Monday, July 8, 2013

e-Patient Dave: "Humor and Bluntness"

e-Patient Dave
 Six years ago Dave deBronkart (better known as "e-Patient Dave") was battling stage 4 kidney cancer. On top of that, financial setbacks (owning two houses during a job switch and ending up with no job) might have ground a lesser man into the dust.
Fast forward to 2013: The cancer's a goner (thanks to modern medicine and Dave’s active engagement every step of the way). And Dave is gainfully self-employed in a field he pretty much carved out for himself. Tapping marketing and technical savvy from his pre-cancer life, an ability to make complex subjects understandable to lay readers, an energy level that could shame a two-year old, and a mega-dose of stage presence, Dave’s keynote speeches on patient engagement are in demand worldwide. His 2011 TED Talk that concluded with a chant of “Let Patients Help” has had nearly half a million views, and has been subtitled in 26 languages. Let Patients Help is also the title of Dave’s new book, published this past March. 

Pat Mastors: How’s the book being received?
Dave deBronkart: Superbly. It’s a short book (100 pages), so people are actually reading it!
It’s already been translated into Spanish, Dutch and Hungarian. German and Greek are underway. This is with no funding, no conventional publisher and no marketing budget. Next with the book: Finding out what happens when people implement what the book says. Maybe building ‘xx’ around it, like making implementation be part of my speaking fee. We’re looking at it.

Pat Mastors: Your schedule is jammed. Aside from the book’s success, what are some highlights of the year?
Dave deBronkart: To be invited to write an essay for the British Medical Journal is as good as it gets...trying to change the culture of medicine to give patients and providers a different sense of what the culture can be. Also essentially creating a market for my own services and making it work. Last year I finally became able to make a living doing what I do. I have a small office near my home in Nashua (New Hampshire) and have been able to hang up a shingle, and hire an assistant, and surround myself with white boards that help me brainstorm and keep track of things.

As for events…I’d have to look back at my schedule…Aetna, The SAS Institute, six state hospital associations this year. August will be the National Council of State Boards of Nursing. That's all within the industry, because they hold conferences. The challenge is reaching the patient community. So I write. This year I started blogging on So that helps.

Pat Mastors: Leah Binder (President & CEO of The Leapfrog Group, a business-led healthcare quality improvement organization), says in a review of your book, “Dave deBronkart has been in that [patient’s] johnny and survived, and I don't think he ever once in his life just did what he was told without comment. He does so with a combination of humor and bluntness, which is why he is so widely respected not only by patient advocates, but by the health care industry". Why do you think you’ve been so successful on the speaking circuit?
Dave deBronkart: Leah said that? (chuckles). I’m aware of different segments and
priorities. It’s not about me. It’s about “what is the audience thinking? What will be relevant to their lives?" Ted Eytan, a great physician friend at the Permanente Foundation, starts some talks by saying, “It’s fine with me if you do email while I talk, because it’s my job to be more interesting than your email.” I think that’s perfect. I work my butt off to understand each individual audience and think about why and how my story can change their lives.
There’s nothing harder in marketing or speaking engagements than persuading people to adopt a solution to a problem they don’t have, and “mainstream America” isn’t in a health crisis – yet. My mission is to help society “prepare the house” for when that knock on the door comes, late one night. I want citizens to know it’s legitimate to augment their physicians’ advice online. I want everyone else – insurance companies, clinicians, policy people – to know it too, so they can help patients help themselves.

Pat Mastors: What’s a typical day in the life of e-Patient Dave?
Dave deBronkart: My style is multi-channel real time all-at-once, but with no sense of direction. I’m like a fire hose. Grab it and direct it, and beautiful things happen. It’s effective and does the job. If not grabbed correctly, it’s like a water snake—all over the place. Now I have an assistant, Kristen, who calls me at 7:30 am, and puts stake in the ground for my schedule that day. More and more, structure is making my day more focused and productive, and technical tools help. Everything is in the Cloud. To keep track of the business side of 200 events in the last 2 years, I use the Zoho CRM sales management system. Kristen also goes through all pending projects. The free Asana Cloud management system came out last year, so that keeps track of tasks. I do email after 7:30, then Zoho and Asana, and I use an app called Expensify. I take a photo with the receipt, and I can toss the paper. All these tools exemplify efficient systems that are free.

Pat Mastors: What are your tips for using social media?
Dave deBronkart: Number one, listen. You can just blather, but it won’t get you anywhere. Happily, to know what's intersting to people, you can just go on Twitter and see what they're saying, what they are talking about. Follow a hashtag and join the conversation by adding something to it that’s relevant…it's the same as being interesting in conversation in real life.

