I’m late to the party. I watched My Octopus Teacher for the first time this past week. I can’t get it out of my mind, and, well, the relationship between the octopus and the scuba diver inspired this blog. There was something profound about the way trust was built—not through force or repetition, but through patience, presence, and understanding. Yes, I’ll get to patient disengagement in a minute, but I am not as efficient as Dr. Linda Lee Farmer was.
My teacher, Linda Farmer, MD, was no octopus, but she was a force—a badass doctor, top of her class, and the mother of my child. Over 19 ¾ years of our marriage, she taught me so many things about myself, about humanity and the deep cracks in our healthcare system, and so much more.
She married a work-in-progress at best. Now, three years after she lost her battle to cancer, I’m still unraveling the lessons she left behind, especially in the healthcare space. I sit here typing, craving her wisdom, her insight. She taught me so much, yet if I had to sum up her professional impact in a single phrase, it would be:
“Medicine comes in many forms, but it begins with compassion.”
Dr. Farmer was a relentless patient educator. She didn’t just hand out instructions to her patients, she made sure they always stuck. After explaining a diagnosis or treatment plan in her clinic, she’d say, “okay, now play that back to me.” The patient would most likely get it wrong. But Dr. Farmer wasn’t okay with that—this 5’1”, 105-pound, native-born South Korean—who carried the angst of a giant—would say “Nope…and you’re not leaving this room until you get it right. Let’s go over it again.”
She was tough and deeply compassionate. Hard, but also soft. She prayed with her patients. Cried with them. Gave them a piece of herself, even on the days when she barely had anything left to give. She ran 2 hours behind schedule many days a week (yes, I did say many days a week), yet more and more patients kept coming to her practice. Why? Because when you were in a room with Dr. Farmer, you got all of her. She grew the practice to over 19,000 patients and added more doctors to keep up with the demand.
Dr. Farmer understood something about medicine that some in the field seemed to forget, but it was crystal clear to the legion of patients and families who trusted her.
Confidence in care comes from clear instructions with shared accountability. Dr. Farmer did her part. Patients were willing to do their part. It worked. Nurses would often brag to me about her, “You know, we never have to worry about Dr. Farmer’s patients. They are trained right the first time.” Anytime my badass wife caught wind of a compliment like this, she would shut it down quickly. “I don’t have time to train patients over and over again. It leads to too many complications.”
I’ve tried to distill her teachings in a way that C-Suite healthcare leaders identify with. Many will say the healthcare system is bleeding money because patients don’t, or won’t, or can’t, follow their care plans. But, I ask: is that truly all the patients’ fault?
How well do we, as a health system, onboard, educate, and guide patients through their care journey? If we don’t first remove, or at least give space for, fear, doubt, and confusion, how can we expect patients to be ready to follow the directions we give?
And this isn’t just a financial crisis. Behind every statistic with dollar signs, there is a very real person, a caregiver, or a family, all who got lost in a system that was supposed to guide them. That they were supposed to trust.
Dr. Farmer understood something intrinsically that many overlook: poor coordination and navigation leads to poor outcomes, complications, and lives lost. Health outcomes aren’t decided in the exam room, they’re shaped in a patient’s daily life–their confidence, mindset, and the progress made between visits to the clinic.
Yet, this is where the system often fails. Between appointments is where the patient’s engagement breaks down, where missed visits, forgotten care plans, and overwhelmed patients turn into wasted resources, lower reimbursements, and higher costs.
It’s not sustainable. And I offer my wife as Exhibit A.
Telling yourself every single day as a provider, “I need to do more,” is not the answer. Going in earlier, staying later, and working through messages and charts all night, isn’t the answer either.
Dr. Farmer set her alarm for 3:35 AM Every. Single. (cussword). Morning. Some days, she made it home by 6:30 PM. Most days, she was home later.
We have to fix the inefficiencies in healthcare. Yes, the daily fires need putting out, but how many of these non-billable issues come from a patient not being on the same page as their care team? We spend our time fighting and reacting through headwinds when the reality is that a well-onboarded, well-trained, confident patient, will create tailwinds for practices.
