Andrew Liu-Chen MD

188 posts

Andrew Liu-Chen MD

Andrew Liu-Chen MD

@andrewchenb

Northwestern University | LKSOM at Temple University | Robotic urologic oncology fellow at USC | Interested in AI, systems improvement, and robotic surgery

Los Angeles, CA Katılım Nisan 2009
408 Takip Edilen241 Takipçiler
Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
Maybe this is a feature, not a bug. Perhaps the rationing creates a steady inflow of youth willing to sacrifice, thus leading to more acceleration in the Bay.
YIMBYLAND@YIMBYLAND

Dog, this is so sad. Imagine all the lives that were never had in San Francisco because it refused to build housing. Multiple lost generations of artists, writers and creatives. Not to mention the literal lives that were never conceived because couples couldn’t afford a home.

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@zachweinberg Was recently discussing Medicaid cuts with colleague stating that we shouldn't be using Medicaid for immigration assistance, food etc and got pushback. Every $ there is one $ less for actual clinical care. We can't have it all! Or at least separate out what you really prioritize.
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Tweets from Zach Weinberg
Tweets from Zach Weinberg@zachweinberg·
In my opinion it's not a right wing or Republican policy position to care deeply about fraud and waste in government. It's a deeply liberal position. Every dollar we waste is a dollar that could be used to help people, to put money back in the pocket of the middle class etc.
Niklas Kleinworth@NKleinworth

@anSea2026 CA employed legalized money laundering schemes to draw-down additional federal money to fund Medi-Cal for illegals. These federal funds aren't like grant monies. Since they are part of the federal match, they become "state dollars." We all paid for this.

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@alexmd2 @ianlarkin @xVexity @mcuban I think the nuance is that a Hospital would prefer a Medicaid underpaying patient over a *non paying* patient which is what the uninsured would be. The sick aren’t going to not come to the hospital because they have no insurance.
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Alexandre Andrianov MD
Alexandre Andrianov MD@alexmd2·
I dont disagree with any of his points. I am just attaching some additional context to explain why hospital lobby for Medicaid expansion and provision of medicaid to everyone regardless of the immigration status despite constantly claiming that they "lose money" on medicaid patients.
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Mark Cuban
Mark Cuban@mcuban·
Why aren’t any of these at risk hospitals publishing their full accounting so everyone can see where they spend their money ? All but one group of hospitals that I have looked at potentially investing in, spend so much on consultants and fees that it’s no wonder they are at risk Plus, I have NEVER seen an industry that is worse than hospitals when it comes to buying medications and items like implants, screws, other devices. They overpay for everything. And then when you show them how to save money, their “supply chain” employees resist any change. They are so set in their ways, it’s a shock more don’t go out of business. Prove me wrong.
NBC News@NBCNews

More than 400 hospitals across the U.S. are at high risk of closing or cutting services because of the Medicaid cuts in President Trump’s “big, beautiful bill,” according to an analysis from the progressive watchdog group Public Citizen. nbcnews.com/health/health-…

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@wcdispatch There is no way that California hospitals pay 10-15x for everything. I can guarantee you that many LA hospitals do not do certain procedures on Medicaid patients because there is no reimbursement to even cover the cost of an equipment rental.
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Walter Curt
Walter Curt@wcdispatch·
As I’ve continued my Medicaid fraud investigations, it’s been incredibly difficult to sift through the hospitals. The scoring methodology I’ve developed looks for spending trends in NPI’s. Nearly every single hospital in California flags. They pay 10-15x for everything.
Mark Cuban@mcuban

Why aren’t any of these at risk hospitals publishing their full accounting so everyone can see where they spend their money ? All but one group of hospitals that I have looked at potentially investing in, spend so much on consultants and fees that it’s no wonder they are at risk Plus, I have NEVER seen an industry that is worse than hospitals when it comes to buying medications and items like implants, screws, other devices. They overpay for everything. And then when you show them how to save money, their “supply chain” employees resist any change. They are so set in their ways, it’s a shock more don’t go out of business. Prove me wrong.

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
I can’t believe @Healthnet would deny my patient a surgery using an Interqual for a completely different surgery. Terrible care for patients and makes no sense.
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
Students were responding in 12 hours in 1949! Before email! Before the internet! When phone calls were expensive!
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
A recap here jamanetwork.com/journals/jama/…. The current overriding sentiment is indicative of the poor understanding of the value that trainees provide and the unintended consequences of a change from this standard
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
It’s sad to see physicians and residents not understand the history of the match. Do some reading and you’ll see that prior to the match it was an absolutely mad world. Alvin Roth literally won a Nobel Prize for fixing the situation.
Andrew Liu-Chen MD tweet mediaAndrew Liu-Chen MD tweet media
Rep. Scott Fitzgerald@RepFitzgerald

The Match, shielded by a medical residency antitrust exemption, controls where future doctors train and what they’re paid. This monopoly leaves thousands of qualified applicants without a residency slot each year. ⬇️

