Photo Friday: Why aren’t more people asked about their goals? #TeamJess

A treasured colleague of mine wrote me this message recently:

I miss your posts about patient engagement — which is part of your overall reputation in the industry. We need your voice to continue!

This week’s photo does not reflect this week’s Washington, DC weather; it was taken on May 11, 2012 during warmer times.

I’m posting it this week because it reminds me of various conversations I’ve had as part of #TeamJess as well as some other conversations recently about what it means to listen to, respect, support people in producing health for themselves and their communities. Everything from whether patients should be able to get their lab results at the same time as their doctor, to whether their doctors should coordinate their care or simply figure out which specialist to refer to.

Look at what a wall in Washington, DC was able to elicit from passers by when it asked a simple question about life goals.

One of the greatest rewards I’ve had in practice was the time a patient told me that an email I sent them (securely, through our personal health record) was reviewed by their mother who felt reassured about an impending trip in the context of worrisome pain symptoms. That and the patient responded by calling me “Ted,” rather than “Dr. Eytan” made me feel that this technology was really capable of turning a health care conversation into a health one, shared by the patient and their support team.

In #TeamJess’ case, I am left with a feeling of disappointment when Jessica forwards the emails from her physician (practice name withheld on request, not affiliated with Kaiser Permanente). And, hint, patients do forward emails to their support teams, which they are allowed to do. There aren’t questions about what Jess needs to accomplish in her work/life, just comments about medications that don’t appear to say very much and referral information that doesn’t appear to refer to very much. E-mail access to doctors (and the marketing of a practice based on it) is about listening better, not sending/receiving email.

What my treasured colleague reminded me of is that the rest of the world has not yet fully embraced patient engagement, or maybe they have embraced a different version which is “we tell you what you do, and you do it.”

I think that’s changing, and the world is learning to love better. I am lucky to know some of the best doctors in the world. Some are senior medical leaders, some aren’t, all are incredibly dedicated to helping people achieve their life goals, without fail, across generations, across specialties. They didn’t go into medicine to keep people from their life goals and neither did I. Fortunately with the right use of tools and technology, we don’t have to.

Here’s a close-up of what’s on that wall. If a wall is capable of listening, are doctors? Answer to that is yes. The second thing is to notice that no one said, “Before I die, I’d like to get good health care.”

This photo is dedicated to my treasured colleague, and #TeamJess, who have been working anywhere from a few weeks to lifetimes to make sure that every patient is listened to, respected, produces great health for themselves and those around them. Let’s join them. Jess has goals to help health care heal better and her time is precious, tick tock :).


I am coming forward as y our treasured colleague! Thank you for listening….
There are so many wonderful opportunities for people to become involved in their health. What about physicians asking patients how they are doing between visits? What would patients like to be able to share? How would physicians (yes you physician readers!) react to getting clinical feedback between visits? How would it be useful?
Hope we can continue the journey together. #simplifyhealth
Anna-Lisa Silvestre. @conversa


We can and remember that your hallmark as a leader has been full transparency in what you do, world-class too,


Have to agree with Anna-Lisa…about keeping the fire burning for engagement. Yes, there are many great clinicians who listen and ask about life goals, but it’s not common. Hard to do, as the visit agenda and the Problem Oriented Medical Record takes over. Yet, people have a hard time answering such questions. I saw 8 people in clinic yesterday. Two, I asked, ‘What do you want your health for?’ I asked because there was time to just sit…and wait. Both required prompts. Why? People are not used to hearing this question asked, in any venue, for any reason!

How you ask is important. The ‘Before I die…” will get different answers than other queries such as, What is your purpose in life? What do you want your health for?

A wonderful colleague and behavioral scientist Vic Strecher just published ‘On Purpose’, a graphic novel about his journey through his family’s tragedy, and a Call for All to create higher meaning in life.

No easy task.
Keep the momentum.


Thanks for being you, you’re of the best doctors in the world that I mentioned above. It’s easy to tell from your comment 🙂


Ted Eytan, MD