if a patient with opioid use disorder is admitted to ICU (eg for pneumonia) & they clearly tell you their dose of buprenorphine or methadone, we should just believe them and give it to them in my experience they’re always correct & delaying tx to try to verify their perscription just causes misery

Are you a PCP pulling your hair out trying to maneuver through maddening insurance and pharma barriers to getting your patients the medications they need? A 2 word solution: pharmacy technicians. Check out our study @annalsofem.bsky.social on the benefit of adding pharm techs to primary care teams👇

Important paper from @mlbarnett.bsky.social and colleagues Patients with Medicare Advantage linger in hospital for a long time because of the limited rehab options it covers (tracks w/ what I see) More evidence that Medicare Advantage is hot garbage that funnels public monies into private pockets

Since its inception, traditional Medicare has been tied to a fee-for-service model. As we mark its 60th birthday, Congress must devote political willpower to change this outdated model and reverse the erosion of America's health. From PCC's Ann Greiner:

Top line recs from @health.nationalacademies.org responding to 2026 CMS fee rules: -AdvPrimCareMng(APCM) services are largely preventive and should be exempt from cost-sharing -efficiency adjustments are justified for procedural and diagnostic services 1/2 www.nationalacademies.org/our-work/res...

Today’s ACS data show health coverage inequities increased in 2024 for Black & Latino ppl, and ppl with low and moderate incomes. These trends were likely driven by the drop in Medicaid enrollment. tinyurl.com/yttxmmp5

In a comment letter to the Centers for Medicare and Medicaid Services, the Primary Care Collaborative and its Better Health — NOW campaign expressed appreciation for several MPFS modernization proposals that strengthen whole-person #PrimaryCare. thepcc.pub/2026MPFSLETT...

Bravo to the authors and journal @annfammed.bsky.social Wonderful to see the broad interest in the important findings

Laugh crying.

I miss the old brand #CDC

According to CMS, primary care centric ACOs once again outperformed their peers participating in MSSP in 2024. It's yet another piece of evidence that when primary care leads, savings and better outcomes follow. Our statement: thepcc.org/news/stateme...

Ditto

The Guardian is covering the rise of @defendpublichealth.bsky.social. #IHAT is evidence-based policy making and grassroots people powered movement building for justice and rights. MAHA is policy-based evidence making rooted in fascist politics and capital-serving eugenic ideas. #IHATnotMAHA

Amen to that

On 60th anniversary of Medicare+Medicaid, @aijenpoo.bsky.social‬ explains double whammy of Medicaid cuts + immigration policies. Immigrants crucial to home care workforce. Loss of TPS will decimate this workforce. Ominous for elderly & people with disabilities. www.democracynow.org/2025/7/30/me...

I hate that anti-abortionists have stolen the term "pro-life". Screw that, I'M pro-life! I'm pro affordable healthcare, medical research and vaccines. I'm pro food stamps, school lunches, and child tax credits. I'm pro foreign aid so millions of children don't die of malaria and TB. That's pro-life!

Heard from #AHRQ that the entire grants staff has been let go! They are unable to issue funds for grants already funded, let alone fund new grants. This is outrageous and will make Americans poorer and sicker. Why? A brief thread about just some recent AHRQ-funded research: #MedSky #HealthPolicy

📢 UCSF Family & Community Medicine is hiring an Administrative Director! Lead a nationally recognized team advancing health equity, research, and clinical excellence at Zuckerberg SF General @zsfgcare.bsky.social. 💼 $143K–$215K | Full-time | Flex schedule 📍 San Francisco 🔗 Apply: bit.ly/46Vh1V8

CBOs proved themselves to be essential for the COVID pandemic response. They are threatened with big loss of funding just when we need them as critical partners to respond to the intensifying pandemic of social and health injustice. Highly recommend this upcoming webinar. shorturl.at/QKiR0

Utah is facing a primary care shortage. "The state is 49th in the U.S. in primary care doctors per capita, only 96 per every 100,000 people." This is causing problems for patients in the Beehive State. Read more from @getgephardt.bsky.social‬ in‪ @ksl.com‬:

Applaud this effort by these organizations. @aafp.org where are you?

CA leaders stand up for immigrant communities in many ways, but are also scheduled to Medi-Cal services for immigrants starting in January. This will have big negative effects on community health.

New Yorker cartoons don’t miss.

NEW: Americans want Medicare for All. The people know that our health care system is broken and that we need universal health care. Let’s get it done.

This is sick on multiple levels.

