Open Payments: The Website Every Patient Should Know About         How it can help you avoid a doctor's conflict of interest
By Wendy Sue Knecht
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April 20, 2021
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Money & Policy
SHARE   If your doctor prescribes a drug for you made by a company that he or she gets paid by or has a financial relationship with, you'd assume the physician would tell you. Likewise, if you're getting a medical device implanted — say a hip replacement — by a doctor who earns commissions from the device maker, you'd assume you'd be told.
Credit: GettyOf the roughly one million doctors in the U.S., over 615,000 received some type of payment from drug and device companies in 2019.
But there are no laws requiring a doctor to tell you about such payments.
Many doctors will tell you, of course; it's the ethical thing to do. The vast majority of doctors are ethical and care deeply about their patients. I know that to be true; I'm married to one.
And disclosure of conflicts of interest is a tenet of many medical societies and hospitals. But there's little, if any, oversight or enforcement.

Doctors' Potential Conflicts of Interest "The more money doctors receive from drug and medical device companies, the more brand-name drugs they tend to prescribe," an analysis by the nonprofit ProPublica media site noted.
ProPublica said even free lunches that drug-company reps often supply to doctors' offices can influence a physician's choice of a medication to prescribe or device to implant.
One frank psychologist friend told me, "When I am choosing between recommending Lexapro or Paxil [two antidepressants] for a patient, I often go with the Paxil because the Paxil rep brings the best lunches."
If your doctor was being paid hundreds of thousands of dollars to promote or provide a drug or device, human nature dictates that those payments could influence the treatment they choose. That choice might just be the best treatment for you, but then again it might not.


Experts say it's worth taking the time to search for the right fitAlthough doctors aren't required to disclose these financial connections, drug and device companies are mandated by law to report the payments to the government. And you have access to that information, though most people don't know it.
What You Can Learn From the Open Payments SiteThe information about payments your doctor is receiving from drug and device makers is on a little-known area of the website from the federal Center for Medicare & Medicaid Services (CMS): Open Payments.
CMS' Open Payments data shows that of the roughly one million doctors in the U.S., over 615,000 received some type of payment from drug and device companies in 2019 to the tune of nearly $2.3 billion.
You can find any payment or gift worth $10 or more on the site; payments appear in categories such as research, consulting, speaking, travel, lodging, gifts and food.
The Open Payments site recently expanded to include payments made to nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and anesthesiologist assistants and certified nurse-midwives.
The site is the result of work by Dr. Chuck Rosen, a professor and orthopedic surgeon at the University of Calfornia, Irvine, School of Medicine. He is also the founder and president of the Association for Medical Ethics.
Rosen was dismayed seeing his fellow surgeons performing unnecessary surgeries while getting paid by companies for using devices that were not necessarily needed. He began writing to U.S. Senators about the potential conflicts of interest and eventually gained bipartisan support from Senators Chuck Grassley (R- Iowa) and Herb Kohl (D- Wisc,) who championed legislation that became the Physician Payments Sunshine Act in 2007, part of the Affordable Care Act.
I believe my doctor's conflicts of interest — almost $500,000 worth of payments from the drug manufacturer — were key to my receiving a device not even cleared by the Food and Drug Administration.
But there has been very little effort made to educate the public about the Open Payments site. The onus is on patients to know about it, see whether their doctors' names show up and talk to their physicians about possible conflicts before being treated or getting prescriptions.
That's tough to do. I say that from personal experience.
As I wrote in my Next Avenue article, "How to Know if a 'Top Doctor' Is a Good Doctor," I chose a prominent plastic surgeon for my preventative double mastectomy to greatly reduce my risk of breast cancer. But he didn't tell me he was conducting research and promotion on a device for Allergan, a pharmaceutical company, and lining his pockets with hundreds of thousands of dollars he was receiving from it. Nor did I know he planned to use that device on me, without my consent. His experiment failed, causing deformity, severe pain and necessitating three additional corrective surgeries to date.
By the time I found out about Open Payments and researched my surgeon there, I already had the surgery. The damage had been done.
It is my opinion that my doctor's conflicts of interest — almost $500,000 worth of payments from the drug manufacturer — were key to my receiving an off-label device, not even cleared by the Food and Drug Administration, for my surgery.
A Bill to Protect PatientsThat's why I am working with my California State Assemblymember, Adrin Nazarian, and the Center for Public Interest Law to protect patients by giving them the right to fully informed consent regarding these kinds of conflicts.
Nazarian recently introduced legislation (Assembly Bill 1278) that would require a physician to disclose the source of payments by drug and device companies and promote patients' knowledge of CMS' Open Payments site resources.
The bill passed its first big hurdle in the Assembly Business and Professions Committee by a 13-0 vote and now heads to the Appropriations Committee. After that would be a vote by the full Assembly and then a similar process in the Senate. There's still a long road and possibly bumpy road ahead, but if all goes well, the bill will pass, providing better transparency and patient protection in California — and maybe after that, in other states or nationally.
The Need for TransparencyIt only makes sense that your doctor should be held to the same standards as your financial adviser or your real estate agent. After all, if your broker will get commissions from a financial product they recommend or your real estate agent has a financial interest in the property they are showing or getting paid commissions from suppliers they recommend, they are required to tell you.
Demanding this type of transparency from doctors, many public advocates say, seems long overdue.
Notes David Lind, president of the Heartland Health Research Institute: "Being ethical and transparent with patients and the public about any relationship with third parties, such as drug companies, should not be optional in medicine. This information is essential."
In the meantime, it's up to you to check out the Open Payments site to see if you discover any potential conflict of interest concerning your health. And don't be afraid to have an honest talk with your doctor.
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Wendy Sue Knecht is a health activist, a former flight attendant, a designer of travel bags and author of Life, Love, and a Hijacking: My Pan Am Memoir. She blogs at WendySueKnecht. Read More

