CMS wants drug prior auth to look less like fax warfare: ePA + FHIR, with decision clocks (QHP: 72h standard/24h expedited; CHIP FFS: 24h). Proposed Oct 1, 2027. https://www.cms.gov/newsroom/fact-sheets/2026-cms-interoperability-standards-prior-authorization-drugs-proposed-rule Now enforce it.

It's like watching the 5 year old child thrashing on the ground at the toy store, and, instead of either ignoring or admonishing the child, you grab what he wants off the shelf and hand it to him so he'll shut up. Guess what. He won't stop doing that. In fact, he'll do it even more.

JAMA IM cluster RCT: a patient+GP deprescribing intervention doubled the odds of big PPI cutbacks—≥50% dose reduction in 14.9% vs 7.0% at 1 year (aAD 6.9%). This is what primary care systems work looks like. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847655

My wife and I have been traveling. AI cannot take the place of going somewhere and being in the moment. We don't even really set an agenda. We just set where we're going to be, and we figure it out when we get there. We find food. We find points of interest. We meet people. Absorb the culture.

In primary care, continuity is the real intervention. It’s also the one thing the insurance-and-industry complex can’t prior-auth, deny, or carve out. That’s why they keep trying.

Aspirin for primary prevention: the ‘take one daily’ myth is outdated. USPSTF: 40–59 w/ ≥10% 10y CVD risk = individual decision (C). Age 60+ = don’t start (D). https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication

CMS+FDA built a fast lane around Medicare’s coverage bottleneck: RAPID. CMS: proposed NCD the same day FDA authorizes an eligible device. About time. https://www.cms.gov/newsroom/press-releases/cms-fda-announce-rapid-coverage-pathway-accelerate-patient-access-life-changing-medical-devices

JAMA TOBRA trial: adding intrawound tobramycin to vancomycin didn’t lower deep SSI after high-risk tibial fracture fixation (7.4% vs 6.6% at 182d). Local antibiotic powder isn’t magic. https://jamanetwork.com/journals/jama/fullarticle/2847579

Saturday night test: if a TV doc orders labs the way no real clinic can, I still flinch. Then I remember: it’s not trying to be accurate. It’s trying to be a story. Reality is messier. Stories still matter.

In the category of “No shit”… taking vitamin C daily doesn’t prevent colds for most people (RR 0.97). But it does shorten them a bit (≈8% adults, 14% kids). The “immune boost” myth is mostly marketing. https://www.cochrane.org/evidence/CD000980_vitamin-c-preventing-and-treating-common-cold

CMS cut the Star Ratings measure set: 11 admin measures out; a Depression Screening + Follow-Up measure in (2027 measurement year → 2029 Stars). Stop optimizing paperwork. Start measuring care. https://www.cms.gov/newsroom/fact-sheets/contract-year-2027-medicare-advantage-part-d-final-rule

Long COVID RCT (Ann Intern Med): 8-week recovery was 63.6% with metformin vs 68.2% with ursodiol vs 68.2% with placebo. Two weeks of either med didn’t move the needle. That’s the post. https://pubmed.ncbi.nlm.nih.gov/41771135/

Dept. Q has the right detail: trauma is paperwork. Mandatory therapy is scheduling. Recovery is boring repetition.\n\nTV makes it look like a montage. It’s mostly work.

In the category of “No shit”… PSA screening isn’t “just a blood test.” USPSTF: don’t screen unless the person wants it (55–69); recommend against PSA screening at 70+. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening

CMS wants drug prior auth to function like infrastructure: ePA + APIs, denial reasons, and tighter clocks. Proposed: QHPs on FFEs 72h standard/24h expedited; Medicaid 7d/72h. Less fax theater; more accountability. #HealthPolicy — Dr. Andrew Carroll

Hush, everyone! Temu Trump has something to deny!

It is, once again, TACO TUESDAY!! www.nytimes.com/live/2026/04...

I will never understand when and why journalists and party members cannot, will not, and do not hold this man's feet to the fire and ask the hard questions, seed doubt, and provide judgement where judgement is so obviously due. These people are the soft, tender flesh in this nutsack of a government.

Doctors of Osteopathy take their medical education at Osteopathic Schools of Medicine, as opposed to MD's, who take theirs from Allopathic Schools. Their training is almost always side-by-side with MD's, and so their skillset is the same. I ❤️ my DO colleagues. www.nytimes.com/2025/07/13/w...

When you voted with your wallet instead of your heart.

