John Ross
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johnrossmd.bsky.social
John Ross
@johnrossmd.bsky.social
13K followers 2.4K following 110 posts
Canadian in Boston. Hospitalist. FIDSA. #M4A #RaisetheWage #BLM #IDSky #GoHabsGo http://bit.ly/4mtlvaN
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johnrossmd.bsky.social
So, private equity has been quietly buying up nursing homes/rehabs, spinning off the real estate into a trust, cutting costs and running them into the ground while milking the Medicare income, and then redeveloping the real estate for profit when the facilities inevitably go bankrupt 2/2
Let's see who you really are meme: Fred discovers that private equity is responsible for the haunted amusement park, and everything else going wrong in the US of A
November 23, 2025 at 3:37 PM
johnrossmd.bsky.social
It's harder to discharge hospital patients now because rehab quality is declining, and families are reluctant to send patients to nursing facilities who are too weak to go home safely. "Golden Acres used to be great, but they cut staffing, and Mom almost died the last time she went there." 1/2
Monetizing Nursing Home Real Estate (from https://pestakeholder.org/wp-content/uploads/2025/04/PESP_Report_NursingHomes_April2025.pdf) Within the nursing home industry, it is common for real estate to be held separately from operations through the use of two separate companies. These companies may share an owner or have different owners, such as a private equity-owned operations holding company and a real estate investment trust (REIT) property holding company. This strategy has been encouraged to help shield assets in the event of lawsuits or bankruptcies. It also provides an avenue to siphon money out of the nursing home to investors.
November 23, 2025 at 3:37 PM
johnrossmd.bsky.social
My nomination for the Most English Thing Ever: Richard Dawson caught bubonic plague in Cheshire in 1625. Realizing that he was about to die, and that his nephew and servant were not strong enough to carry his body, he dug his own grave, and laid down in it in a bed of straw, waiting to die. #IDSky
Richard Dawson being sick of the plague, and perceiving he must die at that time, arose out of his bed, and made his grave, and caused his nephew, John Dawson, to cast straw into the grave, which was not far from the house, and went and laid him down in the said grave, and caused clothes to be laid upon, and so departed out of this world. This he did, because he was a strong man, and heavier than his said nephew and another wench were able to bury ... [parish register of Malpas, Cheshire, 1625]
November 20, 2025 at 2:50 AM
johnrossmd.bsky.social
Sociopathy
C-SUITE·LEADERSHIP McKinsey studied the most successful Fortune 500 CEOs and found they share one similar trait
November 17, 2025 at 12:31 PM
johnrossmd.bsky.social
New WHO TB report just dropped #IDSky
▶️TB back to world's #1 infectious cause of death⚰️
▶️amazing reduction in TB deaths in Africa, now at risk due to USAID cuts
▶️rising TB in the Americas stabilized but trend worrisome. Tanking economies and rising prison populations seem to be major drivers 📉👮‍♂️
Screenshot of Figure 12, Trends in TB Deaths, from the World Health Organization 2025 Global Tuberculosis Report, available at https://www.who.int/publications/i/item/9789240116924. Explanation in text of skeet.
November 14, 2025 at 3:23 PM
johnrossmd.bsky.social
We're all trying to find the guy who did this!
insights.som.yale.edu/insights/why...
But today, I am not talking about a vaccine-derived polio outbreak. For the first time in several years, we have a worsening outbreak of wild-type polio, in Pakistan. Wild type polio—the original polio—has been on the cusp of eradication except for one major region in the world, Pakistan and Afghanistan. There has been enormous progress, with fewer than two dozen cases for several years running. But that progress is being partially undone now. In Islamabad, the capital of Pakistan, where over one million people live, a single case has been detected and wastewater detection there and elsewhere in Pakistan indicates real ongoing concern. In Afghanistan, many more cases are circulating, including vaccine-related cases. Both wild-type and vaccine-related cases can be eradicated through high penetration of vaccination. But that is where the problems begin. There are many reasons why citizens of Pakistan have seen declining rates of immunization, but one of them relates to the U.S. government’s efforts to find Osama bin Laden by using a fake vaccination program to identify bin Laden’s location. In 2014, the US government promised not to do such a thing again, but the damage was done. There are, obviously, many more reasons for individuals to become skeptical. But this one stings a lot. This week the Taliban, the de facto ruling entity of Afghanistan, banned most of their polio vaccination program. This, too, is a very concerning move.
November 13, 2025 at 2:40 PM
johnrossmd.bsky.social
Never forget www.sportsnet.ca/hockey/nhl/m...
