Eugene Lucas, MD

We've understood the health implications of #Vo2Max for sometime now but I'm still concerned that it is not being discussed enough with patients.

POV, you're a doctor trying to advocate on behalf of your patient for insurance coverage Start 10:30 AM -Wegovy denied by Aetna after being covered and after patient achieved clinically meaningful weight loss. -Authored LOMN which included patient's starting weight, obesity related comorbidities, total weight loss percentage, and rationale for medical necessity (risk of weight regain and health complications if medication not covered, general health benefits associated with maintaining optimal weights). -Appeal on basis of LOMN was denied, only explanation provided --> not medically necessary. -Pt called insurance, was told that the information provided in the LOMN authored and signed by the doctor (me) is generally what they need, but a peer-to-peer (phone conversation with a "doctor" representing the insurance company) is required in order to potentially provide coverage. -I call insurance, provide the patient's information and select number option for appeal, hold for 10 minutes, reach someone, then confirm patient info with them and reason for the call, and the representative tells me I need to call a different number to reach the correct department. -The above happened again with the second department, and then again with a third department -Speaking with 4th department, first person then transferred me to a pharmacist. -The pharmacist (CVS Caremark Rep) said there was no record of the LOMN I authored, I offered to share the reference # provided to me by our pharmacy liaison team, pharmacist said he cannot use the reference # to look it up. -I offered to email (with encryption given HPI) the LOMN, he said it must be faxed. -I faxed it while still on the phone, and requested to stay on the phone while he views the faxed LOMN, he said that is not possible, that he can call me back. -Called patient back and provided these updates. End 11:15 PM. @mcuban

An offer i can't refuse

-Insurance companies: Give us a lot money regularly, we'll cover services to support your health -Semaglutide & Tirzepatide: We offer more total health improvement opportunities than any other medication class -Insurance: We will do everything we can to not cover these meds

So happy he shared this. For anyone feeling nervous about returning to an activity after an extended break, there should be comfort in hearing that even Michael freakin' Jordan was nervous to shoot a free throw after a own hiatus of his own.

In my opinion, there’s no room left for a good faith argument to be made against the causal relationship btwn elevations in atherogenic cholesterol particles and the development/progression of CAD. Rapid progression of CAD was demonstrated in this seemingly “healthy” population (LMHRs), in which high LDLc/ApoB was the only risk factor. Alas, i worry that “med” influencers will continue to suspend reason while arguing otherwise and may cause irreparable harm in the process.

A reminder that there's ALOT we still don't know about factors that regulate #obesity and influence AOM effectiveness. If anyone is doing genetic studies & needs ppl on opposite ends of WL spectrum, DM me. We need to better understand how to help ppl in right column :/

Just an FYI regarding concerns for radiation exposure from a body composition assessment using DXA