Health Hats, the Podcast

Health Hats walks & floats through ancient Maya caves in Belize with forearm crutches, teamwork, trust, and shared decision-making every step of the way. Watch this episode on YouTube. Audio is published, but not the same Podcast episode on YouTube Summary What does it take to go cave tubing in Belize when you use forearm crutches and have no electric wheelchair? For Danny van Leeuwen, it takes the 3 T’s: Time (a half-mile walk), Trust (in guides and companions), and Talk (real-time decisions about stairs vs. river crossings). HHP245 is a first-person GoPro video of Danny floating through the sacred Caves Branch River — ancient Maya ceremonial grounds — with his wife and friend Linda. It’s part adventure, part health advocacy, and part proof that with the right team, you can push your capabilities further than you thought. Click here to view the printable newsletter with images. More readable than a transcript. Contents Table of Contents Toggle EpisodeProemNarrativeReflectionRelated 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   Inspired by and Grateful to: Mike and Linda DeRosa, Ann Boland, Ruben, David, and all our guides and helpers Photo Credits for Videos All by Danny van Leeuwen using GoPro10 Referenced in episode Nohoch Che’en Caves, Branch Archeological Reserve, Episode Proem I delight in pushing the boundaries of my capabilities. In Belize, floating in a tube through caves and snorkeling stretched me. How can tubing stretch anything? It’s passive floating. The event included a mile-long walk to the cave entrance – relatively flat with some steps and wading across the river, a mere six-inches deep. No electric wheelchair, just my forearm crutches. Our guide and my compatriots shared in the decision-making and assisted me. This video episode was taken with a GoPro camera hanging around my neck. Watch the video. Reading will not give you the flavor. Narrative Let me tell you a little bit about where we are what you’ll see. Excuse me, as I will be certainly butchering some of the names of stuff. So where we are is Nohoch Che’en Caves, Branch Archeological Reserve, also called the Caves Branch River. It’s in the Cayo District, and districts are like provinces or states. It’s by far the most famous cave tubing destination in Belize and one of the most unique in the world. So this was sacred to the ancient Maya. They were considered portal to Xibalba, the Maya underworld. This wasn’t just mythology. The Maya actively used these caves for religious rituals and ceremonies, particularly during times of drought when they needed to communicate with the rain God, chaac. I don’t know. Archeologists have found ceramic offerings, jade artifacts and human remains inside; evidence of sacrificial rights dating back over 2000 years. The caves were largely forgotten after the Maya civilization declined and weren’t widely known to the outside world until the 1980s and nineties when the Belizean guides and explorers began documenting them and it became a active tourist destination in the early two thousands. So the Caves Branch River flows through a network of limestone caves carved out over millions of years. The system I floated on. Is part of a much larger Karst landscape riddled with interconnected caves. Some of them still unexplored. Pretty amazing, huh? Reflection That was it. Fifteen minutes of about an hour total time and 30 minutes of recording. I hope it gives you a flavor of what we did. It was awesome. I will be producing a couple more videos from Belize over the next few months. The next video will be of the Mayan ruins, then making tortillas and tamales, and then, we’ll see. Related episodes from Health Hats https://health-hats.com/pod223/ https://health-hats.com/pod191/ https://health-hats.com/pod164/ 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

Former Nike exec Mark Hochgesang interviews Danny on Heavy Hitter Sports Podcast about MS & being an adaptive athlete. Just back from Belize! Training works. Summary My friend Mark Hochgesang, former Nike exec and host of Heavy Hitter Sports, recently interviewed me. While I usually wear my life on my sleeve on Health Hats, this conversation revealed something different—how I think about myself as an adaptive athlete. Phil Knight’s mantra: “If you have a body, you’re an athlete.” I never thought of it that way until Mark helped me see it. Training to travel? That’s athletic training. Loading a 60-pound wheelchair into an SUV? Strength work. Walking 3,500 steps a day with MS? Competition with myself. Here’s what we covered: 🧠 The Swiss cheese brain scan – My MS diagnosis story (turns out I’d had it for 25 years) 🎷 The baritone saxophone – My neurologist’s #1 prescription for MS. Music creates new neural pathways. 🚶 The 3,500-step goal – Why movement is non-negotiable, even with foot drop and proprioception issues 💪 The “every other day” rule – Setting yourself up for success (stretching, balance, upper body work, squats) 😤 The two-minute bitch – No “happy horseshit” allowed. Life with MS sucks sometimes. Two minutes to vent, then move forward. 🌍 Training to travel – From 70 miles of Camino de Santiago to just returning from Belize (videos coming!) 👨‍👩‍👦 The team – Wife (OT), sons, grandkids (my scouts!), medical team, massage therapists, the Cuban van driver who didn’t speak English 🎯 The win – People understanding that disability takes many forms and asking “How can I help you?” instead of aggressively helping 💡 The legacy – Being remembered as “the cool Opa” The biggest lesson? Build a team. You can’t do this shit alone. Click here to view the printable newsletter with images. More readable than a transcript. Contents Table of Contents Toggle EpisodeProemRedefining Athletic PerformanceNerd to AthleteCoachingCompetingCalculated RisksDiagnosis – FinallySwiss Cheese BrainHad It for Twenty-Five YearsWhen You Know One, You Know OneMovement RegimenBlessed with OptimismManaging HelpThe TeamSelective Decision-MakingAnd Then There’s MusicTraining to Travel with AbilitiesReading the RoomSuperpower and the 2-Minute BitchPushing Through?Scouting it OutHealth Hats, the PodcastBuild a TeamAggressive HelpLegacyReflection 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 Inspired by and Grateful to: my entire team Photo Credits for Videos Featured Image by Mark Hochgesang Referenced in episode Heavy Hitter Sports Episode Proem Mark Hochgesang, a former Nike exec and my podcasting buddy, recently hosted me on his podcast, Heavy Hitter Sports. You all know I wear my life on my sleeve and take any opportunity to talk about myself. I’m sharing this episode of Mark’s because it reveals a different story of my abilities and self-image, which I now tell through my collaboration with Mark and his deep understanding of sports. Redefining Athletic Performance Mark: Welcome to Season 4 of Heavy Hitter Sports, where we talk to inspirational figures in the world of sports. Athletes come in many shapes and sizes, and not all heroes perform on a big stage. Today’s episode is a bit different and one that I’ve long been looking forward to. It’s focused on how we adapt to unplanned life changes and adversity, then train, compete, and battle to win on our own terms. My guest is a good friend and fellow podcaster, Danny van Leeuwen. Danny is a former nurse, healthcare executive, musician, traveler, and a man who has lived with multiple sclerosis for many years. This is not a tale about limitations or illness. It’s a story about focus, fortitude, optimism, preparation, and team-building to live an amazing life. Danny’s story as an adaptive athlete challenges us to rethink what strength, toughness, and success look like. If you care about maintaining optimal health, sharpening your mindset, and winning the long game, this is the episode for you. Danny, welcome, my good friend. I’m looking forward to catching up and talking to you about some of the challenges that have been thrown your direction in life. And I’d like to open by getting your thoughts on this Nike

