I think @statnews does an excellent job catering to a group of people that have used legislation to extract billions of dollars from the American taxpayer.
Their journalists can’t or won’t interpret science on their own and are basically megaphones for institutions / industry .. but otherwise they are great.
90% of academia’s problems, have come from academics not stewarding our disciplines, traditions, and institutions virtually at all.
Indeed, they’ve seemingly been tirelessly working to saw off the branches upon which they sit. I have found academic publishing to generally be worryingly unserious.
Paying reviewers is likely the tiniest part of the issue sadly.
For additional context on the reasons behind Vinay Prasad’s departure, it may be of interest to watch my recent conversation with @anish_koka on the @SciFrTheFringe podcast, where we discuss this topic in detail.
https://youtu.be/jktRUsYudWk
An excellent article about the beginnings of liver transplantation and its current status.
R to @anish_koka: Excerpt from :
This is a really bad thing.
These jobs in healthcare aren’t nurses or doctors.
They’re middle managers, billing specialists, and people whose sole job is to extract the maximum amount of government dollars for large hospital systems.
They don’t make care better. In fact, they make it much worse. They harass the frontline workers, physicians and nurses, driving them to early exits from clinical medicine. They consider patients nothing more than widgets.
Worst of all, they make your cost of healthcare higher. They are so parasitic that they consume all non-healthcare jobs. Employers can’t hire more workers and companies can’t expand because these parasites just destroy wealth.
This trend is a bigger threat to America than anything else.
Compelling. We now have contracts with employers in over 40 states and also see many patients from “Universal Access” countries who can’t get care. Patients will indeed travel for care, contrary to what many hospitals who’d like to think they aren’t in a market believe. GKS
Until recently, Hamideh Soleimani Afshar and her daughter were green card holders living lavishly in the United States.
Afshar is the niece of deceased Iranian Major General Qasem Soleimani. She is also an outspoken supporter of the Iranian regime who celebrated attacks on Americans and referred to our country as the "Great Satan."
This week, I terminated both Afshar and her daughter's legal status and they are now in ICE custody, pending removal from the United States.
The Trump Administration will not allow our country to become a home for foreign nationals who support anti-American terrorist regimes.
Most people don’t realize that many of these jobs are not caregivers. In fact, we are seeing physicians elect for early retirement and finding a clinical RN over 50 is like finding a unicorn.
In fact, majority of these jobs are non-clinical are actually parasitic to the host: the buyer and the seller (the physician and the consumer).
Recent job-posting data from 2025 shows employers listed 180,800 non-clinical healthcare roles (up 8% from 2024). Key drivers included:
>>Financial/billing roles (medical billing and collections): 37,500 postings, +47% year-over-year.
>>Administrative roles: 59,700 postings, +15%.
>>Roles like patient access specialists and intake coordinators also surged as organizations focused on throughput.
BLS projections reinforce this: medical and health services managers are expected to grow 23% from 2024–2034 (much faster than average), with low unemployment rates in areas like medical secretaries/admin assistants (3.7%), claims adjusters/examiners (2.4%), and medical records specialists (1.0%).
And while we need jobs in the United States, and good paying jobs, the irony is that these jobs aren’t enhancing local economies like the government intends because they drive up the cost of healthcare.
Therefore, the purported economic benefit of adding another manager at the hospital, for example, is off-set by the exponential cost created by the system itself. The costs are reflected in greater government subsidy and arbitrage, but also higher premiums.
A third of all hospices in the country are in Los Angeles per @DrOz
😳
This is what happens when hysteria replaces actual analysis of legislation.
A real cut means spending goes down. What happened here is that the projected rate of future Medicaid growth was reduced from an inflated baseline, while total federal Medicaid spending still keeps rising year after year.
Federal Medicaid spending is still projected to grow from about $691 billion in 2025 to about $996 billion in 2036. So yes, the law reduced projected spending relative to the old forecast. No, it did not make Medicaid spending start shrinking in nominal dollars. It bent the curve down from the inflated post COVID baseline and pushed projected federal Medicaid growth back toward something closer to pre pandemic levels.
California shows why people are right to be skeptical of the hysteria. Medi Cal spending was about $108 billion in 2022 and is projected to hit about $222.4 billion in 2026, while enrollment has stayed essentially flat.
If states are worried about getting fewer Medicaid dollars than they hoped for, maybe they should start by reducing waste, abuse, and gimmicks before claiming that every slower growth rate is “killing Medicaid.”