9 WAYS TO HELP CREATE CHANGE


By Wendy Sue Knecht

Have you ever gotten so mad that you literally didn't know what to do? You might feel that you were wronged. You're angry. You feel unheard. Or you witness unjust behavior, discrimination or sexual harassment and are upset to see people being taken advantage of.  
In those situations, the worse thing you can do is not do anything. As Martin Luther King, Jr. said, "He who accepts evil without protesting against it is really cooperating with it."
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How I Took ActionIn my own case, I had an unfortunate incident with a doctor that prompted a lawsuit and my filing a complaint to the California Medical Board. In the process, I saw the need for clarity that could help consumers.
Now, more than ever, our experience and our opinions matter.
For instance, I couldn't understand why my doctor's settlement with me wasn't listed; a "no settlements" listing by his name was misleading. Apparently, my doctor hadn't met the listing criteria, but the public had no idea of this.

I also had the idea for the medical board to put up a link to the federal government's Open Payments website on its "Doctor search" area so patients could easily find out if their doctor is receiving payments from drug and device companies. The Open Payments site has important information, but is little known by the public.
I decided to attend the California Medical Board's quarterly meeting, which is open to the public (now held virtually). At the meeting, I introduced myself to the executive director and later emailed my thoughts to her.
Weeks later, the Medical Board implemented these important changes on its website, fixing these issues and promoting transparency. If I had only complained, and not suggested these specific changes, nothing would have happened.

