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Neil Floch MD Profile picture
Neil Floch MD
@NeilFlochMD
Associate Professor @Yalemed #Obesity #SoMe Editor @soard_journal / bariatric surgery @MayoClinic trained - Tweets are my views and not my employer @yalesurgery
Mar 12 • 8 tweets • 3 min read
True story: I had one if not the MOST successful bariatric, general, and acute care surgery practices in Connecticut 15 years ago. One day my accountant and lawyer walked in the room for a meeting in the lobby of my office which I owned along with part of a surgical center. They apologized to me and my practice members and said, “sorry but the powers that be have decided that doctors will no longer be paid”. “THEY will pay the hospitals but eventually NOT the doctors.” “THEY (powers that be) will let the hospitals figure it out.” Slowly, after a president’s law was passed our practice dwindled, decreasing year after year, despite every creative angle of legal income we created, after taking trauma overnight call at 3 different hospitals, firing half our employees, eliminating our marketing, working 80-120 hours a week, we eventually could no longer pay ourselves and we sold all, disbanded and every employee and surgeons went their separate ways. I separated from my brother after 20 years. We went to work for the hospitals because they got paid the money. The self- pay option was eliminated by insurance and all leverage to negotiate with them was gone. They have ALL the power and that is what they and Government wanted. NOW this is what the PEOPLE let happen. But the PEOPLE can complain to their politicians and the PEOPLE can vote. Don’t blame doctors, nurses, or healthcare workers, we are powerless. In reality your surgeon only gets $500 for a hernia repair but actually we get nothing because all payments go directly to the hospital or health system or large equity owned surgery practice.
Mar 7 • 16 tweets • 4 min read
The #Obesity epidemic has been first blamed on fatty foods. Many of us grew up learning that fat was bad. We ate low fat and sacrificed butter to eat inferior tasting margarine. 1/ The 1970’s and 1980’s pointed the finger toward fat as government health czars directed the blame away from #sugar and #carbohydrates. 2/
Jan 11 • 13 tweets • 3 min read
The Ozempic effect is a real phenomenon and will pressure state employee coverage and Medicaid which will increase state taxes but obesity prevention must be addressed as the epidemic is running rampant in the #US. 1/ medicalxpress.com/news/2024-01-o… The realization that there is an effective medical treatment for #obesity has instilled an infusion of hope in the American public and the world. Lives can now be transformed with the use of medication and NOT surgery alone. 2/
Oct 19, 2023 • 4 tweets • 1 min read
Having #obesity and its associated diseases is “Big Business” and GLP-1 agonists will effect profits

The “Ozempic effect” is coming for kidney drugs, heart-disease treatments, and more - these drugs may effect the production use and profits of other drugs- @Bloomberg @business 1/
Image The insanity of the public concern is that these medications could negatively effect the economy.

The reality is that these medications could reduce obesity rates and improve the health of people with 229 associated conditions. 2/
Jan 8, 2023 • 16 tweets • 14 min read
The word ‘#obese’ is now considered unacceptable by the world’s academic community and should be changed by the @WHO to #obesity - because: a person has a disease called obesity and that person is NOT the disease itself. @pattynece @Eggface @PaulDavidsonPhD @ConscienHealth Unfortunately the word ‘obese’ is still used as a medical term but many journals are NOW dropping it and editing content to the NEW correct terminology when referring to people, which is “person with obesity” @Nature @NEJM
Jan 7, 2023 • 4 tweets • 3 min read
Banning Noncompete Clauses by the Federal Trade Commission would dramatically change the structure of medical health networks and greatly increase competition-It may destroy vulnerable medical systems who stand to lose physicians to higher paying neighbors ftc.gov/news-events/ne… #Noncompete clauses in contracts prevent employees from leaving a business, practice, or company and opening up their own establishment or joining a competitor in a location adjacent to their previous employer. They prevent competition locally. 2/
Jan 3, 2023 • 4 tweets • 4 min read
A very interesting thread on @Reddit with @Walgreens employees and others discussing the rules made by @LillyPad to only place through prescriptions with the diagnosis of #diabetes - #Mounjaro is NOT YET indicated by the @US_FDA for #obesity as a diagnosis The stigma for #obesity is directed at those with the disease. Unfortunately our society perceives that obesity is a “second class” disease and should be treated as such. Here @Walgreens employees are admitting to discriminating against patients 1/
Jan 2, 2023 • 5 tweets • 4 min read
I know it’s hard for you to believe but many insurance companies have purchased pharmacies:
1. @Aetna bought @CVSHealth
2. @Cigna bought @ExpressScripts
3. @UHC owns @OptumRx
1/ Mergers of medical insurance companies and pharmacy chains is creating a #verticalintegration - many would consider this a monopoly nytimes.com/2018/10/10/hea… 2/
Dec 9, 2022 • 13 tweets • 11 min read
About 5 years ago I had 150 new people following me every day. My tweets were seen by many then one day it all stopped…. A website in Europe detected that I was #shadowbanned by @twitter 1/ Clearly my tweets and retweets were not getting the same impact - I had gained notoriety from my social media presence and I had no answers. I had no recourse. No one at #twitter would respond to my texts, emails, or calls. So… I just worked harder… 2/
Dec 6, 2022 • 4 tweets • 2 min read
This is incredible on so many fronts:
1. Brendan Fraser BOLDLY took on the role@of #TheWhale
2. He is discussing the unfair treatment of people who need #obesity care
3. He is endorsed by @AdamSandler
We have broken New Ground I cannot remember a public figure advocating for the improvement of access to bariatric surgery so openly
Nov 12, 2022 • 12 tweets • 2 min read
Ten myths of weight and weightloss 1. Myth: Our current weight only depends on how much we eat and how much we exercise

