Michael F. Roizen - YOU: The Smart Patient: An Insiders Handbook for Getting the Best Treatment

We were uncertain what to expect when we fielded the initial call from Joint Commission Resources proposing a collaboration. As members of the academic medical community, we are in awe of the Joint Commission, an organization that promotes meaningful improvements in health care delivery. The relationship has been a blessing at many levels, made even more enjoyable by the close friendships we forged with Catherine Hinckley and Eileen Norris. We learned much from our colleagues at the Joint Commission and Joint Commission Resources. We gained new insights into the most important challenges facing American medicine. We gained respect for the magnitude of the patient safety problem and the opportunity to improve it. And we confirmed our belief that we cannot make health care delivery more effective unless we engage our most valuable allythe patients.

Eileen Norris and Catherine Hinckley from Joint Commission Resources worked tirelessly, and added to their busy schedules our weekly Friday and Sunday conference calls. Joint Commission Resources is lucky to have them. Kelly James-Enger created a treasure trove of information that powered the creation of this book. Our thanks to Joint Commission Resources CEO Karen Timmons for her vision for this project and her willingness to take a risk with our style. That speaks volumes about how much she and her organization care about patient safety. Our thanks, too, to Dr. Dennis OLeary, president of the Joint Commission, for his insightful leadership and efforts to champion the cause of patient safety.

Ron Geracis brilliant writing and remarkable editorial insights brought the prose together seamlessly. Gary Hallgren is the most remarkable cartoonist we have ever witnessed. His wit and raw artistic talent yield impressive results. While the hours of conference calls, research, and writing were sometimes exhausting, this powerful team always pulled in the same direction to resolve content and style conflicts. We also owe Ted Spiker a debt of gratitude as he pushed for Ron as our collaborator and provided insights for this work. Finally, our agent Candice Fuhrmans clear vision (and negotiations) allowed this book to grow into the manuscript America deserves.

We also want to thank profusely the group at Free Press (Simon & Schuster) who immediately saw the value of this work and wanted to make our insights part of the American zeitgeist. Thanks especially to our editor Dominick Anfuso, as well as Martha Levin, Jill Siegel, Carisa Hays, Linda Dingler, Beth Maglione, Nancy Inglis, Phil Bashe, and Wylie OSullivan.

Thanks, too, to everyone in the Publications Department at Joint Commission Resources, especially Cecily Pew, Johanna Harris, Angela Grayson, Jan Kendrick, Meghan McGreevey, Ilese Smith, Kathy Connors, Shelby Sheehan, Paul Reis, Andrew Bernotas, Rachel Hegarty, and Claudia Appeldorn. And we also extend our gratitude to Hal Bressler, Ken Swezey, Rick Croteau, Ken Hermann, Jan Aleccia, and Laura Shedore for their wisdom and work on the book.

Anesthesia has always been a leader for patient safety. Jeep Pierce taught me a zealot could change the world, and he did. Bill Hamilton and Jim Arens taught me to ask advice and recruit the best, and Richard Cook, Lyn Kahana, Steve Small, and Paul Barach are the best. They taught me to understand the need for all to make safety a priority. Toby Cosgrove, Joe Hahn, Rob Kay, Mike OBoyle, and Walt Maurer help make anyone who chooses or refers a patient to the Cleveland Clinic smart. They make safety a part of each persons priorities at the Cleveland Clinic (as Dean Harrison does at Northwestern). I feel fortunate to work with them and with the outstanding clinicians and team in the Anesthesiology, Critical Care Medicine, and Comprehensive Pain Management Division at the Cleveland Clinicit is no accident that it has been number one in cardiac care as ranked by U.S. News & World Report for eleven years in a row.

Special appreciation is due Dr. Walt Maurer, the anesthesiologist at the Cleveland Clinic who chairs the Quality and Safety initiatives, who read and reviewed every chapter. We also need to thank Jennifer L. Roizen and her friends at Caltech who reviewed every edition of each chapter and each cartoon and kept us making each better. And Jeff Roizen pushed to keep every quotation of science pure. I also need to thank Mehmets family and staff, who accepted phone calls at any hour.

Many colleagues in other specialties at the Clinic provided content and deserve gratitude, especially my administrative associate Beth Grubb, Mary Beth Modic, and other nurses at the Clinic who improved this manuscript, and the RealAge team; the very supportive public affairs group at the Cleveland Clinic, including Jim Blazar, Eileen Sheil, and Mary Claire Burick, taught me to stay on message. And a special thanks to Myrna Pudersen and Joan McGrath and many others who taught me much about how to present ideas.

I need to acknowledge two special people as well: Diane Reverand stated not to worry about offending medical colleaguesas long as the science was solid, they would understand you were trying to motivate readers to understand they could control their own health and were responsible for doing so and for enjoying the extra energy and vitality; and the great friend who brought Mehmet and me togetherCraig Wynett.

And I need to thank Nancy for her constant love and support. She read this book and used her expertise in critical reading to make our work better. She makes my life better daily.

I hope and believe this book will help YOU to take control of your health experiences and to become a Smart Patient. That would be the best gift any physician could receive.

My colleagues at New York PresbyterianColumbia University have made patient safety part of our institutional culture. I thank our administration, especially Herb Pardes, Steve Corwin, Bob Kelly, Larry Beilis, Ernie Meisner, Deb McGregor, and Laura Forese, for putting these important challenges on my radar screen.

I thank my colleagues in Cardiothoracic Surgery for freeing me to write and brainstorm, especially Eric Rose, Craig Smith, Yoshifuma Naka, Mike Argenziano, Henry Spotnitz, Allan Stewart and the other superb surgeons on our team. The physician assistants, especially Laura Baer, and the nurses in the OR, ICU and floor are the first line of patient safety defense for us. Lidia Nieves, Michelle Washburn, and our beradministrator Diane Amato make sure that no patient (or their medical records) slip through the cracks. Their advice (and scheduling acumen) are priceless.

Thanks to all my colleagues in health care who provided quality control by offering thoughtful feedback on our writing. Thanks to the very supportive public affairs group at New YorkPresbyterian, including Bryan Dotson, Alicia Park, and Myrna Manners, who have taught me to stay on message. I appreciate Ivan Kronenfeld for pushing me to speak out.

My parents, Mustafa and Suna Oz, taught me to attack challenges with passion and gusto. My fathers attention to detail always made him a safe surgeon; I only hope some of this perfectionist attitude rubbed off on me. My parents-in-law Gerald and Emily Jane Lemole bring wisdom into our familys life daily and are role models to me. They taught me early that the patient is the best guardian of their safety. Finally, thanks to my wife Lisa, who makes my life a continuous blessing-filled journey, and the four particularly loud blessings she bore for meDaphne, Arabella, Zoe, and Oliver. Thanks for sacrificing numerous weekends to the altar of The Smart Patient.

This handbook is dedicated to health care organization leaders, physicians, nurses, pharmacists, and other staff at health care organizations in the United States who work daily to heal the sick and injured and who are passionately committed to ensuring the safety of patients and the quality of care provided to them.