What Stephen Sondheim Can Teach Us About Patient Engagement


Bob Abrahamson, Chief Marketing Officer

Stephen Sondheim, one of American theatre’s greatest composers and lyricists, passed away November 26, 2021.   Here is a link to his obituary.  My wife and I watched the documentary Six by Sondheim in celebration of his life. I wasn’t expecting to get a bit of professional reinforcement when I sat down to watch the program.

The documentary includes a series of interviews Sondheim gave over the course of decades.  In one interview, he explains why his songwriting is NOT poetry. Poetry is written in many cases to be read slowly, maybe in quiet, with the ability to go back and re-read at the pace of one’s choosing. The reader goes into the experience laser focused on the text.  

Not so with song lyrics. There is a lot going on in musical theater. There is the action before and after the song, there is music, there is dancing, costumes and lighting.   The audience member can’t hit rewind to catch a missed phrase. The job of the lyricist is to convey meaning artistically but SIMPLY so that meaning with nuance is conveyed.  Sondheim went on to explain that is very hard to do; it takes great effort to communicate simply.

Wow.  Mr. Sondheim just summed up a huge patient engagement challenge without even trying. It is very easy to lose sight of the fact that so much is going on in people’s lives all the time. It starts to explain issues with “adherence” from keeping  appointments, to filling prescriptions or following pre-op instructions, and managing chronic conditions. Yet we must acknowledge that we still have a long way to go in order to hit that sweet spot where we can communicate importance and clear the pathway to behavior change. It starts by understanding where the patient is coming from AND helping them along the way.

It’s not just a matter of meeting patients where they are.  It’s a subtle point and unfortunately, I don’t have Sondheim’s gift with language. It’s that combination of empathy and expertise; putting yourself in the patient’s shoes but also providing the tools, within an accessible framework, to help the person move forward. I suppose it’s not so much as meeting them where they are as helping them get where they want to be on their own terms.

Sondheim also described songwriting in terms of solving a puzzle. The good news is that in today’s world, so many pieces of the patient engagement puzzle are on the table in front of us. The Suitability Assessment of Materials, Patient Activation Measure, Motivational Interviewing, Transtheoretical Model of Behavior Change, and other scientifically based learning methodologies coupled with the vast array of technologies available to facilitate connections make meaningful engagement and collaborative care more possible today than ever before. The challenge is to find the pieces that fit together correctly in any given situation.  We must keep reminding ourselves that we need to keep it simple and that it is not necessarily easy to do so. One size does not fit all.  That is what keeps it interesting.

Stephen Sondheim also believed that teaching was sacred.  So, I thank him for this lesson.  Rest in Peace.  

(In case you’re curious, the image above is from a community theatre production of Sondheim’s A Funny Thing Happened on the Way to the Forum.  Yours truly is pictured bottom center.)

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