The second round of the 1975-76 playoffs featured a series between the Toronto Maple Leafs and the Philadelphia Flyers. But it was really about Pyramid Power versus Kate Smith. The Flyers were the defending Stanley Cup champions and had legendary singer Kate Smith warbling "God Save America" as a good-luck charm. Leafs coach Red Kelly was looking for something to focus his troops, who were in tough against the Broad Street Bullies. Irascible Leafs owner Harold Ballard had even predicted his team would in five games. The Leafs were facing elimination going into the series’ Game 6 in Toronto, so Kelly tried something radically different. He had a 20-foot pyramid placed in the Leafs dressing room – pointed north to draw magnetic energy – and several smaller ones under the Leafs’ bench, hoping his team would draw energy from the objects. Kelly had reason to believe. His daughter had been suffering from severe migraines, and after being told about the pyramids’ healing power, gave her some small pyramids to place under her pillow and she soon felt better. "I thought that was kind of neat that Red would take that time and that thought to do something like that for us," winger Dave (Tiger) Williams recalls. "What was really good about it was the Toronto media just talked about it and never talked about us, so we had some breathing room there finally for a change." Red Kelly, Toronto Maple Leafs coach in 1976. A middle-aged man in a vintage Adidas track suit contemplates a plastic pyramid
November 10, 2025 at 5:18 PM
johnrossmd.bsky.social
You don't need a desert for this, btw. We are exporting power to the grid from rooftop solar in Massachusetts in November.
Rooftop solar supplied 730% of our residential needs in Massachusetts thus far in November
November 6, 2025 at 11:13 AM
johnrossmd.bsky.social
Literal insanity that a company that made a product that saved millions of lives just a few years ago could go out of business www.statnews.com/2025/10/30/m...
Today Moderna faces a crisis unlike any other in its 15-year-history. Wall Street has pushed executives to slash spending, as Covid vaccine sales have slumped and no new blockbusters have emerged. The federal government, which had all but midwifed the company, has turned on it. In May, the Health and Human Services Department — led by Secretary Robert F. Kennedy Jr., who has touted falsehoods about mRNA vaccines — canceled $766 million in contracts to prepare shots for a potential bird flu pandemic. Moderna’s market value has fallen by more than 90% — $185 billion, or a full Sony — from its 2021 peak to around $10 billion this month. Layoffs and restructurings, often undisclosed, have roiled the company. Further cuts have not been ruled out.
November 4, 2025 at 4:49 PM
johnrossmd.bsky.social
The neurobiology labs are there--presumably one of them was the target. Security sent out a mass email with stills of the suspects.
November 2, 2025 at 7:13 PM
johnrossmd.bsky.social
Exhibit A
US life expectancy over time plotted against health expenditure per capita. Starting in the Reagan era, money spent on health care rose markedly compared to other developed countries, while life expectancy gains lagged far behind other wealthy OECD nations
October 26, 2025 at 3:25 PM
johnrossmd.bsky.social
TBH, 50% effectiveness at reducing flu hospitalizations is considered a very good year
CDC chart showing the level of seasonal flu vaccine effectiveness 2009 through 2025
October 23, 2025 at 12:36 PM
johnrossmd.bsky.social
Flu vaccine this year shows average to above-average effectiveness #IDSky
Adjusted VE against influenza-associated outpatient visits and hospitalization was 50.4% and 49.7%, respectively, for any influenza virus, and 45.4% and 46.1%, respectively, for influenza A viruses. Adjusted VE against hospitalization with the predominant influenza subtype, A(H1N1)pdm09, was 41.6%. These interim estimates suggest that vaccination reduced medically attended influenza-associated illness by approximately one half in eight Southern Hemisphere countries. Health authorities should prioritize vaccination of all eligible persons ≥6 months to reduce incidence of influenza disease.
October 23, 2025 at 12:33 PM
johnrossmd.bsky.social
Hmm, wondering if there might be unintended consequences from ending mandatory childhood vaccinations in the state with the highest percentage of senior citizens in the country
Florida plans to end nearly a half-century of required childhood immunizations against diseases that have killed and maimed millions of children. Many critics of the decision, including doctors, are afraid to speak up against it. With the support of Republican Gov. Ron DeSantis, Surgeon General Joseph Ladapo on Sept. 3 announced his plan to end all school-age vaccination mandates in the state. "Every last one of them is wrong and drips with disdain and slavery," he told a cheering crowd of vaccination foes in Tallahassee. "Who am I, as a government or anyone else," he said, "to tell you what you should put in your body?" History shows that mandates increase the use of vaccines. Lower vaccination rates will mean increased rates of diseases like measles, hepatitis, meningitis, and pneumonia -- and even the return of diphtheria and polio. Many of these diseases threaten not just the unvaccinated but also those they come in contact with, including babies and older people with weakened immunity.
October 22, 2025 at 5:04 PM
johnrossmd.bsky.social
Pertussis (whooping cough) cases have exploded in the US in the past 2 years. Get your Tdap if you’re due (every 10 years for adults)

BTW, as of this morning, it looks like all the case counts for 2024-25 have been scrubbed from the CDC website 🫠
As of early September, CDC officials have documented more than 20,000 whooping cough cases across the U.S. this year, compared with 19,302 during the same period of time last year. Altogether in 2024, there were 35,435 documented cases of whooping cough across the U.S., including 655 in Colorado. That was a huge jump over the 7063 cases in all of 2023. Large states, including New York and California, logged high numbers of pertussis infections in 2024. So did some less-populated states like Idaho, Washington and Oregon, each of which reported more than 1,000 cases of whooping cough.
