Home > patient advocacy, patient advocacy certification > The Myth of Patient Advocacy Certification

The Myth of Patient Advocacy Certification

Not a week goes by that someone doesn’t write to me asking about patient advocacy certification.  It’s confusing, because they read that there are courses that will help them become certified, and then they find other pieces I have written about the lack of a certification system.

So it’s time to clarify:

There is a difference between earning a certificate – and being certified, even if Merriam Webster might tell you those two concepts are related.

“To be certified” carries with it an assumption that there is some sort of national (even international) accreditation, recognition, or standard set of skills that someone has developed and earned.  As if a national body of some sort has said “Yes – this person meets this high standard of education and capability, so we are blessing him or her with our certification.”

“To be certified” may even mean to some people that some sort of governmental recognition in the form of a license or listing has taken place.

But there are no governments, nor nationally respected, nor generally accepted groups that have determined a group of standards, nor benchmarks, nor capabilities that supply a certification that is universally recognized.

And that is the key:  none are universally recognized. No such a certification exists, nor is one in the works – yet.

The confusion comes from the fact…



Find the rest of this post in its new location: 

Comments have been moved, too.

  1. January 3, 2011 at 3:08 pm

    I have a bit of a different view on Certification and the programs that exist. (For transparency for readers, Healthcare Liaison, my company, developed the first Certification program in the country for Healthcare Advocates in 2007 (We don’t call anyone a patient!), but we only train people who are already medically trained. So the Certification that we issue says “Certified by Healthcare Liaison, Inc.” We are able to issue continuing education credits through the American Nurses Credentialing Center (a nationally recognized program) for the content of the program. So the public can know that the course itself has been reviewed and approved by an outside, impartial agency.
    Healthcare Advocacy is a new profession, and the way new professions begin their certification journey is exactly what we are seeing here: many systems create programs (think about life coaching: there are at least four programs that certify in that area). It started as one program: now there are at least 10 nationwide. But who will look at these courses? The National Association of Healthcare Advocacy Consultants, which I also started, is the National Professional Organization for Advocates, and we will be addressing the Certification program issue. So readers can rest assured that the there are programs and systems moving into place that will assure consumer protection. I expect, over time, there will be regulation of this profession by individual states (i.e., state licenses). In the meantime, readers can check the NAHAC web site (www.nahac.com) for the Code of Ethics for the Profession.
    The profession is exciting and evolving!

  2. January 3, 2011 at 7:07 pm

    I cannot thank you enough for this timely posting. I was becoming dismayed and overwhelmed as I read about all the webinars and courses–online and otherwise–that were being offered. I saw some of these as early money-making schemes and tried not to feel cowed into submission. Still, there are some courses I plan to take to fill educational gaps. But the distinction you made between having earned a certificate and being a certified patient advocate was an excellent reminder.

  3. Robert Rasa
    January 4, 2011 at 10:12 am

    I think it would be a rather difficult task to “certify” someone in Patient Advocacy”. What might the criteria be?

    • January 4, 2011 at 10:13 am

      Robert – a very good question. We’ll develop a certification system eventually, just as professions of all sorts have done for decades. There will likely be different types of certifications for the various types of advocacy that exist (navigators, billing experts, geriatric care, others). There will also have to be different certification levels to accommodate for differing backgrounds. For example, a nurse who becomes a certified patient advocate will end up with a different certification from someone who develops advocacy expertise but does not have a healthcare background to begin with. To become certified, advocates will have to show a track record, take a test, be recommended, or any of a variety of “proofs” that they know what they are doing and can do it well.

      For now, none of this exists in a universally-recognized way. Joanna described her approach to “certification” (see above) – but that’s what it is – her company’s approach. If you would ask another of the organizations that prepares patient advocates, they might not agree that Joanna’s organization’s criteria are equal to theirs – or Joanna might tell you that her group is better prepared than someone else’s.

      The key is that “universal” agreement and recognition – and that’s what we will develop – eventually. It just doesn’t exist today.

  4. January 4, 2011 at 10:53 am

    Even though there is not a universal “certification” for becoming a Patient Advocate as yet, anyone hiring a Patient Advocate should carefully interview the individual under consideration first….just as you would if you’re an employer hiring an employee. Ask: What experience do you have? What are your skills? How long have you been a Patient Advocate? What are the personal qualities you bring to the job? Can you give me referrals of previous clients? Why should I hire you? How can you improve our current status?

    Sheryl Kurland
    Orlando Patient Advocates

  5. January 14, 2011 at 11:56 pm

    I think since we are talking about “patients” that anyone who advocates for them has to have a medical background. If you don’t understand the disease state that someone may be in chronic vs acute or both you cannot understand anything else in their life that is affected. If it’s insurance you need to understand their medical issues, if it’s resources you need to understand the medical issues to connect them to the right resources. So it is my opinion that all advocates should have a medical background. We have people out there who tout themselves as advocates who may have been in sales, or helped their grandparent or parent or maybe worked in some administrative role somewhere in healthcare who think they can advocate for patients. If we aren’t talking about patients then almost anyone could advocate for anyone if they understand the core issues. Patient’s issues are ALWAYS related to medical issues. Now that long term care facilities taking in anyone who is sick regardless if they can accommodate their needs as the evaluation criteria for acceptance is their payor source, it is a problem that I see every day with social workers who are charged with discharge planning and can’t appropriately discharge many of these patients safely because they don’t have time to find out what “discharging to home” means. There’s a lot of questions to ask and if you don’t know what to ask then you’re not advocating right.
    Certifications started in nursing to replace education that was going to be mandated for nursing many years ago. Because there was such an uproar from pratical nursing and other fields the ANA’s response to this was to get certified. This has turned into a huge money maker and I’m not convinced it means a whole lot. If you hold a degree that took many years to obtain and you have a lot of experience its worth much more than a three month course that buys you a few letters at the end of your name.

    So that’s my two sense worth…Happy New Year Everyone


    Sharon Gauthier RN/MSN-iRNPA
    Independent RN Patient Advocate

  6. January 15, 2011 at 6:40 am


    While I understand your arguments, I have to respectfully disagree with you. Some of the best advocates available to patients today are not nurses, have never earned doctors or nurses degrees, yet have saved many lives and immeasurable heartache and grief.

    For more on this, please read: Do I have to be a nurse to be a patient advocate?

    Thanks for posting.


  7. January 17, 2011 at 8:13 pm

    The time has passed for advocates to be ONLY nurses, doctors, social workers or any other healthcare professional. When medical systems told consumers that they were becoming responsible for more of their own healthcare (by medical savings accounts, higher co-pays etc.), they effectively said to the public “go become an advocate for yourself because the “first dollars” are going to come from you”. People did exactly that, and some of them became extremely talented healthcare advocates.
    Yes, the consumer needs to be careful about choosing an advocate, just like choosing any other professional. The medical system will be shooting themselves in the foot (again) if they think that only medically trained people can be effective advocates.

  8. April 9, 2011 at 6:33 pm

    Hi Trisha, Thank you for your candor and website. It’s wonderful! I’m learning a lot! I am building my aforementioned website because, regretably there is no “real advocacy” for the patients enrolled in our state sanctioned, voter approved (in 1998), “Oregon Medical Marijuana Program”. After reading what you have to say, I’m beginning to think that the mere existence of such an entity was, quite possibly, intentionally suppressed, dismissed or ignored. I am still researching why this caveat was not included. Based on some of my initial queries, just this Feb & Mar 2011; the official attitude is “…you’re on your own.” I would like to be one of many trail blazers, to encourage my fellow patients, to “have a voice” in the “advocacy” & “legal process” too. Not a very desireable idea in the eyes of a variety of extremely “well-connected” caregivers, groups, blogs & “non sanctioned dispensary clubs” that troll for patients to “donate” or “exchange” $$$ for their assortment of products. The “sticker shock” alone is huge for many fixed income patients, of which @least 40% are noted in the state statistics as such. It’s a shame. There are apparently “thousands & thousands” of questions, concerns & complaints from patients directed to the state program & the advocacy board. Apparently, none of these thousands of queries have ever been addressed. That alone, to me, is shocking! So, one of my ideas is to become @least one “voice” for patients just to really start the dialogue & get it out there. Thus the new website I’m creating. I look forward to your response, whether positive or negative, it’s all good in the long run. There are, @this juncture, @least 15 states (with half a dozen or so more in the legislative wings) that have medical marijuana programs. So far, I’ve found not one state’s law that allows for patient advocacy. I find that in and of itself very peculiar. Thank you for reading my long winded comment. Sincerely, PattyB