Seems to me @richardferro.xyz that family physicians should all be stepping up para la luche and taking #fmrevolution to heart. Anything less is complicity with this obscene soulless attack on the health and well-being of the patients and communities we care for.

How to Wreck the Nation’s Health, by the Numbers www.nytimes.com/interactive/... by @shwoolf.bsky.social "...the administration is kneecapping the very infrastructure that would make that feasible and is instead enacting policies that will compromise health."

“Millions would lose access to preventive care and effective care management, and more Americans could be forced to rely on already overburdened emergency departments for routine care.” - Ann Greiner, PCC President and CEO. More in Healthcare Innovation ⬇️ www.hcinnovationgroup.com/population-h...

Rather than passing counterproductive and harmful legislation that would undermine efforts to combat chronic illness, @thepcc.org urge lawmakers in both houses to turn instead to a bipartisan approach capable of advancing pragmatic, evidence-based solutions that strengthen Americans’ health.

A lot of justified attention to devastation for patients and hospitals (esp rural) to be caused by Medicaid cuts in budget bill. But will also pummel an already precarious primary care sector 😫

The ethical puzzle about universal health care is not that the poor get it but that the rich do too. Why? It’s just so much more economically efficient than a system in which you’re paying huge numbers of people to constantly squabble over who should pay for what.

This is incredibly beautiful storytelling.

Congrats to Drs. Shieva Khayam-Bashi, Ron Labuguen, Dae Hyoun (David) Jeong, Sen Nguyen, Mukund Premkumar, Adrian Tomes & Manuel Tapia, recipients of the 2025 Excellence in Student Teaching Awards! Find out how they go above & beyond in teaching, mentorship & patient-centered care. bit.ly/44j0RDe

#Burnout isn’t about needing more yoga—it’s about moral injury caused by a broken system preventing workers from providing the quality of care they believe is right. In @ucsfcepc.bsky.social's latest paper, @kgrumbach.bsky.social & Rachel Willard-Grace call for systemic change. bit.ly/44IZLkW

Amid potential rollbacks of federal Medicaid funding, the PCC led 94 national and state organizations in urging Congress to reject proposals that destabilize primary care and undermine efforts to address America’s chronic disease crisis. Our letter: thepcc.pub/April_Medica...

Another argument against privatizing government health insurance programs. In addition to a long list that includes wasteful profit extraction.

Adding to this push by @vmontori.bsky.social @ericreinhart.bsky.social Mark Linzer et al to move from burnout to moral injury. We call for more focus on harm to health workers of industrial health care consolidation, disempowered labor, govt austerity policies www.annualreviews.org/content/jour...

Findings of this public survey very complementary to concurrent survey of frontline primary care clinicians reporting pervasive perceived harm of Trump health policy actions www.milbank.org/publications...

New survey on awareness of Trump cuts: "We found that a high proportion of the American public (almost 80%) had heard about the firing of federal scientists and health workers… undoubtedly an underestimate of current levels." @rebekahnagler.bsky.social @efranklinfowler.bsky.social et al

Ocean Beach, San Francisco

This is what I have to say about today’s developments.

Rural health care providers are staring down existential threats from both cuts to Medicaid and the elimination of HRSA initiatives www.washingtonpost.com/health/2025/...

Gotta love Steve Kerr wearing a Harvard basketball tshirt to postgame media session. Veritas

Across the U.S., many states are making primary care a priority. Learn how these efforts are improving quality and satisfaction in health care. Dive into the details on our State Investment Hub. thepcc.pub/stateinvestm...

At Capitol on way to DC mall rally

Spot on analysis by Dr. Ryan McCormick @examined.bsky.social in this substack piece on why autocracies crush government health agencies. Thanks @kennylinafp.bsky.social for calling it out #FMSky

We’re still learning about the steep cuts to CDC, but I want to focus on the particularly dangerous and misguided elimination of CDC’s tobacco control program. If it’s not reversed, this would have devastating consequences and put American lives at risk.

It is sitting really uncomfortably for me that these ghouls are treating IHS like the public health equivalent of Siberia. IHS is critically important for the delivery of medical care to underserved populations. And they’re treating working there like it’s a punishment.

America has never been subject to this level of authoritarianism, and quite frankly, sheer incompetence. Out of the ashes, this moment should radicalize us to embark on an era of new reform — of our economy, our democracy, and our commitment to social justice and the law.

One month into the Trump admin, the Larry A. Green Center for the Advancement of Primary Health Care for the Public Good surveyed primary care clinicians on effects of federal policy changes on their practices & patients: buff.ly/OID7uVu @rebeccaetz.bsky.social sky.social @kgrumbach.bsky.social