Reality: Our weight depends on genetic, environmental factors and behavior as well as what and how much we eat, exercise accounts for little weight loss but can help maintain our weight
Apr 18, 2021 • 11 tweets • 13 min read
#Obesity is killing Americans
#Obesity increases risk for death from #covid #covid19
#Obesity is a disease
#Obesity is associated with over 200 other medical conditions
#Obesity is usually & eventually unhealthy
#Obesity & those with it should never be shamed or stigmatized #Obesity is mostly dictated by #genetics & environment
#Obesity is ignored by politicians
#Obesity occurs in 42% of Americans
#Obesity and people with it are ignored, shamed, humiliated, and discriminated against
#Obesity may occur after psychological trauma 2/
Apr 17, 2021 • 6 tweets • 6 min read
When the #ACA was implemented: there was no mandate established to ensure that #emr #ehr electronic medical records could communicate and physicians could obtain medical records from #doctors caring for the same patients at other offices or hospitals. 1/ What ensued was that the government forces practices to an incur most of the cost of buying expensive electronic medical records and forced them to use them or incur more financial penalties. In retrospect those who did not use #emr and #ehr benefitted 2/
Jan 4, 2021 • 9 tweets • 13 min read
There are many questions about the @moderna_tx #vaccine now being distributed in the #USA I am happy to answer them
(My qualifications: board certified general surgeon, associate editor @SOARD_JOURNAL, I can read research data and understand it, I don’t confuse fact & opinion) 1/ Q: What doses of the @moderna_tx #vaccine are being given?

A: Two 100 microgram doses 4 weeks apart.

#vaccination #covid19 2/
Jan 2, 2021 • 8 tweets • 15 min read
How a #vaccine works: when we get #covid19 we make #antibodies and #Tcells. A #vaccine introduces #antigens: heat-killed, parts of #virus, #mrna that makes virus #spike into our bodies to produce the antibody and Tcells WITHOUT infecting us with #coronavirus & making us sick. 1/ ImageImageImageImage When a new disease comes along like #COVID19 #coronavirus our body does not have #antibodies or #Tcells to fight it off. First we recognize it (the #antigen) and START to BUILD our defense or army to fight it back. #vaccines #vaccine (from who.int) 2/ Image
Jul 18, 2020 • 17 tweets • 7 min read
As a physician, I find it shocking that patients with all diseases are not treated with the same respect and concern as one another. The truth is that someone with a cancer or heart condition has a respected medical disease and something with #obesity does NOT. 1/ The #US nation is now afflicted with #obesity. 42% of Americans suffer from this disease and while the news has covered many stories concerning these facts, the disease continue to rise in its frequency. Individuals continue the same habits that help contribute... 2/
Apr 2, 2020 • 11 tweets • 5 min read
After listening to a webinar from 5 Chinese #doctors in Wuhan, China who are in the middle of their outbreak - the following can be learned. 1/ Treatment: Much of the same medications and therapies are being used and developed worldwide with no dominant medication working the best. #Corticosteroids are being used, antivirals, #gammaglobulin, and #convalescentplasma 2/
Mar 14, 2020 • 19 tweets • 21 min read
This is a MUST SEE video on the #Coronavirus in Italy. The #ICU intensivist explains the epidemic and treatment- Report From The Front Lines @JAMA_current - YouTube #Covid_19 #COVIDー19 #COVID This is a good summary but somewhat inconsistent to what we have been hearing on #twitter about #italy. The question about triaging those sick and above 60 yo was NOT answered directly. He said the goal was for everyone to get an ICU bed but was that successful? 1/
Dec 9, 2019 • 8 tweets • 9 min read
This opinion article by Douglas Makinnon is both troubling and groundbreaking. First, no one should ever condone #fatshaming - as it has been proven to be detrimental to individual struggles with #obesity and does not lead to resolution. 1/ The publication of this opinion, which “calls out” the #US government for a “waste of energy” during an #obesity crisis - #obesityepidemic is one of the few times a political publication has addressed the lack of action on resolution of this chronic diesease. @ObesityAction 2/
Mar 14, 2019 • 17 tweets • 15 min read
I have been a loyal #tweep now for over 5 years. I have obeyed, I have promoted, I have taught, I have listened I have helped those who misunderstood and tried to convince those who did not believe in #twitter. I believe and I want others to believe in its #freedomtotweet I have done my best as a #physician #surgeon and communicator to help other doctors learn the benefits of #twitter - I have talked at over 20 local, national and international meetings about the benefits of this incredible application #twitter - recruiting #doctors - #meded