Trauma surgeon--left the medical system & now I help patients take their health back — & doctors take their practices back. Founder @james_clinic and @mav_med
Joined December 2015
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It starts with a bad diet, maybe some poor sleep, lots of stress, or feeling 'off'.
Exhausted all the time and can't get rested.
Here's what we've found treating hundreds of patients: (thousands, most likely by now)
The covid shots should NEVER have made it to people.
They failed in trials.
They failed in practice.
Children continue to be harmed by them. WHY?
Because someone, somewhere is making a buck.
Crowd erupts in thunderous applause and a standing ovation!
“The fight to pull the COVID vaccine off the market is a pro-life issue.”
Go @ZachLahn - Iowa’s next governor!
One lesson from years of surgical consultations:
Don't let the reason for the consult become your diagnosis.
Someone has already decided what they think is wrong.
That may be correct.
But I still want the history, examination, physiology, imaging and clinical course.
And I want to know what doesn't fit.
Sometimes the most important finding is the one nobody was looking for.
Always doubt the premise and review films and labs yourself.
Common Sense Medicine 🧵
When I was practicing surgery, I received a notice that I'd committed a SCIP violation.
SCIP was the Surgical Care Improvement Project, a hospital quality initiative.
Here's what happened.
I was consulted for an umbilical hernia in a man in his 60s on a Thursday afternoon.
Except he had a nearly obstructing transverse colon mass.
He also had a prior above-knee amputation, dehydration, and acute kidney injury.
I placed a Foley catheter in the ER, admitted him, and scheduled his colon resection for Friday.
Postoperatively, he went to the ICU for monitoring.
He was not a particularly healthy patient.
Here are the SIX problems with their SCIP violation:
This was urgent surgery, not an elective procedure.
The Foley was placed therapeutically in the ER for fluid management and renal monitoring, not simply as part of routine preoperative preparation.
The patient had a distended abdomen and bilateral above-knee amputations. Using a urinal or commode wasn't a practical alternative.
He had significant fluid shifts and renal-function fluctuations. The clinical reasons for continued monitoring were documented in the chart.
I wasn't the physician rounding over the weekend. My colleague made those daily decisions, which I agreed with. But the violation was assigned to me because I was the operating surgeon.
I appealed, explaining the clinical circumstances and my reasoning. The quality program refused to make an adjustment.
The patient recovered and went home.
But the checkbox remained unchecked.
Common sense and good clinical judgment don't always translate into quality indicators.
Until those indicators account for reasonable clinical decision-making and the complexity of individual patients, they tell us very little about the actual quality of care being delivered.
Compliance is not the same as quality.
Halloween is coming up….
This is my costume from 2 years ago.
Mission accomplished. 🤠 ❤️
What say you-bring it back,
or try something new?
There is a massive need for pediatricians who have an open mind and respect patients choice.
There are deserts where families are fired from Peds practices-and need a place to go!
If you’re one of them, DM me!
I don't want 50 employees who need me to answer every question.
I want 50 people who are continually developing the skills and judgment to deliver excellent patient care.
At James Clinic, we hire people who genuinely care. Then we invest in training them.
Every morning at 7:
Monday: Operations
Tuesday: Clinical education
Wednesday: Tumor board and complex cases
Thursday: Clinical education
Friday: Clinician meeting
This week we're discussing HBOT in cancer care. Last week included IV vitamin C.
The goal isn't to make everyone dependent on me.
It's to build a team capable of thinking, learning, and solving problems together.
That's how a medical practice scales without losing its culture.
It's 9 PM on the Monday-est Monday lately, and I just finished charting.
I still work long hours.
The difference?
My blood, sweat and tears now go toward practicing medicine on my terms, with both the authority and responsibility that come with ownership.
I left a corporation that replaced me in 24 hours.
And built the practice I always wanted.
I will never regret that decision.
I tell my clinicians this all the time:
A piece of data is a snapshot.
I need to see the movie.
Where did the patient start?
What's changed?
How quickly?
What happened after treatment?
Are they actually getting better?
One laboratory result tells me something.
The trajectory tells me much more.
That's why longitudinal care and follow-up matter.
One of the nice things about being a direct clinic, we can build in extra follow-ups, and the patient doesn't have to worry about additional fees.
We recently had a patient very ill with pneumonia.
She saw us five times in five days.
She was sick when we started, but we monitored her trajectory make sure she was getting better every day.
She avoided a hospital stay due to our ability to follow her closely and obtain oxygen.
The Hot/Crazy Matrix got a physician edition. 😂
Being a great doctor doesn’t automatically make you a great business owner.
I break down the Maverick Matrix. Where do you land? 👇
#MaverickMedicine #PhysicianLife #DrMollieJames
I was subject to a similar issue here in the US-2 years ago today.
My team and I went to NC to help in the aftermath of Hurricane Helene.
We brought free medications, IV’s and supplies-as well as many devoted volunteers.
I called it a “field hospital” 🏥
The NC-DHHS called to ask what operations my hospital performed, and specific details such as labs, imaging, overnight stays.
It was an abandoned garage that we congregated in to help fill the gap while they were recovering.
They sent me a “cease and desist” to stop operating a hospital without a license.
Not one of them were actually insight providing care themselves.
For those of you who thought the visit from a Bedford Borough Council official to investigate our daughter Zoe’s (age 12) pretend teddy bear cafe was too ridiculous to be real, here is the arrival of official. This is totally legit. She really did show up at our property to investigate the illegal teddy bears having their coffee🧸🧸☕️☕️
Just to get ahead of the noise:
We were fully sanctioned by local and federal agencies to be there
I had an NC license & DEA
We were working with local authorities
Our partnership extended to several humanitarian organizations there too
they agreed if I stopped using the word hospital, we could continue our volunteer efforts.
Then the state dropped a free Clinic a mile down the road
They forced the county to kick us out
So, instead of helping people impacted, we spent several days packing up, distributing the medical supplies to others. She would make sure they got in the hands of people who needed them, and coordinating with volunteers.
The other orgs experienced similar friction.
No good deed goes unpunished.