Health Hats, the Podcast

Kirk & Lacy on shifting research funding away from federal grants: what happens to community partnerships when the money—and the rules—change? Summary Three Audiences, One Report Lacy Fabian and Kirk Knestis untangle a fundamental confusion in community health research: there are three distinct audiences with competing needs—funders want accountability, researchers want generalizable knowledge, and communities want immediate benefit. Current practice optimizes for the funder, producing deliverables that don’t help the people being served. The alternative isn’t “no strings attached” anarchy but rather honest negotiation about who benefits and who bears the burden of proof. Kirk’s revelation about resource allocation is stark: if one-third of evaluation budgets goes to Click here to view the printable newsletter with images. More readable than a transcript. Contents Table of Contents Toggle EpisodeProem1. Introductions & Career Transitions2. The Catalyst: Why This Conversation Matters3. The Ideal State: Restoring Human Connection4. The Localization Opportunity5. Evidence + Story = Impact6. The Funder Issue: Who Is This Truly Benefiting?7. Dissemination, Implementation & Vested Interest8. Data Parties – The Concrete Solution9. No Strings Attached: Reimagining Funder Relationships10. Balancing Accountability and Flexibility11. Where the Money Actually Goes12. The Pendulum Swings13. The Three Relationships: Funder, Researcher, Community14. Maintaining Agency15. Listen and LearnReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Substack Patreon Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site management Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection Claude, Perplexity, Auphonic, Descript, Grammarly, DaVinci Podcast episode on YouTube Inspired by and Grateful to: Ronda Alexander, Eric Kettering, Robert Motley, Liz Salmi, Russell Bennett Photo Credits for Videos Data Party image by Erik Mclean on Unsplash Pendulum image by Frames For Your Heart on Unsplash Links and references Lacy Fabian, PhD, is the founder of Make It Matter Program Consulting and Resources (makeitmatterprograms.com). She is a research psychologist with 20+ years of experience in the non-profit and local, state, and federal sectors who uses evidence and story to demonstrate impact that matters. She focuses on helping non-profits thrive by supporting them when they need it—whether through a strategy or funding pivot, streamlining processes, etc. She also works with foundations and donors to ensure their giving matters, while still allowing the recipient non-profits to maintain focus on their mission. When she isn't making programs matter, she enjoys all things nature —from birdwatching to running —and is an avid reader. Lacy Fabian’s Newsletter: Musings That Matter: Expansive Thinking About Humanity’s Problems Kirk Knestis is an expert in data use planning, design, and capacity building, with experience helping industry, government, and education partners leverage data to solve difficult questions. Kirk is the Executive Director of a startup community nonprofit that offers affordable, responsive maintenance and repairs for wheelchairs and other personal mobility devices to northern Virginia residents. He was the founding principal of Evaluand LLC, a research and evaluation consulting firm providing customized data collection, analysis, and reporting solutions, primarily serving clients in industry, government, and education. The company specializes in external evaluation of grant-funded projects, study design reviews, advisory services, and capacity-building support to assist organizations in using data to answer complex questions.  Referenced in episode Zanakis, S.H., Mandakovic, T., Gupta, S.K., Sahay, S., & Hong, S. (1995). “A review of program evaluation and fund allocation methods within the service and government sectors.” Socio-Economic Planning Sciences, Vol. 29, No. 1, March 1995, pp. 59-79. This paywalled article presents a detailed analysis of 306 articles from 93 journals that review project/program evaluation, selection, and funding allocation methods in the service and government sectors. Episode Proem When I examine the relationships between health communities and researchers, I become curious about the power dynamics involved. Strong, equitable relationships depend on a balance of power. But what exactly are communities, and what does a power balance look like? The communities I picture are intentional, voluntary groups of people working together to achieve common goals—such as seeking, fixing, networking, championing, lobbying, or communicating for best health for each other. These groups can meet in person or virtually, and can be local or dispersed. A healthy power balance involves mutual respect, participatory decision-making, active listening, and a willingness to adapt and grow. I always listen closely for connections between communities and health researchers. Connections that foster a learning culture, regardless of their perceived success. Please meet Lacy Fabian and Kirk Knestis, who have firsthand experience in building and maintaining equitable relationships, with whom I spoke in mid-September. This transcript has been edited for clarity with help from Grammarly. Lacy Fabian, PhD, is the founder of Make It Matter Program Consulting and Resources. She partners with non-profit, government, and federal organizations using evidence and storytelling to demonstrate impact and improve program results. Kirk Knestis is an expert in data use planning, design, and capacity building. As Executive Director of a startup community nonprofit and founding principal of Evaluand LLC. He specializes in research, evaluation, and organizational data analysis for complex questions. 1. Introductions & Career Transitions Kirk Knestis: My name’s Kirk Knestis. Until just a few weeks ago, I ran a research and evaluation consulting firm, Evaluand LLC, outside Washington, DC. I’m in the process of transitioning to a new gig. I’ve started a non-profit here in Northern Virginia to provide mobile wheelchair and scooter service. Probably my last project, I suspect. Health Hats: Your last thing, meaning you’re retiring. Kirk Knestis: Yeah, it’s most of my work in the consulting gig was funded by federal programs, the National Science Foundation, the Department of Ed, the National Institutes of Health, and funding for most of the programs that I was working on through grantees has been pretty substantially curtailed in the last few months. Rather than looking for a new research and evaluation gig, we’ve decided this is going to be something I can taper off and give back to the community a bit. Try something new and different, and keep me out of trouble. Health Hats: Yeah, good luck with the latter. Lacy, introduce yourself, please. Lacy Fabian: Hi, Lacy Fabian. Not very dissimilar from Kirk, I’ve made a change in the last few months. I worked at a large nonprofit for nearly 11 years, serving the Department of Health and Human Services. But now I am solo, working to consult with nonprofits and donors. The idea is that I would be their extra brain power when they need it. It’s hard to find funding, grow, and do all the things nonprofits do without a bit of help now and then. I’m looking to provide that in a new chapter, a new career focus. Health Hats: Why is this conversation happening now? Both Kirk and Lacy are going through significant changes as they move away from traditional grant-funded research and nonprofit hierarchies. They’re learning firsthand what doesn’t work and considering what might work instead—this isn't just theory—it’s lived experience. 2. The Catalyst: Why This Conversation Matters Health Hats: Lacy, we caught up after several years of working together on several projects. I’m really interested in community research partnerships. I’m interested in it because I think the research questions come from the communities rather than the researchers. It’s a fraught relationship between communities and researchers, often driven by power dynamics. I’m very interested in how to balance those dynamics. And I see some of this: a time of changing priorities and people looking at their gigs differently —what are the opportunities in this time of kind of chaos, and what are the significant social changes that often happen in times like this? 3. The Ideal State: Restoring Human Connection Health Hats: In your experience, especially given all the recent transitions, what do you see as the ideal relationship between communities and researchers? What would an ideal state look like? Lacy Fabian: One thing I was thinking about during my walk or run today, as I prepared for this conversation about equitable relationships and the power dynamics in this unique situation we’re in, is that I feel like we often romanticize the past instead of learning from it. I believe learning from the past is very important. When I think about an ideal scenario, I feel like we’re moving further away from human solidarity and genuine connection. So, when considering those equitable relationships, it seems to me that it’s become harder to build genuine connections and stay true to our humanness. From a learning perspective, without romanticizing the past, one example I thought of is that, at least in the last 50 years, we’ve seen exponential growth in the amount of information available. That's a concrete example we can point to. And I think that we, as a society, have many points where we could potentially connect. But recent research shows that’s not actually the case. Instead, we’re becoming more disconnected and finding it harder to connect. I believe that for our communities, even knowing how to engage with programs like what Kirk is working on is difficult. Or even in my position, trying to identify programs that truly want to do right, take that pause, and make sure they aim to be equitable—particularly on the funder side—and not just engage in transactions or give less generously than they intend if they’re supporting programs. But there are strings attached. I think all of this happens because we stop seeing each other as human beings; we lose those touchpoints. So, when I think about an ideal situation, I believe it involves restoring those connections, while more clearly and openly acknowledging the power dynamics we introduce and the different roles we assume in the ecosystem. We can’t expect those dynamics to be the same, or to neutralize their impact. However, we can discuss these issues more openly and consistently and acknowledge that they might influence outcomes. So, in an ideal scenario, these are the kinds of things we should be working toward. 4. The Localization Opportunity Health Hats: So Kirk, it strikes me listening to Lacy talk that there’s, in a way, the increased localization of this kind of work could lead to more relationships in the dynamic, whereas before, maybe it was. Things were too global. It was at an academic medical center and of national rather than local interest. What are your thoughts about any of that? Kirk Knestis: Yeah, that’s an excellent question. First, I want to make sure I acknowledge Lacy’s description philosophically, from a value standpoint. I couldn’t put it any better myself. Certainly, that’s got to be at the core of this. Lacy and I know each other because we both served on the board of the Professional Evaluation Society on the East Coast of the United States, and practice of evaluation, evaluating policies and programs, and use of resources, and all the other things that we can look at with evidence, the root of that word is value, right? And by making the values that drive whatever we’re doing explicit, we’re much more likely to connect. At levels in, way, in ways that are actually valuable, a human being level, not a technician level. But to your question, Danny, a couple of things immediately leap out at me. One is that there was always. I was primarily federally funded, indirectly; there’s always been a real drive for highly rigorous, high-quality evaluation. And what that oftentimes gets interpreted to mean is generalizable evaluation research. And so that tends to drive us toward quasi-experimental kinds of studies that require lots and lots of participants, validated instrumentation, and quantitative data. All of those things compromise our ability to really understand what’s going on for the people, right? For the real-life human stakeholders. One thing that strikes me is that we could be as funding gets picked up. I’m being optimistic here that funding will be picked up by other sources, but let’s say the nonprofits get more involved programs that in the past and in the purview of the feds, we’re going to be freed of some of that, I hope, and be able to be more subjective, more mixed methods, more on the ground and kind of maturein the, dirt down and dirty out on the streets, learning what’s going on for real humans. As opposed to saying, “Nope, sorry, we can’t even ask whether this program works or how it works until we’ve got thousands and thousands of participants and we can do math about the outcomes.” So that’s one way I think that things might be changing. 5. Evidence + Story = Impact One of the big elements I like to focus on is the evidence—the kind of, so what the program is doing—but also the story. Making sure both of those things are combined to share the impact. And one of the things that I think we aren’t great about, which kind of circles back to the whole topic about equitable relationships. I don’t often think we’re really great at acknowledging. Who our report outs are for 6. The Funder Issue: Who Is This Truly Benefiting? Health Hats: Yes, who’s the audience? Lacy Fabian: Describing the kind of traditional format, I’m going to have thousands of participants, and then I’m going to be able to start to do really fancy math. That audience is a particular player who’s our funder. And they have different needs and different goals. So so many times, but that’s not the same as the people we’re actually trying to help. I think part of actually having equity in practice is pushing our funders to acknowledge that those reports are really just for them. And what else are we doing for our other audiences, and how can we better uphold that with our limited resources? Do we really need that super fancy report that’s going to go on a shelf? And we talk about it a lot, but I think that’s the point. We’re still talking about it. And maybe now that our funding is shifting, it’s an excellent catalyst to start being smarter about who our audience is, what they need, and what’s best to share with them. 7. Dissemination, Implementation & Vested Interest Health Hats: So, in a way, that’s not only do we need to think about who the work is for. How do we get it to those people? So how do we disseminate to those people? And then, what are the motivations for implementation? And it seems to me that if I have a vested interest in the answer to the question, I am more likely to share it and to try to figure out what the habits are—the changing habits that the research guides. What are some examples of this that you’ve, in your experience, that either you feel like you hit it like this, worked, or where you felt like we didn’t quite get there? So, what are your thoughts about some practical examples of that? Kirk Knestis: I was laughing because I don’t have so many examples of the former. I’ve got lots of examples of the latter. Health Hats: So start there. 8. Data Parties – The Concrete Solution Kirk Knestis: A good example of how I’ve done that in the past is when clients are willing to tolerate it. We call them different things over the years, like a data party. What we do is convene folks. We used to do it in person, face-to-face, but now that we’re dealing with people spread out across the country and connected virtually, these meetings can be done online. Instead of creating a report that just sits on a shelf or a thumb drive, I prefer to spend that time gathering and organizing the information we collect into a usable form for our audiences. This acts as a formative feedback process rather than just a summative benchmark. Here’s what we’ve learned. You share the information with those who contributed to it and benefit from it, and you ask for their thoughts. We’re observing that this line follows a certain path. Let’s discuss what that means or review all the feedback we received from this stakeholder group. It’s quite different from what we’ve heard from other stakeholders. What do you think is happening there? And let them help add value to the information as it moves from evidence to results. Health Hats: This is the solution to the funder problem. Instead of writing reports for funders, Kirk brings together the actual stakeholders—the people who provided data and benefit from the program. They assist in interpreting the findings in real-time. It’s formative, not summative. It’s immediate, not shelved. 9. No Strings Attached: Reimagining Funder Relationships Health Hats: I think it’s interesting that a thread through this is the role of the funder and the initiative’s governance. I remember that we worked on a couple of projects. I felt like the funder’s expectations were paramount, and the lessons we learned in the process were less important, which aligns with what we didn’t show. Publication bias or something. Sometimes in these initiatives, what’s most interesting is what didn’t work —and that’s not so, anyway. So how? So now that you’re looking forward to working with organizations that are trying to have questions answered, how is that shaping how you’re coaching about governance of these initiatives? Like, where does that come in? Lacy Fabian: Yeah. I think, if we’re talking about an ideal state, there are models, and it will be interesting to see how many organizations really want to consider it, but the idea of no-strings-attached funding. Doesn’t that sound nice, Kirk? The idea being that if you are the funding organization and you have the money, you have the power, you’re going to call the shots. In that way, is it really fair for you to come into an organization like something that Kirk has and start dictating the terms of that money? So, Kirk has to start jumping through the hoops of the final report and put together specific monthly send-ins for that funder. And he has to start doing these things well for that funder. What if we considered a situation where the funder even paid for support to do that for themselves? Maybe they have somebody who comes in, meets with Kirk, or just follows around, shadows the organization for a day or so, collects some information, and then reports it back. But the idea is that the burden and the onus aren’t on Kirk and his staff. Because they’re trying to repair wheelchairs and imagining the types of models we’ve shifted. We’ve also left the power with Kirk and his organization, so they know how to serve their community best. Again, we’ve put the onus back on the funder to answer their own questions that are their needs. I think that’s the part that we’re trying to tease out in the equity: who is this really serving? And if I’m giving to you, but I’m saying you have to provide me with this in return. Again, who’s that for, and is that really helping? Who needs their wheelchair service? And I think that’s the part we need to work harder at unpacking and asking ourselves. When we have these meetings, put out these funding notices, or consider donating to programs, those are the things we have to ask ourselves about and feel are part of our expectations. 10. Balancing Accountability and Flexibility Health Hats: Wow. What’s going through my mind is, I’m thinking, okay, I’m with PCORI. What do we do? We want valuable results. We do have expectations and parameters. Is there an ideal state? Those tensions are real and not going away. But there’s the question of how to structure it to maximize the value of the tension. Oh, man, I’m talking abstractly. I need help thinking about the people who are listening to this. How does somebody use this? So let’s start with: for the researcher? What’s the mindset that’s a change for the researcher? What’s the mindset shift for the people, and for the funder? Let’s start with the researcher. Either of you pick that up. What do you think a researcher needs to do differently? Kirk Knestis: I don’t mind having opinions about this. That’s a fascinating question, and I want to sort of preface what I’m getting ready to say. With this, I don’t think it’s necessary to assume that, to achieve the valuable things Lacy just described, we must completely abrogate all responsibility. I think it would be possible for someone to say, money, no strings attached. We’re never going to get the board/taxpayer/or whoever, for that. Importantly, too, is to clarify a couple of functions. I found that there are a couple of primary roles that are served by the evaluation or research of social services or health programs, for example. The first and simplest is the accountability layer. Did you do what you said you were going to do? That’s operational. That doesn’t take much time or energy, and it doesn’t place a heavy burden on program stakeholders. Put the burden on the program’s managers to track what’s happening and be accountable for what got done. Health Hats: So like milestones along the way? Kirk Knestis: Yes. But there are other ways, other dimensions to consider when we think about implementation. It’s not just the number of deliveries but also getting qualitative feedback from the folks receiving the services. So, you can say, yeah, we were on time, we had well-staffed facilities, and we provided the resources they needed. So that’s the second tier. The set of questions we have a lot more flexibility with at the next level. The so-what kind of questions, in turn, where we go from looking at this term bugs me, but I’ll use it anyway. We’re looking at outputs—delivery measures of quantities and qualities—and we start talking about outcomes: persistent changes for the stakeholders of whatever is being delivered. Attitudes, understandings. Now, for health outcomes—whatever the measures are—we have much more latitude. Focus on answering questions about how we can improve delivery quality and quantity so that folks get the most immediate and largest benefit from it. And the only way we can really do that is with a short cycle. So do it, test it, measure it, improve it. Try it again, repeat, right? So that formative feedback, developmental kind of loop, we can spend a lot of time operating there, where we generally don’t, because we get distracted by the funder who says, “I need this level of evidence that the thing works, that it scales.” Or that it demonstrates efficacy or effectiveness on a larger scale to prove it. I keep wanting to make quotas, right, to prove that it works well. How about focusing on helping it work for the people who are using it right now as a primary goal? And that can be done with no strings attached because it doesn’t require anything to be returned to the funder. It doesn’t require that deliverable. My last thought, and I’ll shut up. 11. Where the Money Actually Goes Kirk Knestis: A study ages ago, and I wish I could find it again, Lacy. It was in one of the national publications, probably 30 years ago. Health Hats: I am sure Lacy’s going to remember that. Kirk Knestis: A pie chart illustrated how funds are allocated in a typical program evaluation, with about a third going to data collection and analysis, which adds value. Another third covers indirect costs, such as keeping the organization running, computers, and related expenses. The remaining third is used to generate reports, transforming the initial data into a tangible deliverable. If you take that third use much more wisely, I think you can accomplish the kind of things Lacy’s describing without, with, and still maintain accountability. Health Hats: This is GOLD. The 1/3: 1/3: 1/3 breakdown is memorable, concrete, and makes the problem quantifiable. Once again, 1/3 each for data collection and analysis, keeping the organization alive, and writing reports. 12. The Pendulum Swings Lacy Fabian: And if I could add on to what Kirk had said, I think one of the things that comes up a lot in the human services research space where I am is this idea of the pendulum swing. It’s not as though we want to go from a space where there are a lot of expectations for the dollars, then swing over to one where there are none. That’s not the idea. Can we make sure we’re thinking about it intentionally and still providing the accountability? So, like Kirk said, it’s that pause: do we really need the reports, and do we really need the requirements that the funder has dictated that aren’t contributing to the organization’s mission? In fact, we could argue that in many cases, they’re detracting from it. Do we really need that? Or could we change those expectations, or even talk to our funder, as per the Fundee, to see how they might better use this money if they were given more freedom, not to have to submit these reports or jump through these hoops? And I believe that’s the part that restores that equity, too, because it’s not the funder coming in and dictating how things will go or how the money will be used. It’s about having a relational conversation, being intentional about what we’re asking for and how we’re using the resources and then being open to making adjustments. And sometimes it’s just that experimentation: I think of it as, we’re going to try something different this time, we’re going to see if it works. If it doesn’t work, it probably won’t be the end of the world. If it does, we’ll probably learn something that will be helpful for next time. And I think there’s a lot of value in that as well. Health Hats: Lacy’s ‘pendulum swing’ wisdom: not anarchy, but intentional. Not ‘no accountability’ but ‘accountability without burden-shifting.’ The move is from the funder dictating requirements to relational conversation. And crucially: willingness to experiment. 13. The Three Relationships: Funder, Researcher, Community Health Hats: Back to the beginning—relationships. So, in a way, we haven’t really —what we’ve talked about is the relationship with funders. Lacy Fabian: True. Health Hats: What is the relationship between researchers and the community seeking answers? We’re considering three different types of relationships. I find it interesting that people call me about their frustrations with the process, and I ask, “Have you spoken with the program officer?” Have you discussed the struggles you’re facing? Often, they haven’t or simply don’t think to. What do you think they’re paid for? They’re there to collaborate with you. What about the relationships between those seeking answers and those studying them—the communities and the researchers? How does that fit into this? Kirk Knestis: I’d like to hear from Lacy first on this one, because she’s much more tied into the community than the communities I have been in my recent practices. 14. Maintaining Agency Health Hats: I want to wrap up, and so if. Thinking about people listening to this conversation, what do you think is key that people should take away from this that’ll, in, in either of the three groups we’ve been talking about, what is a lesson that would be helpful for them to take away from this conversation? Lacy Fabian: I think that it’s important for the individual always to remember their agency. In their engagements. And so I know when I’m a person in the audience, listening to these types of things, it can feel very overwhelming again to figure out what’s enough, where to start, and how to do it without making a big mistake. I think that all of those things are valid. Most of us in our professional lives who are likely listening to this, we show up at meetings, we take notes. We’re chatting with people, engaging with professional colleagues, or connecting with the community. And I think that we can continue to be intentional with those engagements and take that reflective pause before them to think about what we’re bringing. So if we’re coming into that program with our research hat on, or with our funder hat on, what are we bringing to the table that might make it hard for the person on the other side to have an equitable conversation with us? If you’re worried about whether you’ll be able to keep your program alive and get that check, that’s not a balanced conversation. And so if you are the funder coming in, what can you do to put that at ease or acknowledge it? Suppose you are the person in the community who goes into someone’s home and sees them in a really vulnerable position, with limited access to healthcare services or the things they need. What can you do to center that person, still like in their humanity, and not just this one problem space? And that they’re just this problem because that’s, I think, where we go astray and we lose ourselves and lose our solidarity and connection. So I would just ask that people think about those moments as much as they can. Obviously, things are busy and we get caught up, but finding those moments to pause, and I think it can have that snowball effect in a good way, where it builds and we see those opportunities, and other people see it and they go, Huh, that was a neat way to do it. Maybe I’ll try that too. 15. Listen and Learn Health Hats: Thank you. Kirk. Kirk Knestis: Yeah. A hundred percent. I’m having a tough time finding anything to disagree with what Lacy is sharing. And so I’m tempted just to say, “Yeah, what Lacy said.” But I think it’s important that, in addition to owning one’s agency and taking responsibility for one’s own self, one stands up for one’s own interests. At the same time, that person has to acknowledge that everybody else knows that the three legs of that stool I described earlier have to do the same thing, right? Yeah. So, it’s about a complicated social contract among all those different groups. When the researchers talk to the program participant, they must acknowledge the value of each person’s role in the conversation. And when I, as the new nonprofit manager, am talking to funders, I’ve got to make sure I understand that I’ve got an equal obligation to stand up for my program, my stakeholders, and the ideals that are driving what I’m doing. But at the same time, similarly, respecting the commitment obligation that the funder has made. Because it never stops. The web gets bigger and bigger, right? I had a lovely conversation with a development professional at a community foundation today. And they helped me remember that they are reflecting the interests and wishes of different donor groups or individuals, and there’s got to be a lot of back-and-forth at the end of the day. I keep coming back to communication and just the importance of being able to say, okay, we’re talking about, in our case, mobility. That means this. Are we clear? Everybody’s on the same page. Okay, good. Why is that important? We think that if that gets better, these things will, too. Oh, have you thought about this thing over here? Yeah, but that’s not really our deal, right? So having those conversations so that everybody is using the same lingo and pulling in the same direction, I think, could have a significant effect on all of those relationships. Health Hats: Here’s my list from the listening agency, fear, mistake, tolerance, grace, continual Learning, communication, transparency. Kirk Knestis: and equal dollops of tolerance for ambiguity and distrust of ambiguity. Yes, there you go. I think that’s a pretty good list, Danny. Lacy Fabian: It’s a good list to live by. Health Hats: Thank you. I appreciate this. Reflection Everyone in a relationship faces power dynamics – who's in control and who's not? These dynamics affect trust and the relationship’s overall value, and they can shift from moment to moment. Changing dynamics takes mindfulness and intention. The community wanting answers, the researcher seeking evidence-based answers, and those funding the studies, have a complex relationship. Before this conversation, I focused on the community-research partnership, forgetting it was a triad, not a dyad. The Central Paradox: We have exponentially more information at our disposal for research, yet we’re becoming more disconnected. Lacy identifies this as the core problem: we’ve stopped seeing each other as human beings and lost the touchpoints that enable genuine collaboration—when connection matters most. This is true for any relationship. The Hidden Cost Structure Kirk’s 1/3:1/3:1/3 breakdown is golden—one-third for data collection and analysis (adds value), one-third for organizational operations, and one-third for reports (mostly shelf-ware). The key takeaway: we’re allocating one-third of resources to deliverables that don’t directly benefit the people we’re trying to help. Perhaps more of the pie could be spent on sharing and using results. Three Different “Utilities” Are Competing Kirk explains what most evaluation frameworks hide: funder utility (accountability), research utility (understanding models), and community utility (immediate benefit) are fundamentally different. Until you specify which one you’re serving, you’re likely to disappoint two of the three audiences. Data Parties Solve the Funder Problem Pragmatically. Rather than choosing between accountability and flexibility, data parties and face-to-face analysis let stakeholders interpret findings in real time – the data party. I love that visual. It’s formative, not summative. It’s relational, not transactional. The Funding Question Reverses the Power Dynamic. Currently, funders place the burden of proving impact on programs through monthly reports and compliance documentation. Lacy’s alternative is simpler: what if the funder hired someone to observe the program, gather the information, and report back? This allows the program to stay focused on its mission while the funder gains the accountability they need. But the structure shifts—the program no longer reports to the funder; instead, the funder learns from the program. That’s the difference between equity as a theory and equity as built-in. Related episodes from Health Hats Artificial Intelligence in Podcast Production Health Hats, the Podcast, utilizes AI tools for production tasks such as editing, transcription, and content suggestions. While AI assists with various aspects, including image creation, most AI suggestions are modified. All creative decisions remain my own, with AI sources referenced as usual. Questions are welcome. Creative Commons Licensing CC BY-NC-SA This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:    BY: credit must be given to the creator.   NC: Only noncommercial uses of the work are permitted.    SA: Adaptations must be shared under the same terms. Please let me know. danny@health-hats.com. Material on this site created by others is theirs, and use follows their guidelines. Disclaimer The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors, or Methodology Committee. Danny van Leeuwen (Health Hats)