October 20, 2025 at 10:50 AM
johnrossmd.bsky.social
Two amazing bits from this interview with Jonathan Rosenbaum:
- Thomas Pynchon apparently has ANOTHER completed novel in the can
- Rosenbaum is disappointed that Pinecone, a frail 88-year-old, is not as ambitious and experimental as he was at 36, when Gravity's Rainbow was published
Interview with film critic Jonathan Rosenbaum in Film International: I’m curious about Paul Thomas Anderson’s new film, One Battle After Another (2025), even though I didn’t really like his adaptation of Inherent Vice (2014). I don’t think Vineland is a great novel, but it’s a good novel. It has more possibilities. I don’t think Pynchon is as ambitious now as he once was, and it seems he’s now interested in writing these detective novels. They’re still fun to read, though. When I last spoke with Hat & Beard Press, the publisher of In Dreams Begin Responsibilities, they confirmed that Pynchon actually has a second completed novel in addition to the one that will arrive in October—Shadow Ticket.
October 14, 2025 at 2:20 PM
johnrossmd.bsky.social
Looks like I don't get to retire just yet 😢
Scamcoin price plummets
October 12, 2025 at 5:16 PM
johnrossmd.bsky.social
Pleased to report that this 88-year-old fella still has the juice
Shadow Ticket, a new novel by Thomas Pynchon
October 9, 2025 at 11:51 AM
johnrossmd.bsky.social
Penicillin, ivermectin, clofazimine #IDSky
Andy Reid in a bland suit, Travis Kelce in ugly
October 7, 2025 at 2:01 AM
johnrossmd.bsky.social
From an essay by an American surgeon about his work in Gaza (disturbing content) www.nejm.org/doi/full/10....
One night we had 60 dead and 200 injured — or what Palestinians call “just another Tuesday.” People died on the floor waiting for care. One 5-year-old child lay on the ground. His intestines spilled out of his belly. His older brother begged me to help. I grabbed his hand and joined it with the child’s. I wanted to say, “I’m sorry. He’s gonna die. Just hold his hand until he does.” Instead, I just stared at him — and then left him there to pound the floor in grief as I took an undignified leap over a father grieving over his daughter’s mangled body to help triage the scores of wounded people still lying on the blood-smeared floor. One child showed up barely holding on. An explosive blast had shattered her head open. A chunk of shrapnel stuck out of her skull. Fragments of gelatinous brain trickled out and stained her flowered shirt. She was somehow still alive, gasping for breath, blood foaming and bubbling through her mouth and nostrils — one of many cases deemed “hopeless.” We could not waste resources trying to save her, but we didn’t want her to die alone. So we took turns holding her hand until she died.
October 3, 2025 at 6:46 PM
johnrossmd.bsky.social
In The Simpsons universe, antibiotic courses are either 4 or 8 days long
Homer Simpson, with 4 digits on each hand
September 29, 2025 at 11:00 PM
johnrossmd.bsky.social
In AD 1349, an earthquake destroyed the southern half of the exterior wall of the Roman Colosseum. The southern side was built on a dried-up tributary of the Tiber River, whose unstable alluvial soils liquified during the shaking www.nuquake.eu/Publications...
Aerial photo of the Roman Colosseum. The northern part of the exterior wall is preserved, while the southern half is gone
September 28, 2025 at 2:34 PM
johnrossmd.bsky.social
Wild times
[partial text of a complaint against David Geier for practicing without a medical license in Maryland] The Board [The Maryland State Board of Physicians] bases its charges on the following facts that the Board has cause to believe are true: 1. The Respondent is not and never has been licensed to practice medicine or any other health occupation in the State of Maryland or any other State. The Respondent has a Bachelors of Art degree in biology from a Maryland State university. The Respondent has taken several graduate courses, but has not earned a graduate degree in any specialty or discipline. 2. As detailed below, on October 8, 2008, the Board received a complaint from the mother ("Parent A") of a former patient of Dr. Mark R. Geier ("Patient A", below).4 Parent A complained inter alia that the Respondent examined and diagnosed her son at an office visit on May 19, 2008.
September 26, 2025 at 9:06 PM
johnrossmd.bsky.social
The classic "dig toxic" rhythm is atrial tachycardia with varying degrees of AV block, as below. Non-specific findings, such as "scooped out" ST segments and PVCs are also common. Rarely, bidirectional ventricular tachycardia (not good) may be seen
Atrial tachycardia with high-degree AV block due to digoxin. Digoxin may lead to a huge variety of ECG findings; the chapter on digoxin toxicity in Marriott's Practical Electrocardiography (8th ed.) was about 60 pages long
September 26, 2025 at 1:39 PM
johnrossmd.bsky.social
Withering described all the classic toxicities of of high doses of digoxin/digitoxin: "sickness, vomiting, purging, giddiness, confused vision, objects appearing green or yellow...slow pulse, even as slow as 35 in a minute, cold sweats, convulsions, syncope, death"
William Withering, a serious man in periwig and frockcoat
September 26, 2025 at 1:28 PM