Health Hats Danny celebrates 50 – years with his honey & pounds lost. With gratitude for privilege, & best health thru family, media, music, travel, & advocacy. Summary Think of 2025 as Danny’s Sofrito year—familiar and unexpected ingredients simmering together. The base: 50 years married, daily saxophone practice, steady MS management. The aromatics: Cuban jazz immersion, co-founding a Personal Health Data Bank, and celebrating with old friends on Bloom Mountain. The heat: losing 50 pounds, earning $150 as a “professional” musician, and learning from his grandsons. What makes sofrito work is the slow sauté, the patient layering of flavors. Danny’s learning the same with music (leave white space), with health (five out of ten is excellent), and with AI (it changes the work but doesn’t replace Mom’s feedback). Between PCORI Board meetings, podcast production, band rehearsals, and startup strategy sessions, he’s discovered that retirement’s spicy complexity comes from knowing when to drop out, when to join the rhythm section, and when to let the energizing endorphins carry you through disturbing times. The recipe? Nap whenever and keep improvising. Click here to view the printable newsletter with images. More readable than a transcript. Contents Table of Contents Toggle EpisodeProemFrom Mom to AI50 Years of Love and Privilege RoastedRolling in CubaToo Many and Too Few HornsBest GovernanceGame-Changing StartupOnwardBest Health NowEndorphins and GratitudeRelated 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 and outro Claude, Auphonic, Descript, Grammarly, DaVinci, Whisper Transcription Podcast episode on YouTube Inspired by and Grateful to: All of you! Photo Credits for Videos 50th Anniversary images by Patti Harris, Rich Rieger, Jodi Buckingham, Ann Boland, Christine Higgins, and me Swiss cheese image by Rahul Pugazhendi on Unsplash Nourish image by Santiago Lacarta on Unsplash Cuba images by Ann Boland, Richard Fish, Gisselle Perez, and me Zoom images by Michael Chaffin and Steve Heatherington Links and references The Curse of an Aching Heart Music by Al Piantadosi, Lyrics by Henry Fink 1913 played by the Summer Street Stompers https://health-hats.com/wp-content/uploads/2025/12/The-Curse-of-an-Aching-Heart-20251206.mp3 Referenced in episode Dan Fox and Morningside Studios, the Havana Music School, the Havana Jazz Festival Lechuga Fresca Latin Band and Summer Street Stompers Dixieland Band Research partnerships and participatory governance of AI Personal Health Data Bank https://goodlistening.org Episode Proem I love retirement. I have plenty to do on my own schedule. I can nap almost whenever I want. I‘m no better at saying no. Every day feels rich, although I don’t always know what day it is. From Mom to AI My podcast about best health continues to flourish and nourish. Thank you very much. I embrace the tension between creativity and productivity as I test new approaches and media. I published fifteen new episodes in 2025, plus 32 YouTube episodes, and countless social media shorts. What do you think of my new intro and outro? Grandsons Leon and Oscar encouraged me to update them. Leon has been updating my website, as a growing proportion of people access my back catalog. Both Leon and Oscar advise me on direction, content, and strategy, especially using social media. I meet regularly with my virtual, supportive, and challenging podcasting peeps. I enjoy experimenting with AI in production to find and create images and suggest brief descriptions and section headings. My favorite prompt is “Suggest three ironic titles, brief descriptions, and section headings, a tech-savvy teen would appreciate.” I rarely use the suggested responses, but I chuckle and take an unexpected path. AI does not make me more productive; it changes the work a tad. When I first started blogging, I would read draft episodes to my mom. Her feedback was more often helpful than AI’s. I miss my mom. 50 Years of Love and Privilege Roasted The highlights of the year included celebrating our 50th wedding anniversary with old friends and my grandsons. Our son, Ruben, served as Master of Ceremonies. Nine people from our 1975 wedding joined us in July on Bloom Mountain in West Virginia to tell stories. We played the Dating Game and Danny and Ann Trivia. We, rather, I, got roasted. Oscar, Bruce Kimmel, and I played Simple Gifts on clarinet, bass, and baritone sax. We sang Simple

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 to

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 Officer (ACMIO) at Boston Children’s Hospital. Fifteen years ago, we worked together, learning from emerging adults about their worries and issues with data sharing. We enjoyed catching up and reviewing the current landscape. For my followers who prefer the written word, this transcript has been lightly edited and organized for readability. When Life Throws Your Kid a Curveball Health Hats: Hi. When did you first realize health was fragile? Fabienne: Oh, that started pretty early on in medical school. I had some very transformative interactions and experiences with patients and families during my medical school rotations, particularly in pediatrics, which really led me to pursue a career in pediatrics. But there really were some extraordinary families. And it just became very apparent that things could change very quickly and that patients and parents were managing patients with really chronic conditions. Regularly, something could change—really change —and we had to be very vigilant about everything. And the familie

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. I used the Auphonic app to clean up the audio and remove noise, and then the Descript app to create transcripts of all the recordings. I went into my Claude podcast Project (a Project is an ongoing thread with everything I’ve done with Claude for my podcast over the past three months). I attached the transcripts and prompted the AI platform to identify themes. OK, that was helpful, but dull. So, I prompted Claude to think like a tech-savvy teen with a sense of humor. Eureka! Now we’re getting somewhere. I edited heavily and then prompted Claude to identify clips of speakers that illustrated the themes. I used the Perplexity app for research. Finally, I did the last written edit with a polish from the Grammarly app. For audio, I returned to the Descript app, found the recommended clips, and extracted them. Then I recorded a video of myself, again using Descript. Compilation editing of the video was done with the DaVinci app. I should give production credit to Auphonic, Claude, Descript, Grammarly, Perplexity, and DaVinci. Paradox, Irony, Catch 22 Datapalooza

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. NC: Only noncommercial uses of the work are permitted. SA: Adaptations must be shared under the same terms. Please let me know. [email protected]. 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)

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. Learn with People implies endless curiosity with the people I travel with. Makes sense, I’m a networking extrovert who learns best with others. I prefer to travel with selected peeps (my team). Best health means accepting current circumstances and maximizing abilities, function, and spirit. So, we’re headed to a relatively better place, or at least the best possible health given whatever circumstances of the moment. A journey typically involves a destination (goals), tactics, and costs. The only guaranteed person on the team is me, you, or us, depending on whether it’s community health. Otherwise, the team is constantly changing. Who’s on the team, who’s off? Travel implies choices. Right, left, up, down, stop, rest, shop, eat. We can’t continue without making decisions together. Decision-making means power, group dynamics, and trust-governance. I broke all this down to get to governance, small group governance. After 50 years in health care, I’m still a student of governance. How do we, as mission-driven teams, attain our health goals with the power we possess? How do we coll