RecommendedHow to Know if a 'Top Doctor' Is a Good Doctor | Health

Later, I made an appointment with my district's state Assembly member, Adrin Nazarian. He was empathetic about my plight and open to hearing my suggestions.
And now, we have an Assembly bill about to go before the California State Legislature. The legislation would mandate that a doctor tell a patient if they have a financial interest in a drug or device they plan to use in their treatment. This valuable information is critical to a patient's right to informed consent.
Unfair and unjust things happen. Though we can't change the past, we can affect the future. We can choose to make meaning out of these events and work to make sure they don't happen again to anyone else. 
I made a decision to not focus on what went wrong, but to focus on how I could make it right.
As I found when I was wronged by unethical treatment, you alone can also be the catalyst for change. My bad experience was an opportunity to do good. I made a decision to not focus on what went wrong, but to focus on how I could make it right.
Even after favorably settling a lawsuit, I realized that there would not be any change occurring from a monetary settlement. I knew the only way to make any meaning out of my situation was to help prevent the same thing from happening to others.

At the time, I didn't know much about how to make a change. But I stumbled around and found my way. I'd like to share nine tips on how any of us can help to create change and make our world a little better for others.
9 Steps You Can Take1. Don't ever accept injustice. Mobilize yourself instead of wallowing in being a victim or in what you feel is wrong. Being a victim is not something you have to tolerate. Resist taking on a victim mentality, it will only slow you down. Instead, adopt a mindset of not accepting wrongdoing and find what you can do to help make a change.
2. Embrace your fate. Even when the worst thing happens, try to look at the good that can come from it. Even the worst situation can leave you an opportunity to make things better. If it can happen to you, it can happen to anybody.You might not be able to change your situation, but you can help prevent it from happening to others. Mothers Against Drunk Driving (MADD) was started in 1980 by Candace Lightner after her 13-year-old daughter Cari was killed by a drunk driver in California. Now, there are over 600 MADD offices and affiliates throughout the United States and Canada.
3. Focus on the change you want to make and hone in on it. Come up with specific goals on how you can make a difference — what needs to be done. Is it legislation? Is it calling out an employer? It is a road repair? It's important to be clear about your goals. Just being angry or complaining won't create change.
The best way to get your point across is through rational thinking and a calm delivery.
4. Assume that there are going to be other people that care. If the change is important to you there are also other people out there who also believe it's important. They just might be silent about it. No good cause is futile. Most of the time, people just need to know that an issue exists before they can see the need for change; it is your job to bring awareness. You'll be surprised who will listen.
5. Make a list of who you can go to and how to reach them. Be creative. Is it your local politician who can help make a policy change, or a school administrator or the manager of a grocery store?  Should you contact people who work at local news stations or national news reporters? Check websites and find out how to approach people. When I went to Assembly member Nazarian, he couldn't believe that what I was asking for was not already a law. By the way, he was eager to hear from a constituent.
6. Look for the obvious. For some issues, there are clear things you can do. Join a group already working on your cause; give money, give your time or both. Those opportunities are all around us and easy to navigate.
7. Get over your fear of speaking up. You might be afraid to draw attention to yourself, believing you will then be the subject of scrutiny. Stop that kind of thinking by knowing that your cause is greater than you are. You can be afraid, but just do it. Just pick up the phone.
8. Realize that the way you speak up matters. If you are too angry, nobody will be able to hear you. The best way to get your point across is through rational thinking and a calm delivery. An angry tone makes it difficult to be heard, even when you have a valid point. There are so many good issues and ideas that get overlooked because people are too angry in the way they present them.
9. Don't accept "no" for an answer. Think about alternative routes you can take if you get turned down. You have to be relentless in your pursuit. Give yourself credit; your voice matters as much as anyone's. You may encounter a "no," but around the corner is probably a "yes."
So, whether the injustice directly affects you — or you see it happening to others — in my opinion, everyone has a moral obligation to do something. It can be a small act or it can be a large act. But whatever it is, don't think that what you do doesn't matter. It does. One person can make a great difference in the lives of others, and that person just might be you.
With my own situation, I have a sense of satisfaction knowing that I can have a hand in helping others. Even though change happens in small steps, I'm glad I took that first step.
 