Second, when you speak, say something useful to the audience. Earn an audience. When you find an article others might find useful, tweet it. Others will re-tweet. Don't obsess about numbers.The most re-tweets I’ve ever gotten is 10. I’m almost up to 15 thousand followers on Twitter. 
In the early days I would crawl around from profile to profile, to see who’s following who. When I'd find someone interesting with lots of followers, I might respond to something they said. And if they re-treet it, suddenly others are seeing your name. Find people aligned with your interests and Tweet with them. You should also show spartly because ome personality, some opinion. It makes you human. 

The converse of all this is to not listen and not pay attention to how audience is reacting. And that, by definition, makes you not interesting.

Pat Mastors: Aside from getting Let Patients Help to be used more broadly, what’s next for you?
Dave deBronkart: I want to create the next wave of patient speakers. I cost (charge) more than many organizations can afford now. I want this summer to start a "speaker’s" academy of informative blog posts. It would probably start with adding a page to my website. As in, “Here is what you need to know about how I do it”. Partly to help other patient advocates and bring in more voices, and partly because I want industry to hear them. They [the advocates] need to be taught what I learned, though…that it’s not about me. 

Dave manifests that "it's not about me" attitude in other ways. To the extent his schedule allows, he's a focused and effective cheerleader for the work of fellow patient advocates and health  innovators.  He's drummed up crowd funding support for our projects on Medstartr and Healthtech Hatch, including a recently funded film about Regina Holliday's Walking Gallery of Healthcare.  He's also been a great mentor and friend to me personally, sharing invaluable insights in my newly published book: Design To Survive: 9 Ways an IKEA Approach Can Fix Health Care & Save Lives

Days after the above interview (conducted via a phone call squeezed into Dave's drive time), he launched the aforementioned "Speaker's Academy" with a post from Randi Oster. You can bet he'll build a great community there, setting us newbies straight, when necessary, with "humor and bluntness".


  1. Energy level that could shame a two year old, huh?? Hahahaha!! Scuse me, I'll be right back... gotta run around the house...:)

  2. I do not exaggerate. I have tried to keep up with you running to catch a cab in Manhattan!

  3. Glad to be apart of the "Speakers Academy" and sharing the lessons learned!

  4. To be clear, while my energy level and enthusiasm may be higher than the average 63 year old, my MESSAGE that gets traction is to explain why medicine should listen to people like YOU.

    Your book does an absolutely fabulous job of laying out clearly how medicine falls short and causes avoidable disasters, in stark contrast to the miraculous treatments, surgery and care that saved me.

  5. Dave, I'm humbled by your comments and support. Thank you! Like you, my gratitude for the "miracles" of modern medicine is boundless (great doctors, staff and teamwork saved my mother, brother and most recently, my daughter from bad outcomes. I KNOW this is due in part to learning from people like YOU and acting on that understanding). But so much unintentional harm could be avoided if we all just admitted health care delivery is simply too fractured and complicated to allow ourselves the luxury of letting our guard down (as referenced in the book, even Don Berwick experienced this when his wife was hospitalized). Many good people are working on improvement, and with some success; but on balance providers are on overload. As always, they're only human, and mistakes are inevitable (see this illuminating TED talk by Brian Goldman. Incentives that have driven treatment for too long have patients in the crosshairs. Nursing and other staff are being cut to meet new mandates. People have GOT TO KNOW about this stuff, so they can participate themselves, work WITH their medical team, and use the pressure of their consumerism to be the "pull-through" for improvement. That's why your rallying cry of "Let Patients Help" is so resonant and timely-- would be great to get large numbers of patient/family advocates to hang out at your Speaker Training forum and spread the message!

  6. Here's the TED Talk link by Brian Goldman on doctors making mistakes (he got a standing ovation, reportedly from an audience made up largely of physicians.):

  7. Yeah, I met Brian when we both spoke in Kingston, Ontario this spring - he's terrific - I'll be reviewing his book The Night Shift for the Journal of Participatory Medicine. And he interviewed me (for an hour!) - it'll be a segment on his radio show in September! Woot.

    p.s. If I had my way, your book would be REQUIRED reading for everyone entering any hospital, every bit as important as training before one's first parachute jump. I mean it.

  8. Why am I not surprised you've met Brian? I look forward to checking out his book AND hearing your interview.

    And thanks ever so much for the P.S. above.

  9. Great blog and post Pat, keep it up I will be subscribing to your feed.
    Check this out too: