We have a life to live—and that life is shaped not only by our health, but our values, emotions, lifestyle, and choices. So, perhaps the 4M’s Framework can help us do that.
Great information . Thank you . I’ve had a couple of great doctors, a few good doctors, a couple of lousy ones. The great ones listen and help me achieve my goals
HI there, I was admitted to the hospital in May.I have never been in a hospital. What I learned was truly amazing. You are correct in everything you have said. Luckily, I am my best advocate.What I learned, besides what you listed,is my official doctor can no longer get me into the hospital.He told me to get another CAT Scan.I thought he made an appointment for me.NO !!! I needed to go to Emergency and wait -10 hours and they would give you a room if I wanted( they wanted me to stay )!?! I arrived @3pm and @ 10pm they arranged or a CAT SCAN. I midnight I left. It was the most insane experience I think I have had in a long time..I have found Hospitalization has become a very "Corporate" organization.There seems to be NO deviation from plan.It becomes one way only.My Dr was not consulted about anything that was done. I am more aware than ever to be prepared. That means paperwork in order(ie living trust)and to be aware of medications given that you may not really need. Great article..
Hi Joanne, I'm so sorry you had to go through that. Unfortunately, it happens all to often. The only thing I know is to that we must understand how the systems really work and to advocate for ourselves - as you did.
A wonderful reminder of the power of self-advocacy. Bringing our own goals and strength to the table completely changes the dynamic. Thanks for sharing this, Janice.
I make a list every time I go to my primary care doctor. It's already intimidating walking in, and having questions prepared helps me actually ask what matters instead of freezing up. I can't say I've had care that resembles the full 4M's Framework, though. Mentation specifically, the emotional and psychological side, has never really come up unless I brought it up myself. I'm going to start including it directly in my list going forward.
Hi Nathan, you are better prepared than most people I suspect. You make a good point - we need to include emotional and psychological issues in our discussions with doctors. I don't think anyone has asked me about them first.
Appreciate that, Janice. It says something that neither of us has had a doctor lead with it. If patients have to bring these conversations into the room themselves, that's another reason frameworks like this matter.
Hi Nathan, I do agree. As it turns out, it's up to us to make things happen for ourselves. That's why I was glad to discover the 4M's framework for older adults - it give us a good set of guidelines.
I go to a Nurse Practitioner who is excellent. An RN from ICU who truly listens and has used her experience as a nurse to take care of me both physically and emotionally. I’m a retired nurse so I do have some opinions but she is the provider and I respect her knowledge and direction. I don’t waste her time but she listens to my concerns and we collaborate. I’m truly grateful for this. She is far better at this than most MDs
Hi Susan, Sounds like you have someone who fits perfectly. One of two medical professionals who I felt respected me, my concerns, and my issues was a nurse practitioner, the other was a holistic doctor. That approach and attentiveness can really make a difference.
Not sure how to attach a file from the New York Times. But, today’s paper has an article entitled “ This is Why Women Are Scared to Tell Their Doctors the Truth”. How fortuitous ! So ladies , I hope you can find it.
Similar hospital experience , Joanne Fisk . Infuriating . But the doctor who sent me to ER happens to be a caring man , so I’m cutting him some slack. He was on overload and concerned that I get more immediate help. Turns out I needn’t have gone.
But, Janice , back to the M’s , the poor PCPs are given 15/20 minutes and paid very little by Medicare. We must indeed advocate and ask them to hear us . We can actually say “ what would you do if it were your mother ?”
Health and happiness to all on this thread . So many of you in your 80’s …. Blessings .
I’m still in my 70’s ; sadly started early with medical issues . But still very grateful , as my two best friends from my earlier life have died from cancer.
Thank you for this. I’m currently writing here on Substack about how we use Resiliance in the Fourth age. I’ve just bought your kindle book and will enjoy it I’m sure. I have a liver disease called PBC. It’s an autoimmune disease where my bile ducts are being destroyed. I find my Hepatologist is very helpful and listens to what I say. My most recent experience is that I was put on a drug which I took for three years, not realising that it was the side effects that were making me ill, not the disease. I discussed with him the pros of quality of life, not quantity. He agreed with what I said and I feel so much better having been off it for a year now. However he hasn’t given up on me, and I still have telephone appointments. But he is still after trying out other drugs to slow down the progress. So I’m going to have to be very wise and well informed when deciding on anything he suggests. Ditto with statins. But that’s another story. I’m 82 by the way.
Hi Patricia, Thank you for buying the book, I hope you will enjoy it. It's interesting that the side effects of the drugs were making you ill rather than the disease. That happens all too often. You are very wise to be well informed and address any concerns as you make your decisions.
Thank you. Your newsletter gave me the courage to speak openly with my PCP. While he doesn’t check all the 4M boxes, he’s more receptive than I initially thought. Turns out, it was up to me to tell him what *I* need. Imagine that!
Hi, That's great!!! And bravo to you for speaking up. As I look back, that is what I could have done a better job at - particularly during my husband's hospital stay. I knew him, my intuition said all the medications they were giving him were wrong, and I didn't say a word. It would be a different story today.
We have a life to live—and that life is shaped not only by our health, but our values, emotions, lifestyle, and choices. So, perhaps the 4M’s Framework can help us do that.
Great information . Thank you . I’ve had a couple of great doctors, a few good doctors, a couple of lousy ones. The great ones listen and help me achieve my goals
Very helpful perspective, Janice. Thanks for the reminder to speak up and advocate for ourselves.