Wendy Sue Knecht is a health activist, a former flight attendant, a designer of travel bags and author of Life, Love, and a Hijacking: My Pan Am Memoir. She blogs at WendySueKnecht. Read More

It was a huge honor  to preside over the 2019 Neerja Bhanot Pan Am Trust Award. It was beyond special to stay with Aneesh and Shanti Bhanot, they are family to me. I  loved every minute of my week in India with them,  Ahkil and Mamta and family, and all the wonderful people I met in Chandigarh. I could feel Neerja's presence.  Her good deeds will never be forgotten, and she serves as a role model for millions.  Sifiya Haneef, the honoree, is well deserving of this award, and I was honored to get to know her and give her this award. It was a week to remember and one of the most meaningful of my life.

When I got married for the first time 15 years ago, at 47, people asked me if it was going to be difficult to adjust to marriage because I was “set in my ways” or “used to so much freedom.” Those comments were disturbing, but I shrugged them off as just being silly.
I also became a stepmother of adult children when I got married. And I received plenty of unsolicited comments on how hard that was going to be as well.

 .My situation is different, I thought. I had no kids of my own and I looked at having stepchildren — two girls (Meg and Abby) — as a huge plus. The “girls” were young adults, ages 18 and 22, and loved their dad very much. They wanted him to be happy and were very accepting of me. They couldn’t have been more welcoming. I thought it was all perfect.
But even in the best of situations, there are growing pains when you are thrown into a stepparenting role.
In my case, it was the proverbial “caught between a rock and a hard place” situation. I was not their girlfriend, but not their parent either. So where did I fit in? How did I fit in?
It took some finessing. Somehow, though, we grew to love and appreciate one another beyond my wildest hopes.
I was not their girlfriend, but not their parent either. So where did I fit in? How did I fit in?
Yes, I made mistakes, which I hope I learned from. But I did a few things right, too, fortunately.
My 7 Stepparenting TipsHere are seven stepparenting tips I can pass along:
1. Be aware of your place. Remember, this family existed before you came along and they have their own patterns of behaviors. It’s going to be frustrating at times. You didn’t raise these kids, and you may not agree with how they interact, their expectations or even the way they treat one another.  Accepting this can be tough at times. But doing so will help you further a better relationship with both your spouse and stepchildren.
2. Don’t weigh in on parent/child issues unless asked. I didn’t learn this as early as I wish I had. It’s easy to feel comfortable enough with people you love to say anything, but I don’t advise it. I made the mistake of giving my opinion too freely and that has come back to haunt me at times. When issues come up between parents and their adult children, let them work it out unless you are specifically asked. Respect their interactions with one another. Sometimes it is better to sit back and be an objective observer. In the long run, it will serve you well.
3. Set boundaries early. When the relationship is new, you want to do everything to make your stepkids like you, so sometimes you may go a little too far. Then, you will set expectations that’ll be hard to keep. In my case, the girls and I definitely had our own “honeymoon period.” So, I was okay with them borrowing possessions without asking or coming into the bedroom or home office without knocking. However, these are the kinds of things that might make you resentful eventually, and patterns can be hard to reverse.
4. Support their relationship with their parents. One of the things I admire most is how much my stepkids love their father. I love to see them spend time together. One of my stepdaughters often talks about her other friend’s “step-monster” stepparents, who begrudge their spouses time with their kids and are jealous of that time together. I’ve seen this kind of thing unravel otherwise good relationships. Personally, I could not respect someone who didn’t prioritize their children.
I recently asked my now 37-year-old stepdaughter, Abby, how she felt about this when she was 22. “Looking back, one of the nice things was that my sister and I were able to keep our one-on-one relationship with my dad,” said Abby. “We never felt threatened that our relationship with him would change.” This is still gratifying to hear, and I still encourage alone time with their dad. I’m honored when the girls insist on including me.
5. Be tactful in criticizing. As much as you may grow to love your stepchildren, you don’t really earn the right to be critical of them. When asked for your opinion by your spouse, proceed with caution. The old adage, “It’s okay for me to say it, but not you” is often the case. Even when you agree, it’s just better not to be the first one to say so.
6. Learn to take criticism. I often joke that I had great self-confidence before I had stepdaughters. If they feel I’m wearing the wrong jewelry or having a bad hair day or if they just don’t like my outfit, they will let me know. At first, I was taken aback and felt defensive and hurt. I’ve learned to listen, and now take it as a sign of love. After all, they took the time to notice and care. And they are usually right!
7. Don’t compete. I knew enough not to try to be the girls’ mother or to compete with that relationship in any way. But I also knew that, even though the “kids” were basically grown-ups, I was walking into a parental situation. I give parental-type advice when asked. But I know they have a mother and I wholeheartedly respect that relationship and would not think of interfering with it.
We Know We Can Count on Each OtherIn 15 years, my stepdaughters and I have been there for each other through many of life’s ups and downs. And some of the ups and downs have been extraordinary. Four years after my husband and I were married, Meg — 22 at the time — was diagnosed with Hodgkin’s lymphoma. Five years later, Abby, at 30, was diagnosed with the same cancer.
They both came home for treatment and six months of intense chemotherapy. I am happy to say they are both healthy now, living productive lives in Northern California. As incomprehensible as this sounds, the experience was bonding for all of us, and it was an honor to be there to take care of them.
I asked Meg, now 32, for her thoughts about my role as her stepmother. “Exactly what you have described is no different than how I treat, or look at, my father or my mother,” she says. “When I miss you, I call. When I need advice, I call. When I think of a joke you’d love, I text.”
Meg continues: “I would suggest that this proves this isn’t a stepparent/daughter relationship, but rather exactly how daughters would relate to their parents.”
My daughters have been there for me through the death of my mother and other significant life events; we’ve cried and celebrated together.  We know we can count on each other. And I couldn’t be more grateful for them than if I had been their “real” parent.