Exploring bird flu prevention with farm owner Shannon Hayes. Discover boot washing, flock protection with coyotes, and best practices in biosecurity. Summary 🎯 The Lede: Bird flu cycles have shortened, forcing farmers like Shannon Hayes to reimagine their biosecurity protocols completely. Farm owner Shannon Hayes reveals how her family protects their livestock from bird flu at Sap Bush Hollow Farm. Key strategies include washing boots with soap and vinegar solutions, timing poultry purchases for summer months, ending public farm tours, and maintaining coyote populations as natural buffers against wild waterfowl. Hayes emphasizes that bird flu prevention requires continuous practice and adaptation, not perfection. The episode highlights farmers’ critical but often overlooked role in biosecurity and food supply protection during disease outbreaks 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 Shannon HayesBird Flu: Context and HistoryAn Ecosystem for BiosecurityProtocols for Biosecurity Call to actionChanging Protocols – Our BootsChanging Protocols – Chicks, Eggs, and ChickenDucks, Geese, Overflying BirdsTraining our CoyotesMore about Shoes and BootsGap Found at a Farm MeetingPractice, Not PerfectReflectionPodcast 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 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 Sue and Jay Spivack, Jim Donahue, Pat Hultz Links and references Sap Bush Hollow Farm The Hearth of Sap Bush Hollow Podcast & The Radical Homemaker Blog “Drawing on the Right Side of the Brain” by Betty Edwards, ‘Your Local Epidemiologist’ Substack by Katelyn Jetelina and Edward Nirenberg New York State Grown and Certified Episode Proem The only time I felt I could draw was when my Oma was dying. I sketched the outside of her. I had recently read “Drawing on the Right Side of the Brain” by Betty Edwards, which revolutionized art instruction by teaching readers to perceive edges, spaces, and relationships—core skills for realistic drawing. It features exercises in contour and blind contour drawing, emphasizing the importance of drawing what you actually see, not what you think you see. Now, when I’m curious, I want to know the backstory to fill out the edges. My antennae stirred when reading ‘Your Local Epidemiologist’ about Bird Flu. The Paramedic and Emergency Nurse personas in me feel anxious. No reports are coming out of the CDC, the aggregation of State infection data has been discontinued, and the administration is comfortable with days-long reaction times to disasters, having defunded and staffed mitigation work. So, look out farther to the edges of bird flu –the front line of people managing flocks of birds. Bird flu is nothing new, but the usual 10- to 15-year interval between epidemics has changed. Bird flu isn’t dying out or going dormant anymore. The CDC is reporting incidents of infection jumping from birds to people. Our federal government seems unprepared – danger, danger, danger. I know so little, and I’m scared. Not a healthy mix. 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 Shannon Hayes Fortunately, I have a dear friend, Shannon Hayes, owner and CEO of Sap Bush Hollow Farm in Upstate New York – West Fulton. Shannon and I met 25 years ago when my wife and I were buying lamb, chicken, turkey, and eggs from her parents. Shannon podcasts, too. Warm, humorous, informative: The Hearth of Sap Bush Hollow Podcast & The Radical Homemaker Blog. I recommend them.   This conversation with Shannon took place in February of 2025. Shannon is informed, humble, and eager to share. I’ll cut in a couple of times. Not because Shannon’s tale needs a drop of translation or background. But I’ve learned more from these words each time I’ve touched them in production. I needed a second to digest what I just heard. I’ll do that aloud with

MS patient turned healthcare disruptor shares why your biggest “problem users” are actually your most valuable system improvers. Summary 🎯 The Lede: Collaborate with patients, caregivers, and clinician partners to develop tools that truly inform health decisions. From a reluctant keynote speaker who prefers hallway conversations comes wisdom about transforming healthcare through authentic partnership. At the American Nursing Informatics Association conference, Danny van Leeuwen shared how his MS diagnosis led to a revolutionary approach with his neurologist: “You don’t know anything about multiple sclerosis, but I don’t know anything about you.” Key Insights: Healthcare hackers aren’t criminals—they’re your most dedicated users finding creative workarounds Collaboration is about power dynamics; the more you hoard power, the less you can truly partner Everyone needs to be at the table: patients, caregivers, AND clinicians Aim for a .300 batting average—failing more than succeeding, but keep swinging The secret sauce? Bobbleheads on his desk representing different audience personas, grandsons who told him to stop burying the lede, and the understanding that making healthcare decisions is like renovating a kitchen—endless choices requiring trusted partners. Ready to take one more step in collaboration? 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 EpisodeProem: A Reluctant Keynote Speaker’s ConfessionGrandkid WisdomLead with the LedePodcast introPrepare for ActionStart with Self-KnowledgeMS Detective: Dr. SherlockActivists, DisruptorsThe Bottom LineHealth and Care Decisions, Like Kitchen RenovationBobbleheads of InformaticistsIn Defense of Healthcare Hackers, the Good KindMy HacksCall to actionInevitable Disruption, PearlsCat Herding 101: Without Losing Your MindCollaboration: Sharing Your ToysHouse Cleaning before ReorganizingPartnership from the Ground UpThe Power Dynamics Tango: Who’s Leading This Dance?Foundational ExpectationsCapacityThe .300 Batting Average PhilosophyCulture, Listening, Sharing PowerNext StepsReflectionPodcast 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 Mark Heyward Johnson, Kristina Moran, Leon and Oscar van Leeuwen, Michael Chaffin, Josef Chlachula, Tom Trainer, Pegret Harrison, Fred Gutierrez, Jeff Horner, CA Stockwell, Wendy Coad, Bob Lecher Links and references American Nursing Informatics Association Susannah Fox Episode Proem: A Reluctant Keynote Speaker’s Confession A confession: I’m a keynote speaker who’s ambivalent about keynote speeches. Give me the hallway conversations, the poster sessions, and the coffee-break connections—that’s where my unexpected learning happens. But when my friend and podcast guest, Mark Heyward Johnson, invited me to speak at the American Nursing Informatics Association conference in New Orleans, I faced a delicious challenge: how do you transform a formal presentation into the kind of authentic exchange that changes how people approach their work? Grandkid Wisdom The answer, it turns out, lies in the space between listening and action—and in the wisdom of my two teenage grandsons, who advised me to stop burying the lede and use fewer words on my slides, along with my international colleagues who offered expertise in honing audience engagement through storytelling and keeping the focus on the ask. Lead with the Lede The conference took place at the end of March. I received the full professional multimedia recording of the presentation in mid-May, and I’m starting the episode production in early June. Before I can create a lede introducing the episode, I need to clarify its purpose. What action do I hope readers, listeners, and viewers will take after consuming this content? The lede for the presentation is: Collaborate with patients, caregivers, and their clinician partners to develop and evaluate tools that inform health and care decision-making. So, is my purpose to share the recording of the presentation and hope podcast consumers take one more step in partnerships? Or is the process of creating a presentation more valuable to my followers? Can I do both? 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. Prepare for Action What is my ambivalence about attending and speaking at conferences? As

