3.9 million to study the genetics of cocaine & meth sensitivity in fruit flies

2023 MD school revenue sources: 😱 ~$192 billion = TOTAL REVENUE supporting all fully-accredited US MD schools in 2023 👨🏽‍⚕️ ~$81 billion = collected by MD schools from FACULTY CLINICAL PRACTICE PLAN — Translation: faculty doctors, including many doctors who never teach but are med school-affiliated, see a lot of patients — Medicaid/Medicare & other public & private insurers pay out to the med school for patient care, med school uses some of that $ to pay faculty doctors’ salaries, uses rest for operational & ~etc~ expenses 🏥 ~$40 billion = collected by MD schools from AFFILIATED HOSPITALS — Translation: This is a bit convoluted, but when a hospital pays a med school for patient revenue generated by certain faculty agreements, it ends up in this category — hospitals ALSO often pay med schools for getting to have their faculty around (separate from patient revenue) — & they pay for the prestige of the med school affiliation TBH — and pay to contribute to ~research~ costs — and sometimes, for other reasons, related to partnership initiatives — hospitals generally have plenty of $ via insurance, federal DSH payments, federal grants & subsidies, Medicare GME, plus donations — including Pharma + med device donations — this funnel is one way that Pharma $ indirectly & consistently hits med ed 🏛️~$28 billion = collected by MD schools from FEDERAL RESEARCH GRANTS & CONTRACTS — Translation: this category is 100% sourced straight from federal funds — taxes + debt 📄 ~$16 billion = collected by MD schools from OTHER GRANTS & CONTRACTS — Translation: more federal $ ends up here through grant shuffles (IYKYK) — pharma & med device $ ends up here, too — plus foundation awards, tech partnerships, etc 🧑‍🧑‍🧒 ~$7 billion = collected by MD schools from GOVERNMENT & PARENT SUPPORT — Translation: $ from state & local governments + parent contributions — some indirect federal funds will also show up here 🃏 ~$7 billion = collected by MD schools from MISCELLANEOUS — Translation: they define this in report as “Includes Sales & Services, Royalties, Consulting, Interest Income, Gains (Losses) on Investments, Leases/Rentals, & Other” 🎁 ~$6 billion = collected by MD schools from GIFTS & ENDOWMENTS — Translation: this varies WIDELY amongst schools & year-to-year — ie recently, a single gift of 1B was given to a single school — select med schools have HUGE endowments generating mega returns — but those same schools are also generating mega $ in every other revenue category 📚 ~$6 billion = collected by MD schools from TUITION & FEES — Translation: student loans, including federally subsidized + some parents footing the bill + military HPS + etc — 3% of revenue from tuition is nothing, eh? Chart showing revenue categories from AAMC report:

If every single psychiatrist on earth was forced to publicly & honestly answer the following questions, psychiatry as we know it could no longer exist —— 1) What % of your patients are THRIVING on medication? 2) What is your deprescription rate? 3) How many medications & doses do you ~try out~ on the average patient? 4) How do you decide which potential side effects & adverse reactions are worth warning about? 5) How do you monitor for side effects & adverse reactions? 6) How do you know when a reported side effect is really from a drug vs THEIR underlying disease? 7) How much weight gain is theoretically acceptable in pounds per patient? 8) Is the brain more important than the kidneys or does something else justify lithium? 9) What’s your favorite pharmaceutical company and why? 10) Are cloudy thinking, insomnia, and fatigue really that big of a deal? 11) Is emotionally numb ~better~ than sad? 12) When you write for SSRIs, do you mention the possibility of PSSD? 13) What percentage of patients developing PSSD is theoretically acceptable? 14) How many patients have ended their lives within weeks of starting a new med under your care? 15) What percentage of patients ending their lives within weeks of starting a new med is theoretically acceptable? 16) How do you account for psycho-social-cultural-spiritual aspects of mental health? 17) Have you ever tried a dietary intervention as a first line treatment on anyone? 18) Tell me what you tell patients about the gut-brain axis & gut microbiome? 19) What labwork do you order before starting medication & which medical conditions are you seeking to first rule out? 20) What’s your favorite psych med for a pregnant woman? 21) What’s your favorite psych med for a child? 22) If a patient develops gender dysphoria on a drug, do you consider the drug’s contribution? 23) What‘s your favorite big box pharmacy? 24) How long is “too long” to grieve a loss? 25) Were you a little bit sad when the chemical imbalance theory of depression was publicly discredited? 26) Does anything in the DSM remind you of a horoscope? 27) Is it bipolar 2 or is she on her period? 28) Have you ever created a substance use disorder? 29) If you had to pick, would you say psych labels are empowering or disempowering? 30) How did our ancestors get by without antidepressants? 31) Do you read the FDA summaries for all new medications that you prescribe? 32) Have you ever thought about the fact that doctors can’t access raw clinical trial data? 33) Should we color code grippy socks by diagnosis? 34) Did getting rid of Asperger’s make the world a better place? If so, how? 35) Do you discuss psych med withdrawal BEFORE starting someone on a medication? 36) How many times have you removed a diagnosis from a patient profile due to realizing it was inaccurate? 37) How many times have you removed a diagnosis from a patient profile as a result of them getting better?

So, about the ~$28 billion from fed research grants & contracts to MD schools Schools were allowed to set aside over $8 billion for “FACILITIES & ADMIN” (ie — not research) The F&A ratio for fed grants to MD schools was ~41%, while it was only ~18% for non-federal grants

For the record, it will not be possible to Make America Healthy Again without meticulously examining the use, efficacy, & side effect profiles of SSRIs & other psych meds It is time to scrutinize the cascade of consequences that arise from our wildly loose prescribing practices