Saccades are generated in the brain. There are voluntary and involuntary saccades. As long as you have a functional frontal lobe and midbrain you will have normal saccades your entire life without any practice whatsoever.

I’m not sure what he’s trying to accomplish with his exercise here. With a fully developed brain there is no way he is strengthening his frontal eye fields or superior colliculus. If he is trying to strengthen his eye muscles to give himself better saccades (I assume this is the case since all of his content is about strength and mobility) just going about your daily life generating thousands of saccades every day should suffice. You can’t bulk up your extraocular muscles. That’s called thyroid eye disease.

Yes, our eyes converge when we accommodate (focusing). However, they don’t diverge during accommodation (impossible).

“We rarely expose ourselves to the end of the spectrum”

The interesting question here is “does practicing convergence help with things like convergence insufficiency (inability to bring the eyes together to see a single, clear image at near). There is consensus that convergence exercises work in kids, but not in adults.

Important distinction, licensed eye care clinicians recommend convergence exercises to treat a pathological state. Our unlicensed friend Tim here is recommending convergence exercises as a “use it or lose it” type of activity, which is nonsense.

Also, he’s equating convergence with accommodation, but as we will talk about in subsequent idiotic posts from Tim, you can lose accommodative ability while maintaining the ability to converge. They are related but do have pathways that function independently of one another.

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Dr. Glaucomflecken

@DGlaucomflecken

May 12, 2023

This is a common argument I hear from the pro private equity crowd. I’m trying to reconcile this argument with the business model of PE. Somebody help me. As far as I know, the only ways to generate profit is by cutting costs and/or increasing revenue. (Thread)

Medical practices generate revenue by seeing patients, so one option for increasing profit would be telling physicians to work more days, see more patients, bill higher codes, push cash services, all of which I would consider, “interfering with patient care.”

According to my dissenters, this isn’t happening, so PE is just cutting costs because that’s the only other way to generate profit. So they cut costs (laying off staff, hiring cheaper staff, 1-ply toilet paper, whatever). Then the PE firm, having shown an increase in profit…

Read 6 tweets

Dr. Glaucomflecken

@DGlaucomflecken

Mar 23, 2023

PE thread:

One of the challenges with fighting private equity in medicine is the lack of data. We need to look at costs, outcomes, burnout, etc pre/post PE acquisition. We all know pushing medicine further into for profit territory is bad, but we need data to show how bad it is

Of course, PE will never let it happen. In the era of “evidence based medicine” we have this massive intervention (PE acquisitions) happening everywhere with no ability to study its effects on patient care bc it will almost certainly make PE look really bad

So where are the physician/specialty organizations in all this? They are supposed to be the biggest advocates for physicians AND patients. This seems right up their alley. They should be salivating to find out if PE is good or bad for their members.

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Dr. Glaucomflecken

@DGlaucomflecken

Feb 16, 2023

https://twitter.com/wiley2020/status/1625576788662312960

This is the selling point of private equity. We have the cash to grow your practice and give you more negotiating power with insurance companies, which is better for doctors and patients. Everybody wins, right?

https://twitter.com/wiley2020/status/1625576788662312960

Until you remember the goal of PE is to increase profitability as quickly as possible, so once the deal is signed, they begin reducing costs. It’s a hard transition, but the practice is full of excellent docs who can still make it work with fewer technicians & 1-ply toilet paper

Then 5 years later, the practice is more profitable, so the PE owners sell to another PE company, which results in more cost cutting to achieve profitability. Makes sense, this is how business acquisitions work, except we’re not selling office supplies, it’s patient care

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Dr. Glaucomflecken

@DGlaucomflecken

Jan 13, 2023

Couple things about vision insurance. It’s mostly used for glasses/contacts and routine exams for people with perfectly healthy eyes. Also, it’s dumb. Why would the most important disability accommodation in human history not be covered by medical insurance? Makes no sense…

But if you have a medical ophthalmic diagnosis, then you don’t need vision insurance for routine eye exams. Everybody over 65 has cataracts. That is a medical diagnosis. You can get a routine eye exam covered by Medicare.

I see too many people suckered by health insurance companies into thinking they need vision insurance to see an eye doctor. Not true.

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