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, so I went to a church for draft counseling. My counselor invited me to become a counselor, helping men learn the process, make life decisions, and execute those decisions. I went to college and lived in several group settings. We had to decide how the chores would get done, meals made, bills paid, and transportation arranged. While protesting the Vietnam War, I learned how activists organized rallies, and how the University was run. I gained insights from my professor friends about how change happens. While raising kids and homeschooling, my wife and I experimented with participatory democracy. The same issues arose: chores, money, and who sits where. After that, we lived in an intentional community with four other families on 160 acres. We needed an infrastructure for effective decision-making. We formed a corporation to own the land, created bylaws and a Board of Directors, and established rules for joining and leaving, paying taxes and bills, and behavior guidelines. As a corporate change agent, I was fascinated by governance, managing clinical and IT

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 them. — Irene Nemirovsky. Eleven of us from New England and Houston traveled to Cuba for a week in January for a music-cultural event—a Band Camp organized by Dan Fox and Arlington, MA’s Morningside Studios. Our group ranged from no Spanish (me) to fairly fluent (Sonya and Dan). Our host, the Havana Music School, was also fluent in English along this same continuum. Consequently, we communicated in three languages: Spanish, English, and Music. Few people were fluent in all three. My teacher, Pachy, and I managed well with some help from translation, pantomimes, and trial and error. We enjoyed exchanging knowledge, with me teaching him about’ herding cats’ and ‘God willing and the creek don’t rise.’ However, we had difficulty when he spoke about ‘black notes.’ I thought all notes were black, and he meant that quarter notes were the black ones. The Morningside Music Studios group traveled to Cuba for a week of music. Hosted by the Havana Music School, we enjoyed two hours of individual lessons daily, followed by two hours of rehearsals with students a

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 due to many insurers embracing algorithm-driven decision-making systems that often automatically deny coverage for services that should be included. Instead, they might say they don’t cover it because the appropriate code was not included when billing. So, the provider claims, ‘ Oh, we don’t cover that because the code was missing, ‘ even though it should have been included. I feel as though I’ve been a victim of some of these automated systems, which have significantly impacted my life and pushed me to understand that these AI systems are not hypothetical. We live with them every day, and we don’t have a lot of insight into them as consumers or citizens. And that really pushed me into this responsible AI space of thinking. How do we develop and use algorithms that align with how people would treat each other? Not necessarily how algorithms and robots would treat each other. Health Hats: Are you saying that this is a way to be more transparent about what’s in the algorithms? Emily Hadley: That’s a piece

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 🔗 Featured on Health Hats Podcast 📧 Connect: [email protected] 🌐 More resources: https://linktr.ee/healthhats Join us in exploring how health, love, power, and agency work together as we navigate these challenging times. Subscribe for more insights on healthcare advocacy and personal growth! #HealthcareAdvocacy #PatientVoice #Healthcare #Podcast #SelfCare #CommunitySupport 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 You know who you are. I’m grateful. Podcast episode on YouTube Inspired by and Grateful to All of you Links and references Helene Epstein’s Patient No More Chapter 2: The Very First Thing You Should Do, Today Episode Proem Greetings, I’m trying to make sense of the chaos and disruption all around the U.S. and the world. I struggle to focus and direct my energies. I doom scroll, fret, and get mad at myself. As a child of holocaust survivors, my pathological optimism collides with my apocalyptic thinking. I’m afraid for our safety, health, and care. We need teams, organization, trust, and protection more than ever. Leverage Privilege Coming home from Ann and my inspiring trip to Cuba, I feel overwhelmed by our privilege. We live below our means and have no dependents. Our mortgage is paid off, and we’re in love. I have all the toys I need. I can take calculated risks. I don’t need a black market – yet. I’m seasoned, connected, and as healthy as I can be. My superpower is accepting what is and adapting. I have a platform and understand the infrastructure needed to support action promoting best health and care, whether adapting or resisting. How I miss Mighty Casey Quinlan! Rebels in Health My friends and colleagues, our work must continue—whatever we can manage minute to minute. We know many people and are skilled at what we do. Susannah Fox says in Rebels in Health that we are seekers, networkers, solvers, champions, and communicators (my add). That’s the mix of Rebels in Health we need right now. Navigate I’m oriented to action. What action? Where and how should I increase my presence? Where do my peeps share information – Substack, LinkedIn, YouTube shorts, Instagram, TikTok, Medium, Patreon, BlueSky? Yikes! I’m connected to a network of podcasters. How can we leverage and channel our voices? I can and will assist rebels and champions when and where I find them. I’m staying in the health and care space. It’s what I know and where most of my hats are. Health, love, power, and agency fit together – hand in glove. Adapt How can I adjust my practice patterns and focus during this chaotic time? I will reduce my long-form work—monthly 30–60-minute interviews with time-consuming multimedia tentacles—to shorter form, more often, to enable more time for listening and caring. Self-care rules. Music, a healing force, stays, even increases. I need joy, celebration, and rest every day. I need inspiration (you). Call to action What do you do for self-care? How can I support you on these platforms? Feel free to reach out to me on any platform or medium. I’m here to listen and will do my best to respond. While I figure out the best channels, you can email me at [email protected]. As usual, you can find everything Health Hats here https://linktr.ee/healthhats. Music for the Soul Today’s music selection is The Weight by The Band Featuring Ringo Starr and Robbie Robertson | Playing For Change | Song Around The World. Voices for the Mind I’m following Helene Epstein’s Patient No More Chapter 2: The Very First Thing You Should Do, Today. The easiest weapon against misdiagnosis is in your phone. Podcast Outro I host, write, and produce Health Hats the Podcast with assistance. I’m grateful to you who have critical roles as listeners, readers, and watchers. Subscribe and contribute. If you like it, share it. Love ya, see you around the block. Related epi

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 – Susannah Fox Episode Proem Learn with people on the journey toward best health. That’s my tagline. Getting to best health involves many health and care decisions, big and small, day-to-day. The learning part includes a collaboration between patients, caregivers, and their clinician partners using evidence and experience to inform health and care decision-making. Unless implemented by this triad of patient, caregiver, and their clinician partners, evidence or research is useless, merely ink on paper or bytes in space. Research is rarely implemented unless it’s disseminated (shared). Sharing means spreading the word – disseminating research findings to deciders. This podcast is a dissemination tool, along with conversations, conferences, scientific journals, social media, sermons, newspapers, and books. Implementation is doing something with the research results, like modifying a habit, changing a workflow, taking a pill, or getting help. Share and Use: Dissemination and Implementation Most industry investment in dissemination and implementation (D&I) of researc