Your health data belongs to you—but how can you share it safely? Fabienne Bourgeois, MD, exposes the complex truth about privacy, permissions, and data control. Summary According to Fabienne Bourgeois, MD, patients want control over their health data, but privacy preferences and constant changes complicate this. The discussion is relevant to people with disabilities, caregivers, and others navigating complex health information. About 80% of people share common privacy concerns that current systems can't address. The remaining 20% need more detailed controls and customization, though balancing autonomy with privacy remains challenging. Ownership means individuals have the right to participate in research and make informed choices. They need "digital intermediaries"— professionals who assist with data sharing—and genuinely intuitive interfaces. Privacy protections must remain a top priority as health and AI tools continue to develop. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemWhen Life Throws Your Kid a CurveballEmerging Adults MatterYour Medical Records Called—They're Lost and SeparatedOne Size Fits All? Please!Spoiler: This Affects Way More People Than You'd ThinkCan We Teach Tech to Understand ‘It's Complicated'?All-or-Nothing Privacy: The Sledgehammer ApproachMacGyver Solutions: When Your Software Says ‘No'The Secret Society of People Who Actually CareJuggling Your Mom's Meds and Your Kids' Forms: A Sandwich Generative NightmarePlaying Gatekeeper (Because We're Scared You'll Overshare)80% We Can Solve + 20% That's a NightmareInformed Consent: What If People Actually Understood?Needles in a Haystack: Finding Your 100 People WorldwidePlot Twist: When It's Your Data, Everything ChangesTraining Wheels for Privacy: Teaching People to ChooseThe New Job Nobody's Hired Yet: Your Privacy ConciergeCan We Build This So My Oma Can Use It?Tech's Outrunning Privacy (And We're All Just Watching)ReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Substack Patreon Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site management Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection Claude, Perplexity, Auphonic, Descript, Grammarly, DaVinci Podcast episode on YouTube Inspired by and Grateful to:  Alexis and Sara Snyder, Amy and Morgan Gleeson, Fatima Mohammed Ighile, Esosa Ighile, Jill Woodworth, Tomas Moran, Marianne Hudgins Photo Credits for Videos 80/20 by Austin Distel on Unsplash Design flaws by Getty Images on Unsplash Privacy by Hector Reyes on Unsplash Links and references Fabienne Bourgeois, MD LinkedIn and Publications National Center for Medical Legal Partnerships Episode Proem The slogan, “Give Me My Damn Data,” began in 2009 with E-Patient Dave DeBronkart as a call for transparency and control: patients arguing that real involvement in their healthcare needs open access to their personal health information. But once we have our data, what will we do with it? Who will we share it with, and in what situations? What are the personal and technical challenges of managing that sharing? I know enough to be dangerous about data-sharing technology. I do understand the personal and relationship sides of data sharing, though. To learn more, I reached out to my former colleague, Fabienne Bourgeois, an Adolescent Medicine doctor and Associate Chief Medical Information ...

Healthcare AI isn't a tech problem—it's a mirror reflecting how our health system already fails. Uncomfortable truths from Datapalooza 2025. Summary We're asking the wrong questions about AI in healthcare. Instead of debating whether it's good or bad, we need to examine the system-eating-its-tail contradictions we've created: locking away vital data so AI learns from everything except what matters most, demanding transparency from inherently secretive companies, and fearing tools could make us lazy instead of more capable. Privacy teams protect data, tech companies build tools, regulators write rules—everyone's doing their part, but no one steps back to see the whole dysfunctional picture. AI in healthcare isn't a technology problem; it's a mirror reflecting how our health system already falls short with privacy rules that hinder progress, design processes that exclude patients, and institutions that fear transparency more than mediocrity. The real question is whether we're brave enough to fix these underlying problems that AI makes impossible to ignore. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemParadox, Irony, Catch 22Burying the Treasure to Keep It SafeBias, Treating the Chart, Not the PatientCircular Dependence, Chasing Your TailIt Doesn't Have to Make Sense.Throwing Out the Baby with the BathwaterClear as MudRedistricting to DemocratizeHumanize Through the Looking GlassDriving while looking into the Rearview MirrorA Million Interns Working for YouWhat Keeps Me Up at Night About AI?ReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site management Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection Claude, Perplexity, Auphonic, Descript, Grammarly, DaVinci Podcast episode on YouTube Inspired by and Grateful to:  Christine Von Raesfeld, Mike Mittleman, Ame Sanders, Mark Hochgesang, Kathy Cocks, Eric Kettering, Steve Labkoff, Laura Marcial, Amy Price, Eric Pinaud, Emily Hadley. Links and references Academy Health's Datapalooza 2025  Innovation Unfiltered: Evidence, Value, and the Real-World Journey of Transforming Health Care Tableau  a visual analytics platform Practical AI in Healthcare podcast hosted by Steven Labkoff, MD Episode Proem Here's the thing about AI in healthcare—it's like that friend who offers to help you move, then shows up with a sports car. The Iron Woman meant well, but it doesn't quite meet your actual needs. I spent September 5th at Academy Health's 2025 Datapalooza conference about AI in healthcare, 'Innovation Unfiltered: Evidence, Value, and the Real-World Journey of Transforming Health Care. a is Academy Health's strongest conference for people with lived experience. I'm grateful to Academy Health for providing me with a press pass, which enabled me to attend the conference. I talked to attendees about how they use AI in their work and what keeps them up at night about AI. I recorded some of those conversations and the panels I attended. When I listened to the raw footage, I heard terrible recordings filled with crowd noise and loud table chatter, like dirty water spraying out of a firehose. Aghast, I thought, what is the story here? I was stumped. How can I make sense of this? I had to deliver something. So, here's how I use AI in my work as a podcaster/vlogger.

Letters beat emails for trustworthiness. A gullible skeptic reflects on navigating trust in a 50-year marriage, and the energy cost of distrust. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site management Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection Podcast episode on YouTube Episode Dear Listener and Reader, I thought I'd start writing you letters. I miss letters. I send cards thanking my guests for their participation. People universally appreciate getting something via snail mail. But cards aren't letters. They're preformatted notes, where I just change the image and the name. For giggles, I looked back at my very first blog post, July 31, 2012. It was a paragraph, a letter of sorts, short and simple, Improv and Best Health. It's taking me longer to produce each episode. So, no more frequently than once a month. So, why not a letter, short and sweet, from time to time? Let's start with trust. A letter feels more trustworthy than an email or a tweet. It's signed; a person who writes a letter really wants to communicate and thinks about what they're saying. So, perhaps, not a troll, more trustworthy. I always open letters. My immediate, momentary, default reaction to almost anything is trust. My kids say I'm gullible. My next instant reaction is skepticism. I think about what's not true about whatever. ‘AI is the solution to everything.' What do you mean, everything? What is AI anyway? Like that. I've been married for 50 years because at our core, my wife and I trust each other. We disagree, we misunderstand, we anger, I sulk. Yet we trust. On the other hand, I make stuff up. I misremember, create a story, and if it serves my purposes, stick with it or modify it as needed. My wife and grandkids are my fact-checkers. Still, we trust each other. In my personal life, trust isn't an on-or-off switch, all or nothing. Well, not usually. It's a matter of degree; it's about something. I trust that I can count on you to be there for me, unless you can't. I trust that you'll return my call, unless you're hurt, don't feel like it, or missed it. Distrust sucks energy; be more careful with my words, self-censor, close my heart and mind. I don't expect to trust everybody or everything. When I do trust, it's priceless. Thanks for listening, I'll be back. Related episodes from Health Hats https://health-hats.com/improv-and-health/ https://health-hats.com/pod113/ https://health-hats.com/trust-willing-to-be-vulnerable-worth-the-investment/ Artificial Intelligence in Podcast Production Health Hats, the Podcast, utilizes AI tools for production tasks such as editing, transcription, and content suggestions. While AI assists with various aspects, including image creation, most AI suggestions are modified. All creative decisions remain my own, with AI sources referenced as usual. Questions are welcome. Creative Commons Licensing CC BY-NC-SA This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:    BY: credit must be given to the creator.

Ronda Alexander on strategies to build inclusive health coalitions, manage power dynamics, center marginalized voices, & design sustainable governance. Summary In this episode of Health Hats, host Danny van Leeuwen talks with Ronda Alexander, a community health advocate and skilled facilitator, about the challenges of building and maintaining effective health coalitions. Alexander shares her journey from attending Detroit's innovative Henry Ford Academy to working with Ford Partnership for Advanced Studies on workforce development, ultimately finding her calling at Vital Village Networks in Boston, where she spent seven years supporting national coalitions focused on health equity and early childhood wellbeing. The conversation explores practical ways to manage power dynamics in cross-sector collaborations, from setting group norms that encourage real participation to designing decision-making processes that balance speed and sustainability. Alexander stresses the critical importance of listening to marginalized communities—those "furthest from opportunity"—and making sure they have real seats at decision-making tables, not just token representation. Key insights include strategies for inclusive facilitation, such as incorporating quiet reflection time, small group discussions, and developing shared talking points that coalition members can take back to their organizations. Alexander advocates for proactive governance planning, comparing effective coalition building to chess strategy, where groups think "seven to eight moves down the board" to prepare for inevitable challenges. The episode wraps up with Alexander's call to action for health advocates: start by listening to the communities you want to serve, trust what people tell you about their needs, and design systems that place those most affected by health inequities in leadership and decision-making roles. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemWhen did you first realize health was fragile?Vital Village NetworkLeadership, Impact, and MeasurementData StorytellingCommunity Research CollaborationFundingConvening, FacilitatingGetting Started at Henry Ford AcademyFord Partnership for Advanced StudiesTeaching Takes a VillageBack to DetroitPower DynamicsNorms: Don't Be a JerkFirst, Take a Few SecondsGovernanceFast or Sustainable DecisionsWho are the Decision-makers?Coalition BuildingTalking PointsFirst, We ListenReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site managementresil Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episode on YouTube Inspired by and Grateful to:  Jan Oldenburg, Ellen Schultz, Tomas Moran, Susannah Fox, Betsy Neptune, Tania Marien Links and references Ronda Alexander Henry Ford Academy Henry Ford Museum and Greenfield Village Ford Partnership for Advanced Studies Vital Village Network The Networks of Opportunity for Child Wellbeing Dr. Renee Boynton-Jarrett B'More for Healthy Babies Marginalization refers to the inequality certain individuals face in society due to power imbalances built into our systems. Episode Proem Learn with People on the Journey toward Best Health. That's my tagline. Let's break it down.

