What is chatGPT?

What is chatGPT?

Written: January 2023


ChatGPT is a conversational language model developed by OpenAI, trained on a large dataset of text from the internet. It is capable of generating human-like text based on the input provided and can be used for various applications such as customer service, content generation, and more.


GPT is the abbreviation for Generative Pretrained Transformer, which is a type of language model developed by OpenAI. GPT-3, the latest version of the model, is a large language model that has been trained on a diverse range of internet text and can generate human-like text based on the input provided. GPT models, including ChatGPT, can be used for a variety of tasks, such as answering questions, generating text, and conversing in a way that resembles human conversation.


OpenAI is an artificial intelligence research laboratory consisting of the for-profit technological company OpenAI LP and its parent company, the non-profit OpenAI Inc. It was founded in 2015 by Elon Musk, Sam Altman, Greg Brockman, Ilya Sutskever, Wojciech Zaremba, and John Schulman with the goal of promoting and developing friendly AI in a way that benefits humanity as a whole. OpenAI conducts research in various areas of AI, including machine learning, computer vision, and natural language processing, and it has developed several cutting-edge AI models, including the GPT series of language models, which are used for various applications such as chatbots, content generation, and more.


There is a concern that advanced AI could pose a threat to humanity in the future, but it’s important to note that AI is just a tool, and like any tool, it can be used for good or bad purposes. The key is to ensure that AI is developed and used in a responsible and ethical manner, and that appropriate measures are put in place to mitigate any potential risks.


Currently, AI is not capable of killing the human race as it is limited to the tasks it was designed and programmed to perform, and it lacks consciousness or independent agency. However, it is important to continue to monitor and regulate the development and use of AI to ensure that it remains safe and beneficial for humanity.


It is also worth noting that AI has the potential to greatly improve many aspects of our lives and solve some of the world’s biggest problems, and it’s important to focus on these potential benefits and find ways to realize them in a responsible way.


The United States government has taken some steps to address the development and use of AI, but it does not have a comprehensive AI regulation in place. There have been discussions and debates about the need for AI regulation in recent years, but so far, no federal law specifically regulating AI has been enacted.


However, some federal agencies, such as the National Institute of Standards and Technology (NIST), have issued guidelines and recommendations for the development and use of AI. The Department of Defense has also issued a directive on the use of AI in military systems.


In addition, there have been a number of proposed bills and initiatives aimed at addressing AI regulation, but these have not yet been enacted into law. It is likely that the debate on AI regulation will continue in the coming years as the technology advances and its impact on society becomes more pronounced.


Overall, while the U.S. government has taken some steps to address AI, it does not yet have a comprehensive AI regulation in place.


Artificial intelligence (AI) has made remarkable advancements in recent years, and there are several areas where AI is already performing at or above the level of human experts in some cases. Here are some examples:


Image recognition: AI algorithms are capable of recognizing objects, faces, and other features in images with high accuracy.


Natural language processing: AI models like GPT-3 have advanced to the point where they can generate human-like text and respond to questions with high accuracy.


Fraud detection: AI algorithms can analyze large amounts of data to detect patterns and anomalies that might indicate fraud, often with higher accuracy than humans.


Healthcare: AI is being used in healthcare for tasks like image analysis, disease diagnosis, and personalized treatment recommendations.


Financial analysis: AI algorithms are used for stock trading, credit scoring, and other financial analysis tasks.


Autonomous vehicles: AI is being used to develop autonomous vehicles that can drive themselves without human intervention.


These are just a few examples of the many areas where AI is already performing at or above human level, and as the technology continues to advance, it is likely that AI will increasingly replace human workers in a variety of tasks.


The paragraphs above were all written by chatGPT. I asked questions and the AI answered. This is quite different than doing a Google search from which you get millions of links. The AI generates an answer to your questions.


The chatGPT is not 100% accurate, it makes mistakes, but it is quite intelligent. Some say it is frightening how intelligent the AI is. Some even believe the Ais will ultimately eliminate humanity. Recent tests have validated the intelligence. ChatGPT was given a medical exam and a bar exam. It passed both. Not 100% but it passed. ChatGPT passed a Google software engineer coding interview which is given to level 3 engineer candidates for a job paying $183K salary. The implications are extraordinary.


I called the book I wrote about AI Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better. As the title implies, I took a positive approach to the subject. However, that view is far from a sure thing. I will write more about this. I also commit to disclose chatGPT assistance if I use it in anything I publish.

