[monkburger]

It’s easy to paint with broad strokes, but sweeping generalizations rarely capture the full picture. Not all of us “gatekeep” or overprescribe, we follow evidence-based guidelines and clinical judgment. When a patient presents with nonspecific fatigue and unintended weight loss, for instance, ordering a CBC, CMP, TSH, and A1C isn’t "unnecessary" it’s standard of care to rule out anemia, metabolic derangements, thyroid dysfunction, or early diabetes. That’s not about revenue.. it’s about ruling out high-risk pathology before it escalates.

As for the AMA, it’s far from perfect, but it doesn’t define the ethos of every practicing clinician. Many of us—regardless of where we trained—are here because we care deeply about patient outcomes, not profit. I don’t dismiss international medical graduates; I’ve worked alongside phenomenal ones. What matters to me isn’t where someone studied, but how they think, how they treat, and whether they practice medicine with integrity.

Healthcare needs reform, no doubt—but assuming every U.S. physician is complicit in systemic issues is reductive. Most of us are doing the best we can within a deeply flawed system.