Instead of pretending a slower rate of spending growth is the same thing as gutting the program, we should be asking why a program this flush with cash still has such obvious waste, distortion, and bad incentives.
In the 1622 massacre of the Virginia settlers, a horrific attack in which the “merciless Indian savages” gained access to English settlements by pretending to be interested in Christianity, then massacred men, women, and children alike
The brutal attack wiped out hundreds a settlers, perhaps a quarter or more of the settlers, who had just been managing to move past the Initial rigors of settlement. It also came just at planting time, wreaking agricultural havoc and putting the settlers at risk of starvation
The attack was horrific, set the colony back by years, and was savage in the extreme. It also mostly ended Virginian interest in converting the Indians, which up until then had been substantial
But fortunately for us the Virginians didn’t give in. Instead they collected themselves behind the walls of Jamestown and then blitzed out and took the fight to the Indians, punishing them in a succession of campaigns and attacks that were so severe the Indian menace was mostly quieted for decades afterwards
This is a beautiful screw-up because it implicates many people within the NYT.
Each story goes through multiple editors, yet not one caught this before publishing.
The people who write the news literally know nothing. Stop putting your trust in them
"Man won't fly for a million years" – NYT 1903
There are corrections and there are
CORRECTIONS.
January 2007
I had been in Afghanistan for about 3 or 4 days when we received this 17 year old Pakistani kid who had both his legs blown off above the knee, one arm amputated at the elbow and most of his hand blown off on the other arm.
Now the kicker was that he was a “bad guy” that is to say he was an enemy combatant that our troops brought to us for medical care.
Believe it or not he got blown up while trying to set up an IED (aka roadside bomb) to blow our guys up. He accidentally blew himself up and now it was our job to provide him medical care.
Now you might be saying why not just let him die as he was an enemy. Well the reality is that as a physician it is not your job to judge people it is to treat them and do the best job that you possibly can. I was taught this while in my surgical residency, as we often took care of TDC (Texas department of corrections) inmates while I was at Galveston. It was not uncommon that we’d do surgery on murderers, rapists and even death row inmates.
Anyway, this kid was in pretty bad shape and we took him to the OR about 10 times over a 6 week period to wash out his wounds, revise his amputations and get him healed up. Blast wounds are notoriously difficult to deal with as shrapnel, dirt and bacteria are often forced way deep into the tissue and multiple surgeries are often needed to get all of the infection producing material out.
It was this kid that caused myself and the other orthopedic surgeon Dr. via Tom Large to adopt a rule that no one gets their wound closed up after a blast injury until they’ve had at least three wound washouts.
Anyway, we nicknamed him “stumpy”, I know offensive. But let me tell you when you are in this type of situation, gallows humor helps to keep you sane.
The reality is a high percentage of our patients were both Afghan civilians and Afghan army so they often all had very similar sounding names. It was hard to remember who was who so most of our patients got nicknames associated with their particular injuries. For example, a guy with a big liver laceration we dubbed “hepatocrackadullah”.
Stumpy was later renamed RXL4 which was considered somewhat more politically correct as the medical command staff didn’t like Stumpy- RXL4 stood for “Residual limb x 4” -the more official title for a stump is residual limb.
Enemy combatants were always brought in to the medical facility blind folded with earphones on so that they could not see or hear anything that might be used to cause us harm. It was alway kind of bizarre seeing a kid with effectively no arms and legs blind folded with earphones on, but it was what it was.
Even though the guy was an enemy the hospital staff provided him the best care that we could and after a few weeks he would actually smile and converse with the staff via the translators. Remember he’s a 17 year old kid, no doubt subject to all kinds of propaganda and may have even been forced to fight.
War is a very crazy, hellish nightmare and honestly no one wants to be there, but it is what it is, and once you are there you do what you gotta do!
So after 6 weeks or so we get Stumpy all healed up and at that point we turn him over to the Afghan army.
The next day we found out that as soon as the Afghan army got him they took him outside and shot him in the head and disposed of his body!
I had mixed feelings about this. One it was basically a tragedy all around from every aspect of it. What the fuck were we even doing, why spend all that time effort and resource if this was going to be the result. But realistically what kind of future would he have, even if the war ended and he somehow got home. Poor country, minimal resources, likely a social pariah, no chance to work or have a life, probably better off dead.
I remember a few months later we had an army surgeon that was attached to a Special
Pharma bros will sing the praises of the gift of cheap generics forever.
The reality is that they will continuously attempt to make sure you *need* a branded alternative forever.
Biktarvy therapy for HIV (on patent til 2036: list price $5000/month : 52% market share.
HIV is a great example - pharma ends one of the great medical scourges of the modern era, but decades later when society that has rewarded the group with patents and billions should be enjoying cheap generics , x % of the market is still paying for patented marginally better than generic therapies.
Want to bring marginally better stuff to market ? Go ahead .. priced at $5000/month? And no, this problem doesn’t go away if you make PBMs go away.
Real innovation in biotech is broken because the drug market is completely screwed up in the U.S.
There’s a lot of money (billions) in minor improvements to existing therapies that physicians insensitive to the real costs of these meds just blindly prescribe because they are shiny and new.
As long as someone else is paying, why not, right ?
Cc @MartinShkreli
From Tehran to the C-Suite: A Biotech CEO on AI, Drug Discovery, and the Me-Too Problem
Ali Mortazavi is not your typical biotech CEO. A computer scientist by training, former professional chess player, and veteran of financial markets, he invested in an RNAi company in 2012 — and then, by his own admission, made the crazy decision to become its CEO with zero background in biology, chemistry, or medicine.
What followed is a 14-year education in the brutal realities of drug development — and a front-row seat to the AI revolution now reshaping it. In this wide-ranging conversation, Mortazavi draws on his extraordinary personal story (fleeing revolutionary Iran as a child, arriving in London unable to speak English, rising through chess and finance) to offer a uniquely cross-disciplinary perspective on why biotech is stuck in a me-too loop, why the incentive system is the real bottleneck, and where AI is — and isn't — changing the game.
Subscribe to The Doctor's Lounge:Apple Podcasts | Spotify | YouTube | RSS
Follow the Show:X: @DrsLoungePod
Follow the Guest:X: @AAMortazavi
Co-hosts:@anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @drdigiorgio
Chapters
0:00 - Introduction & Ali's Background
1:07 - The Iranian Revolution at Nine Years Old
4:44 - Fleeing Iran, Arriving in London
6:38 - The Refugee Experience and Starting Over
7:49 - Computer Science in 1990
9:53 - Becoming a Professional Chess Player
11:06 - The Vishwanathan Anand Moment
13:17 - From Chess to Finance to Biotech CEO
14:44 - The Gleevec Illusion and the Reality of Drug Development
16:07 - Jay Bhattacharya, Reproducibility, and the PubMed Button
18:18 - LLMs as Scientific Compression Systems
20:15 - Why LLMs Give "The Average Answer" — The Co-Pilot Model
23:44 - Vibe Coding and the Explosion of Code
25:36 - AI Won't Replace 10x Coders — It Will Replace 90 of 100
26:16 - The GalNAC Case Study: 35 Years of Forgotten Innovation
31:10 - The Me-Too Algorithm and Biotech VC Incentives
34:40 - GLP-1s: Another 30 Years of Sitting Around
35:26 - The FDA, the XBI, and the Current Regulatory Landscape
40:43 - Can Politics Fix the Incentive System?
42:09 - Why Past Progress Happened Without AI
44:24 - Medical Ethics, Experimentation, and the Innovation Tradeoff
48:34 - Biotech Is Archaic: The Preclinical De-Risking Problem
50:05 - No Animal Model Actually Works
52:16 - Over-Regulation vs. Just Plain Hard
53:00 - The US Market as the Global Subsidy Engine
54:05 - China: Wake-Up Call, Not Innovator
56:25 - The London Market: "Don't Call It a Market"
58:52 - AI-Native Biotechs: Too Soon to Tell
59:36 - Where AI Works: Information. Where It Doesn't: Physics.
1:01:29 - Tangram Therapeutics and Libra OS
1:04:25 - The Future: SaaS Collapse, Medicine Returns to Fundamentals
1:07:36 - Closing: Hope, Broken Glass, and Early Adoption
A student-athlete turned in a 146-word essay about Rosa Parks — one paragraph, riddled with errors, no sources — and got an A-minus. That single paper helped expose the biggest academic fraud in NCAA history.
For 18 years, from 1993 to 2011, a department secretary named Deborah Crowder ran fake courses at the University of North Carolina. @UNC The classes never met. There was no syllabus and no professor.
Students turned in one paper per semester. Crowder admitted she never read them. She skimmed introductions and handed out A’s.
UNC’s academic counselors steered athletes into these courses each semester, specifying what grades each player needed. Athletes made up 47% of enrollments despite being just 4% of the student body.
Rashad McCants, a star on UNC’s 2005 championship team, told ESPN he made the Dean’s List without attending a single class. Ten of fifteen players on that title team were enrolled in paper courses.
When whistleblower Mary Willingham revealed that 60% of athletes read at a 4th-to-8th grade level, UNC attacked her publicly and fans sent death threats. She was forced to resign.
In October 2014, a 136-page investigation confirmed the scope: 188 fake classes, 3,100 students, 18 years of fraud.
And the punishment? In October 2017, the NCAA ruled there were no significant violations. Zero penalties. No vacated wins. No postseason bans.
@UNC calls themselves a bastion of academia. How incredibly pathetic.
I’m in the 19th year of private practice and have always made my patients first. I am concierge medicine! @LivingstonMD @ASPS_Members @ASPS_News @AmCollSurgeons @HandSurgeryAssn
“We did not participate in the revolution to go backwards”
Worth a watch to see what they’re all about
Our task force isn’t wasting any time cracking down on fraud.
This morning in the LA area, federal law enforcement is taking down fraudsters who stole $50M+ from Americans by defrauding our healthcare and hospice systems.
Thanks to @DrOzCMS and @USAttyEssayli for their work.
lol.
Really? Any IMGs want to comment on how easy it is to get into competitive medicine fellowships in the U.S. ?
After nearly 4 years working within a large healthcare system, I made the decision to take a different path.
Today was DAY 1 of building something of my own.
I decided to start my own private practice with one clear purpose: to put patients first always. Not driven by systems, quotas, or accepting burnout as the norm, but focused on doing what's right for each individual.
My goal is simple: to provide high-quality urological care where patients feel heard, respected, and never rushed.
Grateful for the journey so far and even more excited for what's ahead.
#LebanonPA
#centralPA
#Urology
#MedTwitter
#MensHealth
#PrivatePractice
I agree with both of you. it is a privilege and honor for IMGs to be able to come here and work. I think a lot of them think it's a right and have an entitled attitude toward it. that's wrong. AMGs should rightfully get first dibs.
At the same time, IMGs are simply taking advantage of a system that is legally available to them.
IMGs aren’t choosing family practice or psychiatry or neurology.
They want to do cardiology , but they end up as hospitalists / fam practice in underserved areas.
Are there any second order effects that may result from using IMGs to fill holes they don’t want to fill?
Should we perhaps address the real drivers that makes psychiatry/ 1º care undesirable ?
As long as there’s a bandaid available, will anyone be forced to address these deeper issues ?
I’m an American medical school graduate. I trained at Temple Hospital in North Philadelphia. I ranked it highly over a number of nice suburban places because it was hard.
It’s a myth that Americans don’t want to practice at places that are difficult / underserved.
I’m not alone, Johns Hopkins is an elite program that serves the toughest part of Baltimore. Almost all AMGs.
We need to move to fix the pipeline that denies capable Americans a chance to become doctors.
Weird. We were reliably told by many experts that the only way to keep COVID at bay was infinity covid boosters.
EXCLUSIVE: Multiple senior HHS officials estimate that, under Gavin Newsom, California's state Medicaid program has lost 25 percent of its budget to fraud. This would mean it is currently losing $50 billion a year to scammers, fraudsters, and organized crime rings.
Today marks 1 year since it was revealed that the infamous & debunked infant mortality race concordance study buried findings that "undermine the narrative."
The study was published in @PNASNews (the journal of the National Academy of Sciences). It still hasn't been retracted.
.@DoNoHarm filed a complaint with the HHS Office for Civil Rights alleging that Corewell Health, Texas Tech, & HCA discriminate on the basis of national origin, favoring foreign-trained physicians in their internal medicine residency programs over American-trained doctors. 🧵1/
Great question! The reason healthcare is overpriced is bad legislation passed by Congress, such as:
• Stark Laws
• The ACA
• The prohibition on Physician ownership of hospitals
Section 6001 of the ACA
• The HITECH Act
• 340B Program
You are the problem!
This mosque in Syria used to be one of the holiest sites in Christianity: the Cathedral of Saint John the Baptist (whose head is traditionally said to be buried there). After the Muslim conquest, Umayyad Caliph Al-Walid converted it into the Umayyad Mosque in 705 AD.
Latest episode : @DrDiGiorgio goes to Washington.
Paying taxes gives me a feeling of inner peace when I think of the learing centers they fund.