Whenever people complain about the number of folks relying on food stamps, it is worth reminding them that SNAP is, by too large of a degree, a subsidy for corporations that refuse to pay a living wage and their political allies who reject public policy prescriptions to reduce income inequality.

If the big beautiful bill is making your health insurance unaffordable, here are a bunch of docs who work outside the traditional medical payments system. If you're in Milwaukee, check out @doctormirer.bsky.social and Presence Primary Care. #directprimarycare

Here’s “Basket Case” except it’s about why you shouldn’t use Face ID or a thumbprint to unlock your phone

Peak validation: putting down the stack of boxes I was carrying to unlock the clinic door, and being complimented on my “perfect squat form” by a passing stranger who turns out to be a FedEx driver.

Day 2 of vaccine preventable disease education. Don’t forget that we don’t need these to come back… #vaccineswork #MedSky #PedSky

Going to post a primer on vaccine preventable diseases daily. Just because they are all coming back and we need to recognize them. #vaccineswork #MedSky #PedSky

Had a great time chatting with Eric and AJ at The News Hole about #DirectPrimaryCare, and clarifying that Michel Foucault is not, in fact, pop culture. Episode below!

Hospitals that can afford Super Bowl ads shouldn’t be sending their patients to collections

“The patient is a physician and has a good understanding of the potential benefits and harms of this plan.” These words are always preceded by a paragraph describing the wildest dumbfuck idea you ever heard.

Overheard my teen on the phone with my mom, advising her grandmother “Vehicular manslaughter is not the answer to your problems.” 🤔

Been wanting to fix that bathroom sign for weeks.

Me: Haha look at this messed up picture of me where I look like an AI-generated image with a statistically improbable number of limbs. Loyal friends: OMG you look so hot. @dandelionqueer.bsky.social @cabell.bsky.social

Not me typing into a meeting chat “Are we pushing anal cancer screenings up there with cervical cancer screenings?” 2026 goals include not having to type “OMG, phrasing, I’m so sorry” into any more meeting chats. 2025 is already toast. #CauseOfDeath

Did a whole bunch FAQs about #DirectPrimaryCare really fast over at TikTok before it (probably?) disappears. www.tiktok.com/t/ZT2JtAJbG/

This

I have no love for PornHub but it’s done less harm than the US Supreme Court.

New posters for my waiting room just dropped. Thanks to my niece Margaret and nephew Arthur for their help with the kids poster. Being my own boss is the best. I get to make all the rules. #DirectPrimaryCare #IndependentPhysician

To that ICU nurse who taught me, then the intern, the trick of shoving cotton balls with a few drops of essential oils up my nose before tackling disgusting jobs: you have truly improved the lot of this family’s designated vomit fairy. (It’s me I’m the vomit fairy).

Y’all will not top my stripper name: Fatty Chimichurri

Ask me if I want to do an exercise with the 10 lb dumbbell or the 12 lb and I’ll choose 12. Ask me if I want 12 lbs or 15 lbs and I’ll also choose 12. Cause the 12 lb weights are a pretty periwinkle color. #doyouevenliftbro

My TikTok about #DirectPrimaryCare as a harm reduction alternative to shooting CEOs appears to have gone viral so perhaps y’all will enjoy it too. www.tiktok.com/t/ZTYmrFumQ/

You literally can't make a system better than the one that already exists for trans minors. Which is why, when some cis people learn about this, they immediately either demand the impossible -- a zero error rate -- or jump straight to bans. Which was clearly their goal all along.

United healthcare initially denied coverage for my daughter’s birth because she wasn’t named on the policy at the time of services. This is not a joke, this really happened.

you know whats a targeted hit when greedy capitalists make decisions about if people should get cancer treatment or not they use your real name when deciding if you live or die

Hmm, seems he doesn't have prior authorisation for my sympathies.

Right! People don’t come out of the womb hating doctors. Well some babies are pretty pissed about being born. But mainly our dehumanizing medical system drives people away. The longing to be cared for is still there, and everyone from fantasists to con artists will prey on it.

Looking for recs from #autistic folks or those w/ #misophonia or sound sensitivity. My reception area shares a wall w/ the building generators and I want to mitigate the buzzing. What products give the most bang for buck? Pink noise machine? Sound dampening screen? Acoustic panels? Other?

Could someone please tell me to stand up and go finish cleaning the pots and pans?* Intellectually I know it’s not that hard but right now I’d rather get my IUD replaced. *For context I did zero of the cooking and this is a fair assignment that I volunteered for.