Advice to help avoid a catastrophe due to incompetent, unethical physicians

• By Wendy Sue KnechtOctober 31, 2018

Credit: Adobe StockFinding
Finding the best doctor in town can be a huge comfort in the midst of a medical crisis. I know. When I was diagnosed with the BRCA2 gene [linked to breast cancer risk], I opted for a preventative double mastectomy to greatly reduce my risk. A prominent plastic surgeon known for breast reconstruction was on staff at a hospital in my city, and that seemed like a godsend.

His stellar reputation preceded him. Unfortunately, he didn’t tell me he was conducting research and promotion on a device for Allergan, a pharmaceutical company, and lining his pockets with hundreds of thousands of dollars he was receiving from them. Nor did I know he planned to use that device on me, without my consent.

His experiment failed, causing deformity, severe pain and necessitating three additional corrective surgeries to date. I learned the truth about this surgeon only after things went terribly wrong.

How best to avoid calamity with a physician who seems great because he or she shows up in “Top Doctor” lists? Take heed and take action. What can seem like a signifier of excellence may actually be a red flag. Here are some qualifiers that often attract patients, and how to properly evaluate them:
The Yelp Star:  There’s a story behind each line of stars in star ratings. Doctors have been known to ask patients for good reviews and even sometimes ask patients to remove bad ones. Sadly, it happens. Physicians can exaggerate and use Yelp for self-serving purposes.
Examine the criteria evaluated in Yelp ratings, such as waiting time, friendliness of office staff and office environment, all of which have nothing to do with patient care. This paradigm can be deceiving and weight the ratings in either direction.

The ‘Top Doctor’ Doctor:“Every year, metro magazines around the country publish lists touting the ‘top’ and ‘best’ doctors in town,” writes Shelly Reese in Medscape, a website for physicians and other health professionals. “The issues are money-makers for the magazines and public relations fodder for doctors, hospitals and health systems. Even doctors themselves appear to be wildly ambivalent — and highly skeptical — about the lists.”