News from johnpatrick.com - 02/03/2023
News from johnpatrick.com - 02/03/2023

How a digital patient experience can lead to future outcome driven healthcare: thoughts for executive teams

Dr. Al Villarin, Vice President and  Chief Medical Information Officer at Nuvance Health in Danbury, CT, and I are members of the Nuvance Health Digital Patient Experience Executive Committee. What we are doing is identifying the pain points patients experience and develop solutions to make healthcare more accessible and easy to acquire. Dr. Villarin and I believe making a doctor appointment and checking in for a visit should be as easy as buying something from Amazon. One of the other goals is to eliminate the need for faxes. Nuvance is making great progress at developing a positive digital patient experience. We decided to share more broadly what we are doing and describe what we see as the future for healthcare. We collaborated on an article and it was just published by mHealth Journal. The article is here. We are hoping it will be helpful to healthcare leaders across the country.

It’s All About Attitude

Robot Attitude continues to attract interest. The reporting about chatGPT may be a factor. The key to success for the “It’s All About Attitude” book series is 5-star reviews. Health Attitude has a lot of very positive reviews but they are not current. Some new reviews are imminent. I hope readers will post reviews on Amazon for all six books. Don’t be bashful. I still have a few promo codes for a free Audible copy. No signup required. If you are interested, just drop me a note at [email protected]


Ukraine is getting closer to becoming part of the EU. Here is what President Zelensky said Friday….

“This morning in Ukraine, like many others, began with an air raid alert. This day, like many others, was spent in extremely brutal battles at the front. But all the same, this evening we can say that Ukraine is moving towards its goal.

We’ve preserved Ukrainian freedom. We’re protecting the values of Ukraine. And we will achieve the goals of our state. European goals of our state.

Today, there was a lot of confidence in this during the summit. We spoke and are already speaking as members of the European community. And we are working to fix this de jure.

There is an understanding that it is possible to start negotiations on Ukraine’s membership in the European Union this year. The partners also understand that this year, as last year, we have to continuously strengthen the defense support of our country and the pressure on Russia, in particular the sanctions pressure.

We are preparing for greater integration of Ukraine into the internal market of the EU – it means more income for Ukrainian companies, more production and jobs in our country, and more income for state and local budgets.

Thank you to everyone who fights for Ukraine! Thank you to everyone who helps us defend ourselves from the occupier!”


Although taking an impairment charge like Tesla due to the decline in Bitcoin’s price, MicroStrategy CFO Andrew Kang said, “Our corporate strategy and conviction in acquiring, holding, and growing our bitcoin position for the long term remains unchanged”. Forecasts for the price of Bitcoin vary from $1,000,000 to zero. Bitcoin has been relatively stable or rising in 2023. Elon Musk has urged McDonald’s, the fast-food chain, to accept the dogecoin cryptocurrency as payment for its burgers. DOGE is up almost 50% for the year. FTX has caused a lot of questions but crypto overall is unfazed. Crypto market cap is at $1.08 T with 42% of it Bitcoin.

Wall Street

Always nice to see a rally. Tech has been leading the charge. GAMMAT is up to $7.8 T despite calls from Congress to take action against them. Signals from the Fed, inflation, jobs, and other factors are running in to each other. Hard to say if the rally will continue or fall back significantly.

News from johnpatrick.com - 02/03/2023
Where are the Documents?

Where are the Documents?

Written: January 2023

Government confidential documents often contain sensitive information related to national security, military operations, diplomatic relations, and other important matters which could potentially harm the interests of our country or our citizens if made public. Therefore, there should be a focus on protecting these documents from unauthorized access or disclosure. The protection is accomplished through a variety of measures, such as encryption, secure storage, and strict access controls.

Additionally, laws and regulations such as the Freedom of Information Act (FOIA) and the Official Secrets Act are in place to help govern the release of confidential information to the public. The focus on government confidential documents currently in the news is no surprise since the subject is of public interest. We all care about the functioning of government and the way decisions are made. Although there may be differences in the motivation behind presidential and vice-presidential treatment of confidential documents, the subject is not political.

 The protection measures, procedures, laws, and regulations have clearly not worked. One preposterous proposal advanced recently by some government staffers was to use different color paper for different levels of confidentiality. For example, for secret information, print it on yellow paper, and for top secret information, print it on red paper. In my opinion, the correct solution revolves around two pairs of words, information technology and document management. In this article, I will attempt to describe possible solutions without getting too technical.

Practicing what I preach, I will start by describing how I manage my own documents. Except for diplomas hanging on the wall and a few embossed items, all of my documents are digital and live in the clouds, Google Drive, Apple iCloud Drive, and Dropbox. Any one of the three would be adequate but as new cloud services came along, I was quick to try them. At some point I may consolidate. Most of my active documents are stored in Dropbox, tens of thousands of them. I have been accumulating digital documents for more than 15 years.