Cardiothoracic surgeon after a total lobectomy for a lung cancer patient.

So, wait, is Diet Coke now on formularies to treat stuff?

The real question is--Has DoorDash reduced the amounts paid out to Dashers on an order because they are now able to, given that taxes on tips are gone. Therefore, improving their bottom line, and showing more profit. That is likely the real motive, either currently or in the near future.

H/t @jumulojimbus.bsky.social

You're ALL mistaken. That meme that he posted and deleted is not the President as Jesus Christ. He was actually channeling Kenny Loggins.

All 3 of those life challenges should not exist. 1. Working Doordash in your senior years, 2. Worrying about taxes on tips, 3. Worrying about affording healthcare

I totally get it. I wear a white cassock and red mantle robe to work every day. Every doctor does. All of us.

Maybe they're starting to get it?

So, where are the WMD's?

Controversial opinion (maybe). I enjoyed #TheMartian a lot more than #ProjectHailMary. Sorry. It was a more fluid, linear film. Unfortunately, there's just something about stories about solo, marooned characters (Project Hail Mary, Cast Away, etc) that makes them less enjoyable.

Just when I thought this administration could not get any more stupid, this idiot-in-chief proves that our perception of stupid is not capable of conceptualizing the absolute void of knowledge they are truly capable of. This is so short sighted. I mean, who the hell is even asking for this?

What an honor. Carroll is a great name. Very sad about his wife, but with any belief in divinity, she's there with him right now.

They'll need to plan a giant red X to be painted on the roof so that the satellites of our enemies know where to aim. www.nytimes.com/2026/04/02/u...

First world problems: www.nytimes.com/2026/04/03/u...

What's missing from this photo, compared to Apollo mission photos, of earth? Can you tell? To me, it looks like a lot less vegetation.

And.....she's gone! www.nbcnews.com/politics/jus...

Put limits on the School Vouchers in AZ! I took action with Protect Education. Will you join me? Use this link to sign up: www.mobilize.us/protecteduca...

Lillian Vernon was born Lilli Menasche in 1927 in Leipzig, Germany, to a Jewish family. Facing rising antisemitism, her family fled to Amsterdam, then New York. These early experiences taught her resilience and resourcefulness that shaped her future. #EternalLight 1/10

I’m just going to say it. East coast weddings are better than west coast weddings. And being from San Diego, that’s hard to finally admit to. But it’s just the truth.

Hats off to the @tsa.gov crew at #PhoenixSkyHarbor airport this morning. Arrived at 4:20 for a 6:30 departure at Terminal 3. Just about every lane was running despite the heavy crowd. I estimate even the long line was 15 minutes. We used TSA Precheck Touchless for the 1st time, and it beats Clear.

My appearance on @fox10phoenix.bsky.social regarding the student hazing death #NAU. The kid's BAC was 0.42. This kind of behavioral continues to be criminal and needs to stop. There is no need for this senseless death. www.fox10phoenix.com/news/nau-stu...

THANK YOU FOR YOUR ATTENTION TO THIS BRAIN SPLATTER!!!

It's actually pretty ironic that by attacking Iran, causing Iran to retaliate as well as lock down the Strait of Hormuz, thereby causing gas prices to skyrocket, reducing use of petrol fueled transportation throughout the world, that DJT may have reduced climate change causing CO2 production.

You know what's funny is that ICE is not getting paid either. So now he's forcing two groups of unpaid people to do a job. Again, make TSA a division of the Department of Transportation, where it belongs. Keep its budget intact and pay the people who do the hard work. Deal with DHS separately.

RIP Chuck Norris, one of the greatest action heroes of all time.

He really needs to learn how to use ChatGPT to write his posts.

American military members, recruits who volunteered to serve their country, are dying for oil… …again.

The TSA should be a subdivision of the FAA, which itself is under the Department of Transportation. Having it under Department of Homeland Security is a mistake. Passport control should be under the auspices of the Department of State, since it involves State matters. CBP is a DHS department.

#Wellcare has denied my patient a lifesaving asthma medication, that you can get for $32 at #Kroger if you use @goodrx.bsky.social, that's a generic, has been around for decades, has several generic manufacturer options, and keeps him out of the hospital. #AmericanHealthcare is SO broken.

A US Warship may have been the weapon by which 180 schoolchildren and staff were decimated, but make no mistake... It's the US President that pulled the trigger. He's announced it. He's admitted it. He's taken pride in it. And he stumbles over his own tongue while trying to deflect it.