Aaron Mitchell
@thewonkologist.bsky.social
Medical oncologist and health services researcher. Focusing on health care costs, physician-industry COI, and oncology reimbursement reform. Opinions mine.
Reposted by Aaron Mitchell
As the ~discourse~ seems to bend interminably towards Republicans trying to figure out how they can (further) HDHP-ify ACA coverage, it's worth revisiting what is probably our best (most rigorous) study on the effect of deductibles in health insurance.
academic.oup.com/qje/article-...
academic.oup.com/qje/article-...
November 10, 2025 at 9:51 PM
As the ~discourse~ seems to bend interminably towards Republicans trying to figure out how they can (further) HDHP-ify ACA coverage, it's worth revisiting what is probably our best (most rigorous) study on the effect of deductibles in health insurance.
academic.oup.com/qje/article-...
academic.oup.com/qje/article-...
Postdoc opportunity at @mskcancercenter.bsky.social ! Read about and apply to OPTICS below:
November 8, 2025 at 4:15 PM
Postdoc opportunity at @mskcancercenter.bsky.social ! Read about and apply to OPTICS below:
Reposted by Aaron Mitchell
Cool. What would you call the other wing then? www.nytimes.com/2025/11/03/u...
November 6, 2025 at 12:38 PM
Cool. What would you call the other wing then? www.nytimes.com/2025/11/03/u...
This study could be titled "what makes doctors quit"
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
Trends in and Predictors of Physician Attrition From Clinical Practice Across Specialties: A Nationwide, Longitudinal Analysis: Annals of Internal Medicine: Vol 0, No 0
Background: The United States faces a predicted shortage of 36 500 physicians by 2036, with an increasing proportion of physicians leaving clinical practice or expressing an intent to do so. Evidence ...
www.acpjournals.org
November 6, 2025 at 3:20 PM
This study could be titled "what makes doctors quit"
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
Our new study, out yesterday in @bmj.com !
👇🏼👇🏼👇🏼
👇🏼👇🏼👇🏼
New @bmj.com research estimates the association between the billing (profit) margin and clinical benefit of cancer treatments and use by oncologists
www.bmj.com/content/391/...
www.bmj.com/content/391/...
November 6, 2025 at 11:56 AM
Our new study, out yesterday in @bmj.com !
👇🏼👇🏼👇🏼
👇🏼👇🏼👇🏼
Our new study is published today in @bmj.com!
We studied whether oncologists tend to use cancer treatments that are more beneficial, more profitable, or both.
I was surprised by the results: clinical benefit mattered, profit did not.
1/
cc: @dusetzinas.bsky.social
www.bmj.com/content/391/...
We studied whether oncologists tend to use cancer treatments that are more beneficial, more profitable, or both.
I was surprised by the results: clinical benefit mattered, profit did not.
1/
cc: @dusetzinas.bsky.social
www.bmj.com/content/391/...
Provider billing margin and cancer treatment selection: population based cohort study
Objective To estimate the association between the billing (profit) margin and clinical benefit of cancer treatments and use by oncologists.
Design Retrospective population based cohort study
Setting...
www.bmj.com
November 5, 2025 at 5:33 PM
Our new study is published today in @bmj.com!
We studied whether oncologists tend to use cancer treatments that are more beneficial, more profitable, or both.
I was surprised by the results: clinical benefit mattered, profit did not.
1/
cc: @dusetzinas.bsky.social
www.bmj.com/content/391/...
We studied whether oncologists tend to use cancer treatments that are more beneficial, more profitable, or both.
I was surprised by the results: clinical benefit mattered, profit did not.
1/
cc: @dusetzinas.bsky.social
www.bmj.com/content/391/...
3 year old: “I want to be a firefighter and not a doctor because I want to save people”
Ouch
Ouch
November 5, 2025 at 3:13 AM
3 year old: “I want to be a firefighter and not a doctor because I want to save people”
Ouch
Ouch
Reposted by Aaron Mitchell
Important new analysis from @matthewherper.bsky.social and @lizzylawrence.bsky.social about the ongoing situation at FDA. This quote from an agency staffer sums up the potential concerns. www.statnews.com/2025/11/04/f...
November 4, 2025 at 2:41 PM
Important new analysis from @matthewherper.bsky.social and @lizzylawrence.bsky.social about the ongoing situation at FDA. This quote from an agency staffer sums up the potential concerns. www.statnews.com/2025/11/04/f...