Documents in the cloud can be much more secure than documents living in a file drawer or on a personal computer or home server. Documents in the cloud are encrypted (scrambled). If hackers broke into Dropbox and stole my documents, they would not be able to read them. As a further level of security, I keep all my documents backed up on a solid-state hard drive. The external drives are very small, hold trillions of bytes of data, and have become inexpensive. I have backups by the hour, day, week, month, and year.

Most of my documents are created on one of my Apple devices as spreadsheets, PDFs, or text-based documents. Some of my documents come from outside. For example, if I get a 1099-MISC document in the mail (most 1099s these days are available to download digitally), the first thing I do is scan it with a desktop Fujitsu ScanSnap scanner. Next, I put the new PDF file in a folder on one of the Apple devices.

Once on a device, the cloud service replicates to my other devices. Folders are important. They enable me to keep my documents organized and easy to find, and I have hundreds of them. One of the folders is named Taxes. Inside Taxes are folders going back to 1994. In the 2022 folder are two folders: To be entered in TurboTax and Entered in TurboTax. Examples of other folders include Financial, Investments, Estate Planning, Health and Fitness, Home Repairs, Travel, etc.

By default, all my folders are only accessible by me. My Apple devices can only be accessed using my faceprint or fingerprint. My hundreds of online websites are protected with long, ugly, and unrememberable passwords. By the end of this year, I expect most websites will be using passkeys stored in my iPhone with no more passwords.

Having my documents secured is good and essential, but there are times I may want to share a document with a family member, board member, or collaborator. When such need arises, I send a Dropbox, Apple, or Google invitation to share the document. There are various levels of trust which can be delegated. The most secure is to delegate the ability to only read the document. This protects the integrity of the document. If I am co-authoring a document or collaborating on a spreadsheet, I delegate the ability to read the document and edit the document. A further level of delegation is to allow the person you invited to delegate further. The more you delegate and more liberally you delegate, the more risk you assume. I only give editing rights when necessary and rarely allow further delegation.  

There are many document management tools available, including both free and paid options. Some popular examples include Microsoft SharePoint, Google Drive, Dropbox, Box, and Evernote. Additionally, there are many specialized document management tools for specific industries or use cases such as legal or medical document management systems. Numerous document management solutions are available for the unique needs of government.

Specialized solutions can go much deeper than what I described about my own document management. For example, a good document management system would keep a log of every access, when a document was accessed, for how long, by who. Controls are available to prevent a document from being printed. There are many options and our government at all levels, federal, state, and local, should be implementing such solutions. Estonia and Ukraine are way ahead of us at creating an e-government.

There are billions of documents in the world. Maybe trillions. When it comes to paper documents, as many as 7.5% of them get lost. All the lawyers you see in the news are carrying briefcases, some of them huge. Guess what is inside of them? iPads and other tablets are perfect for documents. A desktop, smartphone, or tablet can be a SCIF, a sensitive compartmented information facility in government intelligence parlance, an enclosed area within a building that is used to read or process sensitive classified information. There are tools available to sign with a digital pencil. We really do not need paper documents. A possible exception is wills and trusts. Mine are in Dropbox but the lawyers have paper copies in a safe, a steel one. When it comes to litigation, lawyers will demand paper copies. This will change in time.

Is it technically possible to implement totally secure digital document management systems in the United States government? Perseverance, NASA’s Mars 2020 rover, landed on the Martian surface about 140 million miles away on February 18, 2021. The rover used a complex and precise landing system called the “Sky Crane” to safely land on the surface of the planet. The landing sequence began with the spacecraft entering the Martian atmosphere at a speed of about 12,000 mph. Then, a parachute deployed to slow the descent and a set of rockets called the “Terrain-Relative Navigation” system used images of the Martian surface to guide the spacecraft to its landing site. The government can do this but doesn’t know where all its documents are.


Roughly 40 years ago, Lt. Col. Oliver L. North was using PROFS, an IBM Professional Office System, to exchange emails among North, Rear Adm. John M. Poindexter and others at the National Security Council. North was indicted in March 1988 on 16 felony counts. A lot of the evidence revolved around emails which North thought he had deleted. PROFS had a delete key, but what he didn’t know was the IBM system automatically backed up everything, and had a system to recover even emails which had been deleted.


News from johnpatrick.com - 01/27/2023

It’s All About Attitude

Robot Attitude was the best seller this week. The top format was Audible. I guess people to learn about robots while they are driving or exercising. Marketing programs are underway. The key to success for the “It’s All About Attitude” book series is 5-star reviews. Health Attitude has a lot of very positive reviews but they are not current. I hope readers will post reviews on Amazon for all six books. Don’t be bashful. I still have a few promo codes for a free Audible copy. No signup required. If you are interested, just drop me a note at [email protected]


President Zelensky’s diplomacy campaign is working. Here is what he said Friday….

