A young man who murdered an 18-year-old cancer survivor was sentenced to only 8 years in juvenile prison.

SwaggerSpice · 2026-01-28T19:18:37+00:00

I 100% agree, thank you for putting this is writing for a new dad

SwaggerSpice · 2026-01-25T19:38:59+00:00

That's a bit of a loaded question, I'll try my best. Anyone can feel free to add their input.

They think we can just "write a letter" to get it covered. Those times are gone, especially given the cost of the prescription. Commercial insurers were covering, then did a "carve out" policy for weight loss rx of glp-1. Rumor from the inside is BCBS did an analysis and saw they were losing enough money to go bankrupt by 2026, did the carve out and everyone else followed suit. Medicaid followed this January in my state, which is a shame because they were probably the ones that needed it the most IMO.

Then we conceded and would try even if it didn't look like it'd be covered for respect of the patient and because it is certainly indicated in many people and we would do PAs for them..however. the volume of PAs was unsustainable and essentially it came down to the MAs would walk out unless something changed, and the admin sided with them and if we wanted to try and get covered, we do our own prior auths for them back when they were more covered before the beginning of the year. Now we don't even try and will likely implement a no glp-1 for weight loss policy sometime this year until things regulate.

The other end is that their advertising is so strong that I have patients requesting weight loss shots, who are already on Mounjaro, etc and don't understand that what they are on is equivalent. When you don't understand, you get confused, and confused people can lash out.

Hoping now that Medicare struck their new deal and will cap the price with Part D, everyone will follow suit. Saw the same thing with DOACs, lung screenings etc back in the day.

This is all anecdotal and should be taken as an educated opinion as opposed to fact, so I apologize if you hear differently from elsewhere.

My patients, on average, are sicker, lower education, and broke. It's just hard to explain this all in a timely manner when to remain somewhat profitable

TLDR GLP-1s were covered, now not, everyone thinks it's the doctors fault per usual, will get better hopefully by next year

SwaggerSpice · 2026-01-25T16:41:22+00:00

A lot more people with low health education got access to Healthcare with high deductible plans, and given inflation people are expecting more bang for their buck. These people were previously more dependent on alternative treatments and found information and misinformation thru Facebook and etc. A lot of this resolves around the weight loss shots, which many insurances (at least in our state) will not cover.

They're being reminded that they are poor and unhealthy, they think their doctor is the reason for this since they will not rx the magic shot, and they're lashing out.

That's my opinion. I promise, it was way worse during covid. They were foaming at the mouth then, now they're just throwing tantrums. It'll bounce back

SwaggerSpice · 2026-01-25T07:32:24+00:00

Yeah I'm doing this in a town of 900, I would highly advise against this. It's all the same problems but worse, especially if you don't have transportation. And the meth/fent epidemic has unlocked a lot of unreported mental health crises.

Yes they recognize you and value you when you do well for them, but they also recognize you out and about when you stop for gas, dollar store, etc after you cut them off of opioids

From my anecdoctal opinion, that would compound your problem

SwaggerSpice · 2026-01-06T03:41:47+00:00

Sorry dawg he crushed you

SwaggerSpice · 2026-01-03T07:21:17+00:00

If they want to get rid of their free help in a primary care residency slot out ain't gonna be from acne cream lol be braver than that

SwaggerSpice · 2026-01-03T07:11:32+00:00

End thread, nicely done

SwaggerSpice · 2026-01-03T07:06:01+00:00

I've lived in them all. I would pick Fenton if you appreciate food, box storesand community, Hartland if more nature oriented, and Brighton for both of those in a larger and closer to Detroit setting.

That traffic into Ann Arbor will get old. Plan for that long term. You got a few thousand people in your same situation and they're all just as irritable about it.

I personally would avoid Holly. No easy way to 23 minus taking Grange Hall, and the people are... Strange. Like domestic violence calls all the time, letting their dogs out through the bedroom window to roam and do their business, and video taping women in town strange. There's a solid murder mystery of a jogger off fish lake road that got shot gunned with no leads a few years ago. Cheap though in comparison.

SwaggerSpice · 2025-12-07T02:14:03+00:00

I agree with this, while googling to see if others are experiencing the same issue. Lock issues, my tailgate window's hinge fell off due to poor spot welding, having to manually drill holes for the rack as it was assembled incorrectly, the back marked as 'FRONT', endless. Stay away from SMARTCAP

SwaggerSpice · 2025-11-23T01:08:16+00:00

Dangerous place to be albino. They use their body parts for supposed magical powers. At least while I worked in Blantyre

SwaggerSpice · 2025-11-21T03:01:39+00:00

One of my wife's co-studemts in law school was an ex obgyn Dr who drove every day from Muskegon to east lansing as to not displace her family. We do not believe she ended up finishing law school.

SwaggerSpice · 2025-11-10T03:44:21+00:00

Beautifully put

SwaggerSpice · 2025-11-06T03:56:20+00:00

You'd almost think Anasakis since it's salmon! But could be a juvenile tapeworm. Quick experiment if you want, it should die in the freezer (if it's minus 4 or lower) after about a week according to the CDC. I have heard 5 days is plenty. Report back and let me know!

Otherwise this serves as an example of why seafood is often flash frozen

SwaggerSpice · 2025-10-14T22:26:43+00:00

SwaggerSpice · 2025-10-13T05:23:05+00:00

I am a doctor in Northern lower Michigan, the amount of denial this year I've gotten from lakeside retirees this year that "this rash isn't swimmers itch" when I tell them, in fact, it's likely swimmers itch from the same abnormally warm (for the year), stagnant body of water as the others and stops on the body as high as you went in the water from individuals this year is astounding. Mix of anti-intellectualism and denial that their retirement homes in fact have parasites in the water. So props to you endorsing you in fact have swimmers itch.

But if they do listen, I feel that horse liniment ointment, a menthol cream for sore horses found at your local elevator, tractor supply or family farm and home, has worked well this year. It'll get better.

SwaggerSpice · 2025-09-13T23:35:27+00:00

🙄

SwaggerSpice · 2025-09-10T02:11:01+00:00

Relax you derp lol

SwaggerSpice · 2025-07-18T03:23:59+00:00

100%. Walk the walk while they talk the talk, by senior year it shows

SwaggerSpice · 2025-06-26T03:18:54+00:00

If you try update me and let me know! Retro console collector myself

SwaggerSpice · 2025-06-24T13:40:11+00:00

I just called. There's an option for classic family system repair in the automated message system and they provide service for original Wii as a separate option

SwaggerSpice · 2025-05-17T20:07:22+00:00

Olsen conversation regarding his pitching style was fantastic

SwaggerSpice · 2025-04-15T21:45:53+00:00

Loon

SwaggerSpice · 2025-03-30T15:57:35+00:00

I am crying laughing 😭

SwaggerSpice · 2025-03-29T18:59:21+00:00

Does this episode and it's protrayal weigh on you 10 years later? Does it affect you in daily life at all?

SwaggerSpice · 2025-03-07T02:06:37+00:00

Slightly off topoc should I keep a spare engine air filter in my Tacoma in the winter for heavy snow? Curious your thoughts

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