These quoted phrases are precisely what we knew an agency with Vinay Prasad in leadership would look like.
Experts worry FDA’s credibility is being shredded by scandal and 'embarassing' ‘soap opera’ 'clown show' www.statnews.com/2025/11/04/f...
Experts worry FDA’s credibility is being shredded by scandal and 'soap opera'
Experts worry that the FDA’s credibility is being shredded by scandal and "soap opera."
www.statnews.com
November 4, 2025 at 3:26 PM
These quoted phrases are precisely what we knew an agency with Vinay Prasad in leadership would look like.
Reposted by Aaron Mitchell
💊 Prescription drug prices have long risen faster than inflation, straining budgets for patients and the government alike.
A new Medicare policy aims to slow that trend, and it could save billions over the next decade.
Explore the details in our new explainer:
A new Medicare policy aims to slow that trend, and it could save billions over the next decade.
Explore the details in our new explainer:
How Inflation Rebates Can Curb Drug Price Increases
To discourage price hikes on brand-name drugs, the IRA requires manufacturers to pay inflation rebates to Medicare if prices increase faster than inflation.
bit.ly
November 4, 2025 at 1:58 PM
💊 Prescription drug prices have long risen faster than inflation, straining budgets for patients and the government alike.
A new Medicare policy aims to slow that trend, and it could save billions over the next decade.
Explore the details in our new explainer:
A new Medicare policy aims to slow that trend, and it could save billions over the next decade.
Explore the details in our new explainer:
Reposted by Aaron Mitchell
Love to see an implementation win in @ascocancer.bsky.social/ #JCOOP ⬇️
In a mix of community/academic practices in NE, low overall inappropriate use of denosumab/zolendronic acid for mHSPC compared to prior national studies.
ascopubs.org/doi/10.1200/...
In a mix of community/academic practices in NE, low overall inappropriate use of denosumab/zolendronic acid for mHSPC compared to prior national studies.
ascopubs.org/doi/10.1200/...
November 4, 2025 at 3:52 AM
Love to see an implementation win in @ascocancer.bsky.social/ #JCOOP ⬇️
In a mix of community/academic practices in NE, low overall inappropriate use of denosumab/zolendronic acid for mHSPC compared to prior national studies.
ascopubs.org/doi/10.1200/...
In a mix of community/academic practices in NE, low overall inappropriate use of denosumab/zolendronic acid for mHSPC compared to prior national studies.
ascopubs.org/doi/10.1200/...
Our new study is out today in JCO Oncology Practice @ascocancer.bsky.social!
We studied the use of guideline-concordant bone agents for prostate cancer, and found a large degree of inter-provider variation...
1/
ascopubs.org/doi/10.1200/...
We studied the use of guideline-concordant bone agents for prostate cancer, and found a large degree of inter-provider variation...
1/
ascopubs.org/doi/10.1200/...
Interprovider Variation in Initiation of Bone-Modifying Agents for Patients With Prostate Cancer | JCO Oncology Practice
PURPOSEOncology clinical practice guidelines recommend bone-modifying agents (BMAs) to decrease
skeletal-related events for patients with metastatic castration-resistant prostate
cancer (mCRPC) and ag...
ascopubs.org
November 4, 2025 at 3:39 AM
Our new study is out today in JCO Oncology Practice @ascocancer.bsky.social!
We studied the use of guideline-concordant bone agents for prostate cancer, and found a large degree of inter-provider variation...
1/
ascopubs.org/doi/10.1200/...
We studied the use of guideline-concordant bone agents for prostate cancer, and found a large degree of inter-provider variation...
1/
ascopubs.org/doi/10.1200/...
"None of the proposals outlined by Makary and Prasad justify firing hundreds of scientific experts dedicated to protecting public health. Staffing and budget cuts will only further diminish the FDA’s capacity to approve drugs in a timely manner."
jamanetwork.com/journals/jam...
True words
jamanetwork.com/journals/jam...
True words
Priorities of the US Food and Drug Administration
To the Editor As the chair of the Doctors for America Food and Drug Administration (FDA) Task Force, I am responding to the recent Viewpoint “Priorities for a New FDA” by FDA Commissioner Martin A. Ma...
jamanetwork.com
November 3, 2025 at 11:31 PM
"None of the proposals outlined by Makary and Prasad justify firing hundreds of scientific experts dedicated to protecting public health. Staffing and budget cuts will only further diminish the FDA’s capacity to approve drugs in a timely manner."
jamanetwork.com/journals/jam...
