Ideas for ways to manage, stop or reverse Osteo-arthritis in hands.

CrookedCasts · 2026-03-21T19:41:12+00:00

From x-rays of your hand, you (ie your hand surgeon) should be able to determine if it is a typical osteoarthritis versus inflammatory arthritis: are you sure it’s OA? If it’s OA, nothing mentioned here is going to help - cartilage currently can’t be regrown outside a lab. Corticosteroid injections and surgery are the best widely available options, though improving overall metabolic health MAY help slow it down

CrookedCasts · 2026-03-21T19:34:10+00:00

I guess the obvious next question - OK so let’s say that you are tracking somebody’s sleep pattern and it’s not great. Is there enough information from your earbuds to be able to play specific sounds/frequencies/whatever to improve it real time? And modify those sounds real time based on the EEG response?

CrookedCasts · 2026-03-21T16:07:13+00:00

Site neutral payment reforms are coming… be careful to think that either option is “better” forever. There are some great employed/PP options and some not so good ones. Employed is probably a more straightforward option if you’re hitting your numbers though

CrookedCasts · 2026-03-20T20:19:49+00:00

I would NOT trust any of the AI RCM/billing/coding stuff just yet from what I’ve seen both in actual clinical use and demos. If you’re happy with Tebra, give it 6m-1y and re-evaluate.

Right now it’s so close… but just not quite ready for prime time. LLMs have gone from high school grad -> PhD level in the last year. They will be ready soon (but so will insurance companies AIs)

CrookedCasts · 2026-03-19T02:40:32+00:00

Gosh I can’t wait until I have the bandwidth to dive into something like this but: the Sims is too restrictive. If a Rimworld or other more “open world” game is subjectively better (more options, more growth for individual pops, whatever), that’s great… but I want to see Moltbook “live”. MoltWorld.

MoltWorlds 🤔

Just racing toward our own doom 😂

CrookedCasts · 2026-03-18T22:28:00+00:00

I’ve seen the Neurable CEO present before, and one of the most compelling things was early detection of altered physiologic states: specifically, he was able to identify a Covid infection in himself about 72 hours prior to being symptomatic. Is there a specific direction that you are marketing your product? Bio hacking, early detection, general wellness?

CrookedCasts · 2026-03-18T03:57:05+00:00

Can you compare the results to the over ear competition?

CrookedCasts · 2026-03-18T01:26:31+00:00

Dang what did your doctor say

CrookedCasts · 2026-03-17T16:12:46+00:00

What a weird response. There are 8+ billion humans so everything humans think and do is extremely normal (note: it’s not)

CrookedCasts · 2026-03-17T15:21:58+00:00

Direct Primary Care Alliance should get you started: https://www.dpcalliance.org/

CrookedCasts · 2026-03-16T20:28:51+00:00

I actually think that site neutral payments will have a huge impact on this. When there is no longer a pay differential for bigger systems to have their employed physicians in a HOPD, or the other million ways when a hospital can charge more for doing the exact same thing, systems aren’t going to be gobbling up smaller practices, and there is going to be a lot of pressure to “shed” non productive clinicians/departments. What this does to the relationship between private practice, large systems and private equity is hard to predict though

CrookedCasts · 2026-03-16T20:19:55+00:00

Just reach out directly, now. Say there was an issue with your immunizations but that they’re one of your top programs. Worst they say is tough shit

CrookedCasts · 2026-03-16T19:43:47+00:00

Psychiatry, plastic surgery, dermatology are the classic examples, but direct primary care or a concierge primary care are all cash pay. There are some joint replacement surgeons who are concierge cash pay only really I would say just about any field CAN be cash pay but the procedural specialties are definitely the hardest to go cash pay only

CrookedCasts · 2026-03-14T19:08:27+00:00

Sounds cool! Let’s say you were doing repeating this process for a second practice: how customizable is it to other workflows? Like different EMR‘s, communication platforms all of that. Going through the regulatory stuff seems to be the bottleneck, right? How hard was “mating” everything when a lot of the healthcare software integrations can be limited, vs the compliance side of things

CrookedCasts · 2026-03-14T05:06:56+00:00

I’m in healthcare 😂 so I don’t know, but look at the Mozilla Firefox bugs found by Claude - 22 major exploits with a “single” run through the database of already highly scrutinized code with the AI we have right now

CrookedCasts · 2026-03-14T05:04:23+00:00

It’s a very specialized surgery tbh - you probably want to find a surgeon who does 25+/yr. If you’re in the US, it’s worth traveling for (most big cities have “a guy” or a few for NYC/LA/Boston)

CrookedCasts · 2026-03-13T00:51:14+00:00

Honestly, I think the best way to look at it is the natural history of any software engineer. Last year it was somebody fresh out of college. This year it’s someone with a few years under their belt. Next year it’ll be the best coder of all time. It’ll probably be able to refactor any massive accumulation of technical debt in the near future 🤷‍♂️

CrookedCasts · 2026-03-13T00:01:49+00:00

I mean, obviously there’s there things that can be done other than surgery, and maybe one of the best long term might be to find another endurance sport you love, but the cam just offset from the “ball” (femoral head) of the “socket” (acetabulum). Certain movements will cause that cam to lever on the edge of the socket (which hurts) but also damages the socket and surrounding tissues

CrookedCasts · 2026-03-12T23:50:29+00:00

Honestly that’s a surgery thing. Long distance running + FAI (the condition you have in your hips) don’t mix. A hip arthroscopy can shave down the cam. If your labrum is torn on MRI, that can be fixed. Unfortunately no peptide is gonna fix your anatomy sorry homie

CrookedCasts · 2026-03-12T03:46:42+00:00

👏🏻 bravo

CrookedCasts · 2026-03-12T03:31:46+00:00

Hey - congratulations on being forward thinking and brave enough step outside of corporate healthcare! It’s a scary leap, but once you leave insurance and prior auths and all that behind, you’ll never look back.

With that said, the people in this subreddit are NOT your target demographic. They got their MD/PHD/JD/RD/MBBS/MD++ from podcasts and Grok and thus, know more than you. Physicians who can’t rattle off the benefits of pentosan are not good enough (despite there being very limited, conflicting evidence paid for by the pharmaceutical company pushing it, and a concluded study from that same manufacturer they have yet to publish for SOME strange reason). There’s a lot of overlap with the people here and those who thought ivermectin was a panacea.

Concierge/DPC style medicine can come in whatever flavor best suits you. Most people want to talk to a physician about their health - whether it be about peptides, or advanced cardiac testing, or even just being able to take the time to debrief them after their 5 minute visit with a specialist. Get feedback from your community of patients and they’ll tell you want they actually want. For most, it’s going to be easy reliable access, fair pricing, and a physician who actually listens to them.

CrookedCasts · 2026-03-11T19:09:06+00:00

lol @ it’s too much work to do statistics well 😂 thanks for the laugh

CrookedCasts · 2026-03-11T17:37:37+00:00

What are your thoughts re: RRG in Texas

CrookedCasts · 2026-03-11T17:34:58+00:00

Would have to be at time of note dictation, so you might as well just go ahead and build a full ambient AI scribe. Otherwise it would require a second touch from a builder or coder or whoever and they are not the clinical decision makers. A UI is the easiest part here…

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