cureus.com/articles/52142… Current system is a direct result of gov regs: HIPAA, EMTALA, PSQIA, Stark, Medicaid, Medicare, HITECH etc, so I am scared that these guys might run everything? AND I once worked in VAHS!😇

@JohnRAdler Yes, I understand that all systems have flaws. But there is a fundamental difference in the countries that have universal healthcare. They don't take your life savings if you become ill or have an accident. Here they do. US healthcare system is indefensible at this point. imo

@BrielmaierL But seriously what does that mean? At a visceral level it is terrible, yet why? Is it "Racism", or lack of money, but neither kill patients directly through chronic diseases, which is largely what is killing people in MS? What is it?

@JohnRAdler Mississippi residents have a lifespan slightly less than Bangladesh.

@BrielmaierL Who is Roger! And who, other than government is naive enough to believe that 10,000 pages of Obamacare regs represent a rational basis for regulation. How is indecipherable, unfollowable, dumb regulation a good thing? How many lives have been lost to HIPAA?

@JohnRAdler Nobody but Americans are naive enough to believe that any industry can self-regulate. - Roger Clarke

@dschan02 @lemmiwenks So true.....the clinical enterprise is merely a means to subsidize the non clinical agenda of medical schools and other fat so-called charities/non-profits. Always follow the money!!!

@lemmiwenks @JohnRAdler All too often, nonprofit status is a scam. Universities, hospitals, high-overhead charities and NGOs... they're a vast engine of wealth transfer away from productive workers, toward nonproductive administrators, fundraisers, party planners, lobbyists.

Although I despise these (vanity) lists of rich people, there is still an interesting observation to be made. This list contains ~1% of US #billionaires yet #healthcare represents close to 20% of the US economy. It demonstrates that healthcare is a lousy industry in which to get rich!! beckershospitalreview.com/rankings-and-r…

@mahesh_shenai Fixing a totally f..ked up system with ever more layers of bureaucracy never works. Better to revert to first principles. For me #1 first principle is that patients are best positioned to determine the quality of THEIR care!

@JohnRAdler There are many barriers to fair MD value- price fixing, FMV/Stark laws, noncompetes, etc. Hospitals heavily recruit MDs because multiples of margin made per MD salary (some specialties more than others). Thus there is a willingness to pay more, but for these barriers.

@Nostra2Van YES IT IS.....and look at what a mess the teaching profession is these days

@JohnRAdler It’s true in teaching.

@cscla WELL SAID!!

@JohnRAdler They are full of horse pucky.

@egg_bagels OK....more doctors might help, or one could incentivize busy and therefore skillful doctors to work harder. Instead modern underpaid medical school graduates seek "work-life balance" which undermines both capability and productivity.