jglinn

“Dealing with the temporary frustration of not making progress is an integral part of the path towards excellence. In fact, it is essential and something that every single elite athlete has had to learn to deal with. If the pursuit of excellence was easy, everyone would do it. “

@JohnGoldman @JimGalanes 100mg/week of injected test cyp is performance enhancing. It may not delegitimize things but its performance enhancing.

@JimGalanes 100 mg of test a week delegitimizes the whole effort? For whom? I’m a normal guy. My audience is normal people. Normal people optimize hormones when necessary. 100 mg of test sure as hell ain’t gonna run the 1800 miles in my block.

I’ve posted all my lab work. My dexa scans. My vo2max. My run data. My weight. What I eat. My BP. I’m 50. My labs are pristine. My body fat is in the teens. I can run 26 miles at a time. I take no meds other than hormones. My blood pressure is 115/70. Walking the walk.

@artemon @nikillinit Pay the lowest income and the highest risk patients an incentive payment as well? Seems directionally right as you note yet still will suffer without the patient incentives! Bet you could help with the behavioral side!

@nikillinit Don’t know much about ACO ACCESS, but in response to your #1, I think the best is to pay for both inputs and outcomes. So some reasonable payments for inputs, and then a larger payment for outputs. I think the MDPP gets this directionally right for diabetes prevention.

I think the conceptually the new ACO ACCESS model is cool - I'm not an expert here so would love to hear other peoples thoughts. Quick notes: 1) There's alway been a debate about whether we should pay for "inputs" in value-based care that we think will lead to good outcomes or pay for outcomes themselves, even if some of the outcomes can go wrong if the provider does all the right things. This seems to put more of an emphasis on outcomes and a flexibility on inputs 2) At a quick glance though, I think the most interesting part will be what happens when the measurements are collected via patient reported outcome measures. In organization I've talked to or worked out, collecting patient reported outcomes has been a disaster to implement. 3) It is interesting that pseudo-forced interoperability between PCPs and referring clinicians seems to be a part of this program. The pay will have to overcome the friction/lack of willingness to do this, but would be interesting if it does! 4) "To further support collaboration, PCPs and referring clinicians may bill a co-management payment (without beneficiary cost-sharing) for reviewing updates and documenting related care-coordination actions, such as medication adjustments or problem-list updates." - this feels like it's going to be abused and then clamped down on

@nikillinit Maybe this coding system being used isn’t all that great? Maybe the problem is the incentives? Innovation may never be possible with this model?

arc is the same for every new thing in healthcare 1) overly vague CPT code is created and abused 2) payers put blanket rules against using it which also ends up hurting people that use the code correctly 3) new CPT codes come out that are tighter around the specifications on when to use it 4) Payers tend to pay the ones within that narrower CPT code band but give a lot of grief if you deviate outside of it even slightly

@GuruAnaerobic It is truly remarkable! Very impressive!

This is ISANE. I thought a 60yr old running a 11.7 100m was impressive, but this is surely better?

@JimGalanes @RGary2 @USTFCCCA And swimming and rowing and soccer and……

@RGary2 @USTFCCCA Who is ustfccca. And what jurisdiction do they have over ncaa sports. This has been going on for 50 years in NCAA skiing.

Too many NCAA programs no longer prioritize American development. We need guardrails which is why I’ve submitted age-based legislation to @USTFCCCA that will be voted on at our December convention. I hope my colleagues will stand with me and support it. #NCAAreform #NCAAvalues

@stevemagness US learned to lean on college to be the training grounds for oly sports in us. College oly sport has become a recruiting game now. Will be interesting to see how this evolves. Does the us college oly sport model work still? Probably not….I love it but it doesn’t work

One big problem with our sport is very few put their own ambitions aside and look at what’s best for the health of our sport…on every level. It’s one reason why it’s dying. And more and more schools will cut XC and track…

Again. It’s not about how much work you can do, it’s about how much work you can recover from.

One of the most underappreciated dynamics in healthcare is Parkinson’s Law of Triviality: organizations devote disproportionate time to the issues that matter least. In behavioral economics, it’s called “complexity avoidance.” In healthcare, it’s usually called “the weekly meeting” or sometimes referred to as “the huddle.” We’ll spend hours debating badge colors, committee names, logo refreshes, and which department should ‘own’ a metric - while multimillion-dollar structural failures, workforce collapse, and catastrophic billing inefficiencies glide by untouched. The harder the problem, the faster it gets tabled “for further discussion and research.” The easier the problem, the louder the opinions - suddenly everyone’s an expert. This is why health systems have immaculate branding guidelines but chaotic revenue cycles. Why they can produce a 200-page “cultural competence” report but can’t reliably staff a night shift. Why they optimize hallway signage faster than clinical throughput. Why they talk about all the community service that they produce yet none is ever actually observed or experienced. This is why dilettantes are rewarded and brilliance is punished. Healthcare doesn’t suffer from a lack of goobers, gomers, and grifters - it suffers from a gravitational pull toward the trivial. And nothing accelerates that gravity quite like a conference room full of administrators with laptops.

This might seem controversial but it shouldn't be. There's been a trend to vary training based on the sex of the person (i.e. females need more of X, less of Y.). The reality? You vary training far more based on individual characteristics than sex.

@NickHoopes_ PT = restore, maintain, enhance human function

Rehab Hot Take: The “we save the system money” trope is harming the reimbursement battle. Not improving it. It’s a bit contradictory to tell someone you’re saving them money while simultaneously asking for more. Sure, “WE” understand the nuance of the situation But most don’t

@real_michal @Alan_Couzens wrestler

@Alan_Couzens What occupation allows one to become maximally fit?

This is a good question. I suspect... a) We significantly overestimate just how far they walk these days. 1950's mailman *was* fit. 2025 not so much. b) The intensity & continuity of the walking matters. Inaki was solid walking at RHR + ~50 BPM, not taking drink orders.

The future very few in pharma seem ready to believe: - consumers will become the primary buyer - List prices will need to be normal & rational GLP1's aren't an anomaly but rather a preview of what's to come. MD detailing, rebates for formulary placement, etc all going away.

@homegymcoop Time wounds all heels.

I hear often that people use the barbell less as they age. As I've gotten older (I'm 34, not saying I'm 'old') I have shifted my training more towards dumbbells, cables, and machines. I question: Is the reason I use the barbell less, because it's less optimal as I age... Or I'm getting mentally weaker. Hmm...

Not here to comment on politics. But whenever I read “gotchas” like this it just makes me think… Man, people are truly clueless on how freaking hard it is to get 5th or even just make the NCAA championships.

The readout from President Trump's visit to Walter Reed today says he got his flu shot and Covid booster.

@datarade Speak 5 no need app

There's no language learning app founder I know of that speaks 5+ languages.

@hybridathlete “Don’t go full fat fuck” words to live by

If your're under 30, undermuscled, and want to get bigger, do this: -Lift hard for 18-24 months WITHOUT cutting -Eat enough to support your lifting, but don't go full fat fuck -Once you've gained at least 40#, do a focused cut down to ~10% You won't believe how you look.

@clh_strength What’s old is new again….

Isometrics are a powerful tool to use that have very little physiological cost So much upside. Little to no risk

@mboyle1959 Amen

People see our programming and think “too simple”. It doesn’t need to be complicated. Good exercise selection + PRE + good attendance = Success

@TheIshanGoswami Same

they made a special one for us