“Today, we withstood another massive missile strike by terrorists. A strike that fully confirms everything we have been talking about with our partners.

This Russian aggression can and should be stopped only with adequate weapons. The terrorist state will not understand anything else. Weapons on the battlefield. Weapons that protect our skies. New sanctions against Russia, i.e. political and economic weapons. And legal weapons – we need to work even harder to establish a tribunal for the crime of Russian aggression against Ukraine.

Every Russian missile against our cities, every Iranian drone used by terrorists is an argument why we need more weapons.

Only weapons neutralize terrorists. In particular, we are expanding our tank coalition – there is a corresponding decision of Canada, and I am grateful for it. We already have 12 countries in our tank coalition.

And I am grateful to everyone in the world who is really fighting terror together with us. Who is speeding up the supply of necessary defense equipment to Ukraine and who is willing to increase sanctions pressure on the terrorist state.”


A new issue has evolved in the Bitcoin mining arena, orphaned gas wells. There are 81,000 of them across the country with no owner of record. The opportunity is for Bitcoin miners to come to sites with a mobile computing trailerwith gas-driven electricity generation. The mining would use up whatever gas is left in the well and then the mining company would seal off the well so any residual gas stays underground. The price is the state where the well is would remove any liability for the miner. The miner would be doing something the Congress wants but does not have enough money to seal off the 81,000 wells. Clever idea with Bitcoin, the environment, and the government getting a win win win.


Wall Street

Stocks rose Friday and with a fourth week of nice gains. Economics are looking better to analysts. Tesla has gained more than $75 per share above recent lows. Musk met today with White House officials. He is finally getting the attention he has been seeking. Twitter seems to be going well also. Bitcoin seems to be holding above $23,000. Now a third of November high. Crypto market cap up to $1.06 trillion and GAMMAT stocks up to $7.5 trillion.

News from johnpatrick.com - 01/27/2023
Doctoral Journey – Part 6

Doctoral Journey – Part 6


This is the last part of my reflection on the doctoral journey. It started in 2010 and ended in 2015.


Written: July 2014
Edited: January 2023


Several readers, and the university, have asked me if I would recommend University of Phoenix. It depends. I had searched for an accredited, online, healthcare-related doctoral program. U of P was the best one I could find. The structure of the program, with 25 online courses and three 7–10-day residencies in your choice of Phoenix, Washington, or Atlanta, was well organized and rigorous. I will also describe my prior college education and the method of learning at the University of Phoenix, and discuss pros and cons.


I earned an LLB in law in 1971 from LaSalle Extension University (LSEU). LSEU was a nationally accredited private university based in Chicago, Illinois. Courses were delivered by “distance learning”. I read a library of printed law books, wrote assignments with a pen and paper, submitted them by the U.S. Postal Service, and received grades in letters delivered to my physical mailbox. I started the courses in 1969 while I was in the U.S. Army and finished the degree in 1973. (LSEU was founded in 1908 and ceased operations in 1982). An LLB degree is no longer relevant, but I did learn a lot, and gained respect for today’s lawyers who earn a Doctor of Jurisprudence (J.D.) degree. It is a bit hard to imagine how archaic the LSEU method of learning was compared to what is available today at a massive open online course (MOOC) or other online education programs such as EdX.


I attended “brick and mortar” universities for a bachelor’s degree in electrical engineering at Lehigh University (1967) and a master’s degree in management at the University of South Florida (1971). During my years at these schools, there were no Macs, PCs, iPhones, Android, Google or the World Wide Web. The word “device” meant an object, machine, or piece of equipment made for some special purpose. There was no concept of a computer that fit in your pocket or purse. The two universities each had one computer. Lehigh had a GE 225 and USF had an IBM System 360 Model 67. Neither would fit in the house where I am writing this post.


University of Phoenix is predominantly an e-learning school. The online courses are taken at the e-campus. Twenty-five courses taken over 43 months had an average of 15 students in each. The courses were each eight weeks in duration. For most of the course, the first two weeks were dedicated to reading three to five text books, mostly e-books. The professor of a course posted weekly discussion questions which each student answered in an online post. Each student was required to write at least a half-dozen posts responding to what other students had written.


A weekly paper of 1,500 to 5,000 words served as a basis for the course grade. The most significant benefit of the e-learning environment derives from learning from the other 14 students, some of which had vast personal and professional experience. In the traditional university, 15 students learn from one professor. At the e-campus, I felt I was learning from one professor and from 14 students each of whom worked in healthcare for 10-30 years. Like a traditional university, University of Phoenix students and faculty had a bell curve of capability. Online learning is not for everyone. The learning model is very good, but it requires a significant commitment of time on the part of the student, and support from friends and family. Although the online model offers flexibility, the eight-week courses have deadlines and participation requirements. The textbook reading assignments required significant amounts of time. It is hard to take a vacation or a business trip while you are taking a course.