True words
jamanetwork.com/journals/jam...
True words
Reposted by Aaron Mitchell
I got my Covid and flu booster shots recently
The evidence supporting this is extensive 👇🏾
www.nejm.org/doi/full/10....
The evidence supporting this is extensive 👇🏾
www.nejm.org/doi/full/10....
Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026 | NEJM
Changes in the vaccine advisory process in the United States have disrupted immunization
guidance, which reinforces the need for independent evidence review to inform decisions
regarding immunizati...
www.nejm.org
November 2, 2025 at 3:48 PM
I got my Covid and flu booster shots recently
The evidence supporting this is extensive 👇🏾
www.nejm.org/doi/full/10....
The evidence supporting this is extensive 👇🏾
www.nejm.org/doi/full/10....
This is the first @nytimes.com food list I’ve seen that I’ve actually tried most of!
We especially love the PDQs at Padoca bakery, Petee’s Pie, the fan tuan at Win Son, and Ho Foods’ soy milk…
www.nytimes.com/2025/10/29/d...
We especially love the PDQs at Padoca bakery, Petee’s Pie, the fan tuan at Win Son, and Ho Foods’ soy milk…
www.nytimes.com/2025/10/29/d...
New York City Loves a Little Treat. Here Are Our 46 Favorites.
www.nytimes.com
October 31, 2025 at 1:34 AM
This is the first @nytimes.com food list I’ve seen that I’ve actually tried most of!
We especially love the PDQs at Padoca bakery, Petee’s Pie, the fan tuan at Win Son, and Ho Foods’ soy milk…
www.nytimes.com/2025/10/29/d...
We especially love the PDQs at Padoca bakery, Petee’s Pie, the fan tuan at Win Son, and Ho Foods’ soy milk…
www.nytimes.com/2025/10/29/d...
Exactly.
This is explicitly building political favoritism into the FDA review process.
This is explicitly building political favoritism into the FDA review process.
"Despite historically short median review times, the CNPV program proposes to further accelerate the drug-review process."
Then why is this program needed? Oh, I see...
"The CNPV proposal opens the door to conflicts of interest in the relationship between the FDA commissioner and sponsors."
Then why is this program needed? Oh, I see...
"The CNPV proposal opens the door to conflicts of interest in the relationship between the FDA commissioner and sponsors."
The title of this @nejm.org perspective could have been, "Commissioner’s National Priority Voucher Program: The Trumpification of FDA Drug Review."
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
October 28, 2025 at 5:58 PM
Exactly.
This is explicitly building political favoritism into the FDA review process.
This is explicitly building political favoritism into the FDA review process.
The title of this @nejm.org perspective could have been, "Commissioner’s National Priority Voucher Program: The Trumpification of FDA Drug Review."
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
Flaws in the FDA’s New Priority Voucher Program | NEJM
A new FDA program is being promoted as a tool to facilitate the development and approval
of therapies that are important for society. But it risks undermining regulatory innovation
and trust in the...
www.nejm.org
October 28, 2025 at 4:32 PM
The title of this @nejm.org perspective could have been, "Commissioner’s National Priority Voucher Program: The Trumpification of FDA Drug Review."
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
Another must-read from @portalresearch.org
www.nejm.org/doi/10.1056/...
Reposted by Aaron Mitchell
Josh Hawley voted for historic cuts to SNAP, which is indispensable to 42 million Americans' food security.
October 28, 2025 at 2:19 PM
Josh Hawley voted for historic cuts to SNAP, which is indispensable to 42 million Americans' food security.
"We would regard it as a positive step if oncologists were discouraged from accepting personal payments from Pharma."
💯 Let's stop pretending industry COI is a good thing!
Must-read commentary from Ian Tannock, Saroj Niraula in @ascocancer.bsky.social JCO-OP.
ascopubs.org/doi/full/10....
💯 Let's stop pretending industry COI is a good thing!
Must-read commentary from Ian Tannock, Saroj Niraula in @ascocancer.bsky.social JCO-OP.
ascopubs.org/doi/full/10....
Conflict of Interest: Moving From Disclosure to Avoidance | JCO Oncology Practice
ascopubs.org
October 15, 2025 at 4:34 PM
"We would regard it as a positive step if oncologists were discouraged from accepting personal payments from Pharma."
