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Patient Engagement Is Here to Stay
PREPARED PATIENT BLOG | January 15, 2015 | Jessie Gruman
Jessie Gruman founded the Center for Advancing Health in 1992 and served as president until her death in 2014. After over 20 years under her remarkable leadership, CFAH ended operations in December 2014. This post was Jessie's final essay announcing the release of CFAH’s last patient engagement research report and sharing some personal reflections on her career...

Center for Advancing Health Announces Two New Awards to Honor Jessie Gruman
PREPARED PATIENT BLOG | January 7, 2015 | Center for Advancing Health
The Board of Trustees of the Center for Advancing Health (CFAH) is pleased to announce that two new awards honoring the late Jessie Gruman’s exemplary leadership in the field of patient engagement have been established at the following distinguished organizations: the Society for Public Health Education, Inc. and the National Coalition for Cancer Survivorship. A third organization, the Society of Behavioral Medicine (SBM), received additional funding from CFAH to extend its Jessie Gruman Award for Health Engagement, which was established in 2014...

Six Things Health Care Stakeholders Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | December 23, 2014 | CFAH Staff
In July, CFAH released its final report on the state of patient engagement in the U.S., Here to Stay: What Health Care Leaders Say about Patient Engagement, a collection of interviews with 35 key informants from seven groups with an interest in patient engagement. We asked health care leaders to define patient engagement, explore its impact and barriers, and share promising interventions. Six key themes emerged from our discussions...

Patient Engagement – We Have Become Our Parent
PREPARED PATIENT BLOG | December 19, 2014 | Kate Lorig
Jessie defined patient engagement as "the actions we take to support our health and to benefit from health care." As I reflect on this, I see that we have come to a crossroads. Jessie can no longer lead us and the organization she formed, CFAH, will soon cease. Now is the time for us to let our voices continue the discussion and to push the patient engagement agenda forward. Are we ready?...

Jessie Gruman Memorial Fund to Advance Patient Engagement Through New Center at the George Washington University Cancer Institute
PREPARED PATIENT BLOG | December 15, 2014 | Center for Advancing Health
After over 20 years under the remarkable leadership of the late Jessie Gruman, the Center for Advancing Health is ending operations at the end of 2014. To expand on the CFAH body of work and enrich the growing interest in the field of patient engagement, the CFAH board of trustees has selected a proposal from George Washington University to establish the Center for Patient Engagement at the GW Cancer Institute. This gift was made possible by the generous contributions to the Jessie Gruman Memorial Fund.

Asking Patients to Advocate for Their Own Safety Is Not Very Patient-Centered
PREPARED PATIENT BLOG | November 24, 2014 | Marc-David Munk
Imagine, for a moment, if we expected passengers to "have a dialogue" with airline pilots prior to a flight. Is this something we'd consider admirably "passenger-centered?" What about "patient empowerment" materials which ask patients to confront caregivers who don't wash their hands? It's a bad turn of events when we ask patients to ask providers to avoid dirty hands and unnecessary care...

Lying to the Doctor
PREPARED PATIENT BLOG | November 10, 2014 | Anne Polta
Why are patients sometimes less than forthcoming? The top reason, according to a new survey, is fear of being lectured or feeling embarrassed. If doctors want their patients to be honest, they need to make an effort of their own to create a trusting, non-threatening environment that encourages patients to open up...

Should You Trust Your Doctor's Advice?
PREPARED PATIENT BLOG | November 4, 2014 | Michael Kirsch
Should you trust your doctor? Absolutely. But you need to serve as a spirited advocate for your own health or bring one with you. And most importantly, try as best as you can to verify that the proposed solution is targeted to your problem...

Is Your Doctor Talking to Your Other Doctors?
PREPARED PATIENT BLOG | October 28, 2014 | Carolyn Thomas
We'd all like to believe that the average physician would have some clue about a medical crisis happening within a family she's been caring for during the past three decades. But it ain't necessarily so. If you've ever been discharged from a hospital by one doctor only to later be readmitted to the hospital under a different doctor's care, you may be surprised to learn that those doctors are not likely talking to each other...

What to Do If the Doctor Just Shrugs
PREPARED PATIENT BLOG | October 27, 2014 | Bonnie Friedman
As patients we want an answer and a treatment – if not a cure – for what ails us. But sometimes the doctor doesn't know what's wrong, which isn't as rare as we might think. All too often, patients or their families must take charge of their own medical management. Doctors, after all, are human, and some are better diagnosticians than others. Here are some things to do if you or a loved one is struggling with an undiagnosed condition...

Have You SEEN Your Options? Patients Should Make Safe, Effective, Economical, Necessary Choices
PREPARED PATIENT BLOG | October 2, 2014 | Wendy Lynch
My friend Jane is quite a perfectionist, at least usually. I was almost certain that if she was having work done on her kitchen, she would be getting competitive bids, asking for references and reviewing vendors. But not for her shoulder surgery. Perhaps we need a concise mantra for what it means to be a health care consumer...

'Be a Prepared Patient' Gets a New Look
PREPARED PATIENT BLOG | October 1, 2014 | CFAH Staff
Finding good health care and making the most of it is critical for each of us. Yet all too often, reliable, unbiased information is hard to find and understand. On the redesigned Be a Prepared Patient website, we have collected trusted resources and tips to help people navigate their way through health and health care decisions and experiences...

Prepared Patient Now on Twitter
PREPARED PATIENT BLOG | September 24, 2014 | CFAH Staff
Today, CFAH launched @PreparedPatient, a new Twitter feed featuring trusted tips, resources, stories and news to help followers find good health care and make the most of it. Prepared Patient was created by the late Jessie Gruman and continues the themes of @JessieGruman tweets...

Are Medical Checklists Bad for Your Health?
PREPARED PATIENT BLOG | September 15, 2014 | Leana Wen
Checklists are routine in other professions to standardize management, and we know they can prevent hospital infections and surgical error. But can there be a downside to checklist medical care? Consider these two examples...

What Health Care Consultants Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | September 10, 2014 | CFAH Staff
"At the end of the day, there is a growing recognition that we need people to take better care of themselves. Too much money is being spent on the consequences of unhealthy choices and on health care. We don't think that patient engagement is just the flavor of the week. The concept of how we can take more responsibility for our health and health care is not going away." – Janice Prochaska, PhD, President and CEO of Pro-Change Behavior Systems in South Kingstown, RI

The Use and Usefulness of Doctor Ratings
PREPARED PATIENT BLOG | September 3, 2014 | CFAH Staff
What's the best way to choose a new doctor? We can ask friends, family, or our current doctor for a referral. We can pick the provider who's closest to our home or office. We can look them up online and read their reviews. But research finds that online physician ratings are far from perfect...

'I No Longer Have to Go to See the Doctor': How the Patient Portal is Changing Medical Practice
PREPARED PATIENT BLOG | September 2, 2014 | Charlie Smith
Not long ago, the only options my patients had for communicating with me were to come in to the office or relay a message through the office staff. But since recently introducing the patient portal in our electronic medical record, my practice has changed substantially for the better...

What Patients Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | August 27, 2014 | CFAH Staff
"There's a prevailing attitude on the side of clinicians that looking for and using [our own] information is not good behavior on our parts. I think that attitude is a big barrier; people don't want to be seen as troublemakers for asking too many questions, disagreeing with a clinician, or bringing information to the table." – Kelly Young – Patient Advocate, President of the Rheumatoid Patient Foundation, and Founder of Rheumatoid Arthritis Warrior blog

Why I Fired My Doctor and What You Should Look for in Yours
PREPARED PATIENT BLOG | August 25, 2014 | Donna Cryer
My new doctor and I clashed in every way. The short story is that I found another doctor who was a better fit for my "patient style." So what can you learn from my experience? First off, here are two questions you should ask yourself...

What Health Insurers Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | August 20, 2014 | CFAH Staff
"Most health plans view engagement as important and want to support it. But they recognize that they are only one (relatively weak) factor in supporting patient/consumer engagement... Their customers want their insurance premiums going to medical care, not a bunch of mailings about things they already know they should do..." – Arthur Southam, MD – Executive Vice President of Health Plan Operations, Kaiser Foundation Health Plan, Oakland, CA

What Policy Makers Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | August 13, 2014 | CFAH Staff
"Since patients don't live in a vacuum, we must also involve the community in which patients live, work, and play. Community resources must be readily available to meet the needs of the population they serve. Also, as we begin to have patients and families engaged in their care and talk to peers and extended family members, they begin to model engagement to others. We are looking for 'engaged communities.'" - Jean Moody-Williams - Group Director, CMS Quality Improvement Group, Baltimore, MD

What Employers and Purchaser Representatives Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | August 6, 2014 | CFAH Staff
"Employers have an opportunity to reduce barriers and support engagement because they sponsor health plans and can provide access to information, tools, technologies, incentives, and more. Employers have more ability to influence engagement than they often believe they have." – Michael Vittoria, Vice President, Corporate Benefits, MaineHealth, Portland, ME

Seven Things You Can Do to Help Reduce Prescription Errors
PREPARED PATIENT BLOG | August 4, 2014 | Margaret Polaneczky
I just got off the phone with a very upset patient who discovered that her pharmacy has been giving her the wrong medication for the past five months. Despite all our fancy technology and advances in health care, medication errors can and will occur. So what can you do, as a patient, to be sure that your prescriptions are correct?...

What Community Health Leaders Told CFAH About Patient Engagement
PREPARED PATIENT BLOG | July 23, 2014 | CFAH Staff
"When I think of patient engagement, I think of a partnership where people work together to figure out what the patient wants and how to support the process. Engagement is the knowledge base, working through the decisions and helping people to become full partners in their health outcomes." – June Simmons, MSW — Founding President and CEO, Partners in Care Foundation, San Fernando, CA

A Patient Responds to What 'Experts' Say About Patient Engagement
PREPARED PATIENT BLOG | July 14, 2014 | Carolyn Thomas
I was one of the patients interviewed for the recently published Center for Advancing Health report called "Here to Stay: What Health Care Leaders Say About Patient Engagement". It's an interesting, illuminating and frustrating document to read. My concern, as a person who's pretty darned engaged in my own health care, is not that the phrase is meaningless. It's more that non-patients have co-opted the concept of patient engagement for their own purposes...

What Physicians Told Us About Patient Engagement
PREPARED PATIENT BLOG | July 9, 2014 | CFAH Staff
"Being engaged in our health and health care makes the most difference to us as individuals. Our actions need to reflect our own goals, our values and preferences, and what we are willing and able to do to achieve them," says Rushika Fernandopulle, MD, Co-Founder and CEO of Iora Health.

