When was the last time you asked for appreciation from your patients? Or is that too weird of a question for you? You may think, "Why would I need to ask? And besides, isn't that a little too rude to ask for praise?" My answer would be that it is really necessary for our profession. I have had several wonderful diabetes colleagues over the past 10 years who every day make a life-changing impact on patients with diabetes. Without them they may have lost a leg, a kidney, eyesight, etc. They go to work everyday with a smile on their face, stay late, and do it not for the money but the satisfaction of helping others. So many of my diabetes educator colleagues are like this- just genuine, hardworking, and others-focused people. So much so they would never think of asking someone to express their gratitude.  Asking their patients to write an email to the hospital CEO would be taking it 'too far'. I'm writing this post to challenge you to do just that... because I did.

I had been meeting with a patient for about 18 months for weight loss. She came to me obese, a recovering alcoholic with major food addictions, depressed, bipolar, and with arthritic knees. After building rapport with her at our first meeting I convinced her to set a goal and then we just worked with small specific goals and met every month for 18 months. It was not an easy journey. The first several months I was skeptical if she would even return to the next appointment because she has so many diagnoses and trials against her in life. The most wonderful news is she stuck it out and has made amazing changes in her life and has lost over 94 pounds and now exercises 5 days a week to home videos. She truly is a different person inside and out.

At our last MNT appointment, I just threw it out there- "If you are thankful for the service we offer here, I would love it if you could write it down." She immediately said yes she would be happy to and brought the letter to the next appointment. After thanking her for documenting her appreciation, she turned and told me how good it was to write down her thoughts because it made her realize how far she had come. She was frustrated that she had plateaued in the past couple of months and was giving herself a hard time. Writing this letter was therapeutic for her and motivating as well.

And the most important part of this post is the thing I did next: show others!! I didn't keep it and put it up on my bulletin board or keep it for myself, I immediately went to the copier and scanned it and emailed it up the chain of command. Not for my glory, but to show the benefit of my services to the people who make decisions about keeping or cutting my job. Yes this is a bold move, but again necessary and probably not done too often. My challenge to you is to think of a patient in the next few weeks coming in to see you who would be good communicating their appreciation in writing. Then ask. It doesn't hurt to ask. I'm sure they will feel honored that you asked them- and believe me they will get something out of it too.

I will leave you with an except from her letter:

"I weighed in a 222.5 pounds on a 5'1" frame. I had to literally roll myself out of bed and I had arthritic knees and shortness of breath. I was miserable and desperate.

As of this writing, I have shed 94 pounds and I feel and move like a new person. Amy provides me with the encouragement and accountability I need to keep track of my goals. Together we review my eating patterns and she advises me about which foods to employ and which foods to avoid. Even more importantly, she encouraged me to start exercising early on in our relationship. I resisted the idea at first, but once I began to take her suggestions the results have been dramatic and powerful. Amy has followed my exercise regime as it has evolved and has given me techniques to modify and accelerate my routine.

I have battled my weight problem since I was ten years old, but with Amy's help I feel I have finally hit on the answer to my dilemma: slow and steady progress without pills or crash/fad dietiting. Amy has enabled me to see that my new habits are a lifestyle change, not a "quick-fix".

I know that I will need to monitor my weight for the rest of my life and I look forward to continued work with Amy and the opportunity to further implement her suggestions and support.

Thanks again for providing such a healthy and life-changing service!"