The Activated ( and Active) Patient: "It is becoming clear that patients must be part of any meaningful solution to the challenges facing health care. Having more knowledgeable, engaged patients making informed decisions about their care and managing their health would improve both the quality of care and health outcomes. Encouragement and support from physicians for patients adopting these roles will be pivotal in making this a reality. Yet, for patients to be effective team members they need a certain level of knowledge, skill, and confidence. Just like the other “vital signs” taken of the patient, the patient's health literacy level is something that clinicians need to assess. This assessment is possible with survey instruments such as the Patient Activation Measure (PAM), which measures patient knowledge, skill, and confidence for self-management for patients with chronic illness . Activation, as measured by the PAM, appears to be developmental in nature with four stages: In the first stage patients come to understand that they have an important role to play in maintaining their own health. The second stage involves gaining the confidence and knowledge necessary to take action, including knowledge of medications and necessary lifestyle changes, confidence in talking to health care providers and knowing when to seek help. The third stage involves actually taking action, including maintaining lifestyle changes, and handling symptoms on one's own. In the fourth stage patients are able to stay the course even when they are under stress." Here's a clever tool which doctors can use to "measure" how empowered their patients are !