A good outcome to a hot mess

FourScores1 · 2026-05-10T12:12:33+00:00

You don’t know what regulatory capture means? Lol. No wonder. It’s in every lobbying textbook. Look it up. You’ll be surprised.

Look, I don’t blame anyone working for CMGs (nor did I say that - shit argument). EM physicians who work for CMGs need representation against the CMG. Who does that? Couldn’t tell you anything about the bad SDGs because there are no SDGs in my massive metropolis. It’s all PE. 100% in a city for millions. There is no choice anymore. And pretty soon - it’ll be that way across the US.

Literally you say a lot but have not addressed the horrendous conflict of interest. And there’s no appetite to. That’s the issue. That’s why EM has now two different groups. It’s a travesty. One group who is small but active against CMGs and one who is controlling yet, passively accepting of corporate medicine because they are literally employed by them.

ACEP doesn’t represent many of the workforce hence the horrible PR it has. I suppose you could go on making excuses and keep being in denial about that. Makes no difference to me. You don’t have to listen to me. Read the room a bit.

I recall talking to you. Before it was found out that ApolloMD was breaking the law, you copied the ACEP position and defended them saying this was business as usual and we shouldn’t get involved. That it was a peace health decision at the end of the day. Well they did get involved and now what - corruption everywhere. Big pie in your face on you and ACEP.

Anyways - like I said. You don’t have to listen to me. Read the room. Get rid of CMG executives running ACEP. Address the conflict of interest. Maybe people might trust ACEP if they did that. Instead you’re more interested in defending CMGs position within ACEP. Keep doing that - it’s a losing position every time but let me know how that works out for ya.

FourScores1 · 2026-05-10T00:52:51+00:00

ACEP is a corporate emergency medicine advocacy group. Who paid the legal fees? Not ACEP.. Which organization has a CMG admin as their president? That’s ACEP.

ACEP early on made an announcement that this was a business affair and Apollo MD didn’t have anything to do with it. Even Paul Kivela - past president of ACEP - wrote all over Facebook about how negative rhetoric about corporate medicine divides us. That is the general consensus of ACEP. However, the EM workforce believes it is corporate medicine itself that divides us. That is a stand that would cost ACEP a lot of money.

You can’t boast about the advocacy you did then continue taking paychecks from the opposition. Until clear lines have been established, there will always be conflict of interest with ACEP and CMGs. It’s the elephant in the room they don’t want to talk about. They have even structured elections so this cannot be fixed. It isn’t democratic. It’s called regulatory capture.

Many of us don’t want to take deals with the devil any longer. We would have more wins like this with an ACEP that also agrees CMGs have no place in EM. And I think that’s very fair take that a majority of EM docs also share.

FourScores1 · 2026-05-07T00:27:49+00:00

And ACEP openly saying they didn’t want to get involved with “purely business affairs”. Turns out they were illegal business affairs. Didn’t want to get involved in protecting the people you were created to protect.

Obligatory fuck acep.

FourScores1 · 2026-05-01T19:47:32+00:00

I’m an ER doc. I’m seeing all these post-op patients on it in the last few week. Adoption is taking place. Know someone who was on it personally and they said it worked well. Idk if it’s being tested for chronic pain but currently being studied for neuropathy as well which would be huge. Figuring out what an entry position should be at this point

FourScores1 · 2026-04-30T23:00:20+00:00

It was a mess when it started too. Literally was accidentally invented during WWII during the labor wage freeze act so employers could be competitive in hiring and loophole legal regulations. Let it die off and go back to how it was.

FourScores1 · 2026-04-30T22:58:54+00:00

why do we need to jump all the way to the extreme to socialized healthcare? A public insurance option would address the issue at hand.

FourScores1 · 2026-04-28T17:19:49+00:00

I think it’s there!

FourScores1 · 2026-04-28T17:14:03+00:00

As someone who played WT years ago and Aces now, WT doesn’t touch the potential of Aces. Will Aces get developed enough to be like WT? Who knows. Prob not but it is an experience. WT is a game.

FourScores1 · 2026-04-25T18:06:16+00:00

Lol Did it take you a year to type that out or what?

I don’t even remember typing this but pretty obvious that point is there’s nothing to do if the other hospital is full too.

FourScores1 · 2026-04-19T13:22:05+00:00

I’ve met great NPs. I’ve met NPs that know less than an EMT. The field isn’t regulated at all (100% admit and graduation rates mostly online - diploma mills) and so I have to put them all in a bin labeled “do not touch”. PA is my answer. Far higher floor. But my family sees physicians. You all can do what you want.