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@uretericbud @CanesDavid Always figured DV 5 video auto record was for Intuitive training but never put together that pushing force feedback most likely is for the benefit of Intuitive robot models rather than surgeons.
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Alexander Kutikov MD
Alexander Kutikov MD@uretericbud·
Agree. Look how difficult it has been for AI to figure out driving despite an insanely huge dataset. Surgery much more complex, less predictable and the available and potential dataset is many orders of magnitude smaller (despite Intuitive now grabbing everyone’s data without paying for it).
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𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜
𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜@CanesDavid·
We’re extrapolating what AI has solved for computer coding unfairly to every industry. Take surgery for example. Surgery isn’t deterministic like coding, where there’s a right and wrong. In software, it works or it’s broke. Flawless or a bug. 🐛 Surgery isn’t deterministic. It’s messy decision making. Hundreds of correct choices. At every fork there’s not just one way forward. AI ain’t coming for surgery anytime soon.
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Todd Saunders
Todd Saunders@toddsaunders·
“Explain very simply like I know nothing, and you are my teacher” might be my most used Claude prompt. Anyone have something similar they use they like?
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Sanat Dixit MD FACS
Sanat Dixit MD FACS@sdixitmd·
THE biggest scam in hospitals providing charitable care is the write offs taken based off the chargemaster charges that literally no one pays.
Peter Girnus 🦅@gothburz

@JOSEPHM45075332 The charitable write-off is calculated from the gross charge. The gross charge is the fictional number. The charity is fictional. The tax benefit is real.

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WithAScalpel - Fumiya Yoneyama, MD, PhD
WithAScalpel - Fumiya Yoneyama, MD, PhD@WithAScalpel·
Continuous Over and Over Sutures: 👉Behind every reliable suture line is the same foundation: spacing, needle angle, tension, and repetition. 🎥With 7-0 Prolene (BV175-6, 8.0 mm, 3/8 circle) @CiruAndes2 @MediUniandes @Uniandes @FSFB_Salud @pferrada1 @SWexner @TomVargheseJr
Dr Luis Felipe Cabrera Vargas MD FACS@PipeCabreraV

The Connell Mayo suture pattern technique! The drunk 🥴 man mnemonics ⤵️🔪! Only in our @CiruAndes2 @MediUniandes @Uniandes @FSFB_Salud bowel suture workshop! @pferrada1 @SWexner @TomVargheseJr

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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@captgouda24 @kippwjohnson @sarthakgh In my short time in medicine, I’ve learned that finding differences based on population level data is very difficult (see: PSA screening). I wouldn’t be so quick to say absence of evidence is evidence of absence. Either way prices can come down but this isn’t a free lunch. Cheers
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Nicholas Decker
Nicholas Decker@captgouda24·
Wanna save Medicare $4.6 billion a year at no harm to the patient? Stop reimbursing long-term care hospitals three times as much for the same care provided as nursing homes! What was created as a regulatory carve-out in the 80s has grown into hundreds of wasteful hospitals. 1/
Nicholas Decker tweet media
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@ByrneHobart Honest question. Why would/should the owners (largely insurance companies) have high margins and growing margins? Is it a positive thing for society to pay health insurance companies a surplus as they find more ways to shift burden to patients and providers?
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Byrne Hobart
Byrne Hobart@ByrneHobart·
So I've read a few long essays on how abusive pharmaceutical benefit managers and group purchasing organizations are, and they all make a strong case. And then I look at the companies that own PBMs, and their margins are a) not high, and b) not growing. So, what's up?
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@waitbutwhy Look up non operative management of Achilles tendon rupture. - signed a rupturee
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Andrew Liu-Chen MD
Andrew Liu-Chen MD@andrewchenb·
@CanesDavid It’s one of the few measurables that’s independent. If we want to build a culture that emphasizes efficiency it should permeate every part of the OR. Why should scrub techs hustle to turnover when they see the surgeon stroll in late. Every case after the first can have an excuse
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Surrealistship
Surrealistship@SurrealistShip·
@AlanMCole the more a trump nominee is in the news, the worse their performance is. Backroom picks like Scott Kupor are actually doing incredible work
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Alan Cole
Alan Cole@AlanMCole·
This turned out about as I thought. Our deputy assistant for international tax, for example, has been excellent negotiating for US priorities in rough order of importance and urgency. Unfortunately, trade policy, where Trump is more personally involved, has been disastrous.
Alan Cole@AlanMCole

Trump's economic policies, or the policies of some non-progressive he hires to some Deputy Treasury Secretary position and then blessedly ignores, allowing him to exercise quiet competence while Trump himself picks fights with Bette Midler or whatever? I'll defend the latter!

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Keşfet

@zachweinberg @lee_c_zhao @lukha33 @alexmd2 @ianlarkin @xVexity @mcuban @wcdispatch