I've been at another big healthcare conference this week, an experience that always produces a sore right knee and a few QuickHIT posts.

In my umpteenth session about healthcare reform, new payment models, new delivery models, and the like, I noticed that the term 'patient engagement' is becoming hot, 'trending' as the kids on Twitter say.  It is showing up everywhere and noted as one of the big keys to making the grand vision happen.

One of the speakers lamented the problem, citing an anecdotal study where an overweight woman with diabetes was tailed coming out of the doctor's office.  She promptly headed to the state fair where she promptly ordered a corn dog, or two.  Rumors have it that she appeared to enjoy it, diabetes and all.

There are plenty of patients who will be as obsessive about their health as the healthcare visionaries want them to be.  I've been to Boulder, CO where many people stand on their head to only eat organic.  I've seen the bikers peddling up and over 12,000 foot mountain passes.  I've seen new mothers act as if their kid's head will explode if they touch a piece of candy.

But there are plenty of people who may want to be healthy, but enjoy their corn dogs.  Football season is ramping up and I bet you don't see a lot of kale salads at the tailgate.  Ironically, judging by his waist line, the speaker sharing this story enjoyed a corn dog or two as well.  As do I, judging by my 'relaxed fit' pants.

We can, and are, making progress on patient engagement and getting people to take more responsibility for their health.  But if we keep building models that assume all people have maximum health as their sole preeminent goal, I'll bet on the corn dog.