Exploring bird flu prevention with farm owner Shannon Hayes. Discover boot washing, flock protection with coyotes, and best practices in biosecurity. Summary

MS patient turned healthcare disruptor shares why your biggest "problem users" are actually your most valuable system improvers. Summary

These families created a pandemic pod with clear rules & shared childcare. While adults navigated anxiety, their kids called it "the best time of their lives." Summary Bevin Croft and David Weintraub talk about their experience forming a "pod" during the COVID-19 pandemic. Health Hats introduces participatory governance - a concept I've studied throughout my life in various contexts, including families, communities, organizations, and healthcare. My history with governance spans from 1968, through college activism, homeschooling my children, living in an intentional community, and working in corporate settings. The main segment features a conversation with Bevin and David, who formed a COVID-19 support group, or pod, with other families to help one another during the pandemic. They discuss: They spontaneously decided to form the pod in May 2020 Creating formal rules and a written agreement to manage risks and expectations The challenges of prioritizing the pod over extended family relationships The practical arrangements include shared meals, childcare, and rotating responsibilities Their collective approach to virtual schooling for their children The difficulties David experienced as a teacher during hybrid learning How their children viewed the pod experience as "the best time of their lives" despite adults' pandemic anxiety The lasting bonds their "family of friends" developed and maintained The pod used tools from Bevin's work in person-centered practices to create its governance structure. They made decisions based on consensus, with particular attention to accommodate the most cautious member's concerns. Their experience strengthened existing friendships and created lasting bonds between the families. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introMy Life with Participatory GovernanceForming a PodRulesNot easyPrioritiesRules, Contract, RisksTools for AgreementAccountabilityHow are You Different?MealsChildcareTraveling TogetherSchool and WorkingTough Times as a TeacherKids Loved ItBelated Introductions Call to actionReflectionPodcast OutroRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team You know who you are. I'm grateful. Podcast episode on YouTube Inspired by and Grateful to Jan Oldenburg, Nakela Cook, Russ Howerton Links and references World Health Network National Center on Advancing Person-Centered Practices and Systems Episode Proem My advocacy revolves around participatory governance in everything that contributes to a decent quality of life. Participatory governance entails broad involvement, accessible information, transparency, and accountability, leading to trust in decision-making. I'm a lifelong student of governance, having studied it in families, communities, teams, organizations, healthcare, research, and various other settings. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. My Life with Participatory Governance I've watched and participated in governance since 1968, when I was 16, dealing with the Vietnam War draft. I learned that the plumbing of the draft contained laws, written regulations, and unwritten rules, with people making decisions, people moving paper, and massive numbers of kids like me processing through. I wanted to prepare myself,

Who needs Spanish when you've got a saxophone? A music-lover proves that disability access is just another improvisation in Havana's jazz scene. Best viewed as a video https://youtu.be/Qz9Rm89LHD0 Summary Danny, Health Hats, chronicles his week-long trip to Cuba in January for a music-cultural exchange. Using a wheelchair and playing baritone saxophone, he traveled with a group of 11 from the States, organized by Dan Fox and Arlington MA's Morningside Studios. The group participated in a "Band Camp" hosted by the Havana Music School, receiving daily individual lessons, rehearsing in ensembles, and performing Cuban music at a restaurant. Despite Danny's initial anxieties about traveling with his disability and instrument, he found Cubans accommodating and helpful. The podcast features an interview with Claudia Fumero, manager of the Havana Music School, who discusses: The school's focus on teaching Cuban music to foreign visitors How the business began and evolved from connecting students with teachers in their homes to having a dedicated facility Her dream of expanding with more instruments and creating a small café where people can play music The episode is interspersed with musical performances by the ensembles, including renditions of "Sofrito" and "Afro Blue" by Mongo Santamaria. The group also attended the Havana Jazz Festival each night during their stay. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle ProemPodcast introBlending Language and CultureHavana Music SchoolHavana Music School – Morningside Studios ConnectionManaging the BusinessManaging the StayEmployer of Musicians Call to actionDreamsTraveling with DisabilitiesWhy Cuba?More MusicReflectionPodcast OutroRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team You know who you are. I'm thankful. Inspired by and Grateful to Dan, Peter, Ann, Sonja, Jeff, Deb, Bob, Richard, Pachy, Claudia, Gisselle, Miguel, Alejandro, Mauri, Leo, Adrian, Angelito, Lazaro Links and references Morningside Studios Morningside Studio Tours Havana Music School on Instagram The Second Ensemble performance featuring Jeff Stout, Deb Larkin, Bob Salitsky, and Dan Fox Havana Jazz Festival 2025 Sofrito by Mongo Santamaria Mambo Inn by Mario Bauza Afro Blue by Mongo Santamaria Lagrimas Negras by Miguel Matamoros Guantanamera by Jose Marti/JoesitoFernandez Proem Music is a world within itself, with a language we all understand. — Stevie Wonder. My nighttime voices bombarded me. How can you go to Cuba as a musician? You're not good enough. Your wheelchair won't make it over their crumbling roads and sidewalks.  Your horn is too big and heavy with everything else. You can't do too many stairs. You don't speak Spanish. You won't be safe. I hate those deflating voices. I should be excited about this chance of a lifetime. I completely trust Dan Fox, our guide and arranger. My disabilities do not define me. Helpful people are everywhere. I'm going with my partner of fifty years. We love music and culture. Who cares about politics? What the heck? We went. Welcome to the story of our adventures. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Blending Language and Culture Music alone can abolish differences of language or culture between two people and invoke something indestructible within t...

Data scientist Emily Hadley on navigating AI in healthcare, offering practical advice for maintaining patient agency amid algorithmic decision-making. Summary This interview with data scientist Emily Hadley examines the intersection of artificial intelligence and healthcare through a deeply personal lens. Hadley's journey began when her own health diagnosis coincided with her graduate studies in analytics, revealing how algorithm-driven systems often affect patient care—especially through insurance claim denials and clinical documentation. The conversation offers practical guidance for patients navigating AI-influenced healthcare, including reviewing AI-generated clinical notes for accuracy, challenging algorithmic insurance decisions, and insisting on human intervention when automated systems fail. Hadley advocates for preserving patient agency and rights within increasingly automated systems while highlighting how algorithm review boards are striving to provide governance in this largely unregulated space. The interview concludes with resources for staying informed about developments in healthcare AI, emphasizing that while AI tools are rapidly advancing, patient advocacy remains vital. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemA Data Scientist AwakesBuilding Guardrails with AI GovernanceHallucinations and Validation with AI in ResearchPrompt Engineering-Conversational AIVerification and VigilanceStaying InformedReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team You know who you are. I'm grateful. Podcast episode on YouTube No video Inspired by and Grateful to Eric Pinaud, Laura Marcia, Amy Price, Dave deBronkart, Links and references Prompt Engineering Algorithm Review Boards at RTI Dave deBronkart's Patient's Use AI Episode Proem This year, I switched from Medicare Advantage to Traditional Medicare. I still needed to purchase a supplemental commercial plan to cover what Medicare Part B didn't. However, the supplemental commercial plan denied some services the previous Medicare Advantage plan covered. Why? What algorithms did each plan use to determine coverage? How can I manage this? Welcome to the third installment of Artificial Intelligence Can Work for You. We've explored how I use AI in my podcast productions and delved into some AI basics with Info-Tech leader Eric Pinaud. I asked Emily Hadley, a data scientist at RTI specializing in AI algorithms for insurance coverage decisions, to join us. Early in her graduate studies, Emily was diagnosed with Crohn's disease. This led to her interest in studying insurance algorithms. A Data Scientist Awakes Health Hats: How did you gain expertise in AI? Emily Hadley: Great question. I was diagnosed right as I started a graduate program in analytics. In my undergraduate studies, I studied statistics in public policy. I liked the idea of using data to shape how policymakers make decisions, especially in the US. I had done some work with AmeriCorps and then went to grad school to really hone those skills. Being diagnosed at the same time that I was in grad school meant that I was navigating to new, informative, and educational areas. And I think that that's when I really came to realize the power of data and the power of AI in shaping the way that organizations and people make decisions. We live in a really algorithm-fueled society. We constantly encounter technology and AI systems, even when we don't realize it. An example I give is that I've faced many problems getting insurance to cover the things it is supposed to. I didn't realize until a couple of years ago that this is ...

A child of Holocaust survivors balances pathological optimism with apocalyptic thinking while seeking meaningful ways to channel advocacy in turbulent times. Summary In this deeply personal episode, a child of Holocaust survivors reflects on navigating today's global chaos while maintaining hope in healthcare. As a seasoned healthcare advocate, they share insights on: Leveraging privilege for positive change Finding balance between optimism and realism Adapting communication strategies for greater impact The importance of self-care and community support Key highlights: Moving from long-form monthly interviews to shorter, more frequent content The role of music as a healing force Following Helene Epstein's "Patient No More" insights Special music feature: "The Weight" by The Band with Ringo Starr and Robbie Robertson

Successfully sharing & acting on research findings depends on active partnerships with the implementers – patients, caregivers, & their clinician partners. Summary Claude AI consulted to create this summary The 2024 Academy Health Dissemination & Implementation (D&I) Science Conference revealed a significant gap between researchers and implementers (patients, caregivers, and their clinician partners). While D&I science studies how to share and apply research findings effectively, the conference highlighted that implementers—the very people meant to use these findings—were largely absent. Through interviews with attendees, key barriers emerged: high conference costs, lack of deliberate outreach, and content primarily designed for researchers. A compelling example from Ghana demonstrated successful implementation through radio drama and community health workers, suggesting that effective D&I requires meeting people where they are, both literally and figuratively. Click here to view the printable newsletter with images. It is more readable than the transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemShare and Use: Dissemination and Implementation2024 Academy Health D&I ConferenceAccording to Scientists, What is D&I?Setup and IntroductionsNGOs using Implementation ScienceNothing about us without usNGOs implement every dayUnderstanding the caregiver's experienceResearch questions from implementersAlign the languageFacilitating implementationWhat is Dissemination and Implementation Science?Implementers at the conferenceMore intentional invitationsPartnering with PharmaPaying for implementers to attendExperts don't have all the answersCost and timeRadical dissemination by radioTen + ten + thirtyReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Audio Podcast   Inspired by and Grateful to Anonymous, Bernard Appiah, Bryan Ford, Catherine Hoyt, Nadia Sam-Agudu, Tatiana Nickelson, Greg Martin, Kristin Carman, Aaron Carroll, Susannah Fox, Eric Kettering, Rodney Elliott, Lisa Stewart, Ellen Schultz, Kathleen Noonan Links and references The Communication Initiative Network Bernard Appiah Bernard Appiah's publications  Fascinating!! Nadia Sam-Agudu recent publication. Check this out. St. Louis Sickle Cell Association University of Colorado Accord Center. See Infographic here. Communication and Dissemination Strategies To Facilitate the Use of Health and Health Care Evidence Dissemination and Implementation Science to Advance Health Equity: An Imperative for Systemic Change Managing Clinical Knowledge for Health Care Improvement Embedding implementation science in the research pipeline A Systematic Review of Patient Engagement and Its Organizational Impact The Application and Evolution of the Practical, Robust Implementation and Sustainability Model (PRISM): History and Innovations Engagement in Research: PCORI's Foundational Expectations for Partnerships | PCORI Toolkit resources | Consumer Engagement | VCCC Alliance Building the table together: Lessons on authentic community engagement from INSPIRE Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care – Susan...

  Demystify AI's evolution, from Netflix recommendations to ChatGPT, exploring how neural networks learn & why even AI creators can't fully explain how it works. Summary Claude AI used in this summary

Reflecting on community & self-care post-election. MS teaches patience. Adjusting media habits, finding strength in family history, music, & trusted connections. Summary Health Hats muses about physical, mental, and spiritual health, community connections, and self-care during these post-election times. He has changed his media consumption habits and is learning from his experiences with multiple sclerosis. He expresses anxiety and a dark curiosity about the future, drawing strength from family history, marriage, and music, and emphasizes the importance of staying connected with trusted communities and being open to help when needed. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast Inspired by and Grateful to Steve and Sue Heatherington, Heidi Frei, Matt Neil, Tania Marien, Ann Boland, Leon van Leeuwen Links and references Heather Cox Richardson's Letters from an American on Substack Weekly Show with Jon Stewart Kareem Abdul-Jabbar on Substack Virginia Heffernan's Magic+Loss on Substack the Bulwark Katelyn Jetelina's Your Local Epidemiologist on Substack Lyz's Men Yell at Me on Substack the Guardian Sue Heatherington's fresh sight from the quiet edge. Episode Let's review the body from head to toe: tedious brain loop, dry, sticky mouth, queasy stomach, tight muscles, loose bowels, and bone fatigue. Fear, anxiety, despair, and hopelessness, with a niggling curiosity. I'm networking and reaching out to loved ones in person and virtually. Searching for facts, trust, and people to follow. I've stopped almost all pundits in print, audio, and video. My feeds are changing with more music, comedy, animals, and sports. And algebra—why algebra? I'm sticking with following Heather Cox Richardson, Jon Stewart, Kareem Abdul-Jabbar, Virginia Heffernan, the Bulwark, Your Local Epidemiologist, Men Yell at Me, the Guardian, and Sue Heatherington's fresh sight from the quiet edge. I've added AOC, Jeff Jackson, and Isaac Saul's Tangle. More music: My Latin Band, Lechuga Fresca, is on hiatus, so I joined a Dixieland Band. I'm still losing weight—30 pounds so far. I just noticed less abdominal flab to pinch when taking my shots. I can do 20 push-ups and 16 squats and can get myself up off the floor. I walk about 3,500 steps a day. I'm getting a new travel wheelchair. I have several priorities: don't fall, progress with MS as slowly as possible, maintain much of my pathological optimism, continue to play my horn, and contribute to inclusive, nurturing communities. The hardest priority may be maintaining optimism. MS has forced me to exercise my patience muscles. What choice do I have? I can't run to the bus. If I miss it, I miss it. What muscles will we strengthen over the next four years? I'm a terrible crystal ball gazer, but I know the self-care muscles will need attention. At this moment, I don't feel the urge to do much of anything except take care of myself and those with whom I'm fortunate enough to share an existence. When a plan comes to me, I'll share it. If someone else comes up with a plan, I'll check out the someone and the plan with others I ...

What kind of Artificial Intelligence does Health Hats, the Podcast, use in production? Understanding types of AI, transparency, and ethical considerations. Summary Perplexity used in this summary AI Tools in Use Various AI-powered software and apps are utilized in production, including Zoom, Descript, Grammarly, DaVinci Resolve, Canva, Perplexity, and OpenArt AI. Types of AI The episode breaks down different categories of AI, including Narrow AI, Artificial General Intelligence (AGI), and Artificial Superintelligence (ASI). AI functionalities are explained, from Reactive Machine AI to the theoretical Self-Aware AI. Ethical Considerations Transparency and disclosure of AI usage in content creation Maintaining authenticity and human creativity Ensuring content accuracy and preventing misinformation Addressing bias and fairness in AI algorithms Protecting user privacy and data Ensuring Transparency Disclosing AI usage in audio content and metadata Clear communication with the audience about AI utilization Appropriate use of AI as a tool to enhance, not replace, human creativity Verifying and fact-checking AI-generated content The episode emphasizes the importance of using AI responsibly to enhance the podcasting experience while maintaining integrity, authenticity, and trust with the audience. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemAI used in Health Hats ProductionAI in Podcast Production According to Health HatsAI in Content Creation and EditingAudio ProcessingVideo EditingAI for Content EnhancementTranscription and SubtitlingContent GenerationAI for Audience Engagement and AnalyticsPersonalizationAnalytics and InsightsTypes of AI Based on CapabilitiesNarrow AI (Weak AI)Artificial General Intelligence (AGI)Artificial Superintelligence (ASI)Types of AI Based on FunctionalityReactive Machine AILimited Memory AITheory of Mind AISelf-Aware AIAI Ethical ConsiderationsTransparency and DisclosureMaintaining AuthenticityContent Accuracy and MisinformationBias and FairnessPrivacy and Data ProtectionJob Displacement ConcernsClimate and Resource ImpactTransparencyDisclosure RequirementsClear CommunicationAppropriate AI UsageContent VerificationOngoing EvaluationTransparency: AI Notice in Health Hats, the Podcast Show NotesAI Notice for Health Hats, the PodcastReflectionRelated episodes from Health Hats Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Amy Price, Fred Trotter, Dave deBronkart, Eric Pinaud, Emily Hadley, Laura Marcial, James Cummings, Ken Goodman Links and references https://conversational-leadership.net/quotation/ai-is-neither-artificial-not-intelligent/ AI in Podcasting: Transforming Podcast with AI Technology Best AI tools for podcasts AI in Podcasting: A Guide for Brand Marketers https://www.carmatec.com/blog/ai-in-media-and-entertainment-complete-guide/ AI in Media and Entertainment Complete Guide Episode Proem No surprise, I use Artificial Intelligence in my podcast production. As an early adopter of technology,

Effective solutions & ethical guardrails for data-driven decision-making, care, & treatment require patient involvement in policy & technology development. Summary Patient Insights on Health Access, Technology, and Public Policy  Data should inform decision-making for a triad of patients, caregivers, and clinician partners. Some patients desire data sovereignty - the ability to access, use, and share their health data. However, managing personal health data can be overwhelming for individuals. Transparency about data usage and privacy is crucial for building trust. There are concerns about potential stigma and discrimination from data misuse. Including patients in policy and technology development can lead to more effective solutions. Ethical guardrails are needed, particularly for data aggregation and monetization by companies. There's a mix of optimism and pessimism about the future of health data management. Collaboration with patients in development processes can increase the likelihood of successful outcomes. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introLevel set – Get Your Patient On90% Similar, 100% HumanInspiration from Data: Weak Link in our HealthRelationship Triad for Decision-Making: Patient, Caregiver, Clinician PartnerUnintended Consequences – Crystal Ball GazingData Sovereignty – Self-GovernanceFederated Model of Data (Confederacy of Confederacies)Call to actionTrust Communities – Relaxed ControlTransparency – Knowing What You Don't KnowAnonymous Data. Really?Guardrails – Safety and PrivacyStigma and DiscriminationPessimism or Optimism About the FutureReflectionData and Decision-MakingData Sovereignty and ManagementEthical ConsiderationsPolicy and Technology DevelopmentOutlookPodcast Outro Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Kistein Monkhouse, Claire Sachs, Christine Von Raesfeld, Geri Lynn Baumblatt, Aaron Carroll, Erin Holve, Adam Thompson, Kathleen Noonan, Andrea Downing Links and references The Panel Kistein Monkhouse, the moderator, founded Patient Orators. My peeps are Christine Von Raesfeld, founder of People with Empathy and with the Light Collective, and Claire Sachs, founder of the Patient Advocate Chronicles and TPAC Consulting. A federated data model for patient data PCORnet is a prime example of a federated data system. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596061/ Episode Proem Kistein Monkhouse invited me to participate in a 30-minute panel at September's Academy Health's Datapalooza conference titled ‘Patient Insights on Health Access, Technology, and Public Policy.' I thought, ‘OMG, this thesis-worthy topic can't be addressed in 30 minutes.' However, the opportunity begged to be embraced, especially with the citizen expert panel members: Kistein Monkhouse, the moderator, founded Patient Orators. My peeps are Christine Von Raesfeld, founder of People with Empathy and with the Light Collective, and Claire Sachs, founder of the Patient Advocate Chronicles and TPAC Consulting.