Hey #Milwaukee. Your out of town visitors don’t have to wait in line at urgent care if they get sick. I hate the holidays and I love being a doctor, therefore Presence Primary Care is open on Thanksgiving.

Appreciation post for the ED docs who take a minute out of a chaotic shift to get report from us PCPs about the patient we’re sending. Especially the ones who stay collaborative even tho they prolly have a septic patient trying to roll a joint with their own feces in the middle of a STEMI. #EMedsky

Some frequently misunderstood points on BED: -Ppl of any size can have it. -It’s a psych condition not metabolic. Treatment goal is to change distressing behavior, not to lose weight. -It’s more common in ppl w/ADHD & bipolar -Screen for this before starting anyone on weight loss drugs or you suck

If you want to be pregnant in the future, consider doing it now. I don’t say that lightly, because pregnancy has never been so unsafe, at least not in my lifetime. Problem is, we’re going to look back on late 2024 as a time when pregnancy was the safest it was going to get for a long time.

About the detection of bird flu virus in raw milk in CA: CDC, others warn against drinking raw milk. CDFA routinely tests raw milk in bulk tanks. This batch discovered because Santa Clara County health staff buy and test raw milk from retail stores for another line of defense. Public health, y’all.

Presence Primary Care inaugurated our Medicine on the Move series today. We met up at South Shore Park, talked about how to prepare for changes to health care politics in 2025, and went for a walk by the lake. What health topic do you think we should cover next time?

The number of people who go bankrupt every year because of medical bills. Norway - 0 UK - 0 France - 0 Spain - 0 Portugal - 0 Denmark - 0 Australia - 0 Iceland - 0 Italy - 0 Finland - 0 Ireland - 0 Germany - 0 Netherlands - 0 Sweden - 0 Japan - 0 Canada - 0 United States - 643,000

Speaking of stretching a buck, thought you might also like to know what uninsured patients at my #directprimarycare practice pay for routine labs: Chem panel $3 Blood counts $3 A1c (blood sugar) $3 Cholesterol $3 HIV screen $13 Prostate cancer screen $5 Estradiol level $7 Testosterone level $18

doctor dog treating sick cat, 15th century

Eliminating the federal Department of Education would not only make schools more unequal but also eliminate (or at least severely limit) the data collection efforts needed to legally prove how unequal schools are.

If you don’t know how far #directprimarycare docs can stretch a dollar for our uninsured patients, here’s what mine pay for a year of generic meds: Fluoxetine for depression: $6 Metformin for diabetes: $8 Torsemide for ❤️ failure: $15 Triphasic birth control pills: $26 Estrogen + spiro for HRT: $70

I’m starting a medicine bank to try to keep meds affordable for my patients in 2025. I’ll stock it as fully as I can before tariffs come and Oz & RFK get rolling. If you just have $5 I can use it to get a patient a dose of emergency contraception. 🙏 #mutualaid #directprimarycare shorturl.at/8QKgg

I really wrestled with the ethics of exiting the Medicare and Medicaid systems to start my #directprimarycare practice. But that’s currently looking like a real solid decision. 😭😡😱

Indeed. When they rounded up the Japanese Americans, myself and my family included, for internment during WWII out of fear over Japanese spies and saboteurs, two thirds of us were U.S. citizens. Don’t think it won’t happen again when they come for the “undocumented.”

i feel like i’m losing my mind because the democrats said the absolute bare minimum on trans rights during an election where you couldn’t watch sports without seeing 200 anti-trans campaign ads but now “the democrats are too pro-trans” is an opinion i’m supposed to pretend is based in reality

Nuance: let’s not stigmatize when we discuss disability outcomes of vaccine-preventable diseases. It’s not that Deaf, blind, or mobility-limited ppl are tragic, it’s that the ppl whose antivax policy will make more folks experience that also push policy that treats disabled Americans as subhuman.

“Inadequate vaccine use” has caused measles cases to skyrocket worldwide. This will kill kids now and, because measles is a bad disease despite what some cranks say, kill many survivors down the road because of immune amnesia and SSPE. globalnews.ca/news/1086988...

“I don’t like psych patients” Ok, do you realize every patient has psych needs? And every psych patient has health needs? Just say you don’t want to work in healthcare.

When you forget the animal stickers for your pediatric patients, you make do with whatever stickers you have in your purse.

Bc public health is my special interest, taking flouride out of the water has been tried and leads to massive increases in cavities, and infections due to cavities, especially in kids. ucalgary.ca/news/study-s...

The Onion should buy Elsevier next