  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 🎙️ What the Heck is AI, Anyway? I sit down with tech expert Eric Pinaud to demystify artificial intelligence. Whether AI-curious or AI-anxious, this conversation breaks down complex concepts into digestible insights. We explore: • The evolution from Narrow AI (like Netflix recommendations) to today’s Broad AI (like ChatGPT) • How AI learns through neural networks – similar to how we learn music or new skills • Why even AI’s creators can’t fully explain how it works • The environmental cost: ChatGPT’s daily operations cost $700k and use massive energy Most importantly, we discuss how AI is becoming more accessible – anyone can ask questions and get answers, regardless of technical expertise. Though powerful, AI still needs human wisdom and judgment to be truly useful. 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 EpisodeProemIntelligenceIs AI Understandable?What is AI?Narrow AI – One prediction, one decisionBroad AI – Natural LanguageAGI, Artificial General Intelligence – Creating Something NewAI ExamplesFace IDOverwhelmed?ChatGPTHallucinationsReinforcement TrainingStock Market CrazinessHow is Generative AI different from Regular AI?Deep Neural NetworksLearning in HarmonyControllable, Explicable, and PredictableNobody KnowsPrompt = QuestionModeled on the BrainStructured DataUnstructured DataBiasesTime saverScope, Context, and BobbleheadsExperimentingSustainabilityNetworking to Solve a ProblemAGI Artificial General Intelligence – Approaching HumanPeople Solving a Problem, Asking a QuestionAny languageChecking for PlagiarismPerplexityManaging a Large Medical RecordReflectionRelated 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. When Comic Books Predict Tech Better Than Scientists Billions of Data Points Walk Into a Neural Bar… Inspired by and Grateful to John Marks, Amy Price, Dave deBronkart, Emily Hadley, James Cummings, Jeff Harrington, Jacob Sloane, Links and references Chester Gould introduced Dick Tracy’s 2-way wrist radio Claude 3.5 Sonnet The first notable AI development in the 1950s Episode Proem Greetings. Welcome to the second episode in Health Hats’ occasional series, Artificial Intelligence Can Work for You. The first episode, AI: Neither Artificial nor Intelligent, demonstrated how I use artificial intelligence to make my multimedia DIY (Do It Yourself) sausage. A long-time reader, John, called to tell me he opens all my podcast notifications and emails yet never listens to anything smelling technical. But he opened this one, and for the first time, he had an inkling of what AI might be. Mission accomplished! Let’s take another step and use our senses to picture this animal, Artificial Intelligence. How much can we recognize? What feels like sci-fi? What smells like BS? How much is inconceivable? Think of cell phone inventor Alan Gross, who conceived of the cell phone after comic strip creator, Chester Gould introduced Dick Tracy’s 2-way wrist radio in 1946? A path from nowhere in human consciousness to a figment of someone’s imagination in a cartoon (1946), then opening a mind to possibilities (1964), a concept and prototype (1973), and a product (1983). The Digital phone (1990), just thirty-five years ago. You know the rest Intelligence Let’s talk about intelligence for a minute. I frame human intelligence in several ways. One is that data can lead to information, sometimes to knowledge, and occasionally to wisdom. Another is how I think about health: Physical, Mental, and Spiritual Health. So, perhaps for Intelligence, Physical intelligence is clinical information about the body, Mental intelligence is feelings, and Spiritual intelligence is faith and ethics. So far, Wisdom, Feelings, Faith, and Ethics seem uniquely human. Is AI Understandable? Recently, I visited Eric Pinaud, my dear friend and go-to info tech translator. I needed help paddling through the AI soup. I can confidently discuss my AI experiments, hopes, desires, fea

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 trust. If it makes sense and feels possible for me, I’ll act and maybe even join. I’m already connected to many extraordinary, trusted communities nationally, internationally, and locally, and I’ll stay connected. However, my priorities, my communities, and the tint of my lenses will likely change. My comfort will be challenged. I’m very nervous about that. I am so privileged. These muscles will need a strengthening program. I’m grateful that during our 50 years together, my wife and I built a house, had a kid at home, cared for dying family, home-schooled, and changed locations and careers several times. Our sons are fine dads, married to strong partners, and live nearby. We could do the unthinkable. We still can. Those muscles are strong. My Opa survived the Bergen-Belsen concentration camp, and my mother and her parents survived hiding for almost five years. People saved them. I’m grateful for that, too. So, let’s see what happens. Our paths will

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, I explore ways of using Artificial Intelligence (AI) tools during my podcast production. As a technology skeptic, I’m alert to ethics, dangers, and risks. I’m uncomfortable with the term Artificial Intelligence. It’s not artificial or intelligent. Wait, I heard that somewhere? Where? I asked Perplexity, my most common AI tool. Someone said that AI is neither artificial nor intelligent. What was really said? [Side note: I converse with AI, ask questions, pose another question, and clarify, just like talking with my grandkids about Pokémon, video games, or politics. Also, note that in AI-speak, questions are called prompts, and answers are referred to as output or answers.] Perplexity answered: The statement “AI is neither artificial nor intelligent” was made by Kate Crawford, a prominent researcher and author in AI ethics and policy. Here’s a breakdown of what she really said and meant: Not Artificial: Crawford argues that AI is not truly artificial because it is “made from natural resources, fuel, human labor, infrastructures, logistics, histories, and classifications” https://conversational-leadership.net/quotation/ai-is-neither-artificial-not-intelligent/

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. We had a blast preparing and presenting. Here goes. For readers, this newsletter was edited for readability. 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. Level set – Get Your Patient On Kistein Monkhouse: Danny, as it relates to patients, their care partners, and clinicians, where do you see data playing a role in improving health access? Danny van Leeuwen/Health Hats: I want to do some level setting. We’re here about data. The fuller picture is that data leads to information, knowledge, and understanding, and then Lord helps us gain wisdom. Next, imagine yourself as a patient, whether you are a partner, a parent, a child, a neighbor, a relative, or a navigator. Let’s give the umbrella name to those support people: caregivers. When I query people who care as part of every week, locally or remotely, I talk to them about the tool

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, we interview Philip Shadle, CEO of the Aimee Copeland Foundation. You can find videos of me motoring in an all-terrain wheelchair on my YouTube channel—links in the show notes. 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. Off-road wheelchair travel Health Hats: Philip, thank you for taking a few minutes to tell me about yourself and the Aimee Copeland Foundation. I am a person with disabilities. I’ve got all my limbs and use two-forearm crutches and an electric wheelchair. I can walk. My balance pretty much sucks. I like to travel. My wife and I have friends we travel with. When one of our fellow travelers looked up disability travel, they found the Aimee Copeland Foundation. We went to the Cloudland Canyon State Park and used their all-terrain wheelchair. It was awesome, ju

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. One is a charismatic speaker on a stage, engaging an audience I’m delighted to have the opportunity to spend some time with Aaron Carroll and tap into the communication challenges he faces as a communicator and leader. I’ve followed him for years on his blog, The Incidental Economist, and YouTube channel, Healthcare Triage. Dr. Carroll can, has, and will impact your health. 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 Aaron Carroll Health Hats: Aaron, thanks for joining me. I appreciate it. I’ve been following you for a long time. Aaron Carroll: Sure. That’s great. Health Hats: I love your work. You’re inspiring and make complex issues understandable and entertaining. I know how challenging that is. I’m trying to connect

