e-Patient Dave

Power to the Patient!

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Dr. Rich Mahogany’s “Man Therapy” – with 18 Point Head Inspection :-)

Screen capture of "Dr. Rich Mahogany's Man Therapy" (not a real therapist"

Update, December 7: I’m at a meeting talking about community mental health in Colorado, and it turns out this program didn’t work out as being effective.

I recently attended the first White House Dialog on Men’s Health, at the Eisenhower Executive Office Building. The day got a little out of control – speakers in the first session ran way long, nobody reined them in, so the middle hour (where I was going to co-lead a breakout) got cancelled. Oh well. But for me the whole trip was worth it just to discover this: “Dr. Rich Mahogany,” a fictional therapist who makes clear that getting therapy is not just for woosses, it’s for real men, too: his site is Man Therapy, including a manly, interactive 18 Point Head Inspection.

It’s all real – the information is serious – but it’s couched in terms to be humorous, entertaining and engaging, as in “Stick around – there’s something useful here. Have a seat.” Here’s the About video, from their YouTube channel:
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Patient Engagement and Empowerment: A Culture War Begins (lecture at MITRE)

A Culture War Begins - title slideI’m starting 2016 with a series of posts that lay out “the arriving future” of health and care. Previous entries:

Technological advances are making new things possible, and our deepening conception of what medicine is about (and how best to achieve care) are changing our thinking about the nature of the work. We are truly shifting from “the doctor knows everything that needs to be known” to patients as potentially capable partners.

This is real culture change. Predictably, the establishment fights back: some people don’t believe it, some just don’t like change (especially change in their work), and some don’t like what they perceive to be a challenge to their authority.

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It’s time to adopt a good working definition of empowerment.

Source: dave.pt/worldbankempowerment1
Source: dave.pt/worldbankempowerment1

A major theme of my work last year was that it’s time to create a science of patient engagement (see blog posts) – a rigorous inquiry into what patient engagement is, what factors (parameters) increase it, which ones diminish it, develop some hypotheses that researchers can test. This was the theme of my visit to the Mayo Clinic as Visiting Professor in Internal Medicine in March and my tenure as NEHI’s Patient Engagement Fellow.

A science needs practical definitions. The Structure of Scientific Revolutions notes that until a field has an agreement on what a concept means, the practitioners in the field literally have nothing in common to talk about. I’ve seen that myself, when people talk about empowerment but the field goes nowhere.

It’s time for definitions.

Fortunately, a useful definition of empowerment exists.

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Careful and kind care, part 2: Slides & video from Maine Quality Counts

This blog post is formatted using a new method I’ve never tried before, with slides and video side by side. The video didn’t capture the slide images, but you should be able to watch the video and click the slides forward when it seems like a good time.

Email subscribers, if you can’t see the video or the slides, click the headline to come see them online.

This series of posts to start 2016 is motivated by a desire to help healthcare achieve its potential. I believe that’s not possible unless we’re clear about what the potential is and clear about the challenges and obstacles.

Before moving to additional subjects, today I want to go one step deeper on Dr. Victor Montori’s concept of care that is “careful and kind.” (See Saturday’s post, if you missed it.) I have three reasons to go deeper before moving on:
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The arriving future of tech in health(care): Lucien Engelen on LinkedIn

@Reshape's Twitter avatar
Radboud @REshape’s Twitter avatar

This is going to be a fascinating year, with a mix of social and technological change. On Saturday I started the year with The future of caring: careful, kind, “minimally disruptive.” Today I’ll flip to a completely separate channel: how technology is changing what’s possible.

Lucien Engelen head shotLucien Engelen, about whom I’ve often written, is the manically productive visionary at Radboud UMC, the Dutch medical center that sponsored my TED Talk in 2011. In particular, he’s head of their REshape Innovation Center … it’s fitting that @REshape’s Twitter avatar is a kid with a spyglass looking to the far horizon … far, but visible.

A post you should read:

Lucien’s just written a post on LinkedIn with his vision of what’s on the horizon and what is changing, now, already. It’s a short post but it’s a dense learning experience, with dozens of relevant links and a half hour of embedded YouTubes. Lucien’s view of the horizon is (a) different from most observers’, and (b) firmly grounded in what REshape is already doing, so this is not a distant pontificator’s view, it’s from the trenches, feet on the ground. With spyglass.
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A declaration of the future of caring: careful, kind, “minimally disruptive”

KER "Treatment That Fits" diagram
The basic idea of minimally disruptive medicine (from minimallydisruptivemedicine.org)

To start 2016, a vision.

In 450 events in 14 countries, I’ve heard a lot of thoughts about healthcare: its challenges, its possibilities, why change is hard, and who should do what to make things better. Easily one of the most inspiring voices I’ve heard is Victor Montori at the Mayo Clinic’s “KER Unit” (Knowledge and Encounter Research Unit). Here are two resources to briefly introduce you to his work; another will come later this week.

One of his fundamental principles is what he calls “minimally disruptive medicine.” While so many articles in magazines and journals complain about patient “compliance” (i.e. doing what the doctor dictated),  the KER people are nearly obsessed by questions like “Will this work in the patient’s life??” and “Wait – is this what the patient really wants?” A great quick overview is on their home page.

In an email this morning Victor said:
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