Patient Engagement: Here to Stay
PREPARED PATIENT BLOG | July 1, 2014 | Jessie Gruman
What is patient engagement and what does it take to accomplish? With the support of the Robert Wood Johnson Foundation, CFAH set out to explore this concept as it was viewed by various diverse stakeholders. Our interviews with 35 key health care stakeholders lead to an impressive unity of opinion...

All You Do Is Complain About Health Care
PREPARED PATIENT BLOG | June 25, 2014 | Jessie Gruman
"All your Prepared Patient essays do is complain about your health care and your doctors. That's why I don't read them." Yowzah! Do I really complain? Not to be defensive, but I don't think so. Every week I work to vividly describe insights that might shine a little light on this project that patients, caregivers, clinicians and policymakers – well, the list goes on – share of trying to make health care more effective and fair...

Not So Easy to Stop Care When the Patient Is a Loved One
PREPARED PATIENT BLOG | June 16, 2014 | Margaret Polaneczky
To those of us who have had a loved one succumb to cancer, who had to negotiate the frightening choice between the rock and the hard place, always holding out hope for another round of chemo...we know that reining in health care costs will mean more than just raising co-pays and lowering drug costs and funding more effective interventions. It will also mean quashing hope. And learning to tell ourselves the truth...

Ask Questions Before Surgery. You May Save Your Own Life.
PREPARED PATIENT BLOG | June 9, 2014 | Heather Thiessen
I am wheeled into the operating room and walked to the bed. As I get to the table I am so cold and nervous, I begin to shake. I lay down on the operating table, thinking it seems very narrow and hoping I don't fall off. I hear one of the nurses say, "We have the Heparin ready for the new port." I freeze. I lift my head and say, "I'm allergic to Heparin." The anesthesia I've been given kicks in at that point and I drift off to sleep, hoping things go all right...

Entitlement: The Overlooked Dimension of Patient Engagement
PREPARED PATIENT BLOG | June 4, 2014 | Jessie Gruman
What does it means to be an "engaged" patient in the VA system today? It seems you have to know a senator who will intervene on your behalf, to give your health care a priority higher than his other constituents. This is deeply discomforting, and I hate that I am treated in a health care system where even those who are most accountable for the quality of the care it provides (the institutional leaders) can't trust the institution or the professionals who work there to routinely and uniformly deliver excellent care...

Preventing Medical Harm: Alyssa's Story
PREPARED PATIENT BLOG | May 29, 2014 | David Mayer
Carole Hemmelgarn is a hero. In the video that follows, Carole poignantly shares her daughter Alyssa's story, and why their family's loss has been the driving force behind the change Carole is fighting for: the delivery of safer care for all patients and families...

Getting Good Care: 'I Wish It Were More Newsworthy. I'm Afraid It's Not.'
PREPARED PATIENT BLOG | May 21, 2014 | Jessie Gruman
Unfortunately, the nitty gritty of getting good care is not really newsworthy, unless we're talking about how poor it is. However, there are opportunities for journalists and writers to report "news you can use" that would be very helpful to many people, and there is a big gap in reporting on most of these necessary tasks...

Medication Cocktails: Not Every Mix Is Safe
PREPARED PATIENT BLOG | May 5, 2014 | CFAH Staff
One in every five older Americans takes medications that work against each other. And some interactions between prescription drugs and supplements can pose dangerous health risks. So what must we do to make sure that we benefit from the drugs we take?

Society of Behavioral Medicine Announces Inaugural 'Jessie Gruman Award for Health Engagement'
PREPARED PATIENT BLOG | April 30, 2014 | CFAH Staff
Dedicated to promoting behavioral medicine research and the application of that knowledge to improve the health and well-being of individuals, families, communities and populations, Society of Behavioral Medicine created this award to recognize an individual who has made a pivotal contribution to research, practice or policy in the field of health engagement.

When an Advocate Becomes a Patient
PREPARED PATIENT BLOG | April 28, 2014 | Bonnie Friedman
A recent clumsy mishap at the gym landed me in the emergency department. Lying in the hall, feeling hapless and helpless, I was in no position to make any important health decisions, had they been needed, or to remember anything important that might have been said. Later, I understood on a deeply personal level the need for a patient advocate...

Are We Cowboys or Managers of Our Chronic Conditions?
PREPARED PATIENT BLOG | April 23, 2014 | Jessie Gruman
The word "management" raises images of organizational charts and neat project timelines. This bears no relationship to my experience of trying to live a full, rich life with serious chronic disease. My image of having a serious chronic disease is of a cowboy riding a rodeo bull. You call that management? No. But it gives you a pretty good idea of what it feels like to have a serious chronic disease. This is our experience...

Self-Monitoring Health IT Falls Short of Providing the Information We Need
PREPARED PATIENT BLOG | April 16, 2014 | Jessie Gruman
Yes, there are some data-fan, quantified-patient types out there. But most of us are not enamored of monitoring bits and bytes of our biophysical functioning. So perhaps we can turn our attention toward patients' more immediate concerns of having the right information at the right time in order to care for ourselves and those we love...

On Each Other's Team: What We Can Learn by Listening to Older Adults
PREPARED PATIENT BLOG | April 10, 2014 | Chris Langston
If there is a population in which we have the biggest opportunity to see improvements in both cost and quality of care outcomes, it is older Americans. The debate on how best to deliver effective primary care has gone on a long time, sometimes frustratingly so, but it has almost never included a crucial constituency: older adults. The John A. Hartford Foundation is pleased to help change that...

How to Make the Most of Your Doctor Visit
PREPARED PATIENT BLOG | April 9, 2014 | Jessie Gruman
Over the years, we've listened to hundreds of people discuss their experiences with their health and health care. One thing that seems to come up for many people is how hard it can be to find good care and make the most of it, which includes knowing what to do at a doctor's appointment. The following tips can help...

Shared Decision Making: Blending Beliefs and Attitudes With Evidence
PREPARED PATIENT BLOG | April 7, 2014 | Don S. Dizon
My patient, Mary, was a 28-year-old woman who had completed chemotherapy for stage II breast cancer. After discussing surveillance, frequency of follow-up and ASCO guidelines, I recommended against further testing or imaging. Mary was well aware of the evidence, but she had different plans...

Working With Your Doctor's Office
PREPARED PATIENT BLOG | April 2, 2014 | Jessie Gruman
It is common for those who work in and deliver health care to overestimate our knowledge about our bodies, our illnesses and how the health care system works. Such as: Who is the nurse practitioner? Where is Dr. X's office? When is "soon"? Why are you recommending this test? To help people find good health care and make the most of it, the following video explains two key things to ask when making your appointment and three questions to get answered before you leave your doctor's office...

'Everybody Has Plans 'Til They Get Punched in the Mouth'
PREPARED PATIENT BLOG | April 1, 2014 | Carolyn Thomas
In boxing terms, this is completely literal, sound advice. As a figurative metaphor for illness, it's not bad, either. Because no matter how competent, how smart, how resourceful we may think we are before a catastrophic health crisis strikes, many of us may suddenly feel incompetent, ignorant and helpless when thrust inexplicably into the stress of such formidable reality...

Costs Complicated Dad's Cancer Care
PREPARED PATIENT BLOG | March 31, 2014 | Laura Sander
"I walked in a person, and out a cancer patient," my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine – the side on the exam table or gurney, as opposed to the one standing over it. In time, it became clear we were running out of money...

The Goldilocks Approach to Our Health Knowledge: How Much Is Just Right?
PREPARED PATIENT BLOG | March 26, 2014 | Jessie Gruman
Most professional health care stakeholders believe that the more we patients and caregivers know about our health and diseases, the better our outcomes will be. When faced with the facts about our health risks and dangerous habits, they think we will rationally change our behaviors and correct our misunderstandings. As a patient, I want to know: At what point do I know enough to reap these hypothetical benefits?

When a Loved One Is Hospitalized
PREPARED PATIENT BLOG | March 24, 2014 | Bonnie Friedman
My husband has been in the hospital 14 times over the past 24 years. What I've learned is that my role as advocate is just as important to his recovery as the roles of doctors and the nurses. You may not have a medical degree, but you have intelligence and instincts...

My (Un)prepared Patient Story
PREPARED PATIENT BLOG | March 19, 2014 | Jessie Gruman
I'm impressed with the health care that is now available to treat diseases that – even a decade ago – were a death sentence. And I'm so very grateful for them. But we and our doctors and nurses often overlook just how much the success of these tools depend on our active, informed participation. And many of us don't fully understand what it takes to participate well in our care...

Is a Daily Dose of Many Pills in Your Future?
PREPARED PATIENT BLOG | March 17, 2014 | Andrew Schorr
I recently had breakfast with an aging cousin, Walter, who has become infirm in his senior years. I knew he had several doctors and took medicine. It wasn't until breakfast time, however, that I realized how many medicines Walter took – and I was bowled over...

Common Bias Ignored: Patients and Families Lose
PREPARED PATIENT BLOG | March 12, 2014 | Jessie Gruman
There's a pesky cognitive bias that creates a honking big barrier to patients and families making the most of the health advice and services available to us. It's the tendency of experts to overestimate the knowledge of others. Given my current, frequent brushes with health care, I experience this all the time: "Just go to the lab and ask them," I'm told by my chemo nurse. I think: Huh? What lab? Where? Ask who? The effects of health stakeholders' overestimation of our knowledge are profound...

Look Who's Coming Between You and Your Doctor
PREPARED PATIENT BLOG | March 11, 2014 | Trudy Lieberman
Opponents of health care reform, especially those who resist moving to a single payer system like Canada’s, have often used a very powerful argument to sway public opinion. Any significant changes, they warn, to America's private insurance system would mean that the government will come between patients and their doctors by making decisions about the care Americans receive. But what if it's not the government that is inserting itself between you and your doctor?

What Is Patient-Centered Medicine, Really?
PREPARED PATIENT BLOG | March 10, 2014 | Barbara Kivowitz
We have all heard the term patient-centered medicine by now. It's in the PR materials for hospitals, in the Affordable Care Act, in health care model innovations like the "medical home" and the "accountable care organization." But what is it? What would you like to see in a health system that is truly patient-centered?

Medication Adherence: Shift Focus From Patients to System
PREPARED PATIENT BLOG | March 5, 2014 | Jessie Gruman
National conferences aimed at solving the problem of our wide-scale non-adherence to prescription medications feature expert reports about our misbehavior and bewail the huge number of us who fail to adhere to the ideal schedule. Then each conference gives plenty of airtime to more experts describing smart pill bottles, apps that nag at us, and how patient communities can provide important information about our drugs since our clinicians rarely do. Enough with blaming patients for our approach to taking our (many) medications...