Philip Shadle, CEO, Aimee Copeland Foundation opens outdoor accessibility for disabled individuals with all-terrain wheelchairs. My endorphins flow. Yeehaw! Summary This podcast episode features an interview with Philip Shadle, CEO of the Aimee Copeland Foundation, discussing the transformative impact of all-terrain wheelchairs on accessibility and outdoor experiences for individuals with disabilities. The podcast underscores the importance of accessibility and inclusion in outdoor activities, celebrating the collaborative efforts of organizations, individuals, and communities to enhance the lives of people with disabilities. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introOff-road wheelchair travelIntroducing Philip ShadleTravel in Costa RicaFoundation Business ModelAll-Terrain Wheelchair Models Call to actionTraining for Off-Road TravelBirthing the FoundationExpanding the Foundation OfferingsGratefulContestReflectionPodcast Outro Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Ann Boland, Bruce Kimmel, Olivia Zivney, Linda DeRosa, and all my many helpers Links and references Camino de Santiago pilgrimages, Costa Rica Aimee Copeland Foundation Action Track Chair in different sizes. Episode Proem According to the CDC A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions). Clearly, it's not a legal definition. I would add self-image, societal perceptions, and environment as components of that definition. Some days, I feel more disabled than other days, and some situations enhance or reduce my abilities. Ability/Disability is a continuum that changes over time and situation. Travel accentuates my abilities - puts them in high relief - for me. Travel requires close examination of my abilities so I can figure out how to manage minute-to-minute - constant decision-making. Travel allows me to stretch my capabilities. It's exhilarating and eventually exhausting. Periodically, I share my travel experiences. Remember the two Camino de Santiago pilgrimages, one in 2019 and the other 2022? In 2023 we explored Costa Rica.  We're planning a music trip to Cuba in four months. Today, I describe our trip to Cloudland Canyon State Park in northwest Georgia. After a zip-lining accident in 2012, when she was 24, Aimee Copeland was hospitalized and diagnosed with a flesh-eating, bacterial infection. They had to amputate both of her hands, right foot, and entire left leg. Before the infection, she was extremely active, rock climbing, backpacking, and trail running. In response to her frustration with wheelchair life, she created the Aimee Copeland Foundation, which raises funds to create opportunities for connecting with the self, the community, and the earth through the provision of a fleet of all-terrain wheelchairs for free use by people with disabilities within select Georgia state parks.  In this podcast episode,

Aaron Carroll, CEO of Academy Health, discusses his journey to improve health systems & decision making through community engagement & repetitive communication. Summary Aaron Carroll, CEO of Academy Health, shares his journey, from his frustrations with the healthcare system as a pediatrician, and the role of mentorship and science communication in his career. He delves into his efforts to make complex health issues understandable to diverse audiences through various media, his role in improving health care decision making and systems, involving communities in research, and building trust through consistent and repetitive science communication. Dr. Carroll also touches on the importance of implementation science and the challenges of making research findings effective in real-world settings. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introIntroducing Aaron CarrollHealth is FragileWriting a Prescription Isn't EnoughFix itPhase one: Independent InvestigatorPhase Next: Mentor, Communicator, ResponderAcademy HealthCommunicating Science to the Public Where They AreThe Practice of Communicating for ImpactEngaging Lived ExperiencePatients Included at Academy Health Call to actionKey PointsLived Experience at the Table – Your Lived ExperienceResearch SkepticismLearning When the Hypothesis isn't ProvenImplementation ScienceEfficacy and EffectivenessTrust and ListeningRepetition, Repetition, RepetitionReflectionPodcast Outro Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Seth Godin, Nakela Cook, Ann Boland, Ellen Schultz, Steve Heatherington Links and references Aaron Carrol: The Incidental Economist, Healthcare Triage, Robert Wood Johnson Clinical Scholar, New York Times, Indiana University's COVID response. Academy Health: Academyhealth.org/Datapalooza, Communicating for Impact, community-led research grants, Health Data Leadership Institute, Dissemination Implementation Science Conference patient-included criteria implementation science Episode Proem Danny and Ann, July 3, 2024 Together for more than fifty years, my wife and I still practice communication - practice as in repetition, experimentation, and humility with two steps forward and one step back (or one forward and two back). No wonder anyone participating in healthcare continually struggles with the puzzle of communication. Just today, I texted a pharmacy about access to a critical medication with an expired prescription, tried to explain my newly diagnosed diabetes and diet choices on FaceTime with a friend, and drafted a letter about lessons learned about measurement for team members to share with our leaders. I know some master communicators: Seth Godin, Nakela Cook, my wife, Ellen Schultz, Steve Heatherington, and my guest today, Dr. Aaron Carroll, President and CEO of Academy Health. They each excel in different ways under different circumstances. I must take care to keep listening to their content and not float above and marvel at their artistry and skill. DALL·E 2024-07-24 09.19.39 - A scene depicting various master communicators, each in their element.

Family and friends dispersed Mighty Casey (Mary) Quinlan's ashes in the Gulfstream, reflecting on her life and sharing outrageous and mundane pics and stories. Summary On May 24, 2024, Mighty Casey Quinlan's ashes were spread in the Gulfstream of the Atlantic Ocean near Stuart, Florida. This episode captures the layers of that experience, featuring an introduction conversation between Jan Oldenburg and Health Hats, recorded on June 27. The episode includes self-introductions of the dispersal party, a historical photo tour of Casey's life, and a reflection from Hank Burchard. The package of audiovisual pieces including a 17-minute video with introductions and a three-minute photo tour by Casey's sister, CeCe can be found in the show notes. Coming soon, Casey's website, mightycasey.com, will include all her podcasts and the contents of six VHS and one Beta tape recorded over the years. Check our progress. These show notes DO NOT include images.  Images are key to this episode. Click here to view the printable newsletter with images.  Contents Table of Contents Toggle CreditsEpisodeProemPodcast introThere's Something Happening HereHow I Met CaseyCall to actionPhoto Tour with Historian, CeCe CaseyJan and Danny sign offReflection from HankPodcast OutroCreative Commons Licensing Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Jan Oldenburg, CeCe Casey, Michael Casey, Myrna Isaacs, Piper Dankworth, Laurie Rodgers Stukel, Hank Burchard, Dave DeBronkhart, Amy Price Links and references Casey's Website Health Hats Podcasts with and about Casey  Credits Music behind photos scraped from YoYo Ma on Fresh Air Images of Casey throught taken by family and friends over the years Episode This transcript DOES NOT include images.  Images are key to this episode. Click here to view the printable newsletter with images. Proem Health Hats: On May 24th, 2024, we spread Casey's ashes in the Gulfstream of the Atlantic Ocean near Stuart, Florida. This episode layers several of the many pieces of that experience. I stopped here because I'd had enough. Time to publish! You'll find an intro conversation between Jan Oldenburg and me recorded on June 27th, followed by self-introductions of the dispersal party, recorded by our guide, Karen Hallett. Next, we'll take a historical photo tour of Casey's life, piloted by Casey's sister, CeCe. I only included about fifteen of the almost one hundred photos, as the resulting three-minute clip took almost twenty hours to produce. We'll end with me reading Hank Burchard's post-event reflection, and then Jan and I will wrap it up. The written and audio include everything except the videos, of course. I will create a 17-minute video with the introductions and a three-minute one with the photo tour. I'm resurrecting Casey's website to include all her podcasts and the contents of six VHS and one Beta tape Casey recorded over the years. The URL will be Casey's https://mightycasey.com. Try it to see if we've got it ready. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little.

Shana Davidson shares her day-to-day Long Covid challenges using the "spoon theory," a metaphor for the limited energy reserves people with chronic illness face Summary The episode explores the fascination with prolific enigmatic conditions, which are common yet complex and often misunderstood illnesses like fibromyalgia, chronic fatigue syndrome, lupus, endometriosis, and long covid. These conditions highlight systemic issues in healthcare, such as various biases and the complexities of corporate medicine and research. Shana Davidson, having personally experienced misdiagnosis and the challenges of navigating these conditions, emphasizes the intersectional barriers faced by women, people of color, and those with mental and spiritual health challenges. Shana shares her journey with long covid, discussing the day-to-day management challenges using the "spoon theory," a metaphor for the limited energy reserves people with chronic illness face. Shana's experience underscores the difficulties in obtaining a diagnosis and appropriate care, reflecting broader issues in the medical system's handling of chronic conditions. Throughout, the podcast touches on themes of resilience, the need for advocacy, and the struggle for recognition and adequate research in treating long covid and similar conditions. The conversation also highlights the importance of compassion and understanding within the medical community and society towards those living with chronic illnesses. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introLearning health is fragileSpoons, SpooniesPace Yourself versus SpoonsBudgeting spoonsRecovery mode variation in spoonsContracting CovidOpening upYikes, Long Covid?Tired of Pursuing AnswersLong Covid CenterAsynchronous communicationFinally Diagnosed Call to actionRebel HealthSocial media help – 2-edged swordUseful helpSome compassion, pleaseWhat's in a Name?Chronic Disease Management – Diagnosis, Symptoms, Care, TreatmentInvesting in Long CovidReflectionPodcast Outro Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Podcast episodes on YouTube from Podcast. Inspired by and Grateful to  Jeff Horner, Yaneer Bar Yam, Melissa Reynolds Links and references Episode Proem Ants: Prolific and enigmatic. Image by Open Art AI in style of Paul Barson Prolific enigmatic conditions fascinate me. Prolific (many) is the opposite of rare (few), so not a rare condition. Enigmatic means mysterious riddle. Examples of enigmatic conditions include fibromyalgia, chronic fatigue syndrome, lupus, endometriosis, and long Covid. Enigmatic conditions put a spotlight on isms – racism, sexism, ageism, ablism, paternalism. They reveal a near-universal discomfort with uncertainty. And when you pull back the curtain to try to search or solve, you find the weight of corporate medicine, the research industrial complex, and vested-interest policy making. I know the frustration of years of misdiagnosis. I was misdiagnosed with cardiac disease when I had multiple sclerosis. My privilege insulates me from many cultural barriers and humiliation experienced by women, people of color, and those with mental and spiritual health challenges arising...

Turn-around: Grandson interviews Health Hats about his Zelig-like career path and choices: unpredictable, privileged, mentored, supported, and spiritually healthy. Summary Health Hats is interviewed by his editor, grandson Leon, delving into a discussion about his diverse and impactful career. The episode starts with Leon interviewing Health Hats about the origins and motivations behind the podcast, tracing back to a serendipitous naming and a road trip that solidified the podcast's visual identity. Health Hats shares his journey from opting out of a higher-paying job that required him to cut his long hair to embracing a path in healthcare as a psychiatric aide, which led him to nursing school.  The story also touches on being a male nurse in the 70s, transitioning from direct care to significant hospital and quality management roles. Leon and Health Hats discuss the significant impact of personal decisions on career paths, the unpredictability of life, and the profound influence of one's birth and circumstances. Health Hats reflects on his efforts to improve healthcare systems, advocating for better staff and patient conditions and participatory health. The episode explores Health Hats' professional life, his philosophy on work-life balance, his role as a change agent, and his commitment to continuous learning and improvement. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Table of Contents Toggle EpisodeProemPodcast introBirthing Health HatsNursing school – what's hair got to do with it?Wanted a lifeFirst male public health nurse in Western MassWe don't hire men in nursing hereRetiring in our thirties as back-to-the-land hippiesCouldn't manage an emergency at homeTwelve-bed hospitalWest Virginia, a Third World stateAdvanced Cardiac Life Support Call to actionVolunteering for the Emergency SquadFrom direct care to managementChange agent: staffing and visiting hoursRemote Learning for a Master's DegreeMoving onStudent of organizational healthOutspoken, driven change agentBest Boss EverThe will to change – leadershipNo, lay me offRetiringProfessional life, more than the jobCan't keep a jobReflectionPodcast Outro Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, TikTok to @healthhats Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: article-grade transcript editing  Oscar van Leeuwen: video editing Julia Higgins: Digit marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection, including Moe's Blues for Proem and Reflection and Bill Evan's Time Remembered for on-mic clips. Five-minute episodes on YouTube. Inspired by and Grateful to  Jim Bulger and Bob Doherty (deceased), Eric Pinaud, Jane Sarasohn-Kahn, Luc Pelletier, John Marks, Ann Boland, Lynn Hubbard Links and references Are medication error rates useful as a comparative measures of organizational performance? was published in The Joint Commission Journal on Quality Improvements in 1994 receiving the David K Stumpf Award for Excellence in Publication from the National Association for Healthcare Quality. The article was referenced in the book, Error Reduction in Healthcare by Patrice L. Spath in 2000. 1977 article about Danny van Leeuwen, the first male public health nurse in W Mass It sounds like a Zelig effect (if you know Woody Allen) or a Forrest Gump effect (if you know Tom Hanks) Jane Sarasohn Kahn, a blogging health economist West Virginia The University of Minnesota ISP Program Episode Proem As you may know, my production team includes Grandson Leon,

Kathleen Noonan's quest to build bridges between communities & researchers with long-term relationships & respect for experience & expertise, just like juries. Summary Kathleen Noonan, the CEO, catalyzed the transformation of the Camden Coalition into a national platform for complex care. She focused on capacity building, bridging healthcare research with community organizations, and emphasizing the power of diverse partnerships. Noonan is a staunch advocate for community-driven healthcare, pushing institutions to incorporate local insights and foster long-term relationships that shape better research and policy outcomes. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Two five-minute clips on YouTube. Contents Table of Contents Toggle EpisodeProemPodcast introThe fragility of healthJourney to healthcare advocacyInsights from the legal and corporate worldsTransition to Children's Policy and HealthcareFirst encounter with Camden CoalitionThe impact of diversity at conferencesMeeting of the minds over community – research interfacesAn outsider co-directing a Research CenterImplementation, a different animal altogetherWho asks the research questions?Partnering in the communityEarning the right to speakFull of myself Call to actionPunching above our weight classFrom a local to a national organizationComplex care centerCommunity Nursing in 1976 – Walking Inner City route.Capacity to partnerLong-term relationships, lean into expertise.MediationMessy and localCommunity participation in research – capacity buildingStart with the research questions askedLong-term relationships informed consumers and researchersConsider juries as an effective, diverse set of mindsExpertise versus credentialsReflectionPodcast OutroPlease comment and ask questions: Episode Proem In 2020, early in the COVID pandemic, I joined with several colleagues asking the questions: How can the research industry help laypeople and communities find evidence-based guidance on how to live safely? Guidance that answers their questions when needed? Guidance that feels familiar and helpful. Guidance they trust. How can we be inclusive of our communities' awesome diversity? See the podcast episode here. We spent several years exploring those questions, informing my passion for community-research partnerships. I highlight such partnerships as often as possible in my podcast. One of my primary advocacy goals is to promote research that answers questions the public and communities ask. My guest today, Kathleen Noonan, is CEO of the Camden Coalition, a multidisciplinary, community-based nonprofit working to improve care for people with complex health and social needs in Camden, across New Jersey, and nationwide. They develop and test care management models and redesign systems in partnership with consumers, community members, health systems, community-based organizations, government agencies, payers, and more to achieve person-centered, equitable care. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. The fragility of health Health Hats: Kathleen, thank you so much for joining us. I've been looking forward to this. When did you first realize health was fragile? Kathleen Noonan: That's a great question. There are so many different answers to that. At some point as a kid, you realize that your parents aren't just older than you, but older adults don't stay around. When I was a kid, there was a girl on my block who passed away from pneumonia. It was an early developmental moment. But then, when did you realize that health is fragile because the healthcare system i...

Exploring the journey of coffee from farm to cup with expert Jen Stone, delving into flavors, cupping, & the ethics of coffee production. Music & Health, too Full 36-min episode on YouTube Two five-minute clips on YouTube. Click here to view or download the printable newsletter Contents Table of Contents Toggle EpisodeProemPodcast introIntroducing Jennifer StoneHealth is FragileProfound Knowledge of Coffee or CaffeineCaffeine Delivery SystemCoffee CupperCoffee Flavor Notes Call to actionCoffee Flavor Notes in My CuppaDifferent tastes and circumstancesFermentationTransparencySocial Justice in Coffee MakingMy PaletteSlow down and tasteYou've ruined me a bitEquipmentReflectionPodcast OutroPlease comment and ask questions: Episode Proem When I take two minutes to bitch about the annoyances of having Multiple Sclerosis, I insist that I can't be repetitive. I must whine and complain with new words. How many words do we have for describing symptoms of pain? Not enough. Sharp, dull, achy, daily, itchy radiating, nauseating, disabling. Greenland has 46 words for snow and no wonder. Profound knowledge about something leads to more words being needed and created. The better we can describe ourselves to ourselves, the deeper we understand our nuances. More accurate and specific descriptions lead to better communication of our symptoms, moods, and circumstances with our health team. Then, we can make informed decisions, plan, and adjust together. Believe it or not, this rant about words leads us to today's episode on coffee. Welcome to my new hat – coffee snob. Our guest is Jennifer Stone, my colleague in my Thursday morning mastermind group for solo entrepreneurs. Jen is a Sommelier of Coffee and the host of the Coffee Explorer Podcast, a Quality Lecturer, and a Licensed Q Grader by the Coffee Quality Institute. She is internationally recognized as an Expert Coffee Taster and Judge for the Cup of Excellence. She has expertise in finding, sourcing, and sharing remarkable coffees from quality global producers. Over her career, she's opened multiple cafes and created several direct-to-consumer and business-to-business specialty coffee brands. She provided expertise to others in these areas and is always excited to share the best ways to brew coffee with the market. Jen Stone has opened my eyes in unexpected ways. Drink up! Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Introducing Jennifer Stone Health Hats: Jen, you've opened many senses for me. We met over the business. We are working together on our business; you know how that's growing and managing. But I've learned from you about coffee, not just coffee. It's about the sense of taste because it's not just, you know, while I'm learning to appreciate fine coffee. I was concentrating more on what was happening in my mouth. I'm finding it with food, chocolate, and alcohol, and just more awareness. Health is Fragile Health Hats: When did you first realize health was fragile? Jennifer Stone: This is such an interesting question. I love that you asked about the word health as fragile and not life as fragile. When a loved one passes, or you have a near-death experience, that speaks about life, but health, specifically, is a little vaguer. About a year and a half ago, I could say I loved to run. I'm not fast, but I love to jog and exercise. One of my knee joints began to wear down. I have some arthritis in one of my knees, and it felt like this bone-on-bone thing. It was disabling. After a few days of it not going away, no matter how much ibuprofen I took, I realized I needed my knee to strengthen. I don't want to focus on my knee.

