St. Lazarus Family Practice

07/22/2026

https://apple.news/Arzll11QdSQCKvgH1j1ipDw

Coffee can decrease thyroid medication absorption by more than half. Drinking coffee with antidepressants can decrease how much your body absorbs the medication. Mixing coffee with diabetes medication may lead to a spike in blood sugar.

06/16/2026

https://www.facebook.com/share/1EVD4JwHjg/?mibextid=wwXIfr

The popular joint supplement glucosamine is linked to a 25% faster progression from mild cognitive impairment to Alzheimer's disease.

A groundbreaking study published in Nature Metabolism has uncovered a troubling connection between glucosamine—a widely used over-the-counter supplement for joint pain—and accelerated cognitive decline.

Researchers at the University of Florida analyzed 12 years of electronic health records and discovered that patients with mild cognitive impairment (MCI) who regularly took glucosamine were 25% more likely to progress to full-blown Alzheimer's disease than non-users.

Even more concerning, for individuals already diagnosed with dementia, the supplement was associated with a 25% increase in mortality risk. Because glucosamine easily crosses the blood-brain barrier, scientists believe it feeds into an already overactive protein 'sugar-tagging' pathway in vulnerable brains, worsening metabolic dysfunction.

Crucially, researchers emphasize that this risk appears highly specific to individuals whose brains are already undergoing neurodegeneration. In cognitively healthy adults, previous research has actually suggested that glucosamine may have a protective effect. However, with an estimated 40 million glucosamine users in the United States alone—including many seniors who deal with both joint stiffness and cognitive changes—these preliminary findings underscore the urgent need for clinical trials. Until those trials provide definitive answers, experts suggest that individuals with cognitive concerns consult their healthcare providers before continuing their daily joint supplement routine.

source: Hawkinson, T. R., Gentry, M. S., & Sun, R. (2026). Hyperglycosylation is a metabolic driver of Alzheimer's disease. Nature Metabolism.

06/15/2026

https://www.facebook.com/share/p/18faTLLVyX/?mibextid=wwXIfr

She was so sure she was the slow one that she asked her own employer to run a time study on her. She watched her male colleagues leave clinic at 5 or 5:30 while she stayed for hours after, and she needed to know what was wrong with her.

The verdict came back. She was highly efficient. Fast. Her notes were so thorough the reviewer said a scribe would actually be a downgrade.

The problem was never her.

Noemi Adame, MD is a pediatrician with more than twenty years in medicine.

Research keeps finding the same thing: having a female doctor is better for your health. Lower mortality. Fewer readmissions. Better outcomes across multiple fields. It is just not better for hers.

Portal data shows the truth. Patients and staff make 25 percent more requests of female primary care doctors than male ones. The extra inbox messages, the extra refills, the extra forms. All uncompensated. All invisible. Work that no metric counts and no one rewards.

And it does not stay at the office. Two years ago, Noemi's mother died suddenly. Noemi owned the practice. She was the boss. And she showed no compassion to herself. She sat in the ICU watching her mother die while she answered patient texts and sent refills to the pharmacy.

That is what years of socialization does. Women put the needs of others first, and in medicine that instinct gets magnified until a daughter cannot put down her phone at her own mother's bedside.

She respects her male colleagues. She says so plainly. This was never about them. It is about a compensation system that counts how many patients you see in a day and never once counts the 25 percent.

Afterward she rebuilt everything. Restructured her workflow. Hired help. Outsourced her social media to her daughter, who she calls the family's favorite nepo baby. And she retrained her patients to expect a few hours for a reply instead of a few minutes, because she finally learned that no is a complete sentence.

There is a recent JAMA study she keeps coming back to. Generally, women outlive men. Among physicians, that advantage disappears.

It is the title of her article for a reason. Having a female doctor is better for your health. Better for your health. Not for hers.

Listen to the full conversation on The Podcast by KevinMD. Link in the comments.

06/10/2026

BIG CHANGE IS COMING! Beginning July 1, Medicare will be covering GLP-1 for weight loss. See below for qualifying information.
If you qualify, please call our office to make an appointment.

NOTICIAS GRANDES VIENEN!!! Comenzando el 1 de Julio, el seguro de Medicare van a cubrir la medicinas para el tratamiento de obesidad.

Si califiquen, por favor llama a la oficina para agendar una cita.

06/08/2026

Patients, please let CMS- the Medicare/Medicaid provider who sets the bar for all other insurance companies to follow suit how you feel about the new changes. You have a right to healthcare and the changes proposed are pushing medical doctors to the limits. Many clinics and hospitals are closing destroying access to healthcare for entire communities.