Engagement From Patients' Perspective: Different Than Docs, Employers, Health Plans
PREPARED PATIENT BLOG | February 26, 2014 | Jessie Gruman
The Prepared Patient Blog published over two hundred articles in 2013 about what it takes for people to get the most from health care and how the system can be improved to make it feasible for us to do so. Here's a recap of what engagement looks like to us – whether we are sick or well, whether we are caregivers or loved ones: Engagement is not easy and we can't do it alone. Patient engagement is not the same as compliance. It is not a cost-cutting strategy, and it is not one-size-fits-all.

Confessions of a Non-Compliant Patient
PREPARED PATIENT BLOG | February 24, 2014 | Carolyn Thomas
Most days, I have learned to function pretty well. But take a few unexpected health challenges, no matter how minor they may seem to others, arriving at the same time and piled onto an already-full plate and you have an explosion of overwhelm that looms larger than the average healthy person could even imagine. I've become a non-compliant patient...

Patients Unlikely to Deliver on the Promise of Price Transparency
PREPARED PATIENT BLOG | February 19, 2014 | Jessie Gruman
The idea that knowing the price of our care will encourage us to act like wise consumers is a hugely popular topic on blogs, in editorials and in the news. But relying on access to price information to drive changes in our health care choices is full of false promises to both us and to those who think that by merely knowing the price, we will choose cheaper, better care...

Is Your Doctor Paying Attention?
PREPARED PATIENT BLOG | February 13, 2014 | Carolyn Thomas
The $800 bottle of meds in my bathroom cabinet is a powerfully expensive reminder of my (former) family physician's lapse in attention – and my own lapse in catching her error. She'd somehow accidentally doubled both the dosage and the number of times per day to take these meds. How is this even possible? Somebody is not paying attention...

The Limits of Physician Referral in Finding a New Doctor
PREPARED PATIENT BLOG | January 29, 2014 | Jessie Gruman
I've always assumed that the best way to find a new doctor or specialist – preferably within my health plan – was to rely on the advice of a doctor whom I know and trust, who knows my health history and understands what kind of expertise my condition requires. Recently, I have come to question that assumption...

What Does It Take to Get 'Better Living Through Medications' These Days?
PREPARED PATIENT BLOG | January 15, 2014 | Jessie Gruman
Lately, the public's faith in the safety of prescription and over-the-counter drugs has been making me uneasy. Why do so many of us continue to purchase pills that are not effective in causing weight loss, swallow syrups that promise to cure diabetes, and fiddle with our medication-taking regimens?...

It's Time to Stop Blaming the Patient and Fix the Real Problem: Poor Physician-Patient Communication
PREPARED PATIENT BLOG | January 14, 2014 | Stephen Wilkins
If hospitals, health plans and physicians expect patients to change their behavior, they themselves have to change the way they think about, communicate and relate to patients. As a first step, I suggest that they stop blaming patients for everything that's wrong with health care...

More Chronically Ill People Use Online Health Resources – but They're Not So Social, Pew Finds
PREPARED PATIENT BLOG | January 13, 2014 | Jane Sarasohn Kahn
Getting and being sick changes everything in your life, and that includes how you manage your health. For people focused on so-called patient engagement, health empowerment, and social networking in health, the elephant in the room is that most people simply don't self-track health via digital means...

Finding the Price of Health Care Services Remains Elusive
PREPARED PATIENT BLOG | January 9, 2014 | CFAH Staff
It's unfair to advise people to find out the price of a treatment when the price-transparency deck is stacked against them. So who will help patients find reliable price information and (hopefully) bring down the cost of care?

What Does Team-Based Care Mean for Patients?
PREPARED PATIENT BLOG | January 8, 2014 | Jessie Gruman
Team-based care has been endorsed by the professional organizations of our primary care clinicians, and there is a lot of activity directed toward making this the way most people receive their regular health care. What does this mean for us? It's not clear...

Who Can Represent Patients?
PREPARED PATIENT BLOG | January 2, 2014 | Kate Lorig
Many years ago, Alfred Korzybski wrote that "the map is not the territory". This distinction has implications for the role of patients' voices in health care planning and policy...

Advice for People New to Health Insurance (Part 7): Get the Most Out of Your Appointment
PREPARED PATIENT BLOG | January 1, 2014 | Be a Prepared Patient
In part seven of our series, we offer advice about how to make the most of your doctor's appointment. Here's what you should do before, during and after your visit...

Advice for People New to Health Insurance (Part 5): Do You Need a Yearly Checkup?
PREPARED PATIENT BLOG | December 30, 2013 | Be a Prepared Patient
In part five of our series, we look at the yearly check-up and offer resources for people who are trying to decide which preventive care services are right for them...

"We Are All Patients." No, You're Not.
PREPARED PATIENT BLOG | December 19, 2013 | Carolyn Thomas
I read recently about a medical conference on breast reconstructive surgery following mastectomy, to which not one single Real Live Patient who had actually undergone breast reconstructive surgery following mastectomy was invited to participate...

The N=1 Problem of the Patient Representative
PREPARED PATIENT BLOG | December 18, 2013 | Jessie Gruman
What can we learn from an experiment conducted on a single person? How relevant are results to other patients or populations or diseases? While most of us encounter a cascade of events throughout each of our illnesses, in the end, what we bring to the table is our experience through the lens of our own unique attitudes, beliefs and histories...

A Report on Doctor Report Cards
PREPARED PATIENT BLOG | December 17, 2013 | Carol Cronin
You've recently moved and need to find a new doctor. What's available online to help you learn about the quality of the doctors in your area?...

Patient as 'Captain of the Team'? Block That Metaphor
PREPARED PATIENT BLOG | December 11, 2013 | Jessie Gruman
You may have noticed an uptick in messages from your health plan or clinician notifying you that "You are the captain of your health care team." My response to this message? Bad metaphor.

Seven Things I Wish I'd Known Earlier About Cancer Survivorship
PREPARED PATIENT BLOG | December 4, 2013 | Jessie Gruman
It is challenging, in the years following a cancer diagnosis, to assemble health care that protects us from the lingering effects of the disease and its treatment and that alerts us to a recurrence or new cancer. I hope these reflections will help those who've been diagnosed with cancer live as long and as well as they can...

Should Patients Be Responsible for Physician Hand-Washing?
PREPARED PATIENT BLOG | November 26, 2013 | David Williams
For the past few years I’ve heard suggestions that patients should take a more active role in their health care by asking doctors to wash their hands. I strongly disagree...

Do “Experts” Value Patient and Family Input?
PREPARED PATIENT BLOG | November 20, 2013 | Jessie Gruman
Current efforts to make health care more "patient-centered" include inviting some of us to advise on research priorities, care organization and delivery under the assumption that, as patients, we understand what patient-centered outcomes and care are. What do patients know about the inner workings of health care, after all?

Doctors Don't Know What We Won't Tell Them
PREPARED PATIENT BLOG | November 12, 2013 | Colleen Crone
I'd said, "I know this isn't a big deal," when I meant "This is really bothering me." To be truly engaged patients, we have to give ourselves permission to say what we really mean.

Patient Engagement: On Meaning and Metrics
PREPARED PATIENT BLOG | November 7, 2013 | Leslie Kernisan
What is patient engagement? Everyone agrees it's a good thing and that health care providers should be fostering it. How to do so, however, depends on what you believe the term means. I offer a new definition...

We Are the New (Free) Health Care Workforce
PREPARED PATIENT BLOG | November 6, 2013 | Jessie Gruman
Outsourcing work to cheaper workers is a common strategy of corporations. It has largely escaped the public’s notice, however, that much of this new labor force isn't located in Southeast Asia, but is rather found here in the U.S. and is virtually free. It is us...

My BlogTalkRadio Interview: Patient Engagement
PREPARED PATIENT BLOG | October 30, 2013 | Jessie Gruman
Last week, I was interviewed by Dr. Pat Salber and Gregg Mastors on their BlogTalkRadio show, This Week in Health Innovation, about patient-centered care, patient engagement, shared decision making and the cost/quality trade-offs involved, and what all of this means for health care delivery.

Price Alone Is Not Enough: We Need Effectiveness Information Too
PREPARED PATIENT BLOG | October 23, 2013 | Jessie Gruman
When price enters into examination room discussions, even straightforward recommendations can get complicated. How can you decide if the price of treatment is worth it if you don't understand why your clinician recommended this particular course of action?

We Can Do Better
PREPARED PATIENT BLOG | October 22, 2013 | James Appleby
It's a scene that plays out daily in exam rooms across the country. The aging patient, accompanied by a caregiver, is seeing his or her physician and a discussion starts regarding the patient's memory.

Goldilocks Medical Care: Not Too Little, Not Too Much
PREPARED PATIENT BLOG | October 17, 2013 | Leana Wen
What can you do to ensure that you obtain just the right amount of care? It isn't easy — if it were, then we wouldn't have the Goldilocks problem: Is it too little? Too much? Here are five suggestions that may help...

Choice: The Secret Sauce of Patient Engagement?
PREPARED PATIENT BLOG | October 16, 2013 | Jessie Gruman
As a patient, I ask you: What aspects of my health care are not preference-sensitive? Even patients who have passed control to a trusted clinician or caregiver are eager to reclaim territory lost.

Latest Health Behavior News
PREPARED PATIENT BLOG | October 11, 2013 | Health Behavior News Service
In this week's health news: Patient-doctor relationship affects diabetes care | Women in Appalachia at risk for late stage breast cancer | People with asthma need not fear exercise | Treating depression helps some smokers quit...

Beware of Claims That Patient Engagement Cuts Costs
PREPARED PATIENT BLOG | October 9, 2013 | Jessie Gruman
It's a widely accepted truism that increasing patient engagement in health care leads to lower costs and better outcomes. And really, it shouldn't be a problem to convince us to act on our own behalf and engage in the behaviors that support health, right? I see two problems with this viewpoint and with the assertion that patient engagement will lower the cost of health care...

Accuracy of Health News: Pressure on Journalists, Consequences for Us
PREPARED PATIENT BLOG | October 2, 2013 | Jessie Gruman
What's your assessment of the health news and information produced by the media these days? Is it accurate? Useful? Interesting? Improving, or worse than five years ago?

Flu Shot Options: A Test of Patient Engagement?
PREPARED PATIENT BLOG | September 26, 2013 | Anne Polta
Talking about the flu vaccine used to be straightforward. But with the proliferation of vaccine options, it has become much more complicated. More options for consumers = better for everyone, right? Well...

Paying for and Managing Your Medications
PREPARED PATIENT BLOG | September 17, 2013 | Be a Prepared Patient
What people pay for medicine can vary widely. And a recent study found that 20% of Americans take five or more prescription medications. These 'Be a Prepared Patient' resources can help people pay for and manage their medications.