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. 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.a There’s Something Happening Here Health Hats: Why don’t you tell us a little about how this memorial event for Casey took place? What was the genesis of it besides her dying? Jan Oldenburg: Yes. One of the things that Casey had specified in her will was that she wanted to be cremated and she wanted her ashes spread half in the Humboldt current, up the coast of California near Coronado, where she grew up. Half in the Gulf Street, which is not on the Gulf side of Florida, as you may have thought, as I thought originally, it’s on the Atlantic side. And she specified that a portion of her life insurance be dedicated to this event under the auspices of her sister, short of a blood test, Piper. So, Piper with a few family members organized the first boat journey last fall off of the coast Coronado. And they thought through and designed a service. And then they orchestrated the second half, this spring at the end of May,

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 from the diagnostic and treatment journey of those with and caring for enigmatic conditions. Since 2000, I’ve produced many episodes about Covid. You can find them here through this link or in the show notes: People and communities living safely in a pandemic, making choices for best spiritual, mental, and physical health. Over the past few years, I’ve tracked the emergence and response to long Covid, been attracted to lived experience, and identified experts, resources, and advocacy. This episode features Shana Davidson, who is intrigued by the opportunity to tell her story and nervous about the energy it could consume. Shana doesn’t live her life out loud as I do. I’m grateful that Shana agreed to join us today. 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. Le

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, who edits my audio transcript for readability for the 275 Health Hats, the Podcast, followers who prefer reading to audio or video. I call it an article-grade transcript. Leon and I speak often, when I drive or pick him up for school or he drops in for a visit. He critiques warmly and confidently. He often comments on stories and experiences in the episodes. Recently, Leon suggested that he interview me for an episode about my career. You’ve probably heard some of these stories before. In the last episode, I told you about being the first male public health nurse in Western Massachusetts. But you haven’t heard them all by a long shot. Expect more career stories over time. Image from the movie Forrest Gump Perhaps a theme for this episode is the unpredictability of life served by the gifts of spiritual health, the ability to find support, and the incredible privilege of birth and circumstances, setting me up to make choices that accrue to my benefit. Sounds like a Zelig effect (if you know Woody Allen) or a Forrest Gump effect (if you know Tom Hanks) For listeners, please excuse all the times I seem to

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 is so fragmented? It is another whole thing. When did I realize that we make our health more fragile because of the system we’ve built? Journey to healthcare advocacy Health Hats: Tell us about the Camden Coalition and your path to becoming CEO of the Camden Coalition. Kathleen Noonan: I didn’t expect to find myself in healthcare as a 20-year-old or even a 30-year-old. I started out doing children’s advocacy work after college. I was a lobbyist for a children’s advocacy organization in New York City and greatly cared about economic benefits. Some might call it economic justice now, but it was things like earned income tax credits and better wages back then. Those were not the issues I worked on. You get what you get In the children’s advocacy organization. I worked on early childhood and issues of the crack and AIDS epidemic in New York City. I learned much about government and governance, state and local roles, and the federal government&#82

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. I had a dog who needed to run outside quickly occasionally. And I need to be able to take care of my family and go to the grocery. My job requires me to go through airports, make presentations, and stand and walk. It’s a privileged framework, but I have always been ridiculously healthy. Thank God I have had my health, so I’m sensitive to anything glitchy. It was frustrating, and I realized that that little thing could impact my life, much less something larger. Profound Knowledge of Coffee or Caffeine Health Hats: So, how does coffee fit into that? There are so many levels. I describe you as a coffee maven, and I don’t know what that means, but I think you’re a coffee expert. Maven sounds cooler. It impresses me that one of the things that I know about health is that a profound understanding of something is helpful. The more you understand, like you’re talking about your knee and you’re running, the more you understand what’s hap

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? Susannah Fox: I don’t think of myself as an activist. I think of myself as a researcher and a strategist who collects data, studies the landscape, and then tells the truth about what I see. I want people to enter a landscape with an understanding that if they build something on the frontier of healthcare and technology, they must build it on sound foundations. They need to understand the truth of the situation. However, I evolved as a researcher when I started this work and met Tom Ferguson, my mentor when I was working at the Pew Research Center for Lee Rainie. We hired Tom as an advisor. I went to Tom to understand the future of healthcare and technology. He said you must spend time with patients. They are the hackers, rebels, and cowboys on the frontier, bending tools until they break. I started spending time in online patient communities in 2001. Tom would have identified as an advocate and activist, often pulling me toward that. And I was, frankly, resisting and saying, no, I

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, community responses to health challenges, and understanding more about the characteristics of people who gravitate to and champion advocacy. My next episode is with Susannah Fox, author of Rebel Health and a hero of mine (book published on February 13, episode on February 18). I have an episode coming up with Jen Stone about all things coffee. I’m scheduled to meet with Kathleen Noonan, CEO of the Camden Coalition. We’ll likely schedule a time to record a conversation. There is so much good happening in this insane time we live in. Be safe, drink water, love who you can, and fight racism. Keep in touch. Podcast Outro I host, write, and produce Health Hats the Podcast with assistance from Kayla Nelson and Leon and Oscar van Leeuwen. Music from Joey van Leeuwen. I play Bari Sax on some episodes alone or with the Lechuga Fresca Latin Band. I now have one URL for all channels and media. https://linktr.ee/healthhats is where you can subscribe, access episodes, my website, and social media, and search the Health Hats archive. Your

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, Elizabeth Chiarello, is an opioid researcher. She studies pharmacists and their situations in different regulatory contexts. She is a harm reductionist. During this conversation about harm reduction, I think harm reduction is like patient safety, where there are two versions of the word. One is a term of art that comes from a particular clinical context. Of course, as you point out, harm reduction is usually talked about in the context of opioids, which means let’s not criminalize this and instead focus on reducing the harm that this complicated and miraculous class of drugs provides. Patient safety is a similar term, wherein the specific clinical context is a set of procedures that hospitals should follow to ensure that unnecessary harm doesn’t happen. Then, the more general lessons could come from these approaches to harm reduction. Perhaps this concept should have a life outside this context and become broader. Let’s take away some of the judgment in harm reductio

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. The UMass Graduate School of Nursing dean introduced me to this idea. She had health problems, and we recognized this optimism in each other. She had breast cancer and surgery and the whole thing, and I had been newly diagnosed with Multiple Sclerosis. She didn’t have a watch on, but she looked at her wrist and said, okay, you got two minutes, start now. So I bitched, then she did. It was hysterical. It’s tough to bitch for two minutes straight and be creative. You can’t bitch and say the same thing over and over. Two minutes is a long time. After about a minute, it’s just absurd. So now I have a friend I texted just yesterday; we need a bitch session. She’s ready. I did it with my wife a few times, and she’s lovely, and it’s OK. However, having somebody else who’s dealing with whatever insanity is different. Lisa Stewart: I love how you called out the arc between starting the bitching and then recogniz