  9. Tre
    January 2, 2012 at 2:04 pm

    How does restricting eligibility to your program to those already in the medical field benefit…those for whom you advocate (since you reject “patient”)? Am I the only person that finds that such an arrangement could benefit the healthcare professional rather than the…advocatee? If I am the only paranoid individual out here it’s because I must be the only one who sees that those very health care professionals are part of the problem. If your exclusive methods become the norm (for which you are no doubt striving, since it would mean great monetary success for your firm), why not just trust things to hospitals to do right? After all, by your model (and by your patronizing tone) we are supposed to believe that healthcare professionals know what is best for…those in their care.

    • Jeff
      January 28, 2012 at 10:14 am

      Thank you for bringing that up Tre. I agree it’s like the old saying “putting the fox in the hen house”? From my experience over the years of seeing healthcare professionals it has become more apparent of the lines drawn between them and the healthcare payers. I think this bias could carry into any advise they would have for people seeking advocacy help; and lets face it, the help folks are seeking does not stop at insurer issues it also involves provider issues, as-well-as other non-medical issues. So I feel they may not be the “best” advocate or, should I say the the only qualified advocate. Sharon is getting hung-up on the terminology “patient” and I do agree with her in the respect that a “patient” is someone that is under the care of a licensed healthcare professional for some sort of disease management. But in the context of what we are discussing here, in many cases that is only one piece to the puzzle. I think it is short sited and arrogant thinking that only a licensed medical professional is qualified to be an advocate and I feel it would be a dis-service to people seeking advocacy help to have their choice limited to just licensed healthcare professionals. As Sharon said, it is a new profession (with people of varying backgrounds) and it will evolve in time to have a universal education and certification process in-place. Bottom line is that advocacy consultants, no matter what your background, are to help and protect the consumer…not the healthcare industry.

  10. January 29, 2012 at 4:41 pm

    healthcare advocacy is a wide open field, and there now are more than 15 programs nationwide training healthcare advocates. each program may have a niche–the Healthcare Liaison one is training people who already have medical licenses. HCL does have a demonstration project currently underway with a tweaked curriculum for the non-medically trained; some consumers will want medically trained advocates, but some will not, and there will be all kinds of advocates for consumers to choose from.

  11. February 6, 2012 at 9:50 am

    I’m really glad I found this website as I was looking to see what was needed to become a Patient Advocate. I have the medical background. But what do you suggest the next steps are to become an advocate ? We still need to know the laws and keep on top of them, and we still need to know how medicare and medicaid pay for different services (I have 3rd party experience.) Any suggestions would be great ! Thank you.

    • February 6, 2012 at 10:53 am

      Ted (great name) – Your best bet for learning next steps is to read these articles, and to join AdvoConnection: http://members.advoconnection.com/join/application-pac.asp It will allow you to find answers to all the questions you have asked, connecting you with others who are preparing to do advocacy work – and – people who have been doing advocacy work for years. We’d love to have you join us.

  12. Peggy
    February 9, 2012 at 6:20 pm

    Having been a Patient Advocate Program Manager at a large Sub Acute/LTC facility…we created the program from infancy. Every minute detail was closely monitored and discussed as to what was best for the patient. The problem that we ran into m-a-n-y times, was the things that got missed by a CNA, RN, LPN or doctor! Because of the cut back in medicare…the trickle down theory ends up eventually in the advocates lap. We were a vital part of the team in general – and a voice for those that are voiceless. We didn’t need a medical background to communicate basic needs of the patients. What with healthcare changing dramatically over the next few years… it’s going to be even more important to have an advocate working on behalf of the patients. We were the eyes, ears of the facility. We saw things that the average healthcare worker was too busy to pick up on. I’m not putting blame on any particular area…but the quicker we pull this together and give credence to the vital importance of the advocates, it becomes a win – win for all involved.

  1. January 3, 2011 at 4:28 pm

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