What Happens to the Other Half?
PREPARED PATIENT BLOG | September 17, 2013 | Paul Meyer
Only half of patients take the drugs as prescribed for them by their physicians. So what happens to the other half? And why does this costly problem continue despite efforts to improve patients’ adherence to prescription medications? There are many potential solutions, but not all of them are likely to become available...

Notes on Adherence: When Do I Feel Like a Patient?
PREPARED PATIENT BLOG | September 11, 2013 | Jessie Gruman
I'm always juggling more than one role, making second-to-second trade-offs depending on which is the most demanding at the moment. Becoming ill demands that we shift responsibilities around.

The Patient
PREPARED PATIENT BLOG | September 4, 2013 | Beth Nash
My doctor can help me figure out what is right for me by considering my values and preferences and helping me to understand the scientific evidence.

I Wish I'd Known Earlier...Each New Diagnosis Has Unique Demands
PREPARED PATIENT BLOG | August 28, 2013 | Jessie Gruman
Ever heard the saying "You never step into the same river twice"? It has taken me a long time to apply its meaning to my experiences with five different forms of cancer as well as a variety of serious late effects of my treatments...

I Wish I’d Known Earlier...Survivorship Care Is a Mutual Enterprise
PREPARED PATIENT BLOG | August 21, 2013 | Jessie Gruman
I wish I'd known earlier that survivorship care is neither a do-it-yourself project nor is it something that I can simply hand off to experts…As former cancer patients, we can't just walk in to our appointments with our oncologist, survivorship specialist or primary care doctor every six months or year and have survivorship care handled for us…

I Wish I Had Known Earlier...If Your Oncology Team Doesn’t Mention the Topic of Fertility, Then You Should Bring It Up Yourself
PREPARED PATIENT BLOG | August 20, 2013 | Marie Ennis OConnor
I was diagnosed with breast cancer at the age of 34. When I brought up the topic of fertility with my oncologist, I was presented with a stark choice between life-saving treatment or a chance at becoming a mother.

I Wish I’d Known Earlier...I Still Need a Primary Care Provider Since Most Headaches Aren’t Brain Tumors
PREPARED PATIENT BLOG | August 14, 2013 | Jessie Gruman
My experience has taught me that once active treatment is over, regardless of my tendency to regard every lingering ache or pain as a recurrence, if I’m getting my survivorship care from my treating oncologist or other survivorship specialist, I have to find myself a primary care clinician who knows my health history. Why?

Is the Most Important Prescription for Health Care Consumers a Dose of Healthy Skepticism?
PREPARED PATIENT BLOG | August 5, 2013 | Wendy Lynch
Here’s a wonderful idea: patients and providers working together in shared decision-making, accepting and trusting each other’s input. Isn’t that the goal our health care system should strive for? Not so fast.

Being Your Own Advocate
PREPARED PATIENT BLOG | August 2, 2013 | Angie Dresie
In 2010, I had surgery to remove a 2-inch heart tumor in my left atrium, the costs for which were astronomical, but that is not what I am writing about. I am writing about what happened in the months after my surgery and a cure that cost $9.19 if you don’t count all of the unnecessary doctor visits and procedures.

I Wish I Had Known Earlier...That For Many of Us, Symptoms and Late Effects Accumulate Rather Than Fade Over Time
PREPARED PATIENT BLOG | July 31, 2013 | Jessie Gruman
The side effects of cancer treatment sometimes fade but can become permanent glitches — disturbing symptoms whose impact we try to mitigate and whose presence we attempt to accommodate.

Patients Are Waiting to Partner: Invite Them to Participate
PREPARED PATIENT BLOG | July 30, 2013 | Tracy Granzyk
In a recent Baltimore Sun piece, healthcare writer Marie McCarren wrote an op-ed providing “A prescription for fewer medical errors” — reflections from an emergency room visit with her husband that later turned into a stay on the intensive care unit. McCarren emphasized the need for healthcare providers to work at clearly communicating the ways in which family members of patients can help make care safer.

Cumulative Burden: The Real Barrier to Adherence for Complex Patients?
PREPARED PATIENT BLOG | July 26, 2013 | Donna Cryer
Recently, I participated in an excellent meeting, (Patient Summit USA 2013), whose primary theme was patient adherence. Thankfully the other speakers had all moved beyond the notion that "patients forget to take their medication" and that adherence can be solved by fancy pill caps or bottles; yet I was struck that most did not yet fully appreciate the challenges of a complete adherence picture, particularly for patients on multiple therapies.

I Wish I Had Known Earlier...Not Every Oncologist Can or Should Deliver Survivorship Care
PREPARED PATIENT BLOG | July 24, 2013 | Jessie Gruman
We are not the only ones who must be convinced that we have unique health concerns following the active treatment of our cancer. Clinicians must also believe that special care for us is important, and they have to learn how to provide that care.

Patient Non-Adherence (Like Engagement) Is a Physician-Patient Communication Challenge – Not a Health Information Technology Challenge
PREPARED PATIENT BLOG | July 23, 2013 | Stephen Wilkins
Have you noticed all the articles in the health care press lately touting health information technologies’ ability to increase patient medication adherence? Smart phone-based apps, Smart pill bottles and Patient Portals are all about trying to get patients to do something (take a medication) which some physician somewhere has deemed to be the right thing for the patient to do. Some would call this process of generating adherence patient engagement.

Why This Family Doctor Blogs and Writes
PREPARED PATIENT BLOG | July 18, 2013 | Davis Liu
As a doctor, I am compelled to write because of what I know is occurring with alarming frequency in our country. Americans are skipping needed and recommended care that could save their lives and allow them to live to their fullest. Patients are more distracted, as life is more complicated and busier than ever. Households have both parents working, sometimes two jobs, just to make ends meet.

Patient-Centeredness Is the Intuitive Grasping of Health Care Quality
PREPARED PATIENT BLOG | July 15, 2013 | Aanand Naik
The key to improving the health outcomes of our older patients (and the overall quality of our healthcare system) is through re-investment in dialogue between patients and clinicians and a strengthening of trust within the patient-clinician relationship.

Choosing Hospitals Wisely (Is There Such a Thing?)
PREPARED PATIENT BLOG | July 11, 2013 | Leana Wen
Here’s a thought experiment presented a recent conference on healthcare consumer (ah hem, patient) advocacy. Let’s say that you’re told you need surgery of your knee. It’s an elective surgery to repair a torn knee ligament, the ACL. Your insurance covers part, but not all, of the cost. How do you choose which hospital to go to?

What I Wish I’d Known Earlier about Cancer Survivorship
PREPARED PATIENT BLOG | July 10, 2013 | Jessie Gruman
I have been treated for five different cancer diagnoses. Some would call me a cancer survivor. I call me lucky...

Latest Health Behavior News
PREPARED PATIENT BLOG | July 9, 2013 | Health Behavior News Service
This week in health news: Using shame to promote weight loss doesn’t work | Black nursing homes face challenges | Hispanic and Black children not getting the right asthma meds | Electronic health records not widespread

Haggling for Health Care
PREPARED PATIENT BLOG | July 2, 2013 | Naomi Freundlich
I’m not a big fan of bargaining and my half-hearted attempts to get a better price for a used car, garage sale find or contractor’s service have been mostly unsuccessful. There’s always that nagging feeling that the seller is laughing with delight once I’m gone, thinking, “I really pulled one over on that rube!” And so it has come as somewhat of a shock to me that medical care has become the new garage sale, as far as haggling goes.

Health Is Difficult When Solo: Will More e-Caregivers Help?
PREPARED PATIENT BLOG | June 26, 2013 | Jessie Gruman
Last week, both my husband and I came away from a conversation with my doctor positive that we understood my new weight-gain plan. Funny thing: Each of us recalled a different plan.

Consumer Health Information: Patient Engagement and Dead Cats
PREPARED PATIENT BLOG | June 19, 2013 | Jessie Gruman
Have you ever felt that claims about the effects of our access to new and more health information overshoot the mark?...Given the sheer volume of information online, you should be able to find robust information about each of these issues that could transform the way you care for yourself.

I’m Through Feeling Guilty for My Health Problems
PREPARED PATIENT BLOG | June 17, 2013 | Heather Thiessen
Have you ever felt like you needed to apologize for a health problem you were facing? I have experienced this often over my many years in the healthcare system.

Traditional Research Leaves Out a Critical Stakeholder: Patients
PREPARED PATIENT BLOG | June 13, 2013 | Leana Wen
What’s wrong with the following picture? Two medical researchers at a major academic center collaborate to study disease X. They come up with the research question, design the project, obtain grants, and collect data. Their results are published in a scientific journal and presented at several medical conferences. Based on this first study, the researchers start another cycle of idea generation, data generation, and publication.

Clinicians are from Mars, e-Patients are from Venus
PREPARED PATIENT BLOG | June 10, 2013 | Danny van Leeuwen
My experience is that e-patients and clinicians can agree that they seek "best health". Yet there is such a disconnect, such frustration, so much of the time. A pervasive gap exists between the way clinicians and e-patients approach this goal...

5 Lessons Inspire Learned from Its 5 Million Posts Written by Patients and Caregivers
PREPARED PATIENT BLOG | June 6, 2013 | Brian Loew
Recently, Inspire passed a milestone: five million posts written by the patients and caregivers in their online health community. Brian Loew, founder and CEO of Inspire, reflects on what Inspire’s learned from patients and caregivers.

‘How’ Trumps ‘What’ in Patient Experience Success
PREPARED PATIENT BLOG | June 4, 2013 | Jason Wolf
Since my last blog post where I stressed the need for our continued commitment to push the patient experience movement forward I have had a positive, life-changing experience. Early on Friday, April 19, as we were wrapping up Patient Experience Conference 2013, my wife called to let me know she was having contractions. "Nothing imminent," she calmly told me.

Eye to Eye: The Doctor-Patient Relationship in Stage IV Cancer
PREPARED PATIENT BLOG | June 3, 2013 | Lisa Bonchek Adams
Everything changes with a diagnosis of Stage 4 cancer. I don’t really think that’s an overstatement. My relationship with my oncologists has, by nature, changed as well.

Filling Out the Patient Chorus: Are We ONLY Victims, Heroes and Champions?
PREPARED PATIENT BLOG | May 29, 2013 | Jessie Gruman
Some of us are heroes, defiantly wearing stilettos to chemotherapy or battling our over-extended doctors to ferret out a cure for our or our mom’s disease. We want to demonstrate that with a ton of chutzpah, considerable energy and a little luck, we patients can overcome some of the limitations of health care and live to tell the tale. But is a portrait based solely on these types of experiences representative?