Great advice. Thank you.
I am not sorry-I learned alot..Mostly amazed....
HI there, I was admitted to the hospital in May.I have never been in a hospital. What I learned was truly amazing. You are correct in everything you have said. Luckily, I am my best advocate.What I learned, besides what you listed,is my official doctor can no longer get me into the hospital.He told me to get another CAT Scan.I thought he made an appointment for me.NO !!! I needed to go to Emergency and wait -10 hours and they would give you a room if I wanted( they wanted me to stay )!?! I arrived @3pm and @ 10pm they arranged or a CAT SCAN. I midnight I left. It was the most insane experience I think I have had in a long time..I have found Hospitalization has become a very "Corporate" organization.There seems to be NO deviation from plan.It becomes one way only.My Dr was not consulted about anything that was done. I am more aware than ever to be prepared. That means paperwork in order(ie living trust)and to be aware of medications given that you may not really need. Great article..
Hi Joanne, I'm so sorry you had to go through that. Unfortunately, it happens all to often. The only thing I know is to that we must understand how the systems really work and to advocate for ourselves - as you did.
A wonderful reminder of the power of self-advocacy. Bringing our own goals and strength to the table completely changes the dynamic. Thanks for sharing this, Janice.
Hi Robyn, And we seem to forget we have - or are talked out of using - this power we really do have all too often. At least I do!
I make a list every time I go to my primary care doctor. It's already intimidating walking in, and having questions prepared helps me actually ask what matters instead of freezing up. I can't say I've had care that resembles the full 4M's Framework, though. Mentation specifically, the emotional and psychological side, has never really come up unless I brought it up myself. I'm going to start including it directly in my list going forward.
Hi Nathan, you are better prepared than most people I suspect. You make a good point - we need to include emotional and psychological issues in our discussions with doctors. I don't think anyone has asked me about them first.
Appreciate that, Janice. It says something that neither of us has had a doctor lead with it. If patients have to bring these conversations into the room themselves, that's another reason frameworks like this matter.
Hi Nathan, I do agree. As it turns out, it's up to us to make things happen for ourselves. That's why I was glad to discover the 4M's framework for older adults - it give us a good set of guidelines.
I go to a Nurse Practitioner who is excellent. An RN from ICU who truly listens and has used her experience as a nurse to take care of me both physically and emotionally. I’m a retired nurse so I do have some opinions but she is the provider and I respect her knowledge and direction. I don’t waste her time but she listens to my concerns and we collaborate. I’m truly grateful for this. She is far better at this than most MDs
Hi Susan, Sounds like you have someone who fits perfectly. One of two medical professionals who I felt respected me, my concerns, and my issues was a nurse practitioner, the other was a holistic doctor. That approach and attentiveness can really make a difference.
Not sure how to attach a file from the New York Times. But, today’s paper has an article entitled “ This is Why Women Are Scared to Tell Their Doctors the Truth”. How fortuitous ! So ladies , I hope you can find it.
Here's the link" https://www.nytimes.com/2026/08/22/opinion/women-pain-doctors-medical-system.html, but to read the article we have to either create a free account or log in.
Similar hospital experience , Joanne Fisk . Infuriating . But the doctor who sent me to ER happens to be a caring man , so I’m cutting him some slack. He was on overload and concerned that I get more immediate help. Turns out I needn’t have gone.
But, Janice , back to the M’s , the poor PCPs are given 15/20 minutes and paid very little by Medicare. We must indeed advocate and ask them to hear us . We can actually say “ what would you do if it were your mother ?”
Health and happiness to all on this thread . So many of you in your 80’s …. Blessings .
I’m still in my 70’s ; sadly started early with medical issues . But still very grateful , as my two best friends from my earlier life have died from cancer.
We must ask them
Hi Karen, What a great question to be asking. I actually had a doctor say something similar to me once and it was reassuring at the time.
Thank you for this. I’m currently writing here on Substack about how we use Resiliance in the Fourth age. I’ve just bought your kindle book and will enjoy it I’m sure. I have a liver disease called PBC. It’s an autoimmune disease where my bile ducts are being destroyed. I find my Hepatologist is very helpful and listens to what I say. My most recent experience is that I was put on a drug which I took for three years, not realising that it was the side effects that were making me ill, not the disease. I discussed with him the pros of quality of life, not quantity. He agreed with what I said and I feel so much better having been off it for a year now. However he hasn’t given up on me, and I still have telephone appointments. But he is still after trying out other drugs to slow down the progress. So I’m going to have to be very wise and well informed when deciding on anything he suggests. Ditto with statins. But that’s another story. I’m 82 by the way.
Hi Patricia, Thank you for buying the book, I hope you will enjoy it. It's interesting that the side effects of the drugs were making you ill rather than the disease. That happens all too often. You are very wise to be well informed and address any concerns as you make your decisions.
Thank you. Your newsletter gave me the courage to speak openly with my PCP. While he doesn’t check all the 4M boxes, he’s more receptive than I initially thought. Turns out, it was up to me to tell him what *I* need. Imagine that!
Hi, That's great!!! And bravo to you for speaking up. As I look back, that is what I could have done a better job at - particularly during my husband's hospital stay. I knew him, my intuition said all the medications they were giving him were wrong, and I didn't say a word. It would be a different story today.
Always so insightful, my friend. Thank you for doing our homework for us and steering us in the right directions.❤️
Thank you, Sharron - and take care.
😘