Longevity in medicine is quickly slipping away. Provider burnout is at an all time high. There’s a serious nursing shortage. The pressure to do more with less time is paralyzing and demoralizing to providers.
Doctors are seen as the ultimate source of medical information, but they shouldn’t have to be. It’s unnecessary and unrealistic.
Patients often default to, “I’ll talk to my doctor about it,” even when nurses or other health staff are trying to help. This can leave doctors carrying the full weight of education, counseling, coaching, and navigation. After all, that’s why they went to so many years of medical school, right?
I don’t accept this as the solution we all want.
Patients hang on to every word their doctor says, trying to absorb years of medical knowledge condensed into a 15-minute visit. Some questions are simple enough for a clear answer, but many procedures, treatments, and conditions require more than words. They’re better explained with visuals, animations, or structured educational materials that patients can revisit at their own pace.
Expecting patients to fully grasp terms like “metastatic cancer” or “lymphatic spread” in a single conversation is hard and should be avoided. If that same information is delivered before, during, AND between appointments—through a short, engaging video or interactive guide—the doctor’s role starts to shift and the patient’s understanding for their own care is enhanced. Instead of introducing complex concepts to an overwhelmed patient, they’re reinforcing information the patient has already seen—because they’ve had time to process and understand it.
This isn’t just smarter. It’s a more efficient use of time and resources. More importantly, it’s less overwhelming for the patient.
By leveraging tools that support patient education, we can lighten the load on doctors, empower the entire care team, and ultimately improve the care experience to drive patient engagement and better health outcomes.
The system doesn’t need more exhausted superheroes. It needs smarter solutions.
Imagine receiving a new or scary diagnosis today in your own life. One moment, life is normal. The next, you're staring down your mortality, perhaps for the first time. Fear grips you before the doctor even finishes speaking. You’re in no position to process what’s happening, let alone prepare for what’s ahead. How can you ask questions if you haven’t even processed what you were just told?
Yet, this is how the system often works.
You might be handed a stack of printed materials. The doctor explains your diagnosis, treatment plan, and next steps. Then looks at you, and asks the inevitable “do you have any questions?”
At that moment, you don’t even know what to ask. Your mind is racing, emotions are swinging from panic to disbelief. Physically, your heart is beating fast, you’re starting to sweat, you feel like you need to just take some deep breaths.
Learning is nearly impossible when you’re in survival mode. And yet, the expectation is that you will not only hear information, but also retain, process, and act on it correctly. That when your family asks you questions after the appointment, you’ll be able to answer all of them.
We simply don’t learn best that way. When we first learn something, the information disappears at an exponential rate. Within 1 hour, we forget 50% of new information. Within 24 hours, we’ve forgotten 70%. Within a week? 90%. This is called the forgetting curve.
Now apply the forgetting curve to a patient who just heard the words “you have cancer.” The expectation that they will absorb, remember, and accurately follow a care plan is unrealistic, not to mention, unfair.
There is no elevator to better health. Patient’s have to take the stairs. But when those stairs feel insurmountable, shouldn’t we do everything possible to guide them—step by step?
When facing a diagnosis, patients don’t follow a straight emotional path. Instead, they experience waves of uncertainty, hope, frustration, and fear. This journey closely mirrors the Kübler-Ross cycle of grief—which includes denial, anger, bargaining, depression, and acceptance.
At first, denial and fear take over. Patients may question the diagnosis, doubt the accuracy of their tests, or refuse to talk about it altogether. Fear quickly sets in: What does this mean for my future? My family? My finances? A cascade of “what if?” questions follow.
Then, emotions turn inward. Patients enter a passive phase, where bargaining and depression take hold. This is the most dangerous stage—not just emotionally, but clinically. Engagement drops. Patients skip appointments, delay treatments, or fail to follow their care plans.
