David B. Stewart, MD, MHA, FACS, FASCRS

I need people to understand that about 60% of homeless people are employed but just don’t make enough to afford housing and that’s the real issue

I know it's hard to believe but sometimes the people on the streets used to live indoors and owned stuff. They get evicted and their stuff is put outside and they save what they can. Stuff like tvs, phones, cars, etc. All items that are way cheaper than housing btw.

Amir walked 12 kilometres, barefoot, to get food. He kissed the hand of an American soldier, thanking him for a bag of rice and lentils. Then Israel K*LLED Amir, right in front of the soldier. A child, grateful for lentils. Executed in broad daylight. Amir was 5 years old.

This is MMA fighter Sean McInnes. When Anne Marie Boyle asked him to leave her alone, he punched her in the face so hard that he broke her cheekbone and her eye socket, knocked her unconscious, and left her with a life-altering brain injury. He was given less than two years behind bars. It would be a real shame if this post was widely circulated and impacted his career in a negative way.

@joaquinbarroso Unacceptable. Not peer review, it became self-aggrandizement. Can't blame you for not naming, but if more of us did, the reviewers might think twice. Also, us the editor asleep or on vacation? Maybe name them instead. They need to manage their stuff better.

I'm so mad. Once again, got a paper accepted, but Ref2 wants me to add 4 references all having a single author in common, whereas Ref1 suggests 6 with another common author! This unethical behavior should be stopped by the editors. Should I say who those authors are? Thoughts?

I went from exposing billions in dirty money… to not being able to afford food. After I blew the whistle, I lost everything. Sleeping on a cot. No safety net. No backup plan. @PFChangs took a chance on me—gave me a job as a waiter and made sure I ate. I’d go home with lo mein just to get by. People don’t forget who shows up when they’re at their lowest. If you’re hungry—go there for lunch.

novo nordisk's semaglutide went off patent today... weight loss drugs that cost $100/month can now, when produced generically, cost $3 a month per patient (insane)

Afroman is the hero we all need right now.

To our Jewish community: This is what’s happening in the West Bank right now. A Palestinian man describes a brutal sexual assault by Israeli settlers amid a wider pattern of escalating terror and impunity allowed by the state. We have to see Palestinians’ humanity – and the reality of their abuse at the hands of other Jews – and ask what kind of country Israel is becoming. Then demand a different path.

1/ In a phase 2 obesity trial, 100% of patients on Retatrutide 8mg and 12mg lost at least 5% of their body weight. Not most. Not the majority. Every. Single. One. In obesity pharmacotherapy, that doesn't happen. Or at least it didn't — until retatrutide. 🧵 substance-over-noise.beehiiv.com/p/the-drug-tha…

Remember - it’s self-referral when a physician does it. If I own the hospital, and employ the physician - they must self-refer to their and its verticals or else they’re not being a team player. And - I’m even going to “legally” induce those referrals by paying a wRVU. The gaslighting is insane. This is why there’s a hospital in every soap opera.

Rapid fire glp-1 med myth busting - no difference from placebo in pancreatitis - medullary thyroid cancer seen in rats not humans (humans don’t have GLP-1 receptors there while rats do) - muscle loss is same as caloric restriction - gastric emptying slows initially but goes closer to normal after months. No strong data for permanent issues other than random lawsuits. - help with weight loss via appetite. They are not metabolism boosters (yet) - they do have multiple benefits beyond weight loss

Dear @AnthemBCBS @Aetna @Cigna @UHC I can tell you guys are feeling it. NSA is here 2 stay. Get with the program & stop the denials for indicated and medically necessary care. Physicians & payers can play in the same sandbox. We certainly r important to a functioning system. RU?

@FAHhospitals You mean like you own the hospital, the clinic, the radiology suites, the doctors, the physical therapy clinics, the outpatient radiotherapy places, and the home health? And you silo out private physicians from accessing your systems? Cry me a river. Tick-tock

@FAHhospitals “Self referral” is what hospitals make their employed physicians do, all the time. If avoiding conflict of interest is so important, we should end hospitals employing physicians and restore physician’s independence Don’t you agree?

I’m sorry you’re dealing with this. But when a university taking in billions in revenue chooses not to buffer even short-term funding delays or prioritize its resources around science, while administrators expand their offices and take in seven-figure salaries, it says everything about the model. Scientists are treated less as scholars to be supported and more as revenue generators for indirect costs, with all the financial risk pushed onto them.

@sammyjoluxton1 @JacksonG36452 Sammy, exactly. There are ways to avoid a slippery slope, while doing better for terminally ill patients who cannot be cured and who are dying in an ignoble manner due to pain and suffering.

@JacksonG36452 I don’t support how broad Canada’s system is. I’m talking about terminal illness as the only exception

My grandad had bowel + prostate cancer - he was so unwell, in agonising pain every day, being fed medication to knock him out 24/7. He begged us to kill him, every day said he couldn’t wait to die. I know he would have loved to have the option to go peacefully on his terms 😅

Reviewer 1: "this is a great piece and I look forward to seeing it in print" Reviewer 2:

What happens to the heart when people stop GLP-1 drugs? The short answer: nothing good. New from our team: a study of 330,000+ people in @BMJMedicine 🧵