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Postwire Health Blog


Summertime Heat, Physical Therapy and "Drift"

Just got back from physical therapy. I was psyched to go as I thought I was going to get a lot of praise…for once.

Last month, I was given a 45-minute workout plan for home, three times a week, and to report back in four weeks to review. Very excited, as after almost a year and a half, I was given a “real” workout with some weights, elastic bands, and sweat, as compared to stretching and endless diaphragmatic breathing exercises. 


Flip The Clinic

It’s as if I’m in the workout room at my physical therapist’s gym. I hear the banter of people working out, asking questions, getting urged to push harder, hearing encouraging words. The sounds make me feel part of the place, and give me the impetus to start my prescribed home workout.

These sounds are available to me at home because I am watching videos of me doing my personalized PT workout routine. So while I watch the how-to’s of each exercise, including the particular “look outs,” (i.e., things I tend to do wrong which would get in the way of me reaping benefit from the exercise,) I also get a virtual dose of gym club workout adrenaline.


“MMMMORE!!!!!!” What Motivates You?

I know I should do my physical therapy exercises.  I really should.  I have a PT appointment next week and I don’t want to show up…”empty handed” with nothing to report.


If I don’t practice, I will be embarrassed…no better (maybe worse)…and told to repeat the same exercises which feels disappointing and a bit boring.


That said, it is hard to motivate myself to do my exercises.  


So, right now, I am going to stop writing and DO IT……I will report back.  



Open Notes and Mental Health: Taking the Plunge!

Open Notes for Mental Health has had a great coming out party this month!  The founders of the Open Notes movement, Tom Delbanco and Jan Walker from Beth Israel Deaconess Hospital in Boston have taken the  plunge into deeper waters (or as the lead author, psychiatrist Dr. Kahn mused-"into a minefield")  to advance their cause, launching a pilot study to assess the impact on patients and providers of offering mental health notes to patients. The Boston Globe  gave us some early insights into patients’ reactions to the new endeavor. 

I cheered for Dr. Kahn and his team, as I read the solid case they made for including mental health patients in this movement. Yes, they acknowledge that this plunge might indeed have “minefield” elements to it, but they make a strong appeal that sharing these notes has the potential to lead to more actively engaged patients who experience their treaters as being more supportive and less judgmental.

I would like to support this movement with my own observations from piloting the use of Open Notes.  As I wrote in an earlier blog, I’m in Too!  Open Notes and Mental Health, I have been sharing my notes with clients since May 2013, when at a professional meeting in which Tom Delbanco and I spoke, he encouraged me to try it out in my clinical psychology practice.  

I learned that...



As a clinical psychologist in a behavioral health practice, I am always thinking about patient engagement.  I want my patients to feel supported by me, I want them to feel that we are partners working together to reach their goals, and I want my patients to play an active role in providing and gathering information that will guide our treatment process.  Furthermore, I am often in the position of coaching them on how to be actively engaged in their medical, psychosocial or other health and wellness interactions to achieve the best possible outcomes.  


To learn more about the building blocks of patient engagement, I highly recommend reading my colleague and fellow psychologist Dr. Diana Dill’s writings in this area:

Best Practices in Patient Centered Counseling

Defining the Clinical Relationship in Patient Centered Care  

Now let’s get down to some specifics.  Below are real life examples of what I mean and don’t mean about patient engagement.