Most of the courses have learning team assignments. These require active participation on a timely basis. Many of the students in my cohort held full-time jobs while meeting family and caregiving responsibilities. I marvel at the commitment of many of my fellow learners. The area of greatest concern during the entire doctoral journey was the administrative and information technology (IT) processes of the university.  For a university which has a College of Information Systems and Technology and offers both bachelor’s and master’s degrees in IT, they do not totally practice what I assume they teach.


The e-campus is online but rather than utilize contemporary cloud computing approaches such as Google Docs or Dropbox, the classes used attachments of Word and PowerPoint documents. When collaborating as part of a “learning team”, it was awkward at best. A typical posting would contain “who has the latest version of the team paper?”


A second admin/IT concern was with the process for submitting and gaining approval of the research dissertation. After the dissertation committee members all approved my draft by January 12, the next step was to submit the dissertation and a half-dozen related documents to a new workflow system at the university called the Editorial Manager. In theory the new system would eliminate email-tag and uncertainty plus provide 24×7 status information. This turned out to be untrue.


A central and essential element of a doctoral program is the dissertation committee. I was fortunate to have an outstanding, supportive, and constructive committee. The chair of the committee was a member of the faculty and was my advisor throughout the process. The other two members of the committee included another faculty member and a medical doctor from a hospital. After my submission of the dissertation on January 12, the committee members were asked to review the manuscript again following a detailed rating scale. They completed their review and approvals on January 14. At that point, the system showed a dissertation status of “Under Review”. It remained that way for 45 days. No feedback. No target review completion date.


A fourth reviewer had been appointed by the university. The committee members nor I would know who the reviewer was. This independent review is appropriate and adds integrity to the overall process. However, there was a lack of accountability and no expectation as to how long such a review should take. After the 45 days, I received an email outlining 16 requested changes to the dissertation. Some were trivial and some were substantive. I spent a week researching the questions and editing the document. The committee members then approved the revised dissertation, and I submitted it to the Editorial Manger with all the related documents again.


Included with the updated dissertation was a change matrix which I used to list each of the 16 requested revisions and an explanation of what changes I had made. The “process” now indicated “Under Review” for a second time. No feedback. No expectations as to how long it would take for the reviewer to look at my changes. It took the three committee members one day. It took the external reviewer 13 days, not hours, days. I am surely not alone in observing the doctoral dissertation process is not an efficient business process. My tuition was paid in full. I had completed 62 credit hours of academic studies.


At this stage, I was powerless, and the university was unresponsive. The administrative delay caused me to receive an email from the university saying, “According to our records, it appears you may no longer be with University of Phoenix.” On March 25, I received an email saying the reviewer had approved the dissertation “with changes”. The six additional changes were reasonable and mostly constructive. Since no resubmission was required, I made the changes and scheduled the oral defense for the following Friday.


The purpose of the oral defense was to provide a final checkpoint in the journey, to validate if the doctoral candidate can explain his or her research, conclusions, implications, and recommendations. I made a 26-slide presentation to the committee by teleconference, which was then followed by a Q&A session. I then dropped out of the conference call to allow the committee to decide pass, pass with changes, or fail.

Ten minutes later, I received a call from the committee chair informing me the dissertation was accepted without changes. Following his call, I received the email saying “Congratulations Dr. Patrick! Enjoy your weekend.”


On March 28, the doctoral journey was over, almost. The last step is to get the dissertation published. I uploaded the final approved dissertation on March 28, immediately after the oral defense. It took six months o bureaucracy to get it published.



Since I completed my doctorate eight years ago, online education has come a long way, pushed forward significantly by the pandemic. Unfortunately, the shift was not highly successful. Many students and schools had insufficient computer. Network connectivity was poor at many locations. Teachers were not trained, and, unlike University of Phoenix, the syllabuses were not designed for online learning. I see online learning as here to stay, but the biggest threat to its effectiveness may turn out to be AI (artificial intelligence).

News from johnpatrick.com - 01/20/2023

It’s All About Attitude

Marketing programs are underway. The key to success for the “It’s All About Attitude” book series is 5-star reviews. Health Attitude has a lot of very positive reviews but they are not current. I hope readers will post reviews on Amazon for all six books. Don’t be bashful. I still have a few promo codes for a free Audible copy. No signup required. If you are interested, just drop me a note at [email protected]


President Zelensky comments after Rammstein meeting…

Today is the day of Ramstein – and defense news for Ukraine, which our diplomatic marathon brings week after week. Not everything can be announced in public – what is being talked about in Ramstein. It is a closed-door discussion – and it should be.