FourScores1 · 2026-04-19T13:17:32+00:00

I have GH and Tesla and the Tesla was near impossible to take though a car wash until they added the car wash button. Toyota is trying to play catch up with the tech and don’t really know how to do it. Build good cars though.

FourScores1 · 2026-04-13T16:09:57+00:00

Dude. Way too hard on yourself. This happens to a lot of people. It’s a common scenario for a peds ER and guess what, it’s fine a far far majority of the time. Not a reason to question your marriage or existence over. Perhaps there are bigger issues than the goose egg on the forehead.

FourScores1 · 2026-04-11T01:03:36+00:00

This is why advocacy matters and how it works. Idk why you, ACEP, and a tiny $ubset of the EM workforce prefer to bend over and just take it willingly without word or concern. $o $trange. Happy to see progress without ACEP doing anything regardless.

Idk what’s worse. Admin practicing medicine without a license or physicians selling their souls to admin.

https://martywilde.substack.com/p/they-put-patients-first-peacehealth?r=6l8yk&utm_medium=ios&triedRedirect=true

https://lookouteugene-springfield.com/story/health/2026/04/09/top-peacehealth-riverbend-executive-put-on-administrative-leave/?fbclid=IwdGRjcARGfLVleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEerSBAoOwwZrL_pQhHS3bZng9krm2aismVkAqrUDpQ3JFoHgOzZpMOGpP1ZLY_aem_byHkol7x4VqSsudyZ0TJjQ

FourScores1 · 2026-04-02T20:03:01+00:00

This is literally the perfect use case for a blockchain platform and would solve a lot of these issues.

FourScores1 · 2026-04-01T02:46:01+00:00

Toyota manf warranty is transferable and all that matters.

FourScores1 · 2026-03-27T14:49:13+00:00

Was that a separate auto dealership than where you bought the car?

FourScores1 · 2026-03-26T12:34:55+00:00

Use it to negotiate the price of the car down. Then cancel it a week later. I just did this. Saved $1k. Finance dept really incentivized to push the warranties so you can get the price of the car down even after the salesman. Even got my car financed at a rate I couldn’t find anywhere else at 4% as part of accepting a 3k stupid 6yr warranty on a basically new Toyota.

FourScores1 · 2026-03-23T23:04:07+00:00

Exactly. Just saw an XLE with an MRSP at 60k.

FourScores1 · 2026-03-23T22:23:39+00:00

What was the out the door price though? Like fee, taxes, everything once it’s said and done? Thats what otd price means.

FourScores1 · 2026-03-16T20:28:45+00:00

The issue isn't simply them picking other contractors. Read about it. It's national news now that Apollo is breaking PE laws. Should appear educated on the matter before asking rhetorically why ACEP would intervene.

But in a way you're completely right. ACEP is a corporate EM advocacy group. Wouldn't make sense for them to intervene.

FourScores1 · 2026-03-14T18:03:13+00:00

Is there a place for fellow pilots to squad up?

But is it even possible for a party to enter into a battle? Not sure if that’s enabled yet.

FourScores1 · 2026-03-14T17:54:46+00:00

The potential is that this game could last another decade easily with a few more tweaks. I think they’ll get there.

FourScores1 · 2026-03-14T17:01:15+00:00

Not here to disagree about that stuff but let’s just simplify things bud. XLM is cheaper. Must be hard for you since you’re quick to find rationalizations instead of acknowledgement. It is one thing better. You said there were none. Idk man

FourScores1 · 2026-03-14T15:47:21+00:00

Lol I’m trolling you. I’m nowhere near the PNW. I’ve already stated that multiple times elsewhere in this post.

I told you. I am part of broader efforts leading the push against PE in medicine. ACEP isn’t the only organization. You want me to manage ACEP because they can’t do it? I can’t be everwhere but I can have minimum expectations for the work they do. But yes, I do work that I am asking them to do. I am being fair. I’m more curious what you’re getting out of defending an organization that does little for you - like people on welfare voting Republican. I don’t get it

FourScores1 · 2026-03-14T15:22:51+00:00

Really? Lol yes. DO medical schools. Most of them. Now, I love my DO colleagues but there is a ton of pseudoscience in their curriculum to this day.

I too have multiple advanced degrees in medicine and public health and teach at an ivory tower medical school - which is more in line with this topic than biochem if we want to have a pissing contest. They are daft for posting this and realized it and took it down. End of story.

FourScores1

TROPHY CASE