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 functional MRI is that it’s not what we do learn about in medical school, which is you poke your finger, and if you had lidocaine in there, it wouldn’t hurt. But if you don’t, it goes up to your brain and hurts. Instead, pain is just the oldest and best survival system, so it’s a full-brain, total symphony of everything you’ve ever associated with something you want to avoid. So, pain is not just the incoming stimulus. It is all the memory, fear, decision-making, and actions, and it’s just this giant response. So sometimes your brain is wrong about how much pain you should feel, and sometimes you can learn how to override the brain and say no, we’re fine. Pain as opportunity Health Hats: I automatically react whenever anybody uses the word should. And I’m wondering if I can frame it as being helpful to you instead of should. Amy Baxter: It’s an option

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. Why don’t I ask you the same questions I want to ask other people. How did you meet this jamoke called Danny? Michael Funk: I was going to school with his oldest son, Simon. I don’t know, a mutual friend introduced us and I went over to his place, decided that it seemed really comfortable and the type of environment that I hadn’t experienced before. I just wanted to hang out there. I didn’t really know Danny and Ann too well, I guess I met them on the first day. I just kinda came into the house and didn’t leave, and they were okay with that. It was never an issue about who’s this kid, why is he here all the time? Why is he eating all our food? So I just started eating all their food right from the start, and they just made me welcome. It was the first time I’d seen a nuclear family. I don’t want me to say this is a traditional nuclear family cause it’s not. It’s and very amazing and dynamic family, but they’re all about just bringin

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, and she talked about when she gets older and has sickle cell. This is what she will do. I’m like, that’s not how that works. What do you mean when you get older? I have sickle cell. She said, you’re an adult, and you have sickle cell. So, when I’m an adult with sickle cell, I told her that you won’t have sickle cell when you grow up. She was so shocked by that. We looked at each other as if we had two heads, and she ran to the room and told her younger brother, guess what? We’re not going to have sickle cell when we’re older. Did you know that? I thought I was doing an excellent job explaining things to them. I didn’t know they had internalized the fact. They thought they’d also have pain, sickness, and hospitalizations when they got older. They were excited about that, which made me sad. But then, after the sadness, mom guilt, and all the unhelpful feelings, I had to think back: okay, we need more con

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. Anne’s looking at the vegetables. I pick out some garlic. I used it on some fish stew I made while she was in Santa Fe with her sisters. Also, get some pretzels, fresh pasta, and spices. Ann does most all the shopping. I go to the weekly farmer’s market whenever I can. I also order and cook all the meat from our meat share collective. Ann eats little meat but does eat fish, cheese, eggs, and butter, which I get from the Walden Farm Collective. I sure do appreciate all she does for us. Yeah, thank you. It’s from Mahogany Mamas receiving a complement on my T-shirt. Just there, it’s, it’s an online store. Yeah, I have another one. I have a couple of them. They’re soft, and I get a lot of comments. My shirt says, D

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, 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. That set off many health problems in the family, with financial Issues following. The stress on the family, but also the stress in her life and the resulting kind of emotional and mental toll that it took on her and the family, was tremendous. Growing up in a lower socioeconomic environment compounded the devastation. I know some people have faced adverse childhood experiences much worse than that, but that’s an easy one for me. Danny did a, when I was 12 years old, having a mom with a life-threatening illness and a craniotomy and significant surgery with all the sequela that came after that. I was very aware that health was fragile. Mental Illness in family practice Health Hats: You’re a family practice doc. I understand you spent 20 years in practice as the medical director or a clinical d

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 TeamCreditsInspired by and Grateful toLinks 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 to improve care to address it. Cultural competence is becoming aware of your own, who you are, and where you fit within your culture. It’s also about fact-finding, knowing the history of a culture different from yours, and knowing essential customs. One of the challenges is that when you get into medicine or get to a doctoral level of education, society expects you to adopt this expert position. We don’t get to walk into the room and be the experts we are trained to be. And that can feel hard and challenging. That’s a lot of tension, but yeah. It’s a lot to hold. And cultural humility calls for us to do the opposite and to approach people in a way that feels more squidgy. Health Hats: I think that, so you’re not excluding, or cultural competence, what you’re saying is it’s not sufficient. Catherine Smail: Cultural competence can cause harm if you take a bird’s eye view of a population and then apply that to all people. Are

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, I feel like that’s always difficult. Most people, especially on YouTube, try to minimize descriptive content. I’m not sure that’s really what you want. And they want it to be captivating. I don’t think this is right for, say, your audience or who you’re trying to project to. People will click on something because what they’re shown, like the slight taste of the video, right? That creates a sort of suspense. And they’ll have generally blurred-out images, like blank lines or missing lines of text, right? And the reason is to captivate people into clicking to see what the outcoming result is. And this, in turn, yes, as you’re saying, makes the video less descriptive. But I don’t think that’s exactly what you want for your description. It’s an idea, right? Click-through Health Hats: What we’ve been doing is talking about the initial look glance that fleeting seconds where it se

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, or a bruise here and there. Nothing major that took me out. It was challenging for me mentally and financially because I couldn’t report to the next team. Luckily, I was able to have surgery. I came back, wasn’t a hundred percent, but I was good enough, and I could get back in many things. Health is fragile: caregiver And the second time was similar to one of the roles you played as a caregiver. In 2012, my mom passed away from lung cancer, but before that, I was one of her primary caregivers, myself and my dad. That was a year, a moment I’ll never forget when I was her number one caregiver when her care went from curative to palliative care. When a doctor said we were no longer treating them for a cure, we were treating and keeping her comfortable, and I may have destroyed something in that room. I didn’t want to hear it because I didn’t want to know. I was still determining what was next. I couldn’t predict it. I just thought that she’d ge

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, or a bruise here and there. Nothing major that took me out. It was challenging for me mentally and financially because I couldn’t report to the next team. Luckily, I was able to have surgery. I came back, wasn’t a hundred percent, but I was good enough, and I could get back in many things. Health is fragile: caregiver And the second time was similar to one of the roles you played as a caregiver. In 2012, my mom passed away from lung cancer, but before that, I was one of her primary caregivers, myself and my dad. That was a year, a moment I’ll never forget when I was her number one caregiver when her care went from curative to palliative care. When a doctor said we were no longer treating them for a cure, we were treating and keeping her comfortable, and I may have destroyed something in that room. I didn’t want to hear it because I didn’t want to know. I was still determining what was next. I couldn’t predict it. I just thought that she’d ge

