Alex Shteynshlyuger MD
@DrAlexUrology
Followers
1K
Following
11K
Media
132
Statuses
7K
#intersectional #Urologist in NYC; journalist; #BladderCancer, #ProstateCancer, #ED, #Peyronies, Urologic Oncology, Entrepreneur #HEOR and #healtheconomics.
New York, NY
Joined December 2010
Value based care as practiced is impossible to practice ethically. If a patient is given all reasonable options, and chooses the most expensive that may not be the most effective but has the fewer quality of life side effects, who pays for that choice? The surgeon?
Paying physicians fee-for-service ensures access, especially for procedural care. It aligns incentives the same way every other service-based industry does. Want a plumber, electrician, lawyer, coder? You pay for the service rendered. Simple. Transparent. Effective. Naturally
1
2
10
As an MD, the easiest way to be labelled a "troublemaker" is to tell the truth and stand up for patients and yourself.
Did you know that doctors can actually be disciplined for speaking out about what’s happening inside their hospitals? It’s one of the reasons you might not hear more doctors sharing their real opinions, because the companies they work for or the hospitals they have privileges at
5
11
100
2 federal judges sent me letters admitting their staff used AI to draft error ridden court orders Theyre now working 2ensure it doesnt happen again That’s a step fwd but we need to make sure this problem doesnt resurface in ANY federal court My oversight will continue
223
713
3K
I contacted my lawmakers and urged them to support extending telehealth flexibilities. Join me! #ASCOAdvocacy
asco.quorum.us
Urge your lawmakers to make telehealth flexibilities permanent!
0
0
0
Eternally grateful to Anthem BCBS CEO (Gail K. Boudreaux) for issuing a prior authorization valid for 1 day, backdated to a random date (9/23/25) prior to prior authorization decision (9/26/25). Great leadership! @AnthemBCBS
3
1
4
The fact that the police came for phone theft is a miracle. Usually, they show up hours later to 911 calls, if at all.
🚨 Madison Ave & 40th Street — Two Crime Scenes, Half a Block Apart 🚨 Madison Avenue lit up with police lights tonight. Two separate crime scenes, only half a block apart. One woman had her phone snatched right out of her hand — the suspect took off running and disappeared
0
0
0
A Swedish court has ruled that the Eritrean migrant who raped 16-year-old Meya Åberg won’t be deported because the rape didn’t last long enough. The rape took place on September 1st last year when Meya missed her bus and was walking through a pedestrian tunnel after finishing
14K
20K
87K
As expected, any given AI company will be the opposite of its name: OpenAI is closed Stability is unstable MidJourney isn’t mid Anthropic is misanthropic Claude is pure evil.
Here's how Claude Sonnet 4.5 trades off terminal illness sufferers across countries. Nigerians are worth 27 times as much as Germans, and as with GPT-4o there's an Africa > South Asia > other > Europe/US rank-order.
5K
11K
60K
Anthem appears to have announced that it will penalize hospitals & assess of a penalty of -10% on facility reimbursements where the hospital based physicians are out of network (OON), as of 1/1/26. Credit to Ron Howrigon and his post on LinkedIn this morning (see below). The
24
46
125
In her interview with me from 2022, Julia Mason described how 20 years into her career as pediatrician, she had seen one gender dysphoric child. "This was a thing that occurred in one out of 200,000 children. This was a thing that a pediatrician could go their entire career
Twenty years ago in grad school, when we covered DSM-IV Gender Identity Disorder, we were told, “Chances are, none of you are ever going to see anyone with GID, but we’ll go over it anyway, because it’s strange and interesting.”
14
181
1K
Actually, double that. The CPT Panel refused to issue a CPT code to document wRVU associated with prior authorizations, appeals, peer-to-peer, and other time-consuming but uncompensated labor contributed by physicians.
Despite the issues with wRVU, they are a good approximate guage of physician productivity. US doctors produce more than twice as much as doctors in other countries or in the US VA system. That's more patients seen, more procedures done, and more people being treated. Does it
0
0
1
True
Oh my God—don’t get me started on the boondoggle that is Federally Qualified Health Centers. They already get a capitated “all-inclusive” rate per encounter—usually 4.75–6.5× Medicaid and 2.5–3.5× Medicare. Then, on top of that, they receive HRSA Section 330 grants—about $5.7 B
0
0
1
Senator Warren is a master of knee-jerk solutions.
If a company can break the entire internet, they are too big. Period. It's time to break up Big Tech.
0
0
0
It doesn’t matter if back pain is right or left. Today it’s right, next week it’s left, next month bilateral. These are not 3 different problems.
1
0
1
The ICD-10 code set, soon to be ICD-11, is controlled by white-collar work-from-home “policy wonks” that have an idea that the problem in healthcare is the lack of granular data. They are not entirely wrong. But granular data is a lot of work + little clinical value.
Electronic health records are built to optimize billing, not clinical care. A doctor can’t code a note with a diagnosis of traumatic subarachnoid hemorrhage as it’s too generic, according to the computer. But a more generic diagnosis, traumatic brain injury CAN be coded. So
1
0
2
I agree 100%! The PA process has been abused by the insurance companies, and they are AI-driven and not driven by patient care concerns. It makes no sense that a physician who doesn't review the medical record, has never examined the patient, and is often a different specialty
@realdocspeaks I think PA should be eliminated completely. Healthcare is decided on and provided by a physician. Healthcare financing should be provided by an insurance company.
7
12
66
A healthy 50 year old comes to the ER with a fever. She doesn’t appear well. A CT scan that’s reported at midnight suggests an obstructed kidney stone. An antibiotic is started fluids are administered. The next morning ID sees her, she’s lethargic, antibiotics are added, she’s
Yes, but even more importantly, tort reform would help patients and society. We all pay for frivolous suits
32
24
171
@DrAlexUrology Almost like people that don’t understand medicine running hospitals. Maybe they should bring their founder back @HowardSchultz Love his book Pour Your Heart Into It. When those passionate about their product/service turn it over to others who don’t fully understand the business,
0
1
1
