e-Patient Dave

Power to the Patient!

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From TEDMED: What veterinarians like my wife know about medicine.

Photo of Ginny and "Chester"
Ginny and “Chester”

My wife Ginny is a veterinarian. Being a vet like her is different from being a human doctor in several ways:

  • Vets emphasize prevention, to avoid avoidable disease
  • For years many have offered “pet portal” software to view your records from home (let me Google that for you)
  • Treatment decisions are entirely up to the client (though there are certainly haughty vets who don’t like to be questioned)
  • Cost is always a consideration
  • To her the “patient” is not the same as the client
  • and many more.

But probably the biggest difference is embodied in the excellent talk below, from TEDMED 2014 in Vancouver, in which a “people doctor” gets called to consult … at a zoo … and discovers a world of new insights that have changed how she practices.

The amusing thing is that Ginny has always joked about how “people doctors” only have to know one species – and often only one system in that specialty – while veterinarians have to know all the systems in all the species they treat. (Eyes, heart, teeth, kidneys, you name it… not to mention variations like a dog or cat uterus having two “horns” (forks).) That difference turns out to be a joke at the end of this.

It’s a thought provoking 18 minutes. Enjoy.  (Email subscribers, if you can’t see it, click here to come online.)

Here’s a link to the Zoobiquity conference she mentions, where vets and people docs share thoughts. That would be fun to attend. Check out the site – its banner asks, in sequence:

  • Do beluga whales get breast cancer?
  • Do dragonflies get obese?
  • Do pandas get eating disorders?
  • Do flamingos get heart attacks?
  • Do koalas get STDs?

Then, this … check out the intersection:

Zoobiquity screen shot: "Yes they do!"

p.s. This talk is part of a new list created on LinkedIn by Dutch colleague Lucien Engelen, 10 TED Talks that change(d) healthcare. You can read it there, or you can watch it as a YouTube list. But this one isn’t on that list.)

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“Activate your super-patient powers”: Public event (free!) at Brown next Monday

Superpatient flyer screen capture
Click to view & download the PDF (459k)

For years I’ve been saying that this movement won’t really be creating change until it gets out of the conference world and reaches Main Street. (Often I say we won’t really be getting there until the people you meet at the grocery story know what we’re talking about.)

So you can imagine how thrilled I am that Brown University in Providence, R.I. is supporting a first-of-its-kind grass roots event next Monday night, attached to a session I’m teaching the next day for one of their courses.

We’re playing with the idea of tying this to “how superheros got their superpowers” – the so-called “origin story,” like Peter Parker and his radioactive spider – to help people see that they may be capable of more than they realized. And in that context, we realized we have three different types of “superpatients”, who will present:

  • Acute care, like my kidney cancer – it came up suddenly (and now it’s over)
  • Chronic care – people who manage a chronic condition, like famous diabetes blogger Kerri Sparling (@SixUntilMe)
  • Crisis care – patients or caregivers who step up in a crisis and do everything they can to help, exemplified here by Pat Mastors (@PMastors).

These cases are all very different but they have a common thread: when patients get activated they can make a huge difference.
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This event all came together very quickly, so I apologize for the last minute nature of this notice. If you can come, that’ll be great. In any case, feel free to download this PDF or just send people this link.

If this gets great reviews, I hope to do more. If it doesn’t, we’ll fix it. Because from now on it’s “game on” – let the change take root!
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The course where I’m speaking is Brown’s Executive Master in Healthcare Leadership program – a year-long course for mid-career executives. Tuesday is their final session of the course. Thank you to Angela Sherwin and Judith Bentkover for their vision, and to Brown’s program for helping make this happen!

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Speaker Academy #19 (getting paid), cont’d

Update Nov. 20: overnight I received a courteous and complete reply. The funds have now been sent, and my bank seems to have been part of the problem, since a month ago. It would have been useful to know that – without that information there was no way for me to help. I’ll update again as the situation proceeds.
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This is the latest in the Speaker Academy series, which started here. The series is addressed to patients and advocates who basically know how to speak on a subject but want to make a business out of it. I’ll try to be clear to all readers, but parts may assume you’ve read earlier entries.

