The Wrong Unicorns Presented by Commons Clinic

A discussion of healthcare “unicorns.”

thesurgeonsrecord.substack.com/p/the-wrong-...

Your Questions, Answered Health care accountability, Profit vs. profiteering, VBC strategy, and more!

The latest edition of The Surgeon's Record.

Answers to reader submitted questions on healthcare accountability, profit v. profiteering, VBC strategy, and more!

#medsky

Bump in MA payments, bump in hospital payments, decrease in physician payments.

Is the system fixed yet?

Mark Cuban, JP Morgan, and the Healthcare Puzzle: Building a System That Works Presented by Commons Clinic

Mark Cuban, JP Morgan, and the Healthcare Puzzle: Building a System That Works

Building on @mcuban.bsky.social recent healthcare blog post, themes at JPM, and my recent keynote address on MSK VBC.

#medsky

open.substack.com/pub/thesurge...

Reframing Value in Healthcare: A Conversation on Innovation and Leadership With Dr. Phil Louie of Measured Scalpel

A conversation on VBC and healthcare innovation.

#medsky #orthosky

thesurgeonsrecord.substack.com/p/reframing-...

Interesting year ahead as we enter the next phase of digital health and healthcare innovation.

2025 is the year the rubber meets the road.

2025, The Year of the Wood Snake: 7 Unconventional Healthcare Predictions Transformation, wisdom, calculated risk

🚨 Prediction Post Alert! 🚨

Year of the Wood Snake

Transformation.
Wisdom.
Calculated risk.

#medsky

thesurgeonsrecord.substack.com/p/2025-the-y...

Strong work Ed. The cult of personality is not new, but leveraging it to manipulate people has reached new levels. I hope we move toward a future where personal brands are more authentic and less manipulative.

Guest Post: Are Physicians' Salaries Overvalued, Undervalued, or Just Right? By Graham Walker, MD, Co-Founder of Offcall

🚨The Surgeon's Record Guest post alert! 🚨

This week the excellent @grahamwalker.bsky.social tackles the complex issue of physician compensation. It's a nuanced look at a complicated topic.

Thanks Graham! 👇

thesurgeonsrecord.substack.com/p/guest-post...

#medsky

Distrust is a huge issue. There should be checks and balances, but the motives have to be transparent.

It's obvious that everyone is frustrated with the status quo. Payers could start by taking a much more collaborative stance with patients and healthcare providers instead of an adversarial one.

Want to fix things? Stop the games, and come to the table on real solutions.

Also interesting that you mention how capital has been beating labor. This speaks to the angst and frustrations felt by many physicians (78% employed now) and other frontline healthcare workers. The pendulum is set to swing in the other direction in medicine too IMO.

Plenty of examples of the govt's healthcare struggles (the VA system, Medicare Advantage, CMMI, Medicare solvency, etc.)

Healthcare will be best solved the way we solve other difficult problems in the US -- by smart, driven innovators and those with the means and vision to support them.

@profgalloway.com

Appreciate your take on healthcare on today's @pivotpod.bsky.social episode. Interesting that on the one hand you (rightfully) call out politicians (the govt) for being complicit in the mess but on the other hand advocate for Medicare for All.

There's a lot wrong with healthcare, but the doom loop discussions make it seem like we can't get anything right. Those of us who show up on the frontlines every day know this isn't true. There's a lot we do get right, we just don't hear nearly enough about these stories.

Of course we're dictators, those op notes aren't going to write themselves!

Systemic Denial: How Healthcare's Broken System Was Exposed Last Week Fraud, Waste, and Abuse...but Whose?

Thoughts on last week’s shocking healthcare events.

thesurgeonsrecord.substack.com/p/systemic-d...

EMRs perpetuate the problem by leading to overdocumentation or misclassification of these events. The label follows the patient throughout the healthcare system. Once the "allergy" is attached to the patient, it's very difficult to reverse.

It's about time we addressed this problem.

#medsky

Adverse reactions and side effects labeled as allergies are a hidden and increasingly pervasive reason for substandard care.

Patients may be unnecessarily excluded from receiving entire classes of medications, leading to the use of less effective alternatives.

Enjoyed your recent post on current state of digital health unicorns!

Postprandial Healthcare Musings Who needs ketamine when you have tryptophan?

Thoughts on the two biggest obstacles to healthcare reform: misaligned incentives and entrenched payment models.

#medsky

thesurgeonsrecord.substack.com/p/postprandi...

The most worrisome healthcare grifters aren't the ones selling obvious snake oil and quick fixes, they're the ones using degrees and credentials to disguise ulterior motives as insight.

They pass themselves off as legit experts, but it's always a good idea to dig a little deeper.

Innovation in healthcare is critical, but it works best when built in partnership with practicing clinicians—enhancing their work, not replacing or criticizing it. Medicine is built on trust. Let's keep that in mind as we build towards lasting solutions.

Such perspectives are often false narratives framed as insight. They're provocative and pander to the angst many feel toward the system. No one would deny we have problems. There's no point in glossing them over. But we need well-reasoned solutions built on firsthand experience.

It’s particularly troubling when these perspectives are tied to ulterior motives, like promoting a product or company. Underinformed critiques of the profession, especially from those who haven't experienced the frontlines, risk undermining trust in clinicians.

There's a trend of individuals who completed medical school or residency but never practiced positioning themselves as medical experts.

While medical training provides a strong foundation, the real expertise comes from years of patient care.

Giving Thanks: The Moments that Build Resilience Presented by Commons Clinic

On resilience. And taking call over the holidays.

thesurgeonsrecord.substack.com/p/giving-tha...

Could make value based care more of a reality or could lead to more docs dropping Medicare depending on how it’s executed

The unfortunate truth in an era of influencers is that well reasoned, thoughtful arguments backed up by facts are boring and will garner you little attention, interest, or influence.

One Step Forward, Two Steps Back Presented by Commons Clinic

Thoughts on why so many seemingly well-reasoned, logical healthcare innovations struggle to gain traction.

thesurgeonsrecord.substack.com/p/one-step-f...