@DutchRojas
@DrDiGiorgio
@mass_marion
@anish_koka
@real_doc_speaks
This is the shell game I speak of.
The geniuses who make healthcare rules disallowed physicians from running hospitals when they passed Obamacare because of “misaligned incentives”, but “anyone” can open a home hospice / healthcare agency in California.
Enter the Armenian mafia.
Monty python wld like a word.
There’s an industry with an interest in putting you on meds evidenced by dropping target LDLs as new therapeutics to lower LDL hit the market.
There is also an industry with an interest in selling you a path to get off of meds.
Things to consider for a 40 year old with an elevated LDL and CAC of 0. Depending on your other risk factors that is not necessarily a get out jail free card.
Crude cardiac mortality (not adjusted for clinical RFs, so lumping as an example bmi 30 smokers with iron man non smokers) for a 40 yo is 1/2000 so we are not hunting for zebra’s in Alaska.
Numerically there are still a lot of events in calcium zero folks — perhaps there is a phenotype of lean mass hyperresponders ( metabolically healthy except for LDL) that have low rates of cv events.. definitely deserving of more study. Would need long term follow up, and wld be nice to have a better surrogate of longer term cv outcomes.
Also Need much better clinical validation of current tools that say they measure plaque well.
The program was championed by Sanjay Gandhi, youngest son of Prime Minister Indira Gandhi , Scion of the Nehru dynasty that ruled India post British Independence.
The issue is that it is rarely straight to cath!
I frequently see CAC ➡️ stress (it's in AUC!) ➡️ false positive since most nuclear stress in US is done without attenuation correction ➡️ cath ➡️ PCI
Can also happen with CCTA as interpretation is harder with calcium blooming
Either way, asymptomatic patient has both financial and potentially medical and/or procedural toxicity along the way
The only reason to do this is so universities can hide their racist admissions policies in defiance of the Supreme Court decision.
Ever wonder why these costs are so high? What policies are driving it?
Tune in to the US House hearings Wednesday, 3/18. Link below:
I’m honored to testify before the @HouseCommerce Health Subcommittee on March 18 as Congress examines the background, scale, and consequences of rising health care costs.
Health care affordability is one of the defining policy failures of our time.
Frame this one. Frame it.
None of this "Free Palestine” activism in Hollywood is sincere. They do it because it’s an “in thing” and wins approval from the young crowd.
Don’t believe me? A reminder from recent history helps. In the 1990s and early 2000s, “Free Tibet” had an even bigger celebrity endorsement machine. Hollywood stars, musicians, concerts, award speeches, support for Tibet and the Dalai Lama was loud across the entertainment industry.
And now, Free Tibet is nowhere discussed. Not because the issue was resolved. It went silent because China became an indispensable economic power and market for films, music, and brands. Angering China carried real financial consequences, movies banned, concerts cancelled, market access lost. So the moral fervor disappeared.
That should tell us something about celebrity activism. Today they say “Free Palestine” because there are no financial consequences. The day that changes, it will fade like “Free Tibet.” What looks like moral conviction is just aligning with whatever cause is trending.
CIA Chief of Station in Beirut William F. Buckley was brutally tortured at the hands of Hezbollah for fifteen months. In early June of 1985, he was buried in a shallow grave on the side of the road in the Shiite section of the city. His body would not be returned to the United States until December 1991.
What they did to these DOGE kids, purely to harass them and discourage anyone else from even trying to do real civic work, is completely beyond the pale. Truly sick people. Credit to Nathan Cavanaugh for running circles around that mob.
Whenever Paul Ehrlich comes up, this letter comes to mind.
I don’t like celebrating anyone’s death. But Ehrlich’s legacy should be remembered for what it is: apocalyptic environmental predictions that helped legitimize coercive sterilization and ruin countless lives. Horrific.
Remember when the India-Pakistan partition happened and it went perfectly and nobody died and there were zero refugees?
Zaid Jilani remembers.
Stop what you are doing and read this. Thank you for sharing your story, @anish_koka and reminding us of giants like Dr Thomas Starzl and Carl Groth, who not only made saving your daughter possible, but also made medicine great.
https://open.substack.com/pub/anishkokamd/p/the-price-of-progress?r=18lnvt&utm_medium=ios
The DOGE kids are getting deposed because the Left knows how to impose costs. The ACLU harassed me for years, ran up my legal bills, because of my work eliminating woke with DeSantis. They have a whole playbook for punishing productive right-wing people.
1.) The Count Of Monte Cristo
2.) Frankenstien
3.) The Brothers Karamazov
4.) East Of Eden
5.) Jane Eyre
6.) Stoner
7.) Lonesome Dove
8.) Pride And Prejudice
9.) Kindred
10.) Rebecca
⭐️ piece
Big corporate hospital systems have broken trust putting profits over patients.
in @mcall
https://www.mcall.com/2026/03/14/opinion-hospital-monopolies-driving-pennsylvanias-health-care-crisis/
It’s all scam.
All this money is going to politically connected cronies.
That’s the real reason the budget is out of control and NYC needs to raise taxes.
Mamdani won’t do anything to fix this. In fact, he’ll make it much worse.
This is huge and it will reduce drug spending and save lives.
But to really make a dent, we need patent law to be reformed, because right now, companies engage in strategic patenting to block the entry of biosimilars.
They need to be stopped.
Would appear to be a case of an invasive angio precipitated by a positive calcium score ?
The problem with issuing class I recommendations without strong evidence is that many interpret these as standard of care - meaning failure to do these things is low quality care or maybe even malpractice
Next chapter, we could see quality metrics mandating CAC/Lp(a) tests!
