Dr. Neu

@memnosoncos @docshanep @chrissyfarr I never used the word "exclusive" but not sure what you mean by that. My personal practice & most DPCs are more diverse than pretty much any insurance-based practice. We actually take care of MORE uninsured people and those who have fallen through the cracks.

@NeuCare @docshanep @chrissyfarr I don’t. But “exclusive” medicine is … your choice…

I keep thinking that there could be a killer consumer health brand that’s: - cash pay, subscription - mostly async - the entire brand identity is around not dismissing patients for their symptoms - a care team, not just MDs - incorporates curated patient feedback

@memnosoncos @docshanep @chrissyfarr sure. boutique = of, designating, or characteristic of a small, exclusive business. if you prefer your regular/primary care or doctor be run by a mega-corporation (its investors) or bureaucracy, that's your prerogative & the status quo

@NeuCare @docshanep @chrissyfarr “Boutique biz” and healthcare Yeah, specific population, all right

@pkedrosky good analogy. I took this much further with theorizing how "food insurance/managed food plans" in this essay from 2018: fee.org/articles/imagi…

@elonmusk & the only serious push back against this is #DirectPrimaryCare: Video on our physician -led movement in 2017: youtu.be/6-Vqjo2S1us?si…

Major driver of healthcare cost

@chrissyfarr I can only presume it's because these docs/clinics aren't owned by a single corp! If a VC-backed company opened 2000 DPC clinics serving a million+ patients, it would be "huge"! Alas, we are just "little" self-funded, independent clinics popping up everywhere. :)

@chrissyfarr Your analysis has some good points, but the Direct Primary Care model (PCP clinics working on a subscription) has steadily grown year to year--now with thousands of independent clinics nationwide! Why doesn't the investor/biz community see this movement as serious?....

New piece out on Second Opinion on why I think Forward Health failed. Thoughts welcome!!

@Jonathan_Blow @rabois @goforward Some paradigms in modern medicine are certainly misguided. We certainly are more reactionary than preventative. But how does "tech" or @goforward fix that? Rechecking vital signs or lab monthly? prettier lab reports? Honestly I don't understand what "innovation" they offered.

@NeuCare @rabois @goforward That is one problem, and one that gets a lot of PR. But the more serious problem is that a lot of the actual beliefs are just wrong, such that many people who follow doctor recommendations get sicker over time than people who don’t.

Not officially coming out of Twitter retirement, but had to gloat about @goforward closing: fiercehealthcare.com/health-tech/pr… In 2018, investor @rabois & I had a spirited debate about their "innovation" replacing PCPs. That fun thread w/ him calling all docs useless luddites here.

@Jonathan_Blow @rabois @goforward @dpcalliance I'm sorry you feel that way but I didn't say "traditional doctors are great." See my other reply about why they are hamstrung by "traditional" care models. I can promise you that physicians feel as "exploited" as patients.

@NeuCare @rabois @goforward @dpcalliance I switched to Forward because I was tired of being exploited by doctors to the detriment of my personal health and it was an improvement in that regard. If you think traditional doctors are so great given the current system of incentives, you are untrustworthy.

@Jonathan_Blow @rabois @goforward I generally agree with that. The problem for doctors is the business model. It's nearly impossible for PCPs (especially) to provide excellent care when distracted by "traditional" paperwork, billing, & time constraints. It's not that PCPs are morons or won't embrace tech.

(More specifically, I think most people see that American GP medicine has turned into a cynical carousel that mostly doesn’t solve problems and doesn’t try too hard to understand them, and that the broad consensus about what test results mean, etc, is so far out of whack as to be actively harmful. The problem with Forward is they just slotted into that whole thing and offered an equivalent product, but more convenient. That’s cool but the actual product (American medicine) is bad at the core and most people know this at some level.)

@Jonathan_Blow @rabois @goforward Jon, you are probably too dumb to realize how Forward provided fantastic care that a human physician could never deliver. Just ask @rabois 😉 But, seriously, if you are looking for genuine, innovative primary care, check out #DirectPrimaryCare clinics. @dpcalliance

@rabois @NeuCare @goforward As a Forward customer, I think it was broadly a good idea, but poorly run in terms of the actual details of what happens when you use the service. What people want from this kind of service is very different.

@rabois @goforward Neat. I suppose it won't 'be Forward or their "CarePods" though. 😂 Can you please share what you learned from this failure? Or at least some medical advancements gained? Or was the $400 mil flushed straight down the toilet?

@NeuCare @goforward they are. AI is replacing you fortunately.

@goforward @rabois x.com/rabois/status/…

@chrissyfarr @DGlaucomflecken And for the record, I am in favor of the vast majority of medications be available “over-the-counter” without any prescription at all! A bigger discussion, but this ain’t a turf war for me. /3

@chrissyfarr In any case, conjunctivitis (pink eye) is not as straightforward as most believe. 90% of cases are not bacterial & won’t benefit from antibiotic drops. Ask @DGlaucomflecken. He will suggest using copious amounts of Visine instead. 😁 aao.org/eye-health/dis… /2

Got pink eye on vacation. I went to the pharmacist, instead of the doctor, and got prescription eye drops in 5m. If we want to save costs, how about letting pharmacists do their jobs? They’re more than capable of taking care of basic medical needs.

@SkepticalDDS @DahnikaS @viva__lala HIPPO violations aside, some brave doc needs to tell patients’ stories about Vax-induced Lyme. And for my standard speaking fee of 30,000 green peanut M&Ms I would be their champion

@DahnikaS @NeuCare @viva__lala He’s mad because he didn’t get invited to speak at the symposium.

This is abhorrent. The “Functional and Regenerative Medicine” moniker of the one guy is a huge red flag, not to mention the bragging about being endorsed by Kansas politicians. This isn’t a medical lecture; it’s a carnival.