Susannah Fox's "Rebel Health" on the power of Seekers, Networkers, Solvers, & Champions in driving patient-led innovation & the communal fight against disease. Full 36-min episode on YouTube Two five-minute clips on YouTube. Click here to view or download the printable newsletter Contents Table of Contents Toggle EpisodeProemPodcast introRealizing the Fragility of HealthTransition from Research to ActivismThe Role of Perception in HealthcareA System Versus Community View of Healthcare InnovationHacking Healthcare and StartupsMotivation to Solve Call to actionSeekersNetworkersSolversChampionsNetworker, Seeker, Solver, ChampionNetworker, Champion, SolverPersisting BossLeading by Helping the HelpersActors on the Stage of InnovationEmergence of ChampionsServing CommunitiesRevolutionary Energy – Regina Holliday and Casey QuinlanDraft Counseling – Working from the InsideChampions Stoke FiresRebels in Health – You Are Not AloneC-Suite and Government Meet RebelsStep into Your PowerThe Enemy is Disease​ReflectionPodcast Outro Episode Proem Rebel Health by Susannah Fox As a student of advocacy and activism, I draw warmth from the heat of others' passion, marvel at the diversity of origin stories, and burst with curiosity about what might come next. How did they start on this journey, and why do they persist? I've been a nurse for 50 years. One of the best things about nursing for me was the license to be nosy – for a brief time - a visit or a stay. This nosiness melds nicely as a podcaster for an episode. I often ask guests, “When did you realize health was fragile?” Another student of advocacy and activism is our guest, Susannah Fox.  Susannah is a health and technology strategist. Her book, Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care, has just been published by MIT Press. She is a former Chief Technology Officer for the U.S. Department of Health and Human Services, where she led an open data and innovation lab. She has served as the entrepreneur-in-residence at the Robert Wood Johnson Foundation, and she directed the health portfolio at the Pew Research Center's Internet Project. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Health Hats: Susannah Fox, how are you? It's so good to see you. I've been looking forward to this. You've been my idol for a long time. I first learned about you when you were at Pew Research Center, and I thought your perspective and research were so helpful. Realizing the Fragility of Health When did you first realize health was fragile? Susannah Fox: Wow. The first time I realized that health was fragile was when my dad was a flatliner on the table at the hospital after his heart attack. He was in his fifties and someone who, to anyone who looked at him, would've thought he was a health nut. He went four miles three times a week. He was fit. He loved to hike. He was a mountain climber. And yet he had genetically high cholesterol and a hidden, blocked artery. So, they luckily were able to revive him, and he had open heart surgery and lived long enough to then get kidney cancer in his sixties and melanoma in his seventies. My dad was my model for lifelong health and perseverance. I love this question because it explains how you learned that health is fragile. But then also what? What happened when you learned that health was fragile? For me, it was seeing my dad persevere to regain his health each time he had a setback. Health Hats: That's admirable. Transition from Research to Activism Health Hats: You had these experiences and are now in activism. How did that path happen? How did you get where you are now?

Celebrating my audience. Describing my multimedia journey, stats, ongoing advocacy, future episodes and a musical bonus featuring the host on the Bari Sax. Show Notes at the end. Watch on YouTube None today. Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle Watch on YouTubeRead NewsletterEpisodeProemPodcast introManaging my bandwidthStill learning in my sandbox.AdvocacyPodcast OutroEl QuitrinEpisode Notes Episode Proem Welcome to this bonus episode of Health Hats, the Podcast for subscribers I appreciate. Life is good while I play in the sandbox of audio-visual communication about best health. One of my Reckoning colleagues (we review each other's podcasts), Craig Constantine, describes his audience in each episode so he remains focused. I look at the bobbleheads on my windowsill: Scarecrow, Rosie, the Riveter, and Scully from the X-files. My audience is people who help people on their journey toward best health through caregiving, technology, measurement, spiritual strength, and planning. You get the idea. For an added treat. At the end of this post, I'll include Lechuga Fresca Latin band playing El Quitrin by Bebo Valdez with me on the Bari Sax. Link here if you want to listen now. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Managing my bandwidth I'm finding video creation and production so exciting that I spent 100 hours on the last episode, #214, with Fred Trotter. I can't sustain that pace. I realized I had spent so much time on a full-length video with images, title slides, and the like that I neglected the meat and potatoes – the blog/newsletter and audio podcast. I also need more time to play my horn and improve my music production skills. So, after spending all that time, I published the full audio podcast (63 minutes), two five-minute and four one-minute videos, and a 30-second teaser/trailer. I think I'll put the five-minute ones on YouTube as discrete episodes as they stand alone.  You can find them here: Video 1: Naughty Secret about Chart Reviews https://youtu.be/yLRilkr1LJI and Video 2: ChatGPT and health coverage https://youtu.be/pk4wYl0_U9s. Still learning in my sandbox. I remain committed to multimedia because you are all so different, and it's a hoot. I'm continuing my understanding and skill at short-form videos for social media, especially Instagram. My team of Julia, Kayla, Leon, and Oscar cheer me on. I love that I can still learn. If stats interest you - I don't know what they mean - for some reason, the downloads for the audio podcast have increased from an average of 5-10 a day for years to 27 a day for the past 30 days (or an increased from 80 to 800 an episode). 90+% of those downloads are consistently listened to for at least 3/4 of the episode length over the years (that includes people who automatically download. See what I mean about not being sure what stats mean).  For those who subscribe to the newsletter version, with almost 50% opened, and readers spend more than five minutes reading when they do open. Kayla tells me I should be proud of that. Social media stats indicate that people scroll past and increasingly stop but don't stick around for over a second. It is early days, and I'm refining my process. YouTube shorts require clips to be less than 60 seconds, but I'm not sure that's my target so I may go for two-minute clips on Instagram and TikTok. Again, this is a totally fun sandbox. Advocacy Rebel Health by Susannah Fox Advocacy-wise, my attention is shifting to Long Covid,

Fred Trotter on the balancing privacy & connection, the role of AI in societal judgment, and practical privacy protection strategies with a nod to Mighty Casey Watch two five-minute podcast clips on YouTube. Click here to view or download the printable newsletter with associated images Contents Table of Contents Toggle EpisodeProemPodcast introPrivacy in Digital CommunicationHarm reduction, safety, data aggregationCommunication minimalists and maximalistsPrivacy in small villages during the Bronze AgePrivacy in the viral modern ageJudicial enginePrivacy and shameDenied accessPeer-to-peer connection and privacy riskPeople-to-needs connectionA connection you don't know you haveHarm reductionOversimplification of harm reductionRedliningAI Artificial IntelligenceCall to actionChatGPT and health coverageAggregating informationAI judicial processes by Insurers outside the courtsWhat can I do to reduce potential harm?The Light CollectivePassword managersPseudonymityLow-tech approachesThe Electronic Frontier FoundationInter-rater reliability in chart reviewsInter-rater reliability and AIAI can make a complex system faster, not betterSituational awarenessExpectations of organizationsChatGPT and Large Language ModelsThe Mighty Casey Quinlan ApproachDALL.E – AI ImagesPrivacy of creatorsDangerously hopeful​ReflectionPodcast OutroPlease comment and ask questions:Production TeamCreditsInspired by and Grateful toLinks and referencesRelated episodes from Health HatsCreative Commons LicensingCC BY-NC-SADisclaimer Episode Proem How does YouTube know so much about me? I'm searching on my browser for solutions to my too-slow-responding Bluetooth mouse. In moments, YouTube feeds me shorts about solving Mac problems. I'm following a teen mental health Twitter chat, and my TikTok feed shows threads about mental health apps. How do they know? I'm getting personal comments about my mental health. My mental health is mostly good. Who else will know? Do I care? I live my life out loud. I don't share what I wouldn't want on a billboard, which, for me, is almost everything. When is that unsafe? When would I be embarrassed? I'm no longer looking for work, so I don't care. Who can access my data? What should I share? What does privacy even mean? How does privacy impact the need for connection? Isn't privacy a continuum – different needs at different times from different people?  So many questions. Today's guest, Fred Trotter, co-authored the seminal work Hacking Healthcare. Fred is a Healthcare Data Journalist and expert in Clinical Data Analysis, Healthcare Informatics, Differential Privacy, and Clinical Cybersecurity. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Privacy in Digital Communication Health Hats: I picture movement along a continuum when I think about Digital Privacy. Complete privacy is connecting with no one. That's intolerable. No privacy is connecting with everyone about everything. That's unsafe and exhausting. Privacy and risk tolerance go hand in hand for me alone and for me with my peeps and tribes. Risk tolerance isn't fixed it changes with context. My thoughts get muddier when I associate privacy and connection. They are flip sides of the same coin. I need community connection. But the more I connect (content and reach), the more complex privacy becomes. My approach to managing privacy involves harm reduction, a term used in substance use treatment. So, based on my ever-changing risk tolerance and my need for connection, how do I reduce the harm privacy issues can cause? Harm reduction, safety, data aggregation Fred Trotter: It's funny that you mentioned harm reduction. A college friend of mine,

Lisa Stewart interviews Health Hats to discuss family, music, & listening to younger activists taking over navigation & reform of healthcare. Watch on YouTube Download the printable newsletter here Contents Table of Contents Toggle EpisodeProemPodcast introWhy reflect? Accept and look forward.Bitch in bursts, not dribblesCatastrophizing, pathological optimistMusic, podcasting, grandsonsListening to younger activistsConnection through video, Instagram, YouTube shortsImpact Call to actionProgressing in musicProgressive condition and musicTravel with abilities in Costa RicaTravel with abilities in the USWords of wisdomReflection on AdvantagePodcast OutroPlease comment and ask questions:Production TeamCreditsInspired by and Grateful toLinks and referencesRelated episodes from Health HatsCreative Commons LicensingCC BY-NC-SADisclaimer Episode Proem Boland van Leeuwen family Happy Holidays, family, friends, and colleagues. May the 2024 New Year infuse wonder, community, and rejuvenation. I reunited with my friend, Lisa Stewart, at the PCORI Annual Meeting a few months ago. Lisa suggested that she interview me for the new year. When I met Lisa, she was Senior Engagement Officer and Health Equity Advisor at PCORI (the Patient-Centered Outcomes Research Institute). Currently, Lisa is the Principal at Torchlight Engagement Advisors & Leadership Coaching. Her joy lives in connecting ideas, people, and groups for organizations serious about improving the health outcomes of over-burdened communities through health equity strategy implementation and integration, cross-sector partnerships, impact investing, and capacity-building. We ponder privilege, listening, bitching, travel, family, and music. Hang on. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Why reflect? Accept and look forward. Health Hats: Hi, Lisa Stewart. Lovely to see you, Lisa Stewart: Wow. It's lovely to be seen and be here with you. We had this wild and crazy idea that it was time for Danny to be interviewed, right? We're going to turn the tables on Danny. DALL·E 2023-12-16 - a color photo of a person looking in a mirror and seeing a black and white younger version of herself What better time of year as we march into 2024 and start thinking about the life we want to lead and what we want to do differently? I'm thrilled to be in conversation with you anytime, Danny. Anything you want to say? Health Hats: I have mixed feelings about reflection. On my podcast, I start with a proem, a preface. Why do I  have the conversation? Why this guest, why this topic, whatever. A reflection at the end, done after production - the interview, the producing, the editing - were there pearls here? Is there one more story to tell? But the reflection is essential even though I'm not really a backward-looking guy. Lisa Stewart: Tell me more. Bitch in bursts, not dribbles Health Hats: Life has ups and downs. It is just the way it is. You can't have an up without a down where everything is flat - no ups and downs. Sounds boring to me. I have a chronic illness, and I'm pathologically optimistic, right? That's my style. Other pathologically optimistic people have taught me that you need to take two minutes periodically and just vent. And do the life sucks. Woe is me stuff. But mostly, I don't want to look back and think woe is me. So that's what I mean by not looking back. Accept what is and what are we going to do now. Lisa Stewart: Very practical. Do you have a ritual around your two-minute releases? DALL·E 2023-12-16 - biracial couple laughing, one in a wheelchair looking at their watch Health Hats: It's a good question.

Pathways & switches of pain affect well-being & productivity. Amy Baxter, MD. explores recent insights about managing pain and learning coping mechanisms. Watch on YouTube Download the printable newsletter here Contents Table of Contents Toggle EpisodeProemPodcast introLearning from lived experienceOldest and Best Survival SystemPain as opportunityThe thalamus conducts the switchboardPain: Your brain's opinion of your safetyWhat's going on? Communicating to physiciansSickle cell, self-knowledge, mu receptorsNeurotransmitters: on or offBrain FertilizerExercise as WD-40 loosening lubricantAcceptance and Commitment TherapyBuilding Resilience to Trauma and Pain Call to actionHolocaust PTSD, painMelissa versus FibromyalgiaHelpers: Child Life SpecialistsBrain's survival systemPhlebotomists and clownsPain wuss or high toleranceFear and controlHope in the right frontal cortexGuiding someone to manage their painPrimary care in Managing PainOverride and telehealthCultural humilitySoul points and a bucket of painI am not my painLove myself, pain includedReflectionPodcast OutroPlease comment and ask questions:Production TeamCreditsInspired by and Grateful toLinks and referencesRelated episodes from Health HatsCreative Commons LicensingCC BY-NC-SADisclaimer Episode Proem Buzzy, Relief from Needle Pain by Amy Baxter How crazy is it that pain is one of my favorite topics? Not so crazy as pain may be life's most common symptom. One study pegs the annual cost of pain (as a primary diagnosis) to be between $261 to $300 billion. Yikes. No one I'd rather talk with about pain than Amy Baxter. Amy and I correspond regularly about life and pain. We last recorded a conversation about pain in July 2019, Pain: The Solution - Many Solutions. Our knowledge about the pathways and switches of the brain's survival system has increased dramatically since 2019. Let's jump right in. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Learning from lived experience Health Hats: You've learned much about pain since we last talked. Tell us about that. Amy Baxter: I broke my neck in 2015 and then got intubated for a while, and then I had a ripped rotator cuff that I ignored until it got horrific. So, I feel grateful that I've had the experience to cope with my own acute and chronic pain, mostly chronic. It's nothing like I imagine having a genetic issue or having an inflammatory ongoing issue, and particularly something like covid or fibromyalgia or an autoimmune system situation where it's ongoing and systemic. Nonetheless, I've had that experience, which has been valuable. I also have been working with the National Institutes of Mental Health, Helping to End Addiction Long-Term Initiative, bridging that place between pain and opioid use because if we didn't have the issues of post-surgical pain and acute pain that we treated with opioids, we wouldn't have an opioid problem. I've been busy. Health Hats: Goodness, where should we start? Amy Baxter: Let's start with the stuff I put in the TED Talk because I spent a lot of time trying to encapsulate what I'd learned so people could use and benefit from it, change society and how we deal with healthcare in this company or country—Freudian slip. Oldest and Best Survival System Amy Baxter: Physicians are not taught about pain in medical school. We don't know what it is. We don't understand how to treat it. We don't think it's our job because we're supposed to figure out what caused the pain and fix that or inflict pain to diagnose it. But most people go to the doctor for pain. So that was something I hadn't appreciated. What we have learned about pain in the last 20 years through fu...

My son, Mike, died 21 years ago at age 26. Wasn't born with a tattoo telling him how long he had to live. Best spiritual health of his life. Left me a sign. Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle Read NewsletterContentsEpisodeProem 2023Proem 2020Open Hearts 2018Love myself 2002He met a girl 2018Birthday wishes for the old guy 2002Spiritual health 2018Lifetime warranty 2018Not personalizing death 2018Leave me a sign 2018Reflection 2020Podcast OutroComment and ask questionsCreditsLinksRelated podcasts and blogsCreative Commons LicensingCC BY-NC-SADisclaimer Episode Proem 2023 I resurrect this episode to celebrate Mike and thank you, my readers, listeners, and watchers. It's hard to believe that 21 years have passed since Mike died. He would have been 46. We would have been proud of him, and he proud of us. "Danny helped me love myself. I had to love myself to have a good relationship with him." Still, the most glorious thing anyone has ever said about me. Let's celebrate loving ourselves and at least one more. Mike, I feel you. Proem 2020 I wasn't born with a tattoo on my ass telling me how long I have to live. Welcome to the second anniversary of Health Hats, the Podcast, episode number 99. On November 15th, 2018, the first episode honored my son, Mike Funk, who died on November 18th, 2002, eighteen years ago, age 26, of metastatic melanoma. Mike, a wise poet, found his best spiritual health in the last year of his life. Hence, the most memorable sentence in my life. I wasn't born with a tattoo on my ass telling me how long I have to live.  I'm grateful to have known Mike, my son, our brother, our friend. I resurrect this episode to celebrate Mike and celebrate this fantastic medium of sound and storytelling for advocacy and connection. Podcasting enriches my life and my work.  I use podcasting to explore and organize my mind's chaos, experiences, and feelings. I connect with people I admire for brief intimacies. I'm thankful for my podcasting compatriots. We have met weekly and biweekly for two years to support, critique, and challenge each other as artists and technicians. You know who you are. I'm grateful to my readers, listeners, sponsor, Abridge, and web/social media coach, Kayla Nelson. I miss my mom, Ruth van Leeuwen, my first and greatest blog critic, and follower.  She would have tried to learn podcasting technology if she could have found a 15-year-old from her church to teach her how to use a podcast player. She died around Thanksgiving in 2014.   Gratefully, here you go, episode one and ninety-nine. Happy Thanksgiving. Open Hearts 2018 Health Hats: In this session, I'll share some tape of an interview with Mike a few months before he died. Bob Doherty conducted that interview and some thoughts and stories from me. One day, Mike and I were sitting at the kitchen table, talking about dying and superpowers. And Mike thought that he and I had the same superpower. We both accept what is. Not the ‘life sucks, what're you gonna do' variety of acceptance, but the ‘yup, here is impending death, how can we live our best lives' variety. ‘Yup, he died young. Young death happens a lot. You open your heart, and tragedy walks right in. What's the alternative, closed heart? Not for me. So, let me set the stage for you. This recording happened on July 17th, 2002, at my 50th birthday party. We had the party in the Potato Barn in Schoharie County, New York. When you hear some of the audio, you'll hear a lot of noise. I'm able to filter some of it out, but not all of it. So here we are at my 50th birthday party. Love myself 2002 Bob Doherty was interviewing Michael Funk. I'm sure you'll be able to tell who is who. Michael Funk: Yeah. I meant to just shoot questions, and we'll just rap. Bob Doherty: All right.

Personal growth living with a chronic illness, sickle cell, the importance of open communication, building a supportive community, & advocating for oneself. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. Download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodeProemPodcast introFour more years, a motherYou mean I won't get sickle cell?No lying in motherhoodHarder on myselfTreat us differentlyWhere do they fit in the world? Call to actionMoving on and building communityMuslim communityHealthcare CommunityTrust my teamEgo-centered, patient-centeredSpeaking truth to powerMakeup for the Emergency RoomIntentional whyYou can't read my mind?I'm not your caregiver. I'm your partner.End-of-life. It's for real.Live below your means, cut out the noiseReflectionPodcast OutroPlease comment and ask questionsProduction TeamCreditsInspired by and Grateful toLinks and referencesDisclaimerRelated podcastsCreative Commons Licensing Episode Proem I'm delighted to reconnect virtually with my dear friend, Fatima. We last recorded several conversations, two with her mother, Esosa, in 2019 as part of the series on people with complex conditions transitioning from pediatric to adult medical care. The titles included Living a Happy Full Life, Good Listeners, Good Conclusions, and I'm Not Drug-Seeking. I'm in Pain.  Becoming friends with Fatima has been one of the delights of my last decade. I especially value sharing our diverse experiences, finding many common cords (chords), leading to ongoing separate growth and development. From Fatima, I've dared to proudly introduce myself as a 2-legged cisgender old white man of privilege. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Four more years, a mother When we had the conversations in 2019, you were a mom, but it wasn't about you being a mom. Now, you've been a mom for four more years, dealing with sickle cell and being part of the family unit. Your mom said it's not just the person with the diagnosis; the whole family must manage. What are your thoughts about that now? You and your kids are getting older. Your son's graduating from preschool. I can't believe it. Anyway, what are your thoughts about that? Fatima Muhammed-Ighile: She states that sickle cell is a family issue. These last few years, I've understood that more profoundly. My kids are now five and six. They ask questions, and there are times when they can now comprehend how my restrictions, based on when I feel sickle cell pain, affect their lives. So that's required me to have discussions with them that, at times, I wish I could have delayed. Health Hats: If I remember correctly, your daughter probably has the most challenging questions. You mean I won't get sickle cell? Image from https://www.kold.com/2021/01/28/federal-committee-recommends-more-research-care-patients-with-sickle-cell/ Fatima Muhammed-Ighile: It was a lazy Sunday afternoon,

Day starts with angst, leading to screen-free day, reservoir walk, visit to farm stand, reading real book. Revived with renewed sense of gratitude & well-being. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube None today. Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle Watch on YouTubeRead NewsletterContentsEpisodeProemPodcast introScreen-free dayWalking a mile around the ResFarm stand Call to actionBack homeDay's endReflectionPodcast OutroEpisode NotesProduction TeamOther CreditsDisclaimerRelated podcastsCreative Commons Licensing Episode Proem JoJo and Danny selfie Good morning. I'm sitting on my porch with my dog, Jojo, who's now coming up to sit on my lap. The sun is shining. We live on a busy street, so you'll hear many of those noises. I didn't sleep that well last night. I had more angst than I've had in a long time. And my angst was about, oh, I'm doing so much, oh goodness, what is that, a cardinal, that I'm doing so much, I'm so busy, I'm trying so many new things, why can't I settle, do I have ADHD, just worry, worry, worry, worry. I haven't had this kind of worry in a long time, not since I've been working or... Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Screen-free day I finally got some sleep, woke up, and decided that everything I was doing was fun, that I was my master, and that I would have a screen-free day. So... It's already been a little bit of a challenge. I had to text my sister. She wanted to have dinner tonight. I guess that was just a second, and I listened to music on my phone, but I don't think that counts. My wife, the dog, and I will take a walk. I'm going to read an actual book instead of a Kindle. So, I'll check in as the day goes on and let you know how it's going. Walking a mile around the Res Arlington Reservoir image by Danny Hear that sound? That's the sound of the water going out of the Arlington Reservoir. The Arlington Reservoir is the secondary water source for where we Image of Danny and JoJo by Danny live in case our primary water source goes bad. I love that we have this. We're walking around it. It's about not quite a mile. See how I do. Arlington Reservoir image by Danny. Okay, I'm about three-quarters of the way around the reservation. It's really low. I wonder why because we've had a lot of rain. I'm still plugging away, going kind of slow. We've seen some bird watchers who identified some yellow bottom warblers, and then I saw a woodpecker on my own, and of course, there's a ton of squirrels, which the dog sees. There are a lot of dogs. So far, I've been okay. I think I will be thoroughly exhausted when we get back to the car, but we're three-quarters of the way there. So that's good. It's a good day. It's a good day to be able to walk that far. The leaves are beginning to change. But not too much. Hello. Okay. I see a gate here. It's open. I was thinking. I don't know if I could go around the gate. There's a beach path, but it looks narrow. What a beautiful day. It's so sunny. God! It's supposed to be that eclipse, but I'm not here, so I won't see it. But since I'm not doing screen time today, I have to wait till tomorrow to go on YouTube and see it. Anyway... Ooh, I'm fading. I can just feel it. Oh, my goodness. I'm going to have to sit at the next place to sit. Unless I'm, I don't think I can see our car, so I guess I can keep walking. Farm stand We stopped at a farm stand to see what good stuff we could find. I'm roaming around the farm store.

Newsletter subscribers: Apologies. My Mailchimp feed broke down, and I didn't notice until yesterday. You've missed 10 episodes!! I will repost an episode every other day until we're caught up. I'm so sorry! Dr Herndon, former Medicaid CMO: challenges faced to improve mental health care for emerging adults. Better support systems for their transition to independence Subscribers About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Proem.. 2 Podcast intro. 3 Meet Dr. Mike Herndon. 3 Health is Fragile. 3 Mental Illness in family practice. 3 Readiness to manage mental illness in practice. 4 State Medicaid Director 5 Levers of power 6 Aligning incentives 6 Minor success, at best 7 A word from our sponsor, Abridge. 8  Call to action. 8 Family Advocacy. 9 Not easy being an emerging adult 10 Reflection. 11 Podcast Outro. 11 Episode Proem According to the Commonwealth Fund, in 2016, spending in the US on behavioral healthcare was almost $160 billion, with 58 percent of all behavioral health spending being paid for by Medicare and Medicaid. According to SAMHSA, The Substance Abuse and Mental Health Services Administration, Medicaid is the largest payer in the United States for behavioral health services. Medicaid accounted for 26 percent of all behavioral health spending in 2009. Behavioral health is a term for mental health and substance use disorder conditions to differentiate from physical health. As a clinician, I seldom met a person with chronic physical health issues who didn't also have behavioral health issues. I don't know how meaningful statistics are, except to say a lot of people have behavioral health diagnoses in their records. It costs them, their families, and communities a fortune, and government health insurance pays a significant proportion of those direct costs. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Meet Dr. Mike Herndon Health Hats: I invited my friend and colleague, Dr. Mike Herndon, recently retired  Chief Medical Officer for the Oklahoma Healthcare Authority, Medicaid, to chat with us about Emerging Adults with Mental Illness. Mike, thank you so much for joining me. Mike Herndon: You bet, Danny. Happy to be here. Health Hats: Thank you. My friend, Dr. Mike Herndon, and I have done quite a bit together over the years, mainly through PCORI, the Patient-Centered Outcomes Research Institute. We sat on an advisory panel together, then you were appointed to the PCORI Board of Governors, and I came on the board a few years later. You were my Board orientation buddy and helped me navigate and reduce the shock of the experience. I appreciate it. Let's just jump right in. Mike, when did you first realize that health was fragile? Health is Fragile Mike Herndon: That's an easy answer for me. I grew up in rural Oklahoma. In the summer between my sixth and seventh-grade years, I was 12 years old,

Immersion into cultural humility needs curiosity, addresses power dynamics, embraces failure, meditates on self-critique, & fosters respectful relationships. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. Download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodeProemPodcast introCultural competenceCultural sensitivityHealthcare, a product not delivered aloneNot the same person foreverCuriosity in not knowingReading the room, getting it wrongSelf-reflection and self-critiqueNot interacting with a statueRedress the power imbalanceCall to actionWhat about emerging adults?Person-centered approach to cultural identityTeenagers and cultural humility: ListenRelationship dyads and triadsCultural humility for the clinicianHumility in the relationship, power dynamicProviders, hang out on social media feeds where your patients hang outReflectionPodcast OutroProduction TeamOther CreditsLinks and referencesDisclaimerRelated podcastsCreative Commons Licensing Episode Proem Image created on DALL.E Something is missing. I'm not yet ready to conclude this series on emerging adults with mental illness. In the next and last episode, I'll dive for pearls in the fifteen episodes published over the past ten months. What's nagging at me? Each guest spoke from the culture they knew and the cultures in which they received or offered treatment and service. I need an episode about how people can approach, be curious about, and be open to the cultures they experience. Is this cultural competence or sensitivity or what? I sought experts working with a kaleidoscope of cultures—first, Jamila Xible, a previous guest and community health worker with Cambridge Health Alliance. Jamila blows my socks off whenever Photo taken by Thyla Jane PhD on UnSplash I speak with her. Next, my friend and previous guest, Kiame Mahaniah, referred me to Catherine Smail, Ph.D., a psychologist at the Lynn Community Health Center. Cat is a clinician therapist and the Associate Director of Training for Behavioral Health. Erika Malik at the Innovation and Value Initiative referred me to Theresa Nguyen, Ph.D., who has a social work background at Mental Health America. Theresa primarily does research and runs their screening program of youth coming onto the internet to solve problems for the first time. Hang on. Here we go. I learned a ton. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Cultural competence Health Hats: Let's discuss cultural competence, sensitivity, and humility. How do cultural humility, sensitivity, and competence come into the team sport of best health? We'll dwell here briefly, hearing all three guests speak in depth. Catherine Smail: Cultural competence came about in the eighties, a first attempt to start grappling in a new way with the disparate health outcomes that providers saw in their immigrant populations. They tried to understand why that was happening and how ...

Danny & Oscar muse about tension between thumbnails & descriptions, superconductors & the environment, health hats origin, life & bad habits, like snarkiness. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube None today. Check back later Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodePodcast introProemTitles, ThumbnailsDescriptionsClick-throughWho opens, downloadsSuperconductors, trains, speedEnvironmental impactEnvironmental sustainabilityHow does it benefit people?Why do you enjoy hats?PlugLife, the Universe, and EverythingSnarkinessCall to actionReflectionPodcast OutroEpisode NotesProduction TeamOther CreditsDisclaimerRelated podcastsCreative Commons Licensing Episode Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Proem Welcome to this third bonus episode. We're busy producing the next Emerging Adults with Mental Illness episode about Cultural Humility.  It's taking longer than expected because we're combining three 30–40-minute dynamite interviews into one episode, and my team has new school semester obligations. So, Oscar and I chatted, sitting on his couch. I asked him to ask me anything, and he did. No video today. We might put one up in the future. What a hoot. Here goes. Health Hats: Oscar first asked me about how people find my material, whether via the web, podcast platforms, or YouTube. We talked about titles, thumbnails, descriptions, click-through rates. Titles, Thumbnails Health Hats: Titles are hard. Oscar: Titles? In what way are titles hard? Health Hats: For example, in my series on Emerging Adults with Mental Illness, I have 15 episodes or so. I have a few words in the title and then the number in the Emerging Adults with Mental Illness series. The unique thing is those few words. I did that because I wanted people to know it's part of a series. But Emerging Adults with Mental Illness has so many characters that I'm trying to keep it to 60 characters. Okay. Then, it doesn't leave that many characters for something to be unique. Oscar: So, then what if you put the emerging adults with mental illness, and you put it in the thumbnail. You put those like words, like text, in the thumbnail. Descriptions Health Hats: Or in the description. Oscar: When a viewer looks at the video, they'll see the, maybe, the thumbnail for a brief second, they'll see the title, and then they'll, it'll probably like autoplay. They won't see the description until they click on it, and if you want to know, if you wanted them to know that it's part of a series, then you could do it in the thumbnail. Of course, that could mess up your captivating thumbnail. Health Hats: That's a lot of words for a thumbnail. It is hard. So, I try to pay attention to the title and the headings of the description. There's a tension between being descriptive of what's in the section or catchy. Oscar: Okay. Interesting,

Rodney Elliott discusses the PATIENTS Program, a community-research partnership for health equity. The podcast explores authenticity, engagement, & growth. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodeProemPodcast introHealth is fragile: sports injury.Health is fragile: caregiverThe table setter for the PATIENTS Program through the Bridge podcastHenrietta LacksRelationship between academics and the communityListening first wherever we canInternal marketingPlugPeer into the future – a yearGenuine, authentic, transparent, humbleNext play mentalityPodcasting communitiesInternReflection Podcast OutroProduction TeamOther CreditsLinks and referencesDisclaimerRelated podcastsCreative Commons Licensing Episode Proem I specialize in patient/ caregiver/ clinician/ community partnerships and the intersection between research, technology, and the health journey. This sentence describes the nut of what Health Hats offers. The key word is partnerships. My antennae quiver when I sense a mature, evolving community-research partnership. So, I readily agreed when my friends and colleagues, Janice Tufte and Sneha Dave, invited me to attend the SHining the SpOtlight Wide (SHOW) Conference. The PATIENTS Program sponsored the SHOW Conference. The PATIENTS Program envisions a world in which patients and stakeholders are heard, inspired, and empowered to co-develop patient-centered outcomes research (PCOR). The PATIENTS Program is an interdisciplinary research team of community partners and researchers housed at the University of Maryland School of Pharmacy that works to change the way we think about research by creating a path for health equity in West Baltimore. Our guest, Rodney Elliott, and his production partner, Eric Kettering, reached out to me after the virtual conference. They host a podcast, The Bridge: Your Health Your Voice, at the PATIENTS Program. We decided to interview each other for our respective podcasts.  Here's the link to Rodney and Eric's version. Stay tuned for mine. Same raw footage, very different output. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Health is fragile: sports injury. Health Hats: When did you first realize health was fragile? Rodney Elliott: I realized health was fragile at two distinct times. Back to that part when I said I was playing basketball overseas in Europe, I had a significant injury for one year in Italy. I was playing, and it was the start of the game. It was a jump ball. I jumped the ball to start the game. A referee didn't move out of the way like they usually do. And I came down on his foot and fractured my ankle. I was out for the rest of the season. It was playoff time, just horrible. I rehabbed all summer, started that next year, and still had issues, so much so that I had surgery the following year. Up until that point, a sprained finger,

Rodney Elliott discusses the PATIENTS Program, a community-research partnership for health equity. The podcast explores authenticity, engagement, & growth. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodeProemPodcast introHealth is fragile: sports injury.Health is fragile: caregiverThe table setter for the PATIENTS Program through the Bridge podcastHenrietta LacksRelationship between academics and the communityListening first wherever we canInternal marketingPlugPeer into the future – a yearGenuine, authentic, transparent, humbleNext play mentalityPodcasting communitiesInternReflection Podcast OutroProduction TeamOther CreditsLinks and referencesDisclaimerRelated podcastsCreative Commons Licensing Episode Proem I specialize in patient/ caregiver/ clinician/ community partnerships and the intersection between research, technology, and the health journey. This sentence describes the nut of what Health Hats offers. The key word is partnerships. My antennae quiver when I sense a mature, evolving community-research partnership. So, I readily agreed when my friends and colleagues, Janice Tufte and Sneha Dave, invited me to attend the SHining the SpOtlight Wide (SHOW) Conference. The PATIENTS Program sponsored the SHOW Conference. The PATIENTS Program envisions a world in which patients and stakeholders are heard, inspired, and empowered to co-develop patient-centered outcomes research (PCOR). The PATIENTS Program is an interdisciplinary research team of community partners and researchers housed at the University of Maryland School of Pharmacy that works to change the way we think about research by creating a path for health equity in West Baltimore. Our guest, Rodney Elliott, and his production partner, Eric Kettering, reached out to me after the virtual conference. They host a podcast, The Bridge: Your Health Your Voice, at the PATIENTS Program. We decided to interview each other for our respective podcasts.  Here's the link to Rodney and Eric's version. Stay tuned for mine. Same raw footage, very different output. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Health is fragile: sports injury. Health Hats: When did you first realize health was fragile? Rodney Elliott: I realized health was fragile at two distinct times. Back to that part when I said I was playing basketball overseas in Europe, I had a significant injury for one year in Italy. I was playing, and it was the start of the game. It was a jump ball. I jumped the ball to start the game. A referee didn't move out of the way like they usually do. And I came down on his foot and fractured my ankle. I was out for the rest of the season. It was playoff time, just horrible. I rehabbed all summer, started that next year, and still had issues, so much so that I had surgery the following year. Up until that point, a sprained finger,

Journey in adlibbed speaking, video editing, business growth strategies, & the ups/downs of personal life, including music & health challenges. Bobbleheads, too About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodePodcast introOn-micSeeking consultationMastermind communitiesBeehiveMusic, of courseDouble visionEpisode NotesProduction TeamOther CreditsDisclaimerSponsored by AbridgeLinksBusiness PlanRelated podcastsCreative Commons Licensing Episode Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. On-mic Welcome to this second bonus episode for Health Hats, the Podcast subscribers and patrons. These on-mic bonus episodes reflect on my writing, recording, and producing adventures. On-mic means just me extemporaneously.  On-mic is challenging for me as I prefer to write and read a script, but then it looks like I'm reading. I've gotten anti-glare glasses, so my glasses don't reflect. I'm trying out a new feature today with this bonus episode where the app rejiggers my eyes, so it looks like I'm looking at the camera.  How does it look? Seeking consultation Lately, I have focused on improving my video editing skills, like transitions between scenes, use of images when I don't have or don't want to use video, and settling on the fewest possible video editing apps. A couple of months ago, I used six apps, Zoom (to record the call), Descript (for transcription), Shotcut and DaVinci Resolve (for video editing), and Audacity and Auphonic (for audio editing). Steve Heatherington, of The Alpaca Tribe Podcast fame, counsels me on efficient audio and video editing workflow. Last episode, I used three, Descript, Audacity, and Auphonic.  Progress. I just engaged Julia Higgins, a freelance marketing professional, to help me integrate my business plan, website, and use of social media. I'll put a copy of my business in the show notes. I've never really cared about how many followers I have, but now I want to grow my paid subscribers and patrons to build my production team. Also, my wife retired, so I'd like the podcast to be more self-supporting. Reviewing my mission, vision, and audience periodically helps me stay fresh, engaged, and relevant. I can't overstate the joy of working with my grandsons on this podcast. One coaches me in video editing; the other takes the first pass at editing audio transcripts into newsletters. We have several years of mutual warm criticism that greases the process considerably. Mastermind communities I still participate in a weekly Sunday call with other podcasters. We've Zoomed since 2018 as a team at Seth Godin and Alex DePalma's second Podcasting course. Steve Heatherington teaches that course now. I host a couple of mastermind groups. Reckoning with various podcasts with different subjects (Alpacas, Hansel, and Gretel fairytale, secondary education, environmental educator,

Dive into the intricate web of conflicting healthcare incentives. Dr. Wang explains how health economics guides resource allocation for better outcomes. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Table of Contents Toggle About the ShowWatch on YouTubeRead NewsletterContentsEpisodeProemIntroducing Dr. Yun (Sherry) WangPodcast introMental health research-it's complicatedHealth Economics – How is money spent?From whose point of view? Different reasons to spend moneyDirect and indirect costsSchizophrenia, for exampleUnder- and over-utilizationMedicare and MedicaidHealth Economics for decision makingHealth economics for policymakersThe time frame for economic analysis – years or lifetime?A word from our sponsor, AbridgePlugHealth Economics for advocatesHealth economics and homelessnessIncarcerationCrystal ball gazing far into a lifetimeA more comprehensive viewBuprenorphineStigma and BuprenorphineHome value disparities as an indicatorMapping disparitiesReflectionPodcast OutroProduction TeamOther CreditsLinks and referencesDisclaimerSponsored by AbridgeRelated podcastsCreative Commons Licensing Episode Proem Photo by Rodion Kutsaiev on UnSplash Several guests in this Emerging Adults with Mental Illness series discussed conflicting incentives. What does that even mean? Do incentives mean motivation? Why we do what we do? Are we talking about incentives for patients and caregivers, insurance companies, consultants, vendors, policymakers, clinicians, drug companies, pharmacy benefit companies, employers, or communities? In the last episode with Dr. Amanda Chue, we examined dynamic tensions. Incentives certainly cause tensions. Health Image created in DALL.E care is big business, with massive amounts of money involved, extremely fragmented systems within systems, and much power at stake. No wonder we think of conflicting incentives. The first health economist I knew personally was Jane Sarasohn-Kahn, of Health Populi fame. Full disclosure, Jane introduced me to blogging and suggested my name and brand, Health Hats. Introducing Dr. Yun (Sherry) Wang Photo by Francesco Gallarotti on UnSplash Our guest today is Dr. Yun Wang, who prefers Sherry. Dr. Wang is Assistant Professor in Health Economics and Outcomes Research at Chapman University School of Pharmacy. Before joining Chapman, she worked in global health, epidemiology, social science, clinical pharmacy, health economics, and health service research in Asia, Australia, and America. She is also an Alumni Affiliate at the Center for the Study of Race, Ethnicity & Equity, Washington University in St Louis. Her research interests lie in pharmacoepidemiology and health service research for substance users and chronic disease patients—a perfect guest for us. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Health Hats: Sherry, thank you so much for joining us today. I'm excited about this. We met a month or two ago,

PCORI's Dr. Chue brings to light the complexities & challenges of conducting research, engaging stakeholders, and implementing findings in real-world settings. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Executive Summary. 1 Proem.. 2 Introducing Dr. Amanda Chue 01:37. 2 Podcast intro 02:22. 2 Health is fragile 03:14. 2 Path to young adult mental health research 03:48. 3 Evidence gaps 05:22. 3 Do comparators exist? 08:17. 4 Efficacy versus efficiency 11:29. 4 Dynamic tension - Parent engagement in research 12:52. 4 A word from our sponsor, Abridge 13:38. 5  Call to action 14:41. 5 Dissemination to those with lived experience 15:51. 5 Research results impacting clinical work or decisions 19:07. 6 Dynamic tension – CER and innovation 20:04. 6 Dissemination – sharing results 21:36. 6 Community implementation 22:51. 7 Stakeholder Advisory Panels 27:06. 7 Dynamic tensions in public engagement, dissemination, and implementation 30:09. 8 PCORI and public engagement 30:53. 8 Policy making 34:17. 9 Reflection 37:18. 10 Podcast Outro 39:26. 10 Episode Executive Summary PCORI's Dr. Chue brings to light the complexities and challenges involved in conducting research, engaging stakeholders, and implementing findings in real-world settings. It emphasizes the need for long-term partnerships with community organizations and the importance of addressing disparities in research representation. The dynamic tensions in various research and implementation aspects underscore the need for thoughtful and creative approaches to address complex healthcare issues effectively. Proem Image created in DALL.E I treasure the dynamic tensions in life—for example, privacy and community, pathological optimism and catastrophizing, early adopter and skeptic. While not a researcher, I am personally and professionally neck-deep in research. Yet, despite my commitment to research, I'm a skeptic. Who's it for? How can it aid decision-making? Who's included in the research question, process, analysis, and dissemination? Where are the vested interests? Do we already have evidence yet have little will to implement, or does the bureaucracy or culture impede action? I will step in and highlight some dynamic tensions as the conversation flows. What about research funding sources? What's their perspective? What are the dynamic tensions? I asked my cronies at PCORI (Patient-Centered Outcomes Research Institute) to introduce me to a staff scientist specializing in comparative effectiveness research funding for emerging adults with mental illness. Dr. Amanda Chue kindly agreed to speak with us. Image created on DALL.E Introducing Dr. Amanda Chue Dr. Amanda Chue received a BS in human development from Cornell University and a Ph.D. in clinical psychology from American University. She is a Program Officer for the Clinical Effectiveness and Decision Science program at the Patient-Centered Outcomes Research Institute (PCORI). In this role, she manages a portfolio of comparative clinical effectiveness research awards focused on meaningful outcomes for patients. Her portfolio includes several studies on clinical strategies for managing and reducing lo...

Dr. Motley studies emerging black males & females with mental illness compounded by racism & violence. They need support systems & a chance for upward mobility. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Proem.. 2 Podcast intro 01:07. 2 Exposure to community violence 03:54. 2 Emerging adults 2 Emerging and experiencing violence and mental illness 06:12. 3 Breaking the cycle – support systems 08:05. 3 Breaking the cycle – transportation 08:44. 3 Breaking the cycle – belonging 10:51. 4 Breaking the cycle – upward social mobility. 4 A word from our sponsor, Abridge 11:40. 4  Call to action 12:22. 4 Identifying the research question 13:54. 5 Gaps in research 15:27. 5 Staying in touch, up to date 16:06. 5 Think, read, write, talk 18:10. 6 Measuring police violence 18:49. 6 Vacuum-filler, gap filler 20:55. 6 Community Advisory Board 23:00. 7 People with lived experience analyzing study results 25:31. 7 Research without implementation – ink on paper 26:22. 8 Strategies for Youth 28:47. 8 Community uptake of research 29:49. 8 Social media 33:11. 9 Reflection 35:40. 10 Podcast Outro 38:34. 10 Episode Proem Image by Susan Wilkenson on Unsplash Trauma and mental illness seem inexorably linked with racism and homelessness contributing to severity and complexity. How do we know? Does evidence exist? Do we even need proof? Isn't it obvious? I think I need to speak with a social worker, researcher. Fortunately, I met Whitney Irie, Ph.D., MSW, Assistant Professor at Boston College School of Social Work, who introduced me to Robert Motley, Ph.D., MSW, also at Boston College. Robert examines the intersection of racism, violence, and trauma for emerging black adult men and women ages 18-29 and associated mental and behavioral outcomes. Eureka, a match! Image by Stefano Pollio on Unsplash Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Exposure to community violence Robert Motley: During my doctoral studies, my research focused on exposure to community violence among black emerging adults. I conducted a systematic literature review on trauma. What was the prevalence of trauma among black males? What were some barriers or facilitators to using mental health services? Looking at the literature, we found high levels of trauma exposure for black men: 50% to 60% had experienced trauma, some of them seven or eight times during their lifetime. They also had high rates of mental health illnesses such as anxiety, generalized anxiety, psychotic disorders, etc. But the most critical finding was that roughly 56% to 74% of the black males across these studies may have had an unmet need for mental health services. So, you're talking about a large population of black men walking around what I like to call ticking time bombs because they are experiencing a lot of traumas. And we know the adverse effects of trauma on one's mental...

Exploring the world of podcasting and the challenges we face in storytelling, sound editing, & decision-making. We reflect on the evolution of our journeys. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Proem.. 1 Podcast intro. 1 Introducing Steve Heatherington, Alpaca Shephard. 2 Virtual podcasting friends.  Yes, friends. 2 Podcasting and writing. 3 Sound editing. 3 What's the story?. 4 Unexpected engagement 5 A word from our sponsor, Abridge. 5  Call to action. 6 So much to do. Music! 6 Many Decisions to Make. 6 Decisions in disability. 7 Podcast workshop. 8 Reflection. 9 Podcast Outro. 9 Episode Proem Photo by Frugal Flyer on Unsplash Welcome subscribers and patrons to this first exclusive bonus episode #200 (egads, #200). If you could look around the room, you'd see 275 long-standing subscribers, 12 monthly Patrons, and ten one-time supporters who contributed almost $300 in May and nearly $675 in June. Beyond my wildest expectations! I have an advisory call scheduled in early July with some experts who work with emerging adult interns. My colleague and friend Fatima has agreed to help me manage the initiative. I'm burning with excitement to get going. Thanks to you, I can afford it. My friend and crony in podcasting, Steve Heatherington, of Alpaca Tribe fame, joins me in today's bonus episode as we muse about this intriguing podcasting world. I love that I can still learn with my Swiss cheese brain.  Check out the quilt in Steve's background if you're watching the video. Very cool. Image from https://fineartamerica.com/featured/7-mri-of-multiple-sclerosis-medical-body-scans.html Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Introducing Steve Heatherington, Alpaca Shephard Health Hats: Steve. Thank you so much for doing this with me. So, you know that this is for me. This is going to be my first bonus episode. Nice. In my new Patreon world that I'm setting up. I'm excited to talk about all things podcasting with you since we've been buddies for four and a half, five years, and four and a half. Yeah. Four and a half years. And we've been podcasting, and we meet weekly to discuss anything about podcasting and life—the six or seven of us who, however many, it changes from time to time. So anyway, thank you. Why don't you introduce yourself? Steve Heatherington: It's a pleasure and a privilege to meet up like this, and Wow. Honor to be part of the first bonus episode. Wow, that's so exciting. Yeah. How did this happen? It happened by mistake almost. I'm based in Swansea in the UK. And we have a farm, and I'm an alpaca shepherd. So, we got currently got 36 alpacas that I care for. Most of the time, it's straightforward, but occasionally you turn a corner, and there's something new and challenging. I used the alpacas to learn to podcast, and it's kept going. So I've been going over four years now.

Dr Herndon, former Medicaid CMO: challenges faced to improve mental health care for emerging adults. Better support systems for their transition to independence About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Proem.. 2 Podcast intro. 3 Meet Dr. Mike Herndon. 3 Health is Fragile. 3 Mental Illness in family practice. 3 Readiness to manage mental illness in practice. 4 State Medicaid Director 5 Levers of power 6 Aligning incentives 6 Minor success, at best 7 A word from our sponsor, Abridge. 8  Call to action. 8 Family Advocacy. 9 Not easy being an emerging adult 10 Reflection. 11 Podcast Outro. 11 Episode Proem According to the Commonwealth Fund, in 2016, spending in the US on behavioral healthcare was almost $160 billion, with 58 percent of all behavioral health spending being paid for by Medicare and Medicaid. According to SAMHSA, The Substance Abuse and Mental Health Services Administration, Medicaid is the largest payer in the United States for behavioral health services. Medicaid accounted for 26 percent of all behavioral health spending in 2009. Behavioral health is a term for mental health and substance use disorder conditions to differentiate from physical health. As a clinician, I seldom met a person with chronic physical health issues who didn't also have behavioral health issues. I don't know how meaningful statistics are, except to say a lot of people have behavioral health diagnoses in their records. It costs them, their families, and communities a fortune, and government health insurance pays a significant proportion of those direct costs. Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Meet Dr. Mike Herndon Health Hats: I invited my friend and colleague, Dr. Mike Herndon, recently retired  Chief Medical Officer for the Oklahoma Healthcare Authority, Medicaid, to chat with us about Emerging Adults with Mental Illness. Mike, thank you so much for joining me. Mike Herndon: You bet, Danny. Happy to be here. Health Hats: Thank you. My friend, Dr. Mike Herndon, and I have done quite a bit together over the years, mainly through PCORI, the Patient-Centered Outcomes Research Institute. We sat on an advisory panel together, then you were appointed to the PCORI Board of Governors, and I came on the board a few years later. You were my Board orientation buddy and helped me navigate and reduce the shock of the experience. I appreciate it. Let's just jump right in. Mike, when did you first realize that health was fragile? Health is Fragile Mike Herndon: That's an easy answer for me. I grew up in rural Oklahoma. In the summer between my sixth and seventh-grade years, I was 12 years old, and my mom had a pituitary tumor. That hormonal gland in the brain had gotten so large it caused terrific headaches. She had double and blurred vision and had to have a craniotomy, and brain surgery, to remove the tumor.

About McLean Hospital. Referrals, COVID impact, capacity, stigma. Still need more resources & shift towards treating mental health on par with physical health. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read The same content as the podcast, but not a verbatim transcript. A newsletter-like version with images. Could be a book chapter. download the printable transcript here Contents Proem.. 1 Podcast intro 01:49. 2 Health is fragile 02:41. 2 Leadership at McLean's Hospital 04:08. 2 Levels of care 05:12. 2 Massachusetts Child Psychiatry Access Project (MCPAP) 07:04. 3 Supporting Primary Care 09:41. 3 Mental illness and Covid 11:59. 4 Capacity – space, and staff 13:28. 4 Using Peer Experts – lived experience 16:12. 5 A word from our sponsor, Abridge 17:56. 5  Call to action 18:39. 5 Coalitions and partnerships 20:26. 5 Academics, research, advisory panels 24:43. 7 Stigma 27:13. 7 Level the playing field between physical and mental health 30:07. 8 Reflection. 8 Podcast Outro 33:49  9 Episode Proem Photo by razvan-mirel-xhYhjMIfsq8-unsplash Continuing the series spiral with emerging adults with mental illness at the center, along the outbound curve, we experienced a parent, a high school teacher, primary care and emergency doctors, and community services. Now we arrive at mental health providers in the person of Michael Macht Greenberg, who administers an integrated system of mental health medical services, McLean Hospital, of the preeminent healthcare system, Mass General Brigham's Hospital. I met Michael working together at Boston Children's Hospital. Michael was the administrative director of the Department of Medicine, and I led the patient/family experience initiative. We both left Boston Children's more than ten years ago. As circumstances allow, we still meet for coffee at least quarterly, in person or virtually. Michael's low-key presentation belies his passion and compassion for emerging adults and people with mental illness. Podcast intro 01:49 Photo by Diana Feil on Unsplash Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Like what you're reading, hearing, or watching? Go to my web page https://health-hats.com/support to choose a method of support that suits you. Thank you. Health is fragile 02:41 Health Hats: Michael, thank you so much for joining us. I appreciate it. I love seeing you. This is different from our usual coffee at Pete's. Michael Macht Greenberg: Always good to be with you. Thanks for asking to chat. Health Hats: Yeah. When did you first realize health was fragile? Michael Macht Greenberg: Wow. As a kid growing up, when you start losing people, grandparents, and great-grandparents, you start realizing you can lose people. Those people who have been important in your life aren't around anymore. Fortunately, I am a healthy guy, and my experience with fragile health is limited. I'm fortunate that, with limited exception, that hasn't been too dramatic or traumatic. But while growing up and realizing the people you love aren't around forever,

Exploring Youth Clubhouses, drop-in centers for youth in recovery from/at risk for substance use disorders, focusing on access, partnerships, & peer support. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read The same content as the podcast, but not a verbatim transcript. A newsletter-like version with images. Could be a book chapter. download the printable transcript here Contents Proem.. 1 Podcast intro 02:45. 2 Health is fragile 04:08. 2 Youth Clubhouses, safe places 07:27. 3 Access to the Clubhouse 10:23. 4 Community partnership and collaboration 13:22. 4 Youth program engagement and leadership 17:03. 5 A word from our sponsor, Abridge 19:03. 6 Coping tools in your toolbox 19:48. 6 Continual learning. 6 Hopeful, hopeless 25:03. 7 Policy change, harm reduction 28:23. 7 OASAS: Office of Addiction Supports and Services 31:01. 8 Clubhouse Radio 31:45. 8 Narcan and Harm reduction 34:36. 9 Reflection 38:16. 10 Tribute to Casey Quinlan 39:53. 10 Tribute to Michael Funk 43:46. 11 Podcast Outro 44:33. 11 Episode Proem Figure 1: DALL.E image of Sculpture of community-based research in style of Yoshitoshi Kanemaki I gravitate toward, am attracted to, community-based programs that build partnerships with their participants. The programs serve well, plant seeds, build capacity, and inspire copying. Medical, professional, or larger companies have a more challenging time serving, planting, building, and inspiring. Perhaps it's a function of community-based and partnerships with lived-experience experts. I thank Dorothy Cucinelli, last episode's guest, for introducing Paul Taylor and the Youth Clubhouses at the Mental Health Association of Columbia Greene Counties. Youth Clubhouses are drop-in centers for youth and young adults in recovery from or at risk of developing a substance use disorder. These programs provide recovery supports – including peer support – as well as skill-building and community engagement opportunities, educational and vocational support, recreational and prosocial activities, family engagement activities, and sessions on health and wellness. Youth and Young Adults | Office of Addiction Services and Supports (ny.gov) Youth Clubhouses are programs of NY State OASAS. The New York State Office of Addiction Services and Supports (OASAS) oversees one of the nation's largest Substance Use Disorder systems of care. Approximately 1,700 prevention, treatment, and recovery programs serve over 680,000 individuals per year. About Us | Office of Addiction Services and Supports (ny.gov) Kai Hellman invited Paul Taylor and Phoebs Potter to join us. We spoke about youth access to the Clubhouse, Clubhouse partnerships in their communities, youth engagement and leadership, peer support, and harm reduction. We will end the episode with two tributes, one of Mighty Casey Quinlan who died a couple of weeks ago and to my son, Mike Funk who would have been 47 on May 17th. Podcast intro 02:45 Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Like what you're reading, hearing,