The woking of developmental psychology: @JDHaltigan 's critique of developmental psychpathology
https://open.substack.com/pub/fair370/p/reflections-on-john-d-haltigans-critique?utm_source=share&utm_medium=android&r=tduh3 via @SuePHall
Agree with you but think a better strategy is to reclaim the ownership of the medical profession that we have given away over the past 25 years, in large part because we don’t have united advocacy in Washington. The wRVU coupon that CMS provides is essentially the same as it was 25 years ago and adjusted for inflation is a fraction of what it was. Yet the hospital makes a increasing yearly amount on our labor. In my humble opinion our societies need a different strategy. @DutchRojas @DrDiGiorgio @anish_koka @realdocspeaks @GeBaiDC
4.59/mile for 26.2😳 How many could do just one mile at that pace?
When True, a five-year-old under social services, was dropped off for heart surgery at Children’s Nebraska, anesthesiologist Dr. Amy Beethe found him alone in pre-op. Moved by his situation, she decided he needed a stable home.
But what she and her husband, Ryan, offered went far beyond that. @SteveHartmanCBS shares the story of a doctor for whom saving lives is more than just her job. https://cbsn.ws/3PBJWa2
Chronicles of life in the People’s Republic of California.
Latest @DRsLoungePod now up:
Latest @DRsLoungePod :
Kevin Bass, PhD, joins Anish and Dr. DiGiorgio to tell the story of how a viral Newsweek op-ed apologizing for his support of COVID lockdowns and mandates set off a chain of events that ended in his dismissal from Texas Tech's MD/PhD program. Kevin walks through the internal emails, sham professionalism hearings, and rigged dismissal process he uncovered through FERPA records requests — and his ongoing federal and state lawsuits alleging First Amendment retaliation. The conversation then shifts to what Kevin has been building since: using AI pipelines to do large-scale investigative data analysis, from parsing the Epstein files to probing Medicaid fraud — work he argues would have taken a newsroom months, done now in days by one person.
YouTube Chapters:
00:00 - Introduction and Kevin Bass background
01:16 - Kevin's COVID arc: from establishment supporter to dissenter
03:14 - The Newsweek op-ed and Tucker Carlson appearance
08:00 - Internal emails and the professionalism complaint campaign
13:44 - Sham hearings, appeals, and eventual dismissal
19:19 - The rigged consolidated hearing and Darren Gibson
27:34 - Dr. DiGiorgio on the medical training dismissal system
29:51 - Why Kevin still believes in the broader legal system
33:00 - What Kevin has been building since dismissal
36:00 - Using AI to analyze the Epstein files
40:10 - The messiness of large health data sets
46:00 - Immigration policy data analysis
49:06 - Medicaid fraud and the limits of legal definitions
56:20 - Advice to physicians on AI
01:03:10 - The future of health policy research in the AI era
Cohosts: @anish_koka and @drdigiorgio
@drsloungepod
🎧 Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1489323962
🎧 Spotify: https://open.spotify.com/show/7vE4aCMpVHnSGwuOHiGVLp
▶️ YouTube: https://www.youtube.com/@TheDoctorsLounge
Resources:
Kevin Bass's case documentation site: https://case.kevinnbass.com
Kevin Bass on Substack: https://www.kevinnbass.com
Kevin Bass on X: @kevinnbass
Kevin's original Newsweek op-ed (Jan. 2023): https://www.newsweek.com/its-time-scientific-community-admit-we-were-wrong-about-coivd-it-cost-lives-opinion-1776630
Kevin's Epoch Times essay on his dismissal: https://www.theepochtimes.com/opinion/how-my-medical-school-scandalously-dismissed-me-5580841
The TL/DR version of this : there are definite good use cases for calcium scores , but there’s a high probability in the current landscape the test leads to inappropriate escalation, or inappropriate de-escalation because the test just isn’t that good as a discriminating tool.
Problem is most patients (and maybe some doctors) get the impression it’s like a positive or negative mammogram.
If you look at primary papered: there are more events in CAC zero with high FRS scores than CAC > 300 with low FRS scores,
On this day in 44 BC, Julius Caesar is stabbed to death by 30 Roman senators. The conspirators hope that the assassination will help restore the imperilled Republic. It doesn't. #IdesOfMarch
The Francis Collins book tour pledge :
“I will bring a generous spirit to all my interpersonal interactions refusing to ascribe evil intentions to others simply because of different political or societal beliefs”
Cc @DrJBhattacharya
This evening’s festivities.
Kevin Bass (@kevinnbass ) was an MD PhD student in good standing.
Then he wrote a Newsweek editorial in 2023 apologizing for his COVID views that he had come to believe were wrong and unscientific.
Pretty clear he was then kicked out of medical school as a result :
What is up with the UK and their love of coronary CT?
Anyone know the story of how the CTfirst crew managed to hoodwink NICE into recommending it ?
I don’t know folks… @x journal club is pretty top flight.
Drug Coated Balloons non inferior to Drug Eluting Stents?
Not so fast.
A Class 1 "STRONG" recommendation for checking Lp(a) is interesting.
We, at the moment have poor data to suggest a Lp(a) guided therapeutic strategy does anything productive.
Ok 2 do, but why give that such a strong recommendation ?
“A working system quickly figures out what works and what doesn’t. A poorly working system gets stuck in a dead-end loop. I fear the system has gotten worse, not better, since Starzl’s time. We are more compassionate than ever when it comes to funding treatments for patients with rare diseases through government programs, but this means zombie therapies survive longer because a government billing code is essentially forever.”