Questions?  I have a lot of them.  I woke up at 4 am, again.  Why can’t I sleep past 4?  I don’t know. My doc has me on a machine for sleep apnea.  Yes, I’ve added sleep apnea to a litany of other problems.  

I think CRS may be the worst of my ailments. Most of my friends have CRS.  Just in case you don’t recognize the name, it stands for “Can’t Remember Shit.”  Yesterday, Renee and I totally blew off some very important people due to our CRS and an assortment of other problems.  No excuses! If you read this, I’m sorry!

If exercise is the fountain of youth, why do I hate doing it?  Why did my brother have a stroke?  He rarely ever missed a day in the gym.  Obviously, my brother’s stroke is foremost on my mind.  Don’t get me wrong.  As a doc, I highly recommend a regular regimen of exercise and healthy eating. Of course, there are those, like my best friend Robert, who believe that humans have a fixed number of heart beats in a lifetime and that when they run out, they die.  Robert thinks its foolhardy to waste heart beats in a gym.

Hallelujah!  Last night on the news, they announced that napping decreases your risk of heart attack and stroke.  Finally, a beneficial side effect from the mass of pills I take.  I am the napping king!  Of course, this may be the notorious fake news we’ve heard so much about.

I really don’t like being a patient.  There are too many docs to see.  Too many pills to take.  Too many side effects.  Too many tests.  Too much money spent.  Oh G-d, I have discovered a new ailment, the “Toos.”  Luckily, I have CRS and will have forgotten all of the above by noon.

One last question.  Is anybody reading this blog?  If you are, let me know.  If you’re not, its ok.  As a retired doc, I highly recommend finding something meaningful to do with all the empty hours you spend waiting to see your next doc or take your next set of pills.

Here’s an interesting view from 2011.

October 24, 2011

Sometimes I amaze myself.  Apparently, there is now a name for what I have been doing for the past year: “Patient Engagement/Activation.”  KevinMd recently published “Physicians should embrace patient engagement” by Dr Ken Bottles (  

This blog has been my way of engaging/activating patients.  Knowledge is power and providing my patients with the knowledge they need to become active participants in their healthcare has been my goal.  

In Dr. Bottles’ article Jessie Gruman, a cancer survivor is quoted as saying, “As a savvy and confident patient who is flummoxed by so much of what takes place in health care, I am regularly surprised by how little you know about how little we patients know. You are immersed in the health culture. But we don’t live in your world. So we have no idea what you are talking about much of the time. One way to help us feel competent in such unfamiliar environments is to give us some guidance about what this place is and how it works. What are the rules?”

In August, I published, “I Am A Responsible Patient.” (  The article outlined “the rules” for my patients, as well as for any of my readers who were interested in taking an active role in their health.  I have published multiple articles over the last year designed to help patients “feel competent in such unfamiliar environments is to give us some guidance about what this place is and how it works.” (Bottles)

According to Dr. Bottles’ article, “The ten categories of the Engagement Behavior Framework are:

  1. Find safe, decent care
  2. Communicate with health care professionals
  3. Organize health care
  4. Pay for health care
  5. Make good treatment decisions
  6. Participate in treatment
  7. Promote health
  8. Get preventive health care
  9. Plan for the end of life
  10. Seek healthcare knowledge.

I agree with each of these 10 principles.  It is critical that, as physicians, we engage and activate our patients.  The article goes on to report, “Recently Klick Pharma invited 19 health care activists from a wide variety of disease states to participate in a conversation about an ePatient Bill of Rights that would support patient engagement and activation. After four hours of conversation, this group reached consensus on the following key messages of such a bill of rights:

  1. Shared access to my data
  2. Attitude of collaboration and overall respect
  3. The patient is the largest stakeholder
  4. Transparency and authenticity across all areas
  5. Voice of the patient is a legitimate (clinical) source
  6. The right to efficient communication with providers who utilize the technology we need”

I think the key remark in this entire conversation is number three, “The patient is the largest stakeholder.”  The patient is the largest stakeholder, the one with the most to win or lose.  In this ever-changing world, it is incumbent on the patient to take an ever growing and active role in his/her health.  

Investing the time and effort in “self” is critical.  “Seeking healthcare knowledge” (Bottoms) is time consuming and difficult but well worth the investment. Getting “preventative health care” (Bottoms) is important but practicing “preventative health care” (Bottom) is more important (Segal).  

What is missing from Dr. Bottles’ article is the importance and key role of the concept of “continuity of care.”  Communicating with your healthcare provider and forming a longstanding, health care team is essential in optimizing your health.  Long term patient-physician relationships promote trust and trust is the critical factor that allows for “safe, decent care.” (Bottoms)

Dr. Bottles’ article goes on to state, “Experts in patient activation/engagement suggest that hospitals and medical practices provide each patient with a short guide that explains how best to be a patient in that unique setting.”

A “short guide” on “how best to be a patient in that unique setting” does not exist.  There are now 326 articles on this blog and more to come.  Each article hopefully will enable you to be the best patient you can be.

If only there was a “short guide” to being the best doc you can be!

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