My husband, a physician who has appeared on these lists, agrees. “Everyone votes for their friends. And the lists are sometimes a joke. My friend was listed as a ‘best cardiologist,’ though he had long since become a psychiatrist,” he says.
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Then there is the case of Dr. Danny Kao, who had a thriving practice for 25 years in Marin County, Calif. He made a Best Doctors list, but only after he retired.

When you read a quote from a doctor in a magazine, hear him or her on the radio or see the physician on television, keep in mind this may be the result of public relations professionals or purchased ads.

The Ivy League Doctor:Being smart enough to get accepted to Harvard or Yale is certainly commendable. Here are some other qualities that are equally as important as intelligence: sound judgment, openness and honesty. Look for experience, strong deductive reasoning and solid values.
As most doctors will acknowledge, there are really no bad medical schools, but there are good and bad doctors from every medical school.

The ‘Eager to Test, Eager to Prescribe’ Doctor:Running more tests and prescribing more medicine is not always bettermedicine. Does the doctor trust her own judgment? Will ordering lots of tests reduce the likelihood of being sued?
There are some doctors known among other physicians for ordering diagnostic tests or procedures for their own financial benefit. Always ask the reason for any tests prescribed and don’t be reluctant to get a second opinion.

Patients tend to favor doctors who comply with their prescription requests, especially for antibiotics, pain and sleep medication, even though it’s not necessarily “good doctoring.” Dr. Kevin Pho, a primary care physician in Nashua, N.H., (blogger and founder of the website KevinMD.com) sums it up: “Patients may find that doctors who have mixed reviews may actually provide better care because these physicians occasionally say no to patients.”

The Doctor Who Lavishes Attention on You:
Thanks to Electronic Medical Record mandates and diminishing insurance reimbursements, the patient-doctor relationship has devolved to shorter interactions. So, the doctor who spends a lot of time with a patient may be perceived as being a better doctor than she or he actually is.
Don’t confuse time spent with competence and good ethics.

The Doctor With a Clean Record on the Medical Board Site:I was shocked to see the physician who botched my surgery listed as having “No Settlements” on the Medical Board of California website. All settlements over $29,999 here must be reported to the board within a 30-day period, so I expected mine to show up. Then I found this on the Medical Board’s website:
“Judgments and arbitration awards are posted upon receipt. Settlements are disclosed after a physician has accumulated three or four settlements within a five-year period (depending upon the specialty of the physician). After five years, the information is removed from the Board’s website but is still available to the public upon request for a 10-year period.”
Really, three or four settlements within a five-year period? I had to search very deep to get this information on the website. But you’d probably want to know up front that a doctor you’re thinking about going to has had any settlements. A “No Settlements” listing seems very misleading.
Not all state medical boards have the same reporting or disclosure criteria. A better way to find out about your doctor is simply to search the person’s name and the word “lawsuit” in your browser.

The Drug Company Spokesperson Doctor:If your doctor is a spokesperson for a pharmaceutical company or has a financial interest in a drug or device company, beware. He or she may have expert knowledge about a product, but financial interests can and do cloud judgment.
“The more money doctors receive from drug and medical device companies, the more brand-name drugs they tend to prescribe,” a new ProPublica analysisshows. Even a meal can make a difference.”

Websites such as ProPublica and Open Payments list payments given to doctors by pharmaceutical and device companies, often right down to their travel expense reimbursements. When I checked out my surgeon on ProPublica, hundreds of thousands of dollars of payments to him by Allergan appeared. In fact, it showed that he was the highest paid doctor in the country at that time for “SERI Scaffold,” the device he implanted in me. I wish I had known about this site sooner.

Remember it’s not only OK to ask questions, it’s crucial. Your health is at stake. A little extra research can go a long way in finding the right doctor.
By Wendy Sue Knecht
Travel expert Wendy Knecht is a former flight attendant, a designer of travel bags and author of Life, Love, and a Hijacking: My Pan Am Memoir. She blogs at WendySueKnecht.