In #16 (January) I said “For a small business, cash is king.” Then in June, #19 was titled: “What’s up with expense checks??”  To a small business (like a patient starting a speaking business), this is no small issue, and any event that wants to say it’s patient-centered needs to see things from the patient’s point of view. In #19, citing a then-current overdue item, I said:

I’ve used my own methods (very specific communication) for months now, and it’s not working. So, starting tomorrow, I’ll do the blogging that I said (in #16) I’ve never had to do: I’m going to paste in the entire email thread from the current worst offender, with no names attached. And if the money hasn’t arrived by Friday, the names get added. (Their next scheduled check run is Thursday, and I’m sure they know how to use Fedex.)

All those past due items cleared up within a month, through diligent management of each item (by my assistant Kristin and me). That takes more time, costing my business extra resources – exactly as described in #16: they keep the money, I lose interest, and I also expend more to get what they owe me. Most definitely a case of one party not keeping their side of the deal.

But today I received one of the worst examples ever. [Read more…]

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Notes for @BCPSQC #QualityChat Twitter chat

BCPSQC web logoFor Wednesday’s “#qualitychat” Twitter chat here are a few notes.

A few notes from participants at the February event

  • “The BC Cancer Agency has led a provincial project asking patients for solutions to some of the lower Provincial Cancer Care Patient Experience scores.  It is a project to listen to the patient voice and implement some solutions that came from patients and their families. … [We have been] inspired to come together as a province to have a provincial approach and also, look at solutions that patients suggest. ” Sue Fuller Blamey Corporate Director, Quality & Safety, Provincial Health Services Authority and BC Cancer Agency
  • Let Patients Help “was sent to all Community Engagement Advisory Network members … It is also a resource that we like to share in our day to day work now.” Saori Yamamoto Community Engagement Advisory Network Co-ordinator, Vancouver Coastal Health
  • “It really brought things back to the patient and showed us THEIR perspective on healthcare.  One thing that really stood out for me what the emphasis on including patients as partners in their own care, full members of the care team.  It challenged the all-too-common thinking that they are just unknowing recipients of the care that “the experts” decide is right for them and showed that, not only are many of them intelligent and able to participate in the conversation and decision making, but also (and perhaps more importantly), that they are real partners in it, with as much knowledge and information to share re: the “problem” as anyone else on the team.” From a Quality Improvement Consultant
    • Note how this echos the thinking of the Mayo Clinic’s chief residents in this post

Post-event summaries

In less than an hour, moderator @Kevin4Quality (Kevin Smith) posted the after-event resources!

Thanks again to all for a great event!

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“A union of forces between providers and patients”: Mayo chiefs name a patient as 2015 Visiting Professor

Boy, is this a thrill: the Chief Residents at the Mayo Clinic have invited me to be their Visiting Professor in Internal Medicine next March.

A patient. As Visiting Professor.  Is that a sign of the changing times?? The announcement is being made today, during the patient panel at Mayo’s sixth annual social media summit. Here’s their post, including a four minute video interview.

Here’s their press release – their words – then I’ll discuss below.


“A union of forces between providers and patients”:
Mayo chiefs name a patient as 2015 Visiting Professor

[Read more…]

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How great and bad “experts” treat you in Mac care – and lessons for medicine

Henry Feldman
The great: Dr. Feldman (no photo of Eli is to be found!)

For the past year I’ve had a disastrously bad experience as a Mac user, to the point where I had long Facebook discussions on how to select a Windows “ultrabook” – super thin and light, like my current Macbook Air. The final (at last!) happy outcome, just last month, shows the difference between two things that are vital in medicine too:

  • Capable wizards vs clueless goons
  • A caring approach, listening to the person who has the problem, and honoring his (my) observations and concerns.

Ultimately a friend at Beth Israel Deaconess (a doctor!!), Henry Feldman, and his colleague Eli Kaldany, figured out what my problem was – in August, nine months into the problem. (They saw me bitching on Facebook.) They nailed the problem in less than an hour. And, ironically, when another problem happened in September, I finally found someone capable at Apple – and discovered a bit of news I’ll share in a moment. [Read more…]