Pacientes, por favor, comuníquenle a CMS, el proveedor de Medicare/Medicaid que establece los estándares para que todas las demás aseguradoras los sigan, su opinión sobre los nuevos cambios. Tienen derecho a la atención médica y los cambios propuestos están llevando a los médicos al límite. Muchas clínicas y hospitales están cerrando, lo que perjudica el acceso a la atención médica para comunidades enteras.

https://physiciansled.com/amplify-your-voice-for-patients/?fbclid=IwZnRzaASS9GhleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeJcia5MvSZxwmi86dCYGrt8PVCKLi2rVib12mkA-W1h-r0uFoGxQEJA060XI_aem_cngzyBx4iUSNtQGSBdOj1Q

Take Action · Public Comment Open Amplify Your Voice for Patients A Campaign for Physician-Led Hospitals For the first time, Medicare is formally asking whether physician-led hospitals should be allowed to expand and compete. This is a once-in-a-generation opportunity — and it will only count if ...

05/29/2026

https://www.facebook.com/share/1HAHGg2mci/?mibextid=wwXIfr

The nation's largest physician specialty group is so frustrated by the harmful impacts Medicare Advantage plans have on their practices, it is asking CMS for major policy reforms in nine key areas.
https://www.medpagetoday.com/publichealthpolicy/medicare/121343

05/10/2026

Happy Mother’s Day to all of the wonderful mothers out there.

Feliz Día de las Madres a todas la mujeres maravillosas!

05/05/2026

Make sure your services are provided by a M.D. on the premises of the clinic.

She walked into a place that called itself a medical spa. Three months later she was still in the hospital, and the prosecutor told her: you went there of your own volition. What did you expect.

The person who almost killed her had no medical training. She had ordered the product off Alibaba. It was contaminated with mycobacterium. She had no malpractice insurance. She had no license to lose. No prosecutor would touch the case. No lawyer would take the civil suit, because there was no money to recover.

That is the aesthetics industry in 2026. It is a 20 billion dollar business. As big as the NFL. And almost nobody is checking who is holding the needle.

Last year, people in 11 states landed in hospitals from fake Botox ordered off the internet. A woman in Texas died at an IV bar when an unlicensed person hung potassium and ran it into her arm like a martini order. There were HIV cases out of an unlicensed spa in New Mexico. None of this is fringe. This is happening in strip malls and hair salons and weekend pop-ups in every state in the country.

And the people doing it often have no idea they are practicing medicine without a license. They took a two-day course. The course promised them a medical director on paper. Now they are independently injecting strangers' faces with whatever they could order online.

Kate Dee is a board-certified radiologist who left breast imaging for aesthetics ten years ago and watched the industry explode around her. She wrote a book called "Med Spa Mayhem" because she could not keep quiet about what she was seeing in her own field. The way she puts it: physicians worry about losing their license if they do something wrong. If you don't have a license, you don't have one to lose.

So here is what to ask before anyone touches your face, your skin, or puts a needle in your arm. Who am I seeing today, and what is their license. Who is the medical director, and can I see them. Is the person holding the needle qualified to do a good faith exam. If the answer is "an RN comes by once a month," walk out.

Send this to the friend who just booked Botox at a place she found scrolling Instagram. Send it to your sister who keeps mentioning the IV bar that opened next to her gym. Send it to anyone you love who walks into a "medical spa" assuming the word medical means something there.

Listen to the full conversation on The Podcast by KevinMD. Link in the comments.

What is the most concerning thing you have seen or heard about a med spa or IV bar in your community.

04/30/2026

Three of the country's largest health plans are now in active class action litigation for using algorithms to deny medically necessary care. The legal exposure is no longer theoretical.

Here is where the major cases sit right now.
1. UnitedHealth Group. The class action over the nH Predict AI tool used on post-acute care reviews survived a motion to dismiss in February 2025. Discovery is underway.

💥 Plaintiffs allege the tool produced a 90 percent error rate on appealed denials, meaning nine out of ten denials were ultimately reversed on appeal.

👉 Senate investigators separately documented that UnitedHealth's post-acute denial rate climbed from 8.7 percent in 2019 to 22.7 percent in 2022, and skilled nursing denials increased ninefold over the same window.

2. Cigna. In March 2025, a federal court allowed the class action over the PXDX algorithm to proceed. Internal records cited in the complaint show PXDX was used to deny more than 300,000 claims over a two-month stretch in 2022, with an average denial time of 1.2 seconds per claim.

👉 The court ruled that a medical director "pushing the button" on an algorithmic output does not satisfy the contractual medical necessity review obligation.

3. Aetna/CVS
The Senate Permanent Subcommittee on Investigations released a 54-page report documenting that UnitedHealth, Humana, and CVS systematically targeted post-acute care for AI-driven denials.

👉 CVS rolled out a Post-Acute Analytics project in 2021 that was initially projected to save $10 to $15 million on skilled nursing spend. Internal projections were later revised to $77.3 million.

The common pattern across all three.
💥 Algorithmic denial at scale.
💥 Post-acute care as the deliberate financial target. Internal records that read like a cost reduction plan, not a medical necessity review.

For ASCs, IRFs, and LTACHs, the practical implication is this.
👇
Courts are no longer treating algorithmic denial as a routine administrative process. That changes what is reasonable to demand in your contract language, your dispute provisions, and your appeal rights.

DM me if you want to talk through where your contracts stand on these issues.