Without intentional support and intervention, this phase can stretch indefinitely, leading to worsening health outcomes, higher hospitalization rates, and skyrocketing costs. In fact, this is where healthcare utilization surges, because patients are struggling emotionally and aren’t equipped to navigate their care effectively.
It’s where the system often fails patients the most.
With time and the right support patients begin to move toward acceptance. They process the diagnosis, gain a clearer understanding of their treatment options, and take a more active role in their care. But this doesn’t happen overnight, and it doesn’t happen in a straight line.
Healthcare teams often prioritize efficiency, hoping for a smooth, linear transition from diagnosis to acceptance. But the reality is that patients need time, reinforcement, and structured support to navigate both the emotional and logistical challenges of their condition. Patients need to eat when they're hungry and ready for the knowledge.
The best doctors and care teams recognize this. They don’t just treat the disease—they treat the patient. They:
This isn’t just about patient experience. It’s about better outcomes, lower costs, and a more sustainable healthcare system. When we address the emotional journey alongside the clinical one, we set patients up for success.
When patients receive fast, accurate information upon diagnosis, along with clear next steps, they are far less likely to spiral into denial and fear. Instead of feeling lost, they have a roadmap, a sense of direction, and the reassurance that they are not navigating their care alone.
This early clarity leads to faster, more thoughtful engagement. Instead of spending hours searching for answers on Dr. Google—often leading to misinformation, anxiety, or avoidance—patients focus their energy on taking action rather than falling into uncertainty.
When information is presented at the right time and in the right way, the emotional turbulence of bargaining and depression is less severe. Patients reach acceptance sooner, allowing them to engage more effectively in their care.
This shift doesn’t just improve individual health outcomes, it reduces unnecessary healthcare utilization by transforming patients from passive recipients of care into active participants in their healing journey.
True patient engagement is more than just reminders and nudges. Engagement is about empowering patients with a deeper understanding of their care pathways. When patients receive step-by-step guidance tailored to their diagnosis, they:
Engagement isn’t just about communication. It’s about connection. It’s the bridge between a provider’s expertise and a patient’s ability to act on that knowledge.
For better health outcomes and a more cost-effective healthcare system, both providers and patients need tools that support real connections and mutual accountability. We need tools designed to make this shift possible, not just by ensuring patients follow their care plans, but by empowering them to take an active role in their health, and at the same time, give providers the insights they need to deliver better care.
In My Octopus Teacher, the diver earns trust and responds to the feedback and emotional cues given by the octopus. Slowly, patiently, and with consistent presence, he builds a relationship with the octopus.
Healthcare should work the same way. One patient at a time in a repeatable way.
My wife, Dr. Farmer, understood that patients don’t just need information, they need guidance, reinforcement, and a system that sets them up for success. She didn’t expect them to grasp complex medical concepts in one sitting, nor did she have the time to repeat herself endlessly. Instead, she equipped them with clarity and confidence, ensuring they left her care with understanding, not just instructions.
This is where we fail patients today. We assume that one conversation is enough, that one visit will stick. But patients, just like that octopus, need time, support, and the right tools to navigate their care plan. When we don’t provide that, we leave them to figure it out on their own, swimming aimlessly through an ocean of fear, misinformation, and disengagement.
That’s why I built PATHS. Not as another one-way tool that pushes notifications to patients, but as a two-way street of accountability—a system of true engagement and clear navigation.
Healthcare shouldn’t demand superhero effort from providers, and patients shouldn’t have to figure it out alone.
We can do better. We must do better.
If an octopus and a diver can build trust in the deep unknown, then surely we can build a healthcare system that does the same.
PATHS removes the minutiae that often overwhelms patients and instead guides them seamlessly through their healthcare experience. With a focus on step-by-step plans PATHS shows patients where they’ve been, where they are, and where they’re going all in one place.
For Dr. Lee Sharma, a gynecologist and obstetrician in private practice in Auburn, Alabama, ensuring patients retained vital information beyond their visit was a persistent challenge—one that led to unnecessary follow-ups, confusion, and gaps in care.
That changed with PATHS.