Patient Engagement? How About Doctor Engagement?
PREPARED PATIENT BLOG | May 28, 2013 | Carolyn Thomas
It’s a stressful time to be a patient these days, what with expectations running high that we should be both empowered and engaged while self-tracking every trackable health indicator possible – and of course retaining an all-important positive mental attitude – in order to change health care forever.

Is Patient Engagement a Set-Up for Failure?
PREPARED PATIENT BLOG | May 15, 2013 | Jessie Gruman
“Maybe we shouldn’t urge people to engage in their health care: it sets them up for failure and punishment from their clinicians.”

A senior patient advocate and researcher recently made this comment to a gathering of experts in patient engagement. For a few minutes, I was inclined to agree with her.

How Easily We Can Misinterpret the Benefits of Patient-Centered Innovation!
PREPARED PATIENT BLOG | May 8, 2013 | Jessie Gruman
Here's the bad news: We will not benefit from the health care services, drugs, tests and procedures available to us unless we pay attention, learn about our choices, interact with our clinicians and follow through on the plans we make together.

‘Healthy Privilege’ – When You Just Can’t Imagine Being Sick
PREPARED PATIENT BLOG | May 6, 2013 | Carolyn Thomas
What I’ve learned since my heart attack is that, until you or somebody you care about are personally affected by a life-altering diagnosis, it’s almost impossible to really get what being sick every day actually means…

The Best Health Care Decision is Realizing That There Are Choices
PREPARED PATIENT BLOG | May 2, 2013 | Wendy Lynch
Perhaps the most powerful influence we can have in health care is simply acknowledging that we have choices and wondering, out loud, what those might be. Whether or not you plan to do in-depth research about your treatment options, consider asking your doctor three simple questions.

The True Grit-tiness of Sharing Health Care Decisions with Our Doctors
PREPARED PATIENT BLOG | May 1, 2013 | Jessie Gruman
In the Coen brothers remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father. To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests then announces that she plans to come along. She figures she is prepared.

Bad Language: Words One Patient Won't Use (and Hopes You Won't Either)
PREPARED PATIENT BLOG | April 24, 2013 | Jessie Gruman
When I read Trudy Lieberman’s post yesterday, I was reminded that the highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services. But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service.

Whose Patient Engagement Goals Are We Talking About?
PREPARED PATIENT BLOG | April 17, 2013 | Jessie Gruman
What we look for when we participate actively in our health care differs from what our clinicians, employers and health plans believe will result when we shift from being passive to active participants. We don't have the same goals in mind. Does this matter?

Has Patient Engagement Stalled?
PREPARED PATIENT BLOG | April 10, 2013 | Jessie Gruman
A few discouraging reports on patient engagement have skittered across my desk in the past few weeks. What's going on? Why are so many of us so slow to engage in our care when it is increasingly clear that we will do better if we participate more fully? Here's what I suspect...

Self-Tracking Tech Revolution? Not So Fast…
PREPARED PATIENT BLOG | April 8, 2013 | Carolyn Thomas
When the report called "Tracking for Health" was released last month, media headlines announced: “Over Two-Thirds Track Health Indicators!” Surprisingly, very few headlines ran the real news from the report: “Only 21% Use Technology to Self-Track!” Yet as of last autumn, more than 500 tech companies are busy developing The Next Big Thing in self-tracking tools.

Health Care Consumers Are Compromised By Complex Information
PREPARED PATIENT BLOG | April 4, 2013 | Jane Sarasohn Kahn
Americans have embraced their role as consumers in virtually every aspect of life: making travel plans, trading stock, developing photos, and purchasing goods like cars and washing machines. That is, in every aspect of life but health care.

Patient Activation Is Only Half the Solution – Physicians Need to Be Activated as Well
PREPARED PATIENT BLOG | April 1, 2013 | Stephen Wilkins
Focusing just on what the patient brings to the party in terms of their “knowledge, skills and confidence” is only half the problem. What about physician activation?

What Do Patients Need From Clinicians?
PREPARED PATIENT BLOG | March 20, 2013 | Jessie Gruman
In response to their February issue, New Era of Patient Engagement, Health Affairs launched a new Facebook initiative to connect people with patient advocates. I was honored to kick off the Q&A series.

A Disconnect: What Hospitals Want You to Know vs. What You Should Know
PREPARED PATIENT BLOG | March 19, 2013 | Trudy Lieberman
The Association of Health Care Journalists (AHCJ) is making hospital inspection reports from the Centers for Medicare and Medicaid Services available at AHCJ’s new website www.Hospitalinspections.org. The site is not perfect, and there’s a lot of missing information, but still it provides some information about hospitals that has been lacking and offers a basis for asking questions.

Patient-Centered Care: It’s All in the Details
PREPARED PATIENT BLOG | March 12, 2013 | Trudy Lieberman
Having had one eye surgery a few months ago, I knew what to look for. But my patient experience was much different this time and made me aware of how many places in the chain of care where mistakes can occur.

The Team Will See You Now...What Team?
PREPARED PATIENT BLOG | February 27, 2013 | Jessie Gruman
Have you heard that soon most primary care in the US will be delivered by teams? Yep. Team-based care is one of the characteristics of the patient-centered medical home, a way of organizing the care of patients that allows primary care clinicians to see more patients in a day while at the same time delivering better care.

An Open Letter to Mobile Health App Developers and Their Funders
PREPARED PATIENT BLOG | February 13, 2013 | Jessie Gruman
Two recent experiences left me ornery and impatient about the current state of mobile health apps. Why haven’t they just taken off?

An Accidental Tourist Finds Her Way in the Dangerous Land of Serious Illness
PREPARED PATIENT BLOG | February 6, 2013 | Jessie Gruman
Health Affairs February issue, A New Era of Patient Engagement, selected my essay, An Accidental Tourist Finds Her Way in the Dangerous Land of Serious Illness, for its Narrative Matters piece. In the essay, I share experiences from my latest cancer diagnosis and call for policies to support patients and families with the increased responsibilities they face to find good health care and make the most of it.

5 Steps to Building a Great Partnership with Your Doctor
PREPARED PATIENT BLOG | January 24, 2013 | Leana Wen
The last time you went to your doctor, did you feel like he listened to you? Or did you feel ignored and left with more questions than answers?

Helping Patients Do the Work: Minimally Disruptive Medicine Tries to Right-Size Health Care
PREPARED PATIENT BLOG | January 10, 2013 | Janice Lynch Schuster
My husband is an insulin-dependent diabetic who has accumulated an array of chronic health conditions. I confess to days in which I play the role of diabetes cop'?¦I hate it when I do this, and yet it seems to be a role I have fallen into. But I had never thought of living with a chronic condition as a form of work until I interviewed Dr. Victor Montori.

Prepared Patient: Making a Pact With Your Doctors
PREPARED PATIENT BLOG | December 28, 2012 | Health Behavior News Service
Being a prepared patient means taking on some of the jobs 'big and small' that are necessary for staying healthy and coping will illness. Just like with any other job, it helps to have the job description clearly laid out before you start work. Your doctor may be expecting you to do certain tasks from filling prescriptions to changing your sleep or diet that can help you make the most of your care.

When You Fear Being Labeled a “Difficult” Patient
PREPARED PATIENT BLOG | December 10, 2012 | Carolyn Thomas
Most patients know what this feels like, so it’s reassuring to learn that academics are actually studying it: our fear of being labeled a “difficult patient”.

Comparative Effectiveness Research: Richard Birkel of the Center for Healthy Aging & NCOA
PREPARED PATIENT BLOG | December 5, 2012 | Richard Birkel
We believe that CER can be a valuable strategy to improve health care'?¦We are concerned, however, that older adults have often been excluded from clinical trials of drugs, medical devices and procedures.

Comparative Effectiveness Research: Donna Cryer of the American Liver Foundation
PREPARED PATIENT BLOG | November 20, 2012 | Donna Cryer
Patients are not opposed to comparative effectiveness research. I think they understand its value to health care decision-making. But physician-scientists and policymakers rightly perceive the inherent tension between personalized medicine and CER.

Comparative Effectiveness Research: Perry Cohen of Parkinson Pipeline Project
PREPARED PATIENT BLOG | November 14, 2012 | Perry Cohen
It would be nice to know if a treatment is totally worthless or that there are truly horrible side effects to a treatment or that a treatment really won't help slow the disease or relieve the symptom it's aimed at.

Patient Satisfaction: Quality, Cost and the New Rules of Engagement
PREPARED PATIENT BLOG | November 6, 2012 | Holly Korda
It's not enough for patients to be merely satisfied with their health care. Our expectations and perceptions of the patient experience vary widely, but at the end of the day what we seek is health care that is patient-centered: care that meets our needs. Patient-centered care requires patient engagement and self-efficacy, our active participation in our health and disease management.

Comparative Effectiveness Research: Mary Andrus of Easter Seals
PREPARED PATIENT BLOG | October 31, 2012 | Mary Andrus
Easter Seals sees CER as a real opportunity for good information about treatment choices. Wanting to always be person-centered, we hope CER can inform the choices of individuals and families made in consultation with their providers but that CER will not prescribe the treatment.

When Your Doctor Says, “I Have Bad News”
PREPARED PATIENT BLOG | October 30, 2012 | Jessie Gruman
In "When Your Doctor Says, 'I Have Bad News'" I offer advice on how to cope with a scary diagnosis - without getting caught up in the chaos of fear. Written by Jon Spayde for Experience L!fe magazine’s November issue.

Comparative Effectiveness Research: Maureen Corry of Childbirth Connection
PREPARED PATIENT BLOG | October 24, 2012 | Maureen Corry
Despite availability, evidence doesn't always make its way into practice. If we could implement what we know now about safe and effective maternity care, we would see rapid improvements in the quality, outcomes, and value of care for women and babies.

Patient Engagement: No App Can Take the Place of Good Old Conversation
PREPARED PATIENT BLOG | October 15, 2012 | Stephen Wilkins
Physicians, hospitals and other providers are being misled by industry pundits claiming that more health information technology (as in EMRs, PHRs, Smart Phone apps, and web portals) is the key to greater patient engagement. It'??s not.

Comparative Effectiveness Research: Venus Gines of Dia de la Mujer Latina
PREPARED PATIENT BLOG | October 10, 2012 | Venus Ginés
As a patient advocate, it's always good to know what the best treatment options are for our patients. As we continue to see so much fraud in research, there is mistrust about validity of data and the research itself relative to particular at-risk communities.

Comparative Effectiveness Research: Gail Hunt of the National Alliance for Caregiving
PREPARED PATIENT BLOG | September 26, 2012 | Gail Hunt
Gail Hunt is president and CEO of the National Alliance for Caregiving and serves on the Board of Commissioners for the Center for Aging Service Technology, the Governing Board of the Patient-Centered Outcomes Research Institute (PCORI), and the CFAH Board of Trustees. This is the third in a series of interviews between CFAH President and Founder Jessie Gruman and patient and consumer group leaders about their experiences with and attitudes toward comparative effectiveness research.

Getting Engaged
PREPARED PATIENT BLOG | September 24, 2012 | Elaine Waples
We hear inspiring things about patient engagement. The very concept has a hearty, spirited, do-right sound to it. After two years of cancer treatment, there are a few fundamental principles I think patient engagement should mirror.

A Year of Living Sickishly: A Patient Reflects
PREPARED PATIENT BLOG | September 13, 2012 | Jessie Gruman
The essays collected here reflect on what it felt like as a patient with a serious illness, to cobble together a plan with my clinicians that works and to slog through the treatments in the hope that my cancer will be contained or cured and that I will be able to resume the interesting life I love.

Online Health Information Finally Clicks
PREPARED PATIENT BLOG | August 22, 2012 | Jessie Gruman
Kristen Gerencher of The Wall Street Journal’s MarketWatch, recently interviewed me about internet users and online health information.

The Lemon of Illness and the Demand for Lemonade – “The Open Mind” Interview
PREPARED PATIENT BLOG | August 8, 2012 | Jessie Gruman
Richard Heffner, host of The Open Mind on PBS, interviewed me recently about what it’s like to be a patient in the midst of changes in health care delivery, advances in information technology and the implementation of new health policies.

Home Alone? Discharge Planning Starts at Hospital Admission
PREPARED PATIENT BLOG | August 1, 2012 | Jessie Gruman
“...If you need a wheel chair to take you to the door, I’ll call for one. If not, you can go home. Take care of yourself. You are going to do great!” Now I am a sucker for encouraging words, but right then, I panicked...It was 8:45 in the morning. My husband hadn’t yet arrived. I was free to walk out the [hospital] door.

Getting Over My Fear of Doctors
PREPARED PATIENT BLOG | July 31, 2012 | Heather Thiessen
Growing up, I was always in awe of my doctors. It was almost as if they lived on a cloud. You never ever questioned their expertise, and very rarely would you ask for a second opinion. Going to the doctor was a nerve-wracking experience, where you spoke only when they asked questions. I always wondered what would happen if I did question them. But I never did. I was too afraid.

Why I Write: A Doctor's Tribute to Her Mother
PREPARED PATIENT BLOG | July 23, 2012 | Leana Wen
My mother, Sandy Ying Zhang, is my role model and my inspiration for what I do every day. She was diagnosed with breast cancer when she was in her forties, and fought it courageously for seven years until she passed away in 2010.

What Does It Matter to You: Patient Activation and Good Health Outcomes
PREPARED PATIENT BLOG | July 20, 2012 | Janice Lynch Schuster
In our current health care environment, in which patients are sometimes discharged quicker and sicker, they are expected to be more in charge activated than ever. They need to make and keep follow-up doctor appointments, manage complex medication regimens, organize home health care and visiting nurse appointments, store powerful medications, and track, monitor, and report changes in their health status. It's a tough order, especially for people like my father, who do not know or understand the health care system, and find its workings difficult to navigate.

Consumer Ambivalence About Health Engagement ' Will OOP Costs Nudge Us to Engage?
PREPARED PATIENT BLOG | July 19, 2012 | Jane Sarasohn Kahn
In some surveys, U.S. consumers seem primed for health engagement, liking the ability to schedule appointments with doctors online, emailing providers, and having technology at home that monitors their health status.

Fast Food Medicine: A Missed Opportunity for Shared Decision Making
PREPARED PATIENT BLOG | July 13, 2012 | Sarah Jorgenson
Though I may want fast food health care when I'm healthy, I don't want it if I'm sick or have the potential to be sick. People want to have the opportunity for a dining-in experience, not just fast food.

Slow Leaks: Missed Opportunities to Encourage Our Engagement in Our Health Care
PREPARED PATIENT BLOG | July 12, 2012 | Jessie Gruman
The gap between the demands placed on us by U.S. health care delivery and the ability of individuals even the most informed and engaged among us to meet those demands undermines the quality of our care, escalates its cost and diminishes its positive impact on our health.

The Valuable Knowledge of Patients with Diseases Like RA
PREPARED PATIENT BLOG | July 9, 2012 | Kelly Young
A few weeks ago, in front of a few friends and lots of total strangers, I shared experiences about RA and explained specific ways that direct patient input could improve every aspect of health care, from research to diagnosis to treatment delivery.

Are You Afraid of Being Labeled a Difficult Patient?
PREPARED PATIENT BLOG | May 16, 2012 | Barbara Bronson Gray
Turns out we're a nation of doctor pleasers when it comes to health care. A recent study found that patients avoid challenging their physicians because they're afraid of getting the "difficult patient" label.

What's Engagement Now? Expert Sarah Greene Discusses Emerging Challenges
PREPARED PATIENT BLOG | May 9, 2012 | Sarah Greene
I discovered somewhat by accident early in my career -- that science makes faster progress and produces better results if more people with a range of different expertise are brought together. In the past 10 years, I've extended this belief to patients' participation in their care.

What's Engagement Now? Expert Kalahn Taylor-Clark Discusses Emerging Challenges
PREPARED PATIENT BLOG | April 18, 2012 | Kalahn Taylor Clark
I am interested in how public and private policy can make it possible for most people in this country to take good care of themselves.

A Second Opinion from Dr. Google
PREPARED PATIENT BLOG | April 16, 2012 | Carolyn Thomas
I've often suspected that if only the E.R. doctor who misdiagnosed me with indigestion had bothered to just Google my cardiac symptoms (chest pain, nausea, sweating and pain radiating down my left arm), he and Dr. Google would have almost immediately hit upon my correct diagnosis.

Guest Blog: How to 'De-Frag' Your Health Care
PREPARED PATIENT BLOG | April 6, 2012 | Barbara Bronson Gray
If your computer has ever slowed way down you may have been advised to "defrag," which puts all parts of a file together in the same place on the drive, enabling it to run faster and more efficiently. In much the same way, your health care might need to be de-fragged.

What's Engagement Now? Expert Janet Heinrich Discusses Emerging Challenges
PREPARED PATIENT BLOG | April 4, 2012 | Janet Heinrich
Primary care is the entry point into health care for most people. It provides the continuity of care over the lifespan. From that standpoint, it is the most familiar, trusted experience people have with health care.

Defining Patient Engagement
PREPARED PATIENT BLOG | April 3, 2012 | Anne Polta
Everyone in health care is talking these days about patient engagement, but a funny thing happened on the way to the discussion: There doesn't seem to be a widely agreed-on definition of what this actually means.

Guest Blog: Marcus Welby, House and the Wizard of Oz
PREPARED PATIENT BLOG | March 22, 2012 | Elaine Waples
Things are different for me now. Today I belong to that group of people with serious illnesses who spend lots of time in doctors' offices, diagnostic labs, and imaging centers. I quickly discovered that I had some interesting choices about my care.

What's Engagement Now? Expert Maulik Joshi Discusses Emerging Challenges
PREPARED PATIENT BLOG | March 21, 2012 | Maulik Joshi
The participation of individuals and their caregivers in hospital care has taken on increasing importance for us in all our activities as we have come to realize how central those attitudes and behaviors are to the delivery of quality care.

What's Engagement Now? Expert Chris Gibbons Discusses Emerging Challenges
PREPARED PATIENT BLOG | March 14, 2012 | Chris Gibbons
I think that if people are ever going to be able to use technology to engage in their care, the technologies have to be built for them and have to be usable by them.

What's Engagement Now? Expert Patricia Barrett Discusses Emerging Challenges
PREPARED PATIENT BLOG | February 29, 2012 | Patricia Barrett
One way NCQA looks at patient engagement is in the choice arena, by helping people pick who they'll get their care from. We provide information for people and purchasers to use to make choices about individual clinicians, practices and health plans, for example, based on objective ratings.

The Clinician's Role in Patient Engagement
PREPARED PATIENT BLOG | February 27, 2012 | Inside Health Care
This week, three health care insiders highlight the role physicians play in promoting patient engagement.

What's Engagement Now? Expert Douglas Kamerow Discusses Emerging Challenges
PREPARED PATIENT BLOG | February 15, 2012 | Douglas Kamerow
Three of the things that optimal patient engagement depends on are TIME, TOOLS and TEMPERAMENT. Clinicians and patients experience each of these differently, but they are central to us working together to get the best possible outcomes.

'Patient Engagement!' Our Skin is in the Game
PREPARED PATIENT BLOG | February 8, 2012 | Jessie Gruman
The idea that we should actively participate in our health care now attracts attention akin to the discovery of a cure for the common cold.

What's Engagement Now? Expert Carol Cronin Discusses Emerging Challenges
PREPARED PATIENT BLOG | February 1, 2012 | Carol Cronin
Most people still assume that they don't need to worry about the quality of the care they receive, whether it is from a doctor, in a hospital or in a nursing home. It's pretty frightening to realize that you do have to care about it, because it means you have to assume the burden. If quality does vary, you have to do the research. This is hard to deal with when you are upset.

What Are the Chances We Need to Understand Probability?
PREPARED PATIENT BLOG | January 25, 2012 | Jessie Gruman
We are all going to have to become tougher and smarter, even when we are sick if we are going to benefit from the health care available to us. What is it that we really need to know to do this successfully?

What's Engagement Now? Expert Gail Hunt Discusses Emerging Challenges
PREPARED PATIENT BLOG | January 18, 2012 | Gail Hunt
This interview with Gail Hunt is the first in a series of brief chats between CFAH president and founder, Jessie Gruman, and health care experts'among them our CFAH Board of Trustees'who have devoted their careers to helping people find good health care and make the most of it.

Lessons from the Year of Living Sick-ishly
PREPARED PATIENT BLOG | January 11, 2012 | Jessie Gruman
The new year set me reflecting about what I've learned about being sick over the past 12 months that only the experience itself could teach me. You know that old Supremes song, 'You Can't Hurry Love'? I learned that you can't necessarily hurry healing either, even if you work hard at it.

A Patient-Doctor Relationship Make-Over
PREPARED PATIENT BLOG | December 13, 2011 | Conversation Continues
There is a growing recognition that the doctor-patient relationship needs to evolve from the traditional model of dominant doctor/passive patient to one that is more collaborative. Here are examples of how this relationship affects people's involvement in their care.

Guest Blog: Terms of Engagement: Co-Creating Our Future with Patients
PREPARED PATIENT BLOG | December 12, 2011 | Gary Oftedahl
Today, physicians are confronted with an explosion of new technology, increasingly complex interventions, and an evolving focus on the need for longitudinal support of health issues, requiring increased involvement of our patients. While we may use different terms'engagement, involvement, empowerment, activation'in our discussions, all of them speak to the need to have active participation from patients and, in many cases, their family and other caregivers.

Don't Miss the Chance to Engage Us in Our Care When Introducing Patient-Centered Innovations
PREPARED PATIENT BLOG | November 30, 2011 | Jessie Gruman
I believe that it is unrealistic to expect that we will easily understand and ably engage in team care, shared decision making, care coordination and make use of patient portals of EHRs. Each of these carries the risk of being misunderstood by us in ways that further disenfranchise our efforts and good will unless it is discussed ' and recognized ' as the valuable tool it is.

Who Will Help Cancer Survivors Stay Healthy When Treatment is Over?
PREPARED PATIENT BLOG | November 16, 2011 | Jessie Gruman
It is completely understandable if you associate the term 'cancer survivor' with an image of glamorous, defiant Gloria Gaynor claiming that She. Will. Survive. Or maybe with a courageous Lance Armstrong in his quest to reclaim the Tour de France. Or perhaps it is linked for you with heroic rhetoric and pink-related racing, walking and shopping.

1st Person: Are Doctor Ratings Sites Useful?
PREPARED PATIENT BLOG | November 15, 2011 | First Person
When it came time for Jennifer Stevens, an Omaha, Nebraska resident and mother of two, to find an obstetrician for her first baby, she was faced with a dilemma.

Prepared Patient: Using Physician Rating Websites
PREPARED PATIENT BLOG | November 15, 2011 | Health Behavior News Service
User reviews and ratings on websites can help you locate a reputable handyman, the perfect restaurant for your anniversary dinner or the right TV for your den. So why wouldn't you turn to the Internet to find your next doctor? New health review sites promise to help you make this important decision for yourself or your loved ones. However, patients and physicians alike are finding that these doctor reviews aren't as transparent or useful as they might seem.

Hard Cold Facts, or Hard Cold Doctors?
PREPARED PATIENT BLOG | November 10, 2011 | Andrew Robinson
I was first diagnosed while on vacation in 1994. A doctor entered the room and, without warning, said that I had 'a terminal and incurable form of leukemia' and 'less than five years to live.' Just like that. Turns out he was wrong'

Take a Number
PREPARED PATIENT BLOG | November 8, 2011 | Inside Health Care
Nobody likes to wait. And patients and doctors alike are frustrated by the general waiting that seems to be an inevitable part of delivering and receiving care. Here, Art Markman, Lisa Gualtieri, and anonymous patient blogger WarmSocks share their views.

Patient Engagement: Expert Trudy Lieberman Talks About Challenges
PREPARED PATIENT BLOG | November 7, 2011 | Trudy Lieberman
This interview with Trudy Lieberman is the ninth and final of a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Guest Blog: When Patients Demand Treatments That Won't Work
PREPARED PATIENT BLOG | November 4, 2011 | Carolyn Thomas
When my son Ben came down with a sore throat this past summer, he went to his doctor for antibiotics. Both agreed it sure sounded like strep, so without having to wait for the throat swab test results, Ben left the office with a prescription for antibiotics. But were they the appropriate treatment? Do all bugs need drugs?

Getting the Patient's Perspective in Research: Will PCORI Deliver on its Promise?
PREPARED PATIENT BLOG | November 2, 2011 | Jessie Gruman
One major challenge for the new Patient Centered Outcomes Research Institute (PCORI) is to make good on its stated mission to improve health care by producing evidence "that comes from research guided by patients, caregivers and the broader health care community."

Patient Engagement: Expert Carol Alter Talks about Challenges
PREPARED PATIENT BLOG | October 31, 2011 | Carol Alter
This interview with Carol Alter is the eighth in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Drop-kicked into a Foreign Country
PREPARED PATIENT BLOG | October 26, 2011 | Jessie Gruman
We patients are always tourists in the world of health care. Whether we are coming to our doctor's office to rule out a strep infection, a clinic for a bi-monthly diabetes check-in, or a hospital for surgery, we don't work here.

Guest Blog: Instant Access & Old Faulty Assumptions
PREPARED PATIENT BLOG | October 25, 2011 | Rima Rudd
The current literature indicates that we in the various health disciplines provide texts that are poorly written and organized, web sites that are hard to navigate, as well as charts and graphs that are difficult for many to interpret and use. I say that we can make information truly accessible and usable by adding needed rigor to our work.

Patient Engagement: Expert Judith Hibbard Talks about Challenges
PREPARED PATIENT BLOG | October 24, 2011 | Judith Hibbard
This interview with Judy Hibbard is the seventh in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

"That's Not What I Wanted to Hear!": Evidence-Based Medicine and Our Hard Choices
PREPARED PATIENT BLOG | October 19, 2011 | Jessie Gruman
American health care treads a fine line between trying to serve the good of the many and the interests of the individual. But no one has yet figured out a cost-effective, yet humane, way to do both.

Patient Engagement: Expert Shoshanna Sofaer Talks about Challenges
PREPARED PATIENT BLOG | October 17, 2011 | Shoshanna Sofaer
This interview with Shoshanna Sofaer is the sixth in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Patient Engagement: Expert Kate Lorig Talks about Challenges
PREPARED PATIENT BLOG | October 11, 2011 | Kate Lorig
This interview with Kate Lorig is the fifth in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Off Pitch: Simple Conversations Go Astray
PREPARED PATIENT BLOG | October 6, 2011 | Patient Perspectives
In this round-up, patient bloggers describe a mix of difficulties they experience in everyday conversations due to their illnesses.

Patient Engagement: Expert David Sobel Talks about Challenges
PREPARED PATIENT BLOG | October 3, 2011 | David Sobel
This interview with David Sobel is the fourth in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

The Formidable Complexity of Making (Some) Health Decisions: Book Review
PREPARED PATIENT BLOG | September 28, 2011 | Jessie Gruman
Can we have 'evidence-based' care and 'shared decision making'? Are they in concert or in competition with one another? Drs. Pamela Hartzband and Jerome Groopman's new book, Your Medical Mind: How to Decide What is Right for You, argues that a crash is indeed imminent.

Patient Engagement: Expert Molly Mettler Talks about Challenges
PREPARED PATIENT BLOG | September 26, 2011 | Molly Mettler
This interview with Molly Mettler is the third in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Will Oz Connect Washington with the People in the Heartland on Health Care Quality?
PREPARED PATIENT BLOG | September 21, 2011 | Jessie Gruman
When I think back over the past 35 years and my treatment for now four different cancer-related diagnoses, I am amazed by how much has changed. The diagnostic and treatment technologies are light years more sophisticated and effective.

Patient Engagement: Expert Connie Davis Talks about Challenges
PREPARED PATIENT BLOG | September 19, 2011 | Connie Davis
This interview with Connie Davis is the second in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Our Experience Trumps Policy in Changing Our Health Care Beliefs
PREPARED PATIENT BLOG | September 14, 2011 | Jessie Gruman
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that if the doctor ordered it or wants to do it, we must need it.

Patient Engagement: Expert Dale Shaller Talks about Challenges
PREPARED PATIENT BLOG | September 12, 2011 | Dale Shaller
This interview with Dale Shaller is the first in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.

Informed Consent & Doctor-Patient Communications in the News
PREPARED PATIENT BLOG | August 30, 2011 | Conversation Continues
The recent case of Phillip Seaton, a Kentucky man who sued his surgeon after having a partial penile amputation, raises concerns about the effectiveness of the informed consent process, general health literacy and problems with doctor-patient communications.

Inside Health Care: Barriers to Care: ''a Failure to Communicate'
PREPARED PATIENT BLOG | August 24, 2011 | CFAH Staff
A new study shows that 21% of adult Americans delay seeking health care for reasons other than cost. In this collection, a doctor, a journalist, and a health care manager discuss the need for improved systems and candor to support better doctor-patient communication.

Ask Me if I Washed My Hands and Drank Gatorade in the Last Hour
PREPARED PATIENT BLOG | August 23, 2011 | Jessie Gruman
Do you suffer from decision fatigue when you are sick or anxious or overwhelmed by bad health news? Does your doctor make less well-reasoned decisions about the 10th patient she sees before lunch? How about the surgeon during his second operation of the day? How about the radiologist reading the last mammogram in a daily batch of 60? A provocative article by John Tierney in Sunday's NYTimes Magazine adds a new layer of complexity to the body of knowledge collecting around decision-making processes.

The Complexities of Non-Compliance
PREPARED PATIENT BLOG | August 18, 2011 | Conversation Continues
In recent discussions about patient non-compliance, Stephen Wilkins, Dr. Stewart Segal and patient Ann Silberman all emphasize that doctor-patient communication is key.

Guest Blog: Summer Palpitations
PREPARED PATIENT BLOG | August 15, 2011 | Katherine Ellington
When her mom has a heart emergency, medical student Katherine Ellington learns first-hand how health statistics apply to real life. This is the first in a series of three posts.

Making Informed Health Care Choices
PREPARED PATIENT BLOG | August 4, 2011 | Conversation Continues
Recent pieces at HealthNewsReview Blog and in the Washington Post highlight the need for accessible and reliable information about health care services.

Bad Language: Words One Patient Won't Use (and Hopes You Won't Either)
PREPARED PATIENT BLOG | August 3, 2011 | Jessie Gruman
"There is a better way - structural reforms that empower patients with greater choices and increase the role of competition in the health-care marketplace." Rep. Paul Ryan (R-WI) August 3, 2011. The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services. But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service.

Guest Blog: Can the Blind Lead the Seeing?
PREPARED PATIENT BLOG | August 1, 2011 | Amy Berman
Many of you know that eight months ago I was diagnosed with Stage IV inflammatory breast cancer, which has spread to my spine. My incurable diagnosis means that I live with a chronic disease, just like millions of older adults.

Too Much Information in Medical Decision Making?
PREPARED PATIENT BLOG | July 22, 2011 | Conversation Continues
Paula Span of The New York Times New Old Age blog could have used more information about medical risks when helping her father decide whether to remove a benign mole. Span wanted to know what the odds were of a benign mole turning malignant.

Engagement Does Not Mean Compliance
PREPARED PATIENT BLOG | July 13, 2011 | Jessie Gruman
Engagement and compliance are not synonyms. I am compliant if I do what my doctor tells me to do. I am engaged, on the other hand, when I actively participate in the process of solving my health problems.

