Chris Farmer
@MUFarm
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MD, MSPH. Sports medicine doc. After hours woodworker.
Columbia, MO
Joined August 2010
Since I have your fleeting attention — here’s a quick reminder. @CMSGov continues to enact policies that drive consolidation in healthcare. And this hasn’t changed regardless of which party or administration is in power. For all the policy wonks and pundits who keep trying to
We have some final numbers for the impact on Orthopedics as it relates to the final rule for the physician fee schedule. There is no other way to spin it other than the numbers are bleak for independent physicians. While employed physicians will see a 2.5% reduction across
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Just did a P2P with @AnthemBCBS on an acute knee injury (probable MMT, maybe root, maybe small bucket), treated for 4 weeks with NSAIDS and PT after UC visit, now worse and on crutches. Denied because she apparently needs to get to the magical 6-week mark. The reviewer did not
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Mad about ESPN vs YouTube TV? Welcome to healthcare. United and Anthem run the same play every year. Fight in public, “make up” in private, and everyone’s bill goes up. Different field, same game. Patients always pay.
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14 years ago. The best baseball game I’ve ever attended. Good ole iPhone 4 video quality.
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If the same procedure costs less and outcomes are equal or better, taxpayers deserve an answer. Patients and taxpayers both lose when incentives are misaligned.
Why would the United States government, Medicare, pay more to non profit hospital outpatient departments than for profit ambulatory surgery center for the same work? Who is the fiduciary of Medicaid and Medicare funds? @JDVance @DrOzCMS @SecKennedy
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Friday Night Football is back. If you suffer an injury on the gridiron or anywhere else, remember on Saturday mornings you can walk right in to OUCH. We will be open from 8am-12pm. Why choose OUCH? Here’s all the reasons.
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Independent doctors deliver higher-quality care at lower prices. Full stop. That’s why health systems and insurers work overtime to absorb, block, or undercut them. Because outcome and price competition exposes the game. If patients and employers ever had options, the
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Tell me you’re completely out of touch with the healthcare situation in America without actually telling me.
So troublesome to see so many young doctors complaining about how hard the job is. Your job is about taking care of patients. It’s called dedication. It’s called devotion. If you wanted an easy life, you should’ve chosen something else.
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Misleading or Overstated: • “Ultrasound the morning of injury would show damage.” 🟡Speculative — degeneration ≠ prediction. • “Stem cells could’ve prevented it.” ❌ No strong evidence supports this claim.
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• “Ultrasound can detect Achilles tendinopathy better than MRI.” ✔️ Generally true — especially for dynamic imaging. • “Most NBA players don’t return to pre-injury level.” ✔️ Supported by 2022 AJSM data. • “PARS & SpeedBridge are newer surgical options.” ✔️ True —
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Accurate or Mostly Accurate: • “Achilles has poor blood supply 2 thumb-widths above heel (watershed area).” ✔️ True — a well-known weak spot. • “Young athletes can rupture Achilles with high cumulative load.” ✔️ True — especially in high-usage pros.
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1) There is no high-level evidence that routine preventive stem cell injections into healthy Achilles tendons reduce the risk of rupture. 2) No major orthopedic, sports medicine, or regenerative medicine guideline recommends prophylactic tendon injections in asymptomatic elite
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PBMs: Because getting meds shouldn’t be as simple as paying for them.
Going after high drug costs means going after PBM’s owned by insurance companies. THEY are the real cause of high drug prices.
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Imagine getting an oil change at your local mechanic for $50. Now, take your car to the dealership down the street for the same oil change, but they charge you $200—just because their garage is fancier. The oil and the work are the same, but the bill’s much higher. That’s
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I perform the same procedure in my office that a hospital system does in theirs, the patient pays less, even though the quality is the same (or better). Facility fees lead to higher costs and fewer choices. Charging more to subsidize other services is inefficient and regressive.
When you go to a hospital you’re paying more than an independent for the same services. It’s ok if you want to support a hospital brand. But remember the doctors and service are likely the same. Facility fees mean hospital work costs more than 2x. @DutchRojas
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Daughter needed final tib/fib x-ray for fracture repair. Out of global in new city. Seen in OUTPATIENT ortho clinic. $1,400 in facility fees AFTER insurance for 2 X-rays. Those same films are $120 in my office. @UCSFHospitals you are part of the problem. @DutchRojas
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TOMORROW! FREE sports physicals at Columbia Orthopaedic Group (1 South Keene Street in Columbia) from 8am - 11am. We'll keep you in the game for two years! #communitypartner #sportsphysicals
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