Michael Albert MD’s Post

It’s worth reemphasizing: Physicians MUST learn the business of medicine, and it starts in med school. If you don’t have a deep understanding of policy and billing then the system will take advantage of you. You MUST learn the boring stuff alongside the core clinical education if you want to control your destiny. ⤵️

Having more time to review the CY25 Physician Fee Schedule proposal, clear themes emerge: 1️⃣ Disincentivizing Acute Care: CMS reduces the conversion factor for Physician E&M encounters by 2.8%. 2️⃣ Incentivizing Innovative Chronic Care Models: ◾ Increased flexibility for telehealth ◾ Enhanced support for advanced primary care, including chronic care services ◾ Continued support for remote patient monitoring At Accomplish Health, we built a care model for the future, leveraging both synchronous and asynchronous care delivery. We also built the necessary infrastructure to capture data and bill for these services. CMS' emphasis on chronic care management and reduced focus on acute care signifies that many legacy care systems, which rely heavily on E&M services, will need to evolve to remain viable.

BRAIN HEALTH - - - As I get older, I worry more about my cognitive health, so here’s a reminder of evidence-based interventions to reinforce cognition (all supported by RCTs): 1️⃣ plant-based diet + exercise + stress management https://lnkd.in/gZu_rkCj 2️⃣ creatine monohydrate supplementation https://lnkd.in/gPQnduEm 3️⃣ daily multivitamin-mineral supplement https://lnkd.in/gYt9j3XT

GLP1 is a positive chronotrope and directly stimulates the SA node. Some people are really sensitive to this effect! It’s important to educate and monitor your patients about the cardiovascular effects of GLP1!! https://lnkd.in/gsBfwH48

Central GLP-1 activation inhibits TNF-α production, which is a major reason why many patients with autoimmune diseases feel better. https://lnkd.in/gHca_Yy8

🔸NTS-GLP1R neurons mediate satiety-related weight loss. 🔸AP-GLP1R neurons mediate food aversion and nausea. TLDR: GLP1-mediated weight loss and nausea have distinct neural circuits. It’s possible to create a GLP1RA with biased/selective agonism toward NTS-GLP1R, which could limit GLP1-related side effects (SEs). https://t.co/sPGrK7MZVs

Unhealthy % Body Fat Thresholds (based on NHANES data): Men: Overweight = 25%, Obesity 30% Women: Overweight = 36%, Obesity 42% https://lnkd.in/g3MAkxE6

I am proud of what we've built at Accomplish Health—a comprehensive, multidisciplinary virtual obesity medicine practice. Our clinical teams consist of obesity-specialized teams (physicians, APRNs, RDs, and RNs) who work together to support patients across the care continuum, including non-surgical weight management and pre- and post-surgery bariatric care. We can order any necessary labs or diagnostics for our patients and have established a robust RPM (remote patient monitoring) infrastructure to track weight, blood pressure, and glucose levels, ensuring patient progress and safety. Our services are provided within insurance networks, including Medicare, Medicaid, and commercial insurance. This enables us to offer a unique, accessible, and comprehensive obesity care experience covered by insurance. ⤵ For partnership inquiries, please reach out to Shelly Russell. New patients ➡ https://lnkd.in/gVtYXGVF To learn more ➡ https://lnkd.in/ewn6WNGn

Semaglutide and Blindness - - - It's a great episode by the Nadolsky Brothers! The more I research it, the more I think the association is real. Semaglutide causes NAION (rarely) in the same way that SEMA causes AKI. At-risk people (crowded optic disc) are overtreated with minimal monitoring and hypoperfuse (due to a combination of dehydration, lack of BP med adjustment, untreated OSA, etc.) their optic nerve. Early survival curve divergence fits (as observed in the study). If this is all true, we should see a rise in the incidence of GLP1-induced NAION in the telemed pill-mill era. Karl Nadolsky Spencer Nadolsky, DO

GLP1RAs are associated with a lower hazard for various cancers compared to insulin use in people with type 2 diabetes. Um…DUH! Insulin is a growth hormone that can be oncogenic at supraphysiological levels. Most people with T2D have hyperinsulinemia/insulin resistance, and then we give them more insulin on top of it instead of treating the obesity that caused the diabetes. 🤦🏼♂️ 💡My favorite part of the study was good ole metformin still being a boss. ⤵️ Study: https://lnkd.in/gid-bJ9g