In general, we can conclude that today’s Ramstein meeting will strengthen our resilience. The partners are firm in their attitude – they will support Ukraine as much as necessary for our victory.

Yes, we will still have to fight for the supply of modern tanks, but every day we make it more obvious there is no alternative to making the decision on tanks.

I thank all partners who firmly supported the Ukrainian position in the discussions that took place.

Glory to Ukraine 🇺🇦🇺🇦🇺🇦


IIt was 14 years ago when the first Bitcoin block was mined. Despite numerous doubters, haters, and premature obituaries, its performance has been quite impressive.

Even after the first block was mined, it took awhile for the coins to have a market price. There was a transaction in October 2009, where 5,050 coins were sold for $5.02, giving each Bitcoin a price of roughly $0.00099. Since then the price is up around 1,690,706,971%. Not bad. Jamie Dimon continues to bash Bitcoin. This week he said it has hyped up fraud. I continue to believe the criticisms from banks is related to the billions of dollars of fees banks collect from status quo old-fashioned processes potential threatened by cryptocurrency.

Wall Street

The NASDAQ has continued to make strong gains for three weeks in a row. It closed at $11,140. The 52-week high was $14,647, so it has a long way to go. Small tech seeing gains. Big tech seeing some also with all the GAMMAT stocks up and back up above $7T. Bitcoin at $22,350 as I write this. It seems to be following NASDAQ. Tech is laying off a lot of people after starry eyed growth visions and over-hiring. Tech is still the future and the solution to many of the world’s problems. 

News from johnpatrick.com - 01/20/2023
Doctoral Journey – Part 5

Doctoral Journey – Part 5

Written: December 2013
Edited: January 2023


Next week, it will be 40 months since my decision in August 2010 to begin a doctoral journey. It has been eight months since I provided an update on the journey, and that is the purpose of this post. As of September 30, 2013, I have completed 100% of the academic coursework and have learned a lot from 23 courses, most of them 8 weeks in duration, and from writing 95 healthcare papers.


The Doctor of Health Administration program includes three “residencies”. These take place in one of several locations and involve an intensive week of study with faculty and students from your cohort. I chose Atlanta for my residencies, and I have completed all three. The third residency, which ended in November 2012, was 100% focused on the development of a research proposal that ultimately becomes the first three chapters of the doctoral dissertation. 


The research proposal, CARDIAC TELEMONITORING FOR THE REDUCTION OF HOSPITAL READMISSIONS FOR CONGESTIVE HEART FAILURE PATIENTS, was approved by the hospital institutional review board (IRB) in January 2013, and by the university IRB in February. The proposal was approved by the university quality review process in March of 2013.

The hospital study began in mid-March and phase one of the study was completed on November 15. The phase one study resulted in an anonymized secondary data archive, which formed the basis of my research. The research was completed on December 15, 2013.


I began writing the dissertation in November and completed the third draft today. The dissertation contains five chapters: Introduction, Literature Review, Method, Results, and Conclusions. The document is 153 pages and includes 157 references in the bibliography. My research included 460 references. Important steps are ahead.


The dissertation chair approved the latest draft today, and I have I submitted it for review to the other two members of the dissertation committee. With the holiday season upon us, it is hard to say when the committee members will be able to respond with comments. After their approval and any necessary revisions, I will submit the dissertation to the university for a final quality review. This can take 30-60 days and may result in further revisions and a follow-on review which can take an additional 30-60 days.

After the university has approved the dissertation, comes scheduling of the oral defense with the committee. The purpose of the oral defense is to demonstrate a deep level of understanding of the subject matter literature, the research methodology, findings, and conclusions. I will be developing a presentation about the study and prepare for questions, clarifications, and recommendations of the committee.


If the dissertation and oral defense gain approval of the committee, I will have completed all the doctoral requirements and will then publish the dissertation. I cannot make an accurate prediction of when I will reach the end of the journey since it is beyond my control at this stage, but I can fairly say I am on the home stretch. I have follow-on post-doctoral plans which I will discuss in the next update of my scholarly journey. 


As of today, it has been 43 months since my August 2010 decision to begin a doctoral journey. At my last update, on December 21, I thought I was a few weeks away from completion. I was in for a surprise, as the process for completing a dissertation along with the necessary approvals turned out to be nothing like a business process. In a follow-on post next week, I will describe the “process” in more detail for those who may be interested. For now, I am very happy to report the oral defense lasted 68 minutes and the committee approved my research and dissertation without changes. The 43-month journey has ended. Friday afternoon began with the following email, and the rest of the day was a happy one.  