Understanding Your Medical Risk: Nice or Necessary?
PREPARED PATIENT BLOG | July 12, 2011 | Conversation Continues
Sam Wainwright from New America's Health Policy Program offers his opinion on the controversy surrounding whether or not doctors should present or withhold data about patients' medical risks.

What's Expected of You at Your Doctor's Office?
PREPARED PATIENT BLOG | June 14, 2011 | Stephen Wilkins
When you or I visit an accountant, a lawyer or car mechanic, we know what our role is and have a pretty clear understanding of what the ' expert' is supposed to do. But when it comes to a trip to the doctor these days the roles and responsibilities of patients and physicians have become blurred and unpredictable'and the patient seems to generally be on the losing end.

Appointment in Samarra*: Our Lives of Watchful Waiting
PREPARED PATIENT BLOG | June 8, 2011 | Jessie Gruman
Watchful waiting has become a way of life for many of us. Last week Sam had his first six-month scan following treatment for esophageal cancer. It showed that that the original cancer had not recurred and that the tumors behind his eyes and the hot spots on his kidneys and liver hadn't grown. Sam and his wife, Sonia, are celebrating for a few days before they return to worrying, checking for symptoms and counting the days until the next scan.

Conversation Continues: Hospital Discharge Without a Net
PREPARED PATIENT BLOG | June 7, 2011 | CFAH Staff
In The Wall Street Journal's Informed Patient column, Laura Landro notes various efforts hospitals are taking to prevent re-admissions, including Boston University Medical Center's use of a virtual nurse named Louise.

1st Person: After Years of Treatment, a Time to Wait
PREPARED PATIENT BLOG | June 6, 2011 | First Person
For many freshmen, the first year of college is devoted to classes, work and socializing, with little thought given to health or longevity. But for Nikkie Hartmann, a Chicago-based public relations professional, the start of her college career also marked the start of 14 years of dealing with cancer.

Prepared Patient: Watchful Waiting: When Treatment Can Wait
PREPARED PATIENT BLOG | June 6, 2011 | Health Behavior News Service
In today's fast-paced world, waiting ' whether it's at the doctor's office, in line at the grocery store or for an Internet connection ' is rarely considered a good thing. But when it comes to certain medical conditions, delaying treatment while regularly monitoring the progress of disease ' a strategy doctors refer to as 'watchful waiting,' active surveillance or expectant management ' may benefit some patients more than a rush to pharmaceutical or surgical options.

What Must We Know About What Our Doctors Know?
PREPARED PATIENT BLOG | May 25, 2011 | Jessie Gruman
The most important thing I learned was that different doctors know different things: I need to ask my internist different questions than I do my oncologist. This was not some sweet ingénue recounting the early lessons she learned from a recent encounter with health care. Nope. It was a 62-year-old woman whose husband has been struggling with multiple myeloma for the last eight years and who herself has chronic back pain, high blood pressure and high cholesterol and was at the time well into treatment for breast cancer.

Guest Blog: One More Reason Patients Ask Doctors So Few Questions
PREPARED PATIENT BLOG | March 31, 2011 | Stephen Wilkins
The most popular post on my blog is entitled Five Reasons Why People Do Not Ask Their Doctor Questions. Well it seems there is a sixth reason. The Reason? Patients were never supposed to ask doctors questions.

The "True Grit"-tiness of Sharing Health Care Decisions with Our Doctors
PREPARED PATIENT BLOG | March 23, 2011 | Jessie Gruman
In the recent Coen brothers' remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father. To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests ' then announces that she plans to come along. She figures she is prepared.

Defining Patient Engagement
PREPARED PATIENT BLOG | February 18, 2011 | Donna Cryer
The mad scramble to figure out how to 'engage' patients in their healthcare has begun! Everyone from PR firms to hospital board members are trying to figure out how to engage patients in their health care. My question to hospitals and others is this: Why would you reject the help of thousands of individuals positioned in various ways to help you be more successful?

A Valentine to Shared Decision Making
PREPARED PATIENT BLOG | February 14, 2011 | Jessie Gruman
Shared decision making is hot right now. Research. Surveys. Tools. Training. Conferences. Policies. The current model of shared decision making consists of providing patients with evidence that allows them to compare the risks and side effects of different treatments or preventive services when more than one option is available. After studying the evidence, the theory goes, patients discuss it with their physician, weigh their personal preferences and together the two agree upon a course of action.

One Small Step for Patient-Centered Care, One Less Barrier to Engagement
PREPARED PATIENT BLOG | February 1, 2011 | Jessie Gruman
As far as my chemo nurse Olga* is concerned, I can do nothing right. She scolded me for sending an e-mail when she thought I should have called and vice versa. She scolded me for going home before my next appointment was scheduled. She scolded me for asking to speak to her personally instead of whichever nurse was available. She scolded me for calling my oncologist directly. She scolded me for asking whether my clinical information and questions are shared between my oncologist and the staff of the chemo suite. I could go on'

Getting Through the Shock of a Devastating Diagnosis
PREPARED PATIENT BLOG | January 25, 2011 | Jessie Gruman
It could happen tomorrow. The doctor says, "I'm sorry, I have bad news," and suddenly your life is turned upside-down, leaving you reeling from the shock of a potentially life-threatening diagnosis. Here is some advice on getting through that initial period.

Dicker With Your Doc? Not So Fast'
PREPARED PATIENT BLOG | January 20, 2011 | Jessie Gruman
'How to Haggle With Your Doctor' was the title of a recent Business section column in The New York Times. This is one of many similar directives to the public in magazines, TV and Websites urging us to lower the high price of our health care by going mano a mano with our physicians about the price of tests they recommend and the drugs they prescribe. Such articles provide simple, commonsense recommendations about how to respond to the urgency many of us feel ' insured or uninsured ' to reduce our health care expenses.

Prepared Patient: The Handoff: Your Roadmap to a New Doctors Care
PREPARED PATIENT BLOG | December 29, 2010 | Health Behavior News Service
It could be a broken wrist, or a life-altering battle with cancer, but sooner or later most patients run up against the diagnosis that sends them from their primary care doctor's care into the hands of a new physician. In medical circles, this transition is called the "handoff" a casual name that conceals the complications and risks of this journey.

Prepared Patient: Taking Charge of Your Health Records
PREPARED PATIENT BLOG | December 27, 2010 | Health Behavior News Service
File folders, marching across the shelves in an orderly line behind the receptionist's desk, may be the first thing you see when you sign in for a doctor's appointment. While it's tempting to believe that your personal health history is neatly contained within one of those folders, the truth is far more troubling.

Prepared Patient: Effective Patienthood Begins With Good Communication
PREPARED PATIENT BLOG | December 24, 2010 | Health Behavior News Service
Given all the obstacles that prevent us from getting to the doctor's office scheduling an appointment, digging out the insurance card and plain old procrastination it is good health sense to make the most of your time when you are finally face-to-face with your health care provider.

GoodBehavior!: Evidence That Engagement Does Make a Difference
PREPARED PATIENT BLOG | November 15, 2010 | Jessie Gruman
There is tremendous intuitive appeal in the idea that people must be engaged in their health care to benefit from it. To date, however, there has been little direct evidence to support the claim that our engagement affects health outcomes.

Gale Fisher's Missed Diagnosis (Almost)
PREPARED PATIENT BLOG | November 8, 2010 | Andrew Schorr
As Gale Fisher approached her late 60's, she remained active - playing golf and walking, but pain in her right calf made walking difficult, and it was getting worse. Gale eventually saw her doctor who suggested fusion surgery. Gale sought a second opinion from a vascular surgeon. He proposed a major surgery that would require 10 days in the hospital to open the blood flow. Gale sought out third opinion. The information she received changed her life.

Hospital Discharge Without a Net
PREPARED PATIENT BLOG | November 3, 2010 | Jessie Gruman
By the time I reached the sixth day of my hospitalization for stomach cancer surgery, I was antsy to go home and I quizzed each nurse and physician who came into my room about what must happen for me to be liberated the following day. Their responses were consistent: my surgeon would visit in the morning and write orders for my release. Then I would have a comprehensive discussion with my nurse about my discharge plan, after which I could leave.

Patient Engagement on the Med-Surg Floor
PREPARED PATIENT BLOG | November 2, 2010 | Jessie Gruman
Three times a day, as though responding to some signal audible only to the generously medicated, we rise from our beds to join the slow procession around the perimeter of the unit. Like slumped, disheveled royalty, each of us blearily leads our retinue of anxious loved ones who push our IV poles, bear sweaters to ward off the harsh air conditioning and hover to prevent stumbles. Some make eye contact. Few talk. Each of us is absorbed in our suffering and our longing to return to our bed.

Learning About Public Participation
PREPARED PATIENT BLOG | September 29, 2010 | Connie Davis
I've been spending time lately becoming more familiar with methods of public participation and the evidence behind participation. When I first moved to British Columbia, the government was sponsoring 'Conversations on Health' which I initially found exciting and innovative. That effort was designed to give the public a voice about health care in the province. I sent in my comments via the website and read about the public meetings being held throughout the province. I became a skeptic when I compared the data and original reports from the conversations and the conclusions. They didn't seem to match.

New Solid Evidence Showing the Impact of Physician Communication on Our Engagement in Care
PREPARED PATIENT BLOG | August 19, 2010 | Jessie Gruman
Ask us if we are more likely to use a medication as directed if our doctors explain why a specific drug might be helpful, how to take it so that it is most effective and what its possible side effects are and then discuss whether we think we are willing and able to take it.

Getting to the Right Doctor at the Right Time
PREPARED PATIENT BLOG | June 3, 2010 | Jessie Gruman
One of the behaviors necessary to be a prepared patient is to seek and use the appropriate health care setting when professional attention is required.

Participate in My Care? Room for Improvement
PREPARED PATIENT BLOG | May 20, 2010 | Jessie Gruman
The Center for Advancing Health, just released A Snapshot of People's Engagement in Their Health Care, a study that found that most of us do relatively little to participate in our health care.

Getting Test Results
PREPARED PATIENT BLOG | April 27, 2010 | Dorothy Jeffress
Over the years, I've filled out plenty of forms at doctors' offices, but this was a new one for me.

Surprised I was So Unprepared
PREPARED PATIENT BLOG | April 2, 2010 | Jessie Gruman
As the first blogger on this site, I write first as a person who has been diagnosed with three different types of cancer and a serious heart condition -- and as one who manages the long-term effects of that many diagnoses and that much treatment on a daily basis.

Welcome to the "What it Takes'' Blog!
PREPARED PATIENT BLOG | April 1, 2010 | Jessie Gruman
This posting marks the initial gathering of a virtual community of individuals who recognize that each of us must participate knowledgeably and actively in finding and using health care if we are to benefit from it.