7 Ways to Find Love and Friendship Later in Life
Remaining open to connecting with new people can be rewarding

• By Wendy Sue KnechtSeptember 28, 2018
  

There’s no question of the importance of personal interactions and connections with friends as an important source of our well-being. This is especially true as we age, and much has been written about the challenge of making friends and finding love in the later years.
Looking for love, or even just hoping to make a new friend, can seem intimidating when you’re older. But it doesn’t have to be that way.
Personally, I didn’t find Mr. Right until late in life, and it definitely took some work on my part to be ready for the right person when he came along.
Here are a few insights that may be helpful in finding love and friendship as we get older:
1. Re-frame old mindsets  It’s all how we frame things in our minds that affect our vision. With the right mindset, it is easier to find love and friendship.
Although it is often said that as we get older we get more stuck in our ways, this doesn’t have to be true. We learn more about ourselves as the years go by, and our tastes become more distinct; but that doesn’t necessarily imply that we have to become more rigid. As I’ve experienced, it is possible to become more open-minded as we age.
When I got married for the first (and only) time at age 47, I can’t tell you how many comments I received from well-meaning friends and acquaintances: “Really, wasn’t that difficult?” “Weren’t you used to living alone?” and “Weren’t you set in your ways?”
“No!” I would emphatically answer. Being single for so long made me ready to welcome change. Having more self-knowledge made it easier to feel open to new experiences. I realized that being set in my ways was a choice and served no purpose. I made a conscious decision not to be “stuck” in a rigid mindset.
2. Don’t expect others to be perfect  With age comes confidence, and hopefully, the acceptance of our own imperfections. Personally, in my younger days, I had strict standards that everyone had to live up to. My friends used to tell me that I was “too picky” regarding men, which was a nice way of saying “too critical.”  Once you come to accept your own faults and imperfections, it is much easier to accept other people for who they are. Not only do I not expect anyone to be perfect, I would hate for anyone to expect that of me.
3. Don’t let others define you  When we were younger, many of us chose friends a lot like ourselves. Hence the “cliques” in high school, where everyone was pretty much alike. Back then, we needed to be alike to be accepted.
Once we have the self-assurance of age, it is no longer necessary to find a partner or a friend to define ourselves. You can appreciate others more fully when you realize they are not a reflection of you. Differing opinions and tastes can make things more interesting if you are open to listening without judgment. For example, the famous friendship between Supreme Court Justices Ruth Bader Ginsberg and Anthony Scalia comes to mind.
4. Embrace quirkiness  Perfect is boring and quirkiness can be a lot of fun if you have a sense of humor. My husband’s “Obsessive Cleaning Disorder” would have driven me crazy in my 30s, but now I can work around it and even appreciate it. As long I keep my own modicum of neatness, I can reap the benefits of his obsession. I am perfectly happy for him to clean up the dinner dishes and organize the drawers (he does a much better job than I do).
Quirkiness in ourselves and in others can make life more interesting. Don’t fight it, embrace it.
5. Celebrate differences  An appreciation and tolerance of differences is a big bonus of getting older.
A recent vacation was a big eye-opener. In my newly acquired travel agent role, I booked a  small French river barge and filled it to capacity with 21 people. I recruited half of the passengers, whom I knew, and one of my friends brought along the others. Although mostly everyone knew at least one or two of the others on the trip, it was a fusion of childhood, college and work friends from all walks of life, white to blue collar. Everyone took a leap of faith and I held my breath, feeling responsible for the whole lot.
Our group was smart to ignore the topic of politics — one that is way too divisive these days. But everyone took the time to learn from each other. We shared our love of travel, food and wine, and embraced each other’s differing backgrounds. By the time the seven-day trip ended, we all had made a few new friends.
6. Visualize  Remember the self-fulfilling prophecy is just that. If you really can feel in your heart that you are ready to meet a new friend or love interest, you are much more likely to be open to it when the opportunity presents itself. Visualize it happening. I found there is a lot of value in putting good thoughts out to the universe.
7. Keep an Open Mind  Keeping an open mind is key to finding new friends and love as you get older. Never say never; love and friendship could be just around the corner.
By Wendy Sue Knecht
Travel expert Wendy Knecht is a former flight attendant, a designer of travel bags and author of Life, Love, and a Hijacking: My Pan Am Memoir. She blogs at WendySueKnecht.