> On March 28, 2014 at 1:14:21 PM, 

Damien Byas ([email protected]) wrote:
> > Congratulations Dr. Patrick! Enjoy your weekend.

> > 
> > Dr. D. Byas


Epilogue: There will be one more story to complete the doctoral journey.

News from johnpatrick.com - 01/13/2023

It’s All About Attitude

The narration and quality checks are complete. Robot Attitude is now available in Audible. All six books have updated covers and all are available in Kindle, Paperback, and Hardcover formats. Four now available in audible including the newest: Reflection Attitude: Past, Current, and Future. The narration was done by Mr. Hal Maas. He has the perfect voice for the attitude books. I still have a few promo codes for a free Audible copy. No signup required. If you are interested, just drop me a note at [email protected]


Russia continues to blow up schools, maternity hospitals, cultural museums, and churches. Putin has appointed the fourth leader of the military. It doesn’t look like this will solve the disorganization on the battleground.


President Zelensky continues his daily meetings with leaders around the world and with his staff. Here is what he said a few days ago…


“We didn’t lose anything. It was taken from us. Ukraine did not lose its sons and daughters – they were taken away by murderers. Ukrainians did not lose their homes – they were destroyed by terrorists. We did not lose our lands – they were invaded by occupiers. The world did not lose peace – Russia destroyed it.”


I continue in my belief in crypto. Bitcoin and Ethereum are showing some strength, but with a long way to get back to their highs. Analysts are all over the map. Coindesk showed a story today titled, “Bitcoin’s ‘Volatility Smile’ Shows Increased Demand for Bullish Exposure”. If that makes sense to you, please clue me in to what it means. Crypto problems abound, but if you dig you can find positive things. Regulation is needed badly but the regulators are waiting for Congress. Congress is not very focused on the issue. Too soon to say what the new chair of the House committee on financial services will do. Something, I hope. I remain bullish. A 7.5% gain during the coming week would put crypto market cap at a $trillion. Bitcoin hanging in there at 40%.

Wall Street

The NASDAQ had the best week since November. Small tech seeing gains. Big tech seeing some also with the GAMMAT stocks back up almost a half-trillion to $7T. Bitcoin approaching $20,000 as I write this. It seems to be following NASDAQ. Tech is laying off a lot of people after starry eyed growth visions and over-hiring. Tech is still the future and the solution to many of the world’s problems. 

News from johnpatrick.com - 01/13/2023

Doctoral Journey – Part 4


I have received a lot of feedback about the Doctoral Journey series. Some said, “Good luck on the journey”, or “Keep going”, and other comments which made it clear some readers thought I was on the journey now. I guess I did not make it clear enough the journey was from 2010 to 2014, more than ten years ago. I am writing these articles to share what my learning experience had been like. The series is somewhat like Reflection Attitude – Current, Past, and Future in which I reflected on what I had written many years ago. Part 4 below of the current series was written in 2013. I will get back to current and future perspectives on healthcare and technology soon.

Written: April 2013
Edited: December 2022

It has been 31 months since my decision in August 2010 to begin a doctoral journey. I have now completed 80% of the academic coursework and have learned a lot from 20 courses, most of them 8 weeks in duration, and writing 75 healthcare papers. I am currently studying Population Health and Epidemiology.  After completing them in May, there will be three more courses: Evaluation of Healthcare Programs, Contemporary Leadership Issues, and a Doctoral Seminar.

The Doctor of Health Administration program includes three “residencies”. These take place in one of several locations and involve an intensive week of study with faculty and students from your cohort. I chose Atlanta for my residencies, and I have completed all three. The third residency, which ended in November 2013, was 100% focused on the development of a research proposal which ultimately becomes the first three chapters of the doctoral dissertation. 

I have been an Internet advocate for 21 years. My basic tenet has been the Internet provides “power to the people”, and one of the many areas in which this is true is education. Whether it is computer assisted instruction, e-learning, distance learning, or the latest craze of massive open online courses (MOOCs), the concept is the same, to enable people anywhere in the world to learn what they want to learn, when they want to learn it, and use whatever device they want to learn it on.

While evangelizing the power of the on-line environment, I also embrace the validity and need for meeting in person. There is no substitute for what occurred in the third doctoral seminar in Atlanta. Webcams and various forms of virtual reality can enhance an on-line experience, but no virtual capability can replicate the emotion behind the learning shared by students in the class. We all shared a passion for the Scholar-Practitioner-Leader model, and we challenged each other’s proposals, which was a huge benefit to all of us.

The largest challenge standing between the doctoral students and graduation is the dissertation.  The goal every learner shares is to develop a research proposal, get it approved, complete the research, and complete the doctoral dissertation. Some say at least half of doctoral learners never complete their dissertation because of the incredible detail required to get a topic developed and approved for research.