COAST, a 24/7/365 access program in upstate NY, offers access to med-assisted treatment & wraparound services for substance use & mental health concerns About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read The same content as the podcast, but not a verbatim transcript. A newsletter-like version with images. Could be a book chapter. download the printable transcript here Contents Proem.. 1 Podcast intro 01:13. 2 Access through a single number 1:50. 2 Wraparound services 04:16. 2 The behavioral health network collaborative 05:52. 3 Doing something right 08:40. 4 Substance use and mental health 09:32. 4 Warm hand-off 11:52. 4 Partnership with families 12:33. 4 Residential and inpatient? 13:28. 5 A word from our sponsor, Abridge 14:20. 5 Collaboration over competition 15:03. 5 Networking coordination 16:52. 5 Emerging adult priorities 18:07. 6 Matching resources to demand 21:36. 6 Maximize access 25:19. 7 Prevention 28:59. 8 Marketing programs 29:49. 8 Reflection 33:34. 9 Podcast Outro 25:39  9 Episode Proem Photo by Nima Ara on Unsplash, reference not found When I'm in trouble or have a question, I need help when I need it, preferably from a warm person, not an app or a bot. Is this even possible today? One of the health systems I use just shifted the patient portal inquiry responses to a central department, open Monday through Friday, 8 am to 5 pm. No more replies to non-emergent questions from my doctor or nurse within two days as I'm used to. Not a warm person when I need it. I called my dear friend Dorothy Cucinelli as I planned this Emerging Adult with Mental Illness series. Dorothy, CEO of the Capital Behavioral Health Network (CBHN), sponsors COAST (Coordinated Opioid and Stimulant Treatment) 24/7/365 person-answered hotline for people in need. Kelly Lane joins Dorothy to tell us more. Podcast intro 01:13 Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Access through a single number 1:50 Health Hats: Dorothy and Kelly, thank you for joining us today. I look forward to discussing the COAST program (Coordinated Opioid and Stimulant Treatment). And as we've talked about previously, I'm focused on young adults and their families with mental illness and the services they need and can get. So, I was very excited when Dorothy and I were just catching up to hear about the COAST program. I'm wondering if you could tell us a little about how people access COAST referrals, supportive services, young adults, and families. Kelly Lane: Sure. It's easy. We've designed this project with a single number that connects you to services anywhere in our eight-county region, south to Columbia Green County, north to Warren, and Washington. Health Hats: In upstate New York? Kelly Lane: Yes, the Capitol District, Warren, Washington, and Columbia Green. Dorothy Cucinelli: For those listeners who might not know this area, the Capitol District is Albany, about three hours' drive north of New York City. We cover the eight counties in that region, to the Massachusetts border and West,

Introducing you to my new Patreon page so that I can earn some revenue to help me keep the lights on. Fans can pay a $small amount each month for bonus rewards. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read The same content as the podcast, but not a verbatim transcript. A newsletter-like version with images. Could be a book chapter. download the printable transcript here Episode Notes Please comment and ask questions at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, Mastadon to @healthhats Credits The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors, or Methodology Committee. Danny van Leeuwen (Health Hats) Sponsored by Abridge Creative Commons Licensing The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge.  Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements.  Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines. The Show Hey there. As one of my blogging, podcasting, and vlogging cronies, I'm excited to share a sneak peek of a big upcoming launch with you and see what you think. For the past few weeks, I've been working on a Patreon page so that I can earn some more ongoing revenue through my fans to help me keep the lights on. With Patreon, fans can pay a small amount of money each month in exchange for some bonus rewards. The "About" tab tells you more. Free will remain an option. https://health-hats.com/free/ I've launched my page, but it isn't finalized. Go here. https://www.patreon.com/user?u=8382489. Click on the "About" and "Membership" tabs. I'd love to hear any feedback you have about it before I make it live for the world. Specifically, Does everything make sense? Is it clear what Patreon is and what fans get out of joining my community? What do you think of the rewards? Do any, in particular, stand out as things you would join Patreon for? Is there anyone you think I should connect with to help spread the word once I launch? Thanks for letting me know what you think. I'm excited to get this off the ground and couldn't do it without the support of friends, and family like you. I'll be sending out an email to my mailing list subscribers once I launch. So feel free to add your email here  https://health-hats.com/free/ if you'd like to stay in the know. I'm looking forward to incorporating your feedback into my final page. Thanks.

Dr. Joel Hudgins muses on up and downstream changes to Peds ED for emerging adults with mental illness. Higher numbers & acuity, too few beds, services, & staff About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read The same content as the podcast, but not a verbatim transcript. A newsletter-like version with images. Could be a book chapter. download the printable transcript here Contents Proem.. 1 Update on Mighty Mouth Casey Quinlan. 2 Podcast intro. 2 Health is fragile. 2 Crossing the threshold into the ED. 2 How can we help up front?. 3 Upstream and downstream issues 4 Can we really help? It takes a toll. 4 A word from our sponsor, Abridge. 5 System interventions/solutions. 5 Hopeful, hopeless 6 Real people all around. 6 Profound knowledge. 7 Academic medical center versus critical access hospital 7 Reflection. 8 Next: Episode #8: COAST. 8 Podcast Outro. 9 Proem In this series we've met Emeka and Annie, two emerging adults with mental illness and Emeka's mom, Erika. We learned about their ‘something's wrong' experience, finding treatment, family dynamics, and recovery. We met Matt, a high school teacher leading a student-run welcoming Ambassador program, and Dr. Bonnie, a primary care doc, managing the care of emerging adults with developing and full-blown illness with limited resources. You can see that I'm starting in the center with lived experience and spiraling out. Photo by razvan-mirel-xhYhjMIfsq8-unsplash Welcome to today's episode, #7 in the series, of the lived experience of another professional, Dr Joel Hudgins, pediatric emergency physician at Boston Children's Hospital.  Full disclosure, I worked from 2002 to 2008 at Boston Children's leading their patient family experience initiative and I worked as a nurse/paramedic at two rural hospitals in West Virginia in the late eighties, early nineties. Despite my experience in pediatrics and emergency services, I feel out-of-touch with the dynamics of treating an increasing proportion of youth with mental illness while also faced with exploding infectious disease incidence, COVID, RSV, and flu. Emergency care and pediatrics are near and dear to my heart. Let's see what we can learn with Dr. Joel Hudgins. Update on Mighty Mouth Casey Quinlan Before we begin, I published my last episode on April 1, 2023, the mashup of my chats with Casey Quinlan. Many subscribers reached out to me. Is Casey alive or has she passed? I purposefully left it ambiguous because I didn't know when people would be reading, listening, or watching. Besides, Casey told me several times over the years when I called her about various deaths in my family, why do funerals and memorial services need to come after death? Anyway, as of today, April 12, 2023, Casey lives in a hospice, with several visitors a day, alert for short periods of time, still snarky. Go to CaringBridge.com, for up-to-date information from Jan Oldenburg. From Health Hats, the Podcast https://health-hats.com/pod193/ Podcast intro Welcome to Health Hats, the Podcast. I'm Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this. Health is fragile

In mid-March Casey didn't sounds lucid or humorous and she couldn't spin a yarn or offer wisdom. I'm grateful for her impact on the patient-caregiver movement. Blog subscribers: Listen to the podcast here. Scroll down through show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player This episode can be watched on YouTube Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Proem.. 2 Healthcare is Hilarious intro 00:44. 2 Health Hats, the Podcast intro 01:20. 2 From Episode#127 Healthcare is Hilarious, with Mighty Casey Quinlan. Jun 6, 2021 01:59. 3 Feel like I've been shoved through a pipe 02:38. 3 Mobility 04:49. 4 Bemused about dying 06:34. 4 Bored with the new you? 07:51. 5 Not alone 08:55. 5 From episode #132: Healthcare is Hilarious. Continuing Mets Saga. Hospital. Home. 09:41. 5 Pain management 11:16. 6 Recognize privilege 13:10. 6 Hospitalists and coordination of care 14:35. 7 A word from our sponsor, Abridge 16:06. 7 Episode #139: Normal, A Dryer Setting with Mighty Casey Quinlan 16:49. 7 Steroids, love ‘em, hate ‘em 17:30. 8 Leaping tall buildings 19:20. 9 Engaged with sax – changing capabilities 20:16. 9 Patient hackers adapting 21:36. 9 Not quitting till I'm dead 23:26. 10 Episode #181: Might Casey Unplugged 24:00. 10 Health update – not great 25:27. 11 Crying over spilled hair? 27:43. 11 Spiritual Health 30:27. 12 Death by a thousand pilots 31:52. 12 Busting down silos 36:07. 13 Colossal challenge 37:02. 14 Reflection 39:25. 14 Podcast Outro 41:23. 15 Please comment and ask questions at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter,  to @healthhats Credits Music on intro and outro by permission from Joey van Leeuwen, Drummer, Composer, and Arranger including Moe's Blues for Proem and Reflection Web and Social Media Coach, Dissemination Kayla Nelson @lifeoflesion Leon van Leeuwen edits the article-grade transcript.  Intro photo of Vulture Couple by Rich Rieger used with permission Photo of fire by Ani Kolleshi on Unsplash  Photo of fist by Dan Burton on Unsplash  Photo of silos by Ricardo Gomez Angel on Unsplash  Photo of ice cream by Food Photographer | Jennifer Pallian on Unsplash The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors, or Methodology Committee. Danny van Leeuwen (Health Hats) Sponsored by Abridge Inspired by and grateful to Jan Oldenberg, Geri Lynn Baumblatt, Fred Trotter, Claire Sachs, Lygeia Ricciardia, and hundreds of others Links In hospice, Mighty Casey receives SPM's “Doc Tom” Award Related podcasts Episode#127 Healthcare is Hilarious, with Mighty Casey Quinlan. Episode #132: Healthcare is Hilarious. Continuing Mets Saga. Hospital. Home. (health-hats.com) Episode #139: Normal, a Dryer Setting with Mighty Casey Quinlan #139 (health-hats.com) Episode #181: Mighty Casey Quinlan Unplugged #3 | Danny van Leeuwen Health Hats (health-hats.com) About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust...

Thoughtfulness, frustration, and caring of PCP, Dr. Bonnie Engelbart managing referral, consultation, and stretching resources but still, not enough bodies. Blog subscribers: Listen to the podcast here. Scroll down through show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player This episode can be watched on YouTube Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Proem.. 1 Podcast intro 01:26. 2 Health is fragile 02:00. 2 Primary care practice at Cambridge Health Alliance 05:31. 3 Screening for mental illness 06:29. 3 The referral maze 08:10. 3 Team building 11:40. 4 Toll on staff 14:02. 4 The burden of stigma, lack of resources, barriers to continuity 14:41. 5 Need more bodies 17:00. 5 Care partners 18:31. 5 A word from our sponsor, Abridge 19:27. 6 Complex time 20:09. 6 Changes over the past twenty years 21:27. 6 Self-medication 22:56. 7 Questions for emerging adults 24:03. 7 Questions for administrators 25:27. 7 The burden of cost to families 27:19. 7 Culture and language 28:09. 8 Reflection 30:35. 8 Next #7 Emergency medicine: We're not trained for this 32:25. 9 Podcast Outro 33:02. 9 Please comment and ask questions at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, Mastadon to @healthhats Credits Music on intro and outro by permission from Joey van Leeuwen, Drummer, Composer, Arranger including Moe's Blues for Proem and Reflection Web and Social Media Coach, Dissemination Kayla Nelson @lifeoflesion Intro photo of Vulture Couple by Rich Rieger used with permission Photo of Swaziland by Ndumiso Silindza on Unsplash Images of emerging adult with mental illness and community collaboration from DALL.E The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors, or Methodology Committee. Danny van Leeuwen (Health Hats) Sponsored by Abridge Inspired by and grateful to Laura Zucker, Mike Herndon, Sue Donnelley, Luc Pelletier   Links World Health Organization (WHO) Adolescent Mental Health Most mental health concerns, especially for emerging adults, first present in primary care, placing them in a critical role for addressing these concerns. The PSC-17 Pediatric System Checklist is a brief questionnaire that helps identify and assess changes in emotional and behavioral problems in children When kids turn 18, we transition to a form called the AWQ, Cambridge Health Alliance Adult Wellbeing Scale, which screens for depression, anxiety, and substance use. National Alliance of Mental Health: Kids, Teens, and Young Adults, White House Fact Sheet: Improving Access and Care for Youth Mental Health and Substance Abuse Conditions, American Academy of Family Practice (AAFP) article, Managing Behavioral Health Issues in Primary Care: Six Five-Minute Tools. Related podcasts Series: Emerging Adults with Mental Illness Pediatric Transition to Adult Care | Danny van Leeuwen Health Hats (health-hats.com) About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to ad...

Costa Rica welcomes travelers with disabilities. Juve Acuna, travel guide, spent a week with us sharing his expertise in flora, fauna, history, & disabilities. Blog subscribers: Listen to the podcast here. Scroll down through the show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player This episode is best watched on YouTube Please support my blog and podcast. CONTRIBUTE HERE Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Proem.. 1 Podcast intro 03:58. 2 Grandfather of disability travel 04:33. 2 Capabilities and preferences 07:07. 3 Building a network 08:30. 3 Preparation 10:51. 4 National Tourism Board 12:48. 4 Building infrastructure for accessibility 13:44. 5 The network for accessibility 16:39. 5 Pride 17:30. 5 Possibilities, safety 19:42. 6 A word from our sponsor, Abridge 21:14. 6 Photo highlights of the trip 21:57. 7 Swimming in the Pacific Ocean 22:16. 7 Howler and white-faced monkeys 23:17. 8 Reflection 24:02. 8 Podcast Outro 24:53  8   Please comment and ask questions at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, Mastadon to @healthhats Credits Music on intro and outro by permission from Joey van Leeuwen, Drummer, Composer, Arranger  Web and Social Media Coach, Dissemination Kayla Nelson @lifeoflesion Intro photo of Vulture Couple by Rich Rieger used with permission Photo by Iswanto Arif on Unsplash Photos taken by Ann Boland, Paul Boland, Juve Acuna, and Danny van Leeuwen The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors or Methodology Committee. Danny van Leeuwen (Health Hats) Sponsored by Abridge Inspired by and grateful to Ann Boland, Linda and Mike DeRosa, Kate Higgins, Mary Lawler Links Il Viaggio Travel Costa Rica - Plan your trip to Costa Rica with us (ilviaggiocr.com) Where to Go Bird-Watching in Costa Rica - Tripadvisor Arenal Hanging Bridges | Experiencing Costa Rica From The Treetops (parenthoodandpassports.com) Related podcasts Camino | Danny van Leeuwen Health Hats (health-hats.com) About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. To subscribe go to https://health-hats.com/ Creative Commons Licensing The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge.  Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements.  Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines. The Show To see the transcript with images download the printable transcript here Proem Figure 1: Skywalk hanging bridge in Arenal National Park, Costa Rica Figure 2: Danny in his chair with our guide, Juve Just stay in the middle.

Matt Neil, teacher, offers a hopeful story. Not focusing on mental health per se but on belonging and inclusion in a typically lonely time – high school. Blog subscribers: Listen to the podcast here. Scroll down through show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player This episode is best watched on YouTube Please support my blog and podcast. CONTRIBUTE HERE Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings Proem Podcast intro 01:46 Health is fragile 02:20 Health class 03:35 Introducing Ambassadors 04:53 Sustaining the Ambassadors program 06:42 Three points of contact 07:52 New student defined 08:27 Back to school after a life-changing event 09:30 Kathy's table 13:50 Prevention is invisible 15:26 A word from our sponsor, Abridge 18:18 Support and continuity 19:00 Continuity and diversity 21:23 Team leadership 22:42 Ninth grade 23:55 Perhaps they don't want help 25:04 A lesson from failure 25:51 Standardization, data 27:53 Social health, a safe place 29:21 Loneliness, belonging, hope 30:50 Captain, CEO of your health team 32:48 What can we do to help young people? 33:42 Wisdom shared 36:06 Reflection 39:53 Nuggets from the Mine 40:42 What's next? 41:18 Dr. Bonnie Engelbart, Primary Care 41:38 Podcast Outro 43:44 to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Please comment and ask questions at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, Twitter, Mastadon to @healthhats Credits Music on intro and outro by permission from Joey van Leeuwen, Drummer, Composer, Arranger including Moe's Blues for Proem and Reflection Web and Social Media Coach, Dissemination Kayla Nelson @lifeoflesion Intro photo of Vulture Couple by Rich Rieger used with permission Image of emerging adult with mental illness and community collaboration from DALL.E Photo by Alex Simpson on unsplash Photo by Trung Thanh on Unsplash High school The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors or Methodology Committee. Danny van Leeuwen (Health Hats) Sponsored by Abridge Inspired by and grateful to Karl Madeo,  Marc Lefebvre, Bonnie Engelbart, Ruben van Leeuwen, Kathy Bloom Links Related podcasts Series: Emerging Adults with Mental Illness https://health-hats.com/a-learning-community-for-ceos-of-your-health/   About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. To subscribe go to https://health-hats.com/ Creative Commons Licensing The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge.  Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements.  Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines. The Show Proem