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, single life, conflict management). And 4Ms with other solo entrepreneurs with various businesses (mass marketing, public speaking, teaching Mandarin, all things coffee, digital design, and home building). I love the rich and diverse perspectives to learn from. Beehive Created in DALL.E I’m hosting a table in a Beehive at a conference in November. My pitch was: I will host conversations about creating cascadingly complex usable information that can be shared through word of mouth and social media. I will entertain chats striving to hardwire listening to audiences. I will share mechanisms for audiences to more easily fulfill asks: teach, learn, fund, collaborate, and partner. How can participants take one more step in their dissemination and connection journeys? Created on DALL.E What a hoot that’s going to be! This Beehive gig caused me to bring true to the fib I’ve been telling finally. I tell a story that I have bobbleheads on a shelf in front of me so I can focus on who I’m writing

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, and I had been thinking about the health economics angle on emerging adults with mental illness and thinking about health economics. I realized I couldn’t explain it to people. I appreciate that you’re joining us. Tell us briefly about yourself. Sherry Wang: Thank you. I’m an assistant professor at the School of Pharmacy at Chapman University, located in a beautiful place, Orange County, California. We are very close to the beach, and we enjoy sunshine day by day. Don’t be jealous! Mental health research-it’s complicated I’m doing substance use research here. I’m attracted to mental health topics because mental health is not a single topic. Typically, it is combined with addiction—substance use. So, when I dive deeper into the people who abuse opioids, and Fentanyl. Fentanyl right now is the number one illegal drug in the United States, or even in the black market. People overdose and die from that. I feel sad about the truth we could not offer sufficient

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 long-term opioid use for chronic pain and suicide prevention. 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 Health Hats: Amanda, thank you for joining me. I appreciate you taking the time. When did you first realize health was fragile? Amanda Chue: My best friend’s mother was diagnosed with breast cancer in third grade. Her mother was in her early to mid-thirties. And at that point in my life, I’d had some grandparents who had passed from cancer. But it was not until my friend’s mom was diagnosed that it occurred to me that younger adults or even our parents could pass away from a terminal illness. I assumed at that point our parents would all get to reach older age. So, we watched my friend’s mom go throug

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 health. But when you’re not receiving services, it could intensify many of the symptoms they’re already exhibiting or experiencing. Emerging adults Health Hats: Wow. When I spoke to you earlier, it was the first time I heard the phrase emerging adults. I love it. I love it so much that I changed the series title from Young Adults with Mental Illness to Emerging Adults with Mental Illness. Emerging feels much more powerful. How did this term evolve? Robert Motley: I didn’t know this term until 2015 myself. I was at a conference with a workshop called Emerging Adulthood. Dr. Jeffrey Arnett coined the phrase. Advances in technology can prolong the transition into adulthood. They take more time before they take on the responsibilities of adulthood: meaning that you marry, have children, enter your career, and you’re no longer depending on your parents for any type of financial support. Because people stay in school longer, they’re still in this transitional period where they’re trying to figure out wha

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. Episode 224 just went out the door yesterday, and that was a surprise, wasn’t it? In a sense expecting that I was trying to help my wife, who was writing a book at the time, didn’t have time to do the prod podcasting workshop, so I thought I’d do that workshop. So you carry on writing the book, I’ll do the workshop, and we’ll see whether that goes, and I’ll teach you how to do the podcasting bit later. And we still not quite got around to that bit, but it’s come close a few times. Yeah. So, it’s interesting, I discovered a few weeks ago that I’m a podcaster, but I’ve always been a podcaster. Even before I was podcasting, I was a podcaster. And it was a similar thing when I started with the alpacas. I realized I was a shepherd, although I’d never had an opportunity to express that. Podcasting is just a perfect fit for me. And there are many side benefits and things that have been added in there, and many exciting p

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. That set off many health problems in the family, with financial Issues following. The stress on the family, but also the stress in her life and the resulting kind of emotional and mental toll that it took on her and the family, was tremendous. Growing up in a lower socioeconomic environment compounded the devastation. I know some people have faced adverse childhood experiences much worse than that, but that’s an easy one for me. Danny did a, when I was 12 years old, having a mom with a life-threatening illness and a craniotomy and significant surgery with all the sequela that came after that. I was very aware that health was fragile. Mental Illness in family practice Health Hats: You’re a family practice doc. I understand you spent 20 years in practice as the medical director or a clinical doctor in a college health clinic. How did young adult mental illness present to you in those venues? DALL.E Chosen family adults mixed race in Picasso style Mike Herndon: To set the kind of frame of reference for that practice, I returned to th

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, that gives you a thought about how important life is. Leadership at McLean’s Hospital 04:08 Health Hats: Thank you. The reason that we’re talking is that you’re a director of an adolescent mental health system. Could you tell us about what you do? Michael Macht Greenberg: Sure. I work at McLean Hospital, a private psychiatric hospital, part of the Mass General Brigham system. My roles at McLean include Senior Director for Child and Adolescent Psychiatry. I’m also one of the Interim Associate Chief Operating Officers at McLean. So, I have a role specifically related to children, youth, and families and a position regarding the hospital’s executive leadership. Levels of care 05:12 Health Hats: Are the services you provide inpatient? Are they inpatient and outpatient? What’s the array? Michael Macht Greenberg: McLean has an extensive range within the child and adolescent division. We have two inpatient units, probably six or eight residential treatment units of various types, and four or five partial ho

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, or watching? Please support us on Patreon. Link in the show notes. https://patreon.com/healthhats. Membership benefits will include subscriber-only on-mic episodes sharing behind the scenes of podcasting, advocating, musicianship, and life, your name on the producer wall on my website and show notes, mp3s of me playing the sax, invitations to live Zoom chats with fellow subscribers, personal calls and coaching and mentoring with me. Thank you. Health is fragile 04:08 Health Hats: Greetings. Thank you very much for joining us today. I have three guests with me, and I will let you introduce yourselves and briefly tell us about when you first realized health was fragile. Paul, do you want to start? https://www.mhacg.org/clubhouses Paul Taylor: Sure, my name’s Paul Taylor, the Director of Communications and Development for the Mental Health Association. I started in the spring with the agency, trying to put a good spotlight on mental health for the community, build up some of our agency resources, and how we interact with the community. Healthcare is d

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, then up north to the North Country, to the Adirondacks, and south to the Catskills. It’s a big geographic area. It has quite a mix of demographics, everything from people in the cities to very rural locations. One of the challenges we’ve been able to meet successfully is establishing ways for people to access this program regardless of where they live. It’s unique in that, as Kelly said, it’s a phone line, so people can call this number twenty-four seven/three sixty-five. And they are connected immediately with a prescriber. So, someone who can write a prescription and get that person connected to medication-assisted treatment right away. Wraparound services 04:16 A prescription goes to the pharmacy. If the person doesn’t have the means to pay for that medication, our grant program also covers that. And we can even arrange transportation to get that person’s prescription. We use the term wraparound services a lot in the mental health field. And this is a form of that because it covers a lot of differ