A typical dissertation is 200-300 pages in length. Some consider the process more than challenging. A friend of mine told me he completed all of his coursework and received an ABD degree, all but dissertation. A visit to Amazon can reveal many books on how to “survive” a dissertation. I still remember the meeting with the academic review committee when I had to defend my Master’s thesis forty years ago. It seemed challenging at the time, but I can now say it was minor compared to what lies ahead for the doctoral dissertation.

I arrived at the Atlanta residency with a 145 page dissertation proposal with more than 140 bibliographic references I had researched this past summer. The final proposal was submitted in February and approved in March with some minor suggested revisions. The other hurdle to be completed before research can be conducted is the institutional review board (IRB) approval. The IRB application is complex, with 11 appendices and many details about the research protocol which will be followed. The purpose of the IRB is to ensure the proposed study will be conducted in an ethical way and present no risks to the participants in the study. I received the IRB approval earlier this week.

The study I am planning relates to hospital readmissions of congestive heart failure (CHF) patients. My mother passed away from CHF four years ago, and I learned a lot about the disease and the attendant continuum of care during her final months. CHF is the leading cause of hospitalizations and readmissions for the elderly, and accounts for a large share of developed countries’ healthcare expenditures. Although CHF is a condition for which hospitalization is often avoidable, nearly 20% of Medicare patients discharged from hospitals are readmitted within 30 days at a cost to Medicare of $15 billion annually. The problem is frequent readmission of CHF patients to the hospital has a negative impact on the patient and the hospital.

For the patient, it results in a reduced quality of life and a negative impact to their psychosocial and financial condition. For the hospital, it means using extra capacity for care while facing the risk of not receiving reimbursement for the associated cost. The purpose of my proposed research study will be to answer the question of whether home-based telemonitoring can provide an early warning of an impending episode of acute decompensated heart failure and allow for an intervention which can reduce hospital readmissions. I will be using anonymized archival data with no personally identifiable healthcare information to perform an analysis of the impact of the telemonitoring. 

During the months ahead, hopefully more than 100 participants will be recruited to the study. Participants will be randomly assigned to a telemonitoring group or a control group.  My analysis will focus on whether there is a statistically significant difference between the readmissions from the two groups. After the analysis is complete, the remaining steps will be to write the final two chapters of the dissertation, submit to the university for quality review, and finally to present an oral defense to the three-member dissertation committee. If all goes well, everything will be completed before the end of the year.






News from johnpatrick.com - 01/06/2023

It’s All About Attitude

The narration and quality checks are complete. Robot Attitude is now available in Audible. All six books have updated covers and all are available in Kindle, Paperback, and Hardcover formats. Four now available in audible including the newest: Reflection Attitude: Past, Current, and Future. The narration was done by Mr. Hal Maas. He has the perfect voice for the attitude books. I still have a few promo codes for a free Audible copy. No signup required. If you are interested, just drop me a note at [email protected]


President Zelensky has been excelling in global diplomacy. Here is what he said a few days ago…

“Today was another active diplomatic day – four more leaders of partner states were fully informed about Ukraine’s defense needs and the nearest plans of the terrorist state.

Russia will not be able to conceal in silence its preparations for a new wave of aggression against Ukraine and the whole of Europe. The world will know in all details – how and when the aggressor is preparing a new escalation in this war. And every new mobilization step of Russia will be known to the world even before Russia makes it. We will ensure this.

And we strengthen the defense of Ukraine every day. I always discuss two things with all leaders – more defense support for our state, that is, more weapons for our army, and more protection for all Ukrainians – protection on the ground, in the sky and at sea.

Today I would like to express separate gratitude to President Biden and Chancellor Scholz for the decision to strengthen our defense, a very important decision. We will have another Patriot battery and powerful armored vehicles – this is truly a great victory for our country. 

I thank everyone who helps our people defend freedom!

I thank everyone who fights and works to defeat terrorists!

Glory to our strong people! 

Glory to Ukraine!”


I continue in my belief in crypto. Not all crypto. Not the 22,000 tokens out there. Just Bitcoin, Ethereum and a dozen others. Bitcoin has been very stable, more so than many tech stocks. I saw forecast this week of $250,000 by 2030. There are other forecasts of zero long before then.

Wall Street

Weak economic numbers have generated recession fears and strong numbers beget Fed fears. A slowing down, not crashing down, is well received and led to a nice rally today. We are still a very long way from 52-week highs. Tech is laying off a lot of people after starry eyed growth visions and over-hiring. Tech is still the future and the solution to many of the world’s problems. 

News from johnpatrick.com - 01/06/2023