The approach of Mother’s Day is a bittersweet time for many boomers like myself who don’t have our mothers around anymore.
I don’t think I’m alone in saying this, but I never realized how much my mother influenced me until she was no longer here. I’ll stop myself and laugh when I find her voice reverberating in my head to “just put a little lipstick on, you’ll look so much better,” or when I see .04 seconds left on the microwave and open the door to take out the food — a signature move that drives my husband crazy, but seems to have been inherited by my sister and me.
My mom, Ellie, was the mother of three children, ages 11, 15 and 18, when she and my father separated. We moved shortly afterward to The Northfield Garden Apartments in our town of West Orange, N. J., where there seemed to be a disproportionate number of single moms raising families. Most of them were divorced and some were widowed, but there was a definite sense of camaraderie among us.
Those moms worked really hard. As an adult, I have a deeper appreciation for all the sacrifices they made in order to keep their families intact, sometimes having to take on the role of mother and father. For many of them, including my mother, there was a lot of pressure to make ends meet. Their time was spent selflessly working to make their kids’ lives better, with little concern for themselves. For my own mother, dating was not even on the radar, though she was an attractive woman in her mid-forties when my parents separated.
‘What You See Is What You Get’My mother taught us the value of hard work and independence. She worked two jobs as long as I can remember— mostly clerical during the week and sales on the weekend. Whatever she did, she did with zest. Although I’m sure she was tired, and albeit cranky at times, she powered through and never lost her sense of humor. I couldn’t wait to get my working papers when I was 14 so I could get an after-school job, assert my own independence and help buy my clothes.
Ellie was the epitome of a “what you see is what you get” person. She wasn’t educated past high school, but she had street smarts beyond many Harvard graduates. She imparted lessons large and small on my siblings and me, and values that have given us the wherewithal to be productive and happy adults.
Most importantly, we were taught to have gratitude for what we had. Ellie always appreciated the “little things,” and I remember her once going on and on about a new switchplate she bought that “changed the whole look” of our tiny kitchen. She had the ability to truly make the best of any situation. Oddly enough, I never felt envious of any of my wealthier friends who lived in nice homes with two parents.
Fortunately, life got easier as time went by, and Ellie eventually remarried. But she never lost her sense of gratitude and her values never changed. When Ellie passed away at 89, we celebrated her life as she requested, in a party fashion, with champagne and her favorite food.
Words of WisdomOn that day, we also displayed her Top Ten words of wisdom all around the house. Ellie’s sayings are simple but wise — here are a few examples:
1. If you’re feeling sick, take a shower and get dressed. You’ll feel much better.
2. Don’t make it a big deal. Just do it.
3. Animal prints never go out of style.
4. Something high-priced and low-cut always works.
5. Don’t waste time!
With regard to the last one, in her later years, Ellie would sleep in her gym clothes so she could get up and go right out walking when she woke up. Talk about not wasting time! Ellie never slowed down until she had to, and that is just what I plan to do, too. I may even adopt the gym clothes idea …
Of all the important life lessons Ellie taught me, I am truly convinced the biggest gift you can give your children is a sense of gratitude. To all those moms out there, in heaven and on earth, who sacrificed so much for us and taught us so well, thank you.
By Wendy Sue Knecht