💯 Let's stop pretending industry COI is a good thing!
Must-read commentary from Ian Tannock, Saroj Niraula in @ascocancer.bsky.social JCO-OP.
ascopubs.org/doi/full/10....
💯 Let's stop pretending industry COI is a good thing!
Must-read commentary from Ian Tannock, Saroj Niraula in @ascocancer.bsky.social JCO-OP.
ascopubs.org/doi/full/10....
The thing we have learned very clearly about Jay Bhattacharya in the last six months is:
He wants to be a podcaster.
He seems to have no interest in running NIH or learning about science. He’s the leader of #darkscicomm
He wants to be a podcaster.
He seems to have no interest in running NIH or learning about science. He’s the leader of #darkscicomm
Bhattacharya is busy tweeting from his personal account about how he was right about lockdowns.
This is where he seems to want to spend his time, rather than doing his day job.
This is where he seems to want to spend his time, rather than doing his day job.
October 11, 2025 at 12:23 AM
I'll be presenting our new findings at @ascocancer.bsky.social Quality this weekend!
I was surprised to find an apparent lack of association between private equity ownership and low-value (but high-profit) cancer care:
meetings.asco.org/abstracts-pr...
@reshmagar.bsky.social
I was surprised to find an apparent lack of association between private equity ownership and low-value (but high-profit) cancer care:
meetings.asco.org/abstracts-pr...
@reshmagar.bsky.social
Program Guide – ASCO Meeting Program Guide
meetings.asco.org
October 7, 2025 at 1:29 PM
I'll be presenting our new findings at @ascocancer.bsky.social Quality this weekend!
I was surprised to find an apparent lack of association between private equity ownership and low-value (but high-profit) cancer care:
meetings.asco.org/abstracts-pr...
@reshmagar.bsky.social
I was surprised to find an apparent lack of association between private equity ownership and low-value (but high-profit) cancer care:
meetings.asco.org/abstracts-pr...
@reshmagar.bsky.social
I'll be presenting our new findings at @ascocancer.bsky.social Quality this weekend!
We found substantial health system-level variation in the appropriate use of bone agents to prevent fractures in prostate cancer:
meetings.asco.org/abstracts-pr...
@mjmorrismd.bsky.social
We found substantial health system-level variation in the appropriate use of bone agents to prevent fractures in prostate cancer:
meetings.asco.org/abstracts-pr...
@mjmorrismd.bsky.social
Program Guide – ASCO Meeting Program Guide
meetings.asco.org
October 7, 2025 at 1:27 PM
I'll be presenting our new findings at @ascocancer.bsky.social Quality this weekend!
We found substantial health system-level variation in the appropriate use of bone agents to prevent fractures in prostate cancer:
meetings.asco.org/abstracts-pr...
@mjmorrismd.bsky.social
We found substantial health system-level variation in the appropriate use of bone agents to prevent fractures in prostate cancer:
meetings.asco.org/abstracts-pr...
@mjmorrismd.bsky.social
Reposted by Aaron Mitchell
New: Broad support across the political spectrum for extending enhanced ACA premium tax credits.
October 3, 2025 at 1:58 PM
New: Broad support across the political spectrum for extending enhanced ACA premium tax credits.
Reposted by Aaron Mitchell
The wounded knee thing is really Trumpism distilled to its essence. It’s not enough to be able crush people who can’t fully defend themselves, it’s not enough to actually crush them, you also have to love and admire those who do the crushing otherwise the Trumpists’ delicate feelings are injured
September 26, 2025 at 12:43 PM
The wounded knee thing is really Trumpism distilled to its essence. It’s not enough to be able crush people who can’t fully defend themselves, it’s not enough to actually crush them, you also have to love and admire those who do the crushing otherwise the Trumpists’ delicate feelings are injured
Reposted by Aaron Mitchell
got some bad news for anyone who voted for Trump because he promised to bring down prices
www.ft.com/content/dd6d...
www.ft.com/content/dd6d...
Donald Trump announces 100% tariff on branded pharmaceutical products
The US president also unveiled levies on heavy trucks, kitchen cabinets and bathroom vanities
www.ft.com
September 26, 2025 at 1:46 AM
got some bad news for anyone who voted for Trump because he promised to bring down prices
www.ft.com/content/dd6d...
www.ft.com/content/dd6d...