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Archive for the ‘decision making’ Category

It’s the Universe Calling: Time for Plan B

A few months ago, I was invited to speak in June during a one-day program for members of the Pennsylvania Bar Association on the topic of recovering from a catastrophe.  Attorneys who attend will learn about the things they need to do should something devastating happen in their lives (an accident, caregiving for a loved one, a fire, whatever….)

About ten days ago, I heard from a dear dear friend that he has been diagnosed with a terminal disease. Prognosis, just a few months. I am devastated – my heart just aches for him, his family, and yes, for myself, too.  And I wonder…. he is a small business owner…. what will become of his business and his clients?

Then this weekend, I was approached to review a new book, written by a doctor who, as a result of a devastating car accident in 2005, became a patient himself and dissected all that was wrong with his care.  Included in his story is the fact that he has given up his thriving practice of gastroenterology, a practice which had to take a back seat as he recovered from his injuries.

Which is when (yes, I’m slow….) I realized that the universe was telling me something.  Or at least posing this question:  As advocates, as people who others rely on, how prepared are WE for devastation in our lives and, importantly, how that will affect THEM?

How many of us have a Plan B?

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Why Do You Choose to Be a Patient Advocate or Navigator?

During the past few years of connecting with patient advocates and navigators, I’ve asked dozens (maybe hundreds) of people why they chose patient advocacy work.

Each person has one, individual, personal answer to that question, but there are an astounding number of similiaries.  Among them:

  • They believe they were cut out to help patients in need.
  • They have had some sort of experience that tells them that whatever they’ve been doing to that point is no longer enough.
  • Working with patients, helping them navigate and find improved outcomes from the healthcare system, feels like a higher calling.
  • They don’t like what they were doing before, whether that meant they worked in hospitals, as school teachers, librarians or for insurers or other payers who forced them to make choices they were not comfortable with.

Among those who have worked in healthcare previously, perhaps as nurses or physicians, perhaps as some other health-related job, they all give an additional reason.  This is the one almost-universal answer I’m given:

  • When they chose nursing (or whatever their previous healthcare job was), they learned to be an advocate for patients.  The evolution to the current healthcare system has taken away that opportunity. Therefore they hope that being an  advocate or navigator will allow them to refocus on what’s important to them – the missing advocacy piece.

Just as striking are the reasons for the shift to advocacy that are missing.  No one ever tells me:

  • They want to earn a lot of money.
  • They are choosing work that is safe and secure.
  • They want to be advocates because they want to take a lot of time off.

I find this so interesting.  I can’t think of any other career that gives people such satisfaction, while at the same time, offering so little perceived security (or time off!)

I say “perceived” – because when done right, owning a business can be very secure. If you have chosen to start a private patient advocacy business, once you can get the ball rolling, it can be very secure.  If you are the owner of the business, including a solo practitioner, no one else can fire you or lay you off!

No big points to today’s post – just a few observations …. and a question for you: Why did YOU choose to become  a patient or health advocate or navigator?  Do you concur with the reasons outline above?  Do you disagree?  I invite you to share your thoughts.

•  Learn more about what it takes to become a patient advocate.

•  Learn more about starting a patient advocacy business.

• • • • • • LEARN MORE • • • • • •
| FOR PATIENTS | FOR ADVOCATES |

Patient Advocacy and the Allegiance Factor

March 5, 2011 2 comments

As we prepare for Private Professional Patient Advocates Week next week, I’ve been asked by a handful of people what the difference is between a private patient advocate and any other health advocate.

It’s an important question, and the answer is actually quite simple.

The difference between a private patient advocate or navigator, and those found in hospitals, through insurance companies, or other places, is what I call The Advocate’s Allegiance Factor.  It’s based on who is producing the paycheck.

Private patient advocates are paid directly by the patient or the patient’s caregiver and have only one allegiance – to the patient.  The patient’s needs, whether they be medical, navigational, financial or locational – are the prime concern of the patient advocate. Period.

However…

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Who Deserves a Patient Advocate’s Help?

February 14, 2011 2 comments

I’ve wrestled with this question more than once.  It’s the question raised on occasion by those who talk about universal healthcare, and a for-profit healthcare system.  It’s a question asked by those who are concerned that not everyone in the United States has access to healthcare.  It’s asked by almost anyone who asks me what I do for a living.

The question is, “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”

Lots of soul searching, and more than a few conversations have produced the definitive answer to that question.  The answer is:

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Can a True Patient Advocate Be Paid by Someone Else?

February 5, 2011 1 comment

Several questions have come my way recently about what kinds of job opportunities might exist for patient advocates.  I refer people to an article I’ve written elsewhere, but the real answer is – to be a true advocate, you must analyze who is paying for your services, and what your responsibility will be to them.

Finding an Employer

In 2011, most of the job possibilities for patient advocates are found either with hospitals or insurance companies.  Hospitals have, for a long time, employed patient advocates, sometimes called patient representatives, who are tasked with helping patients.  And word comes from an AdvoConnection member, through our Forum, that beginning in 2014 with healthcare reform, insurance companies will be required to have patient navigators on their staffs if they want to participate in insurance exchanges. Some have already begun to hire advocates.

But here’s the problem with those jobs.

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Lessons from The Loss of a Patient

January 31, 2011 2 comments

Sooner or later, it happens to every patient advocate or navigator who works with patients on the medical aspects of their care (as opposed to other forms of advocacy, like billing or legal advocates).

One of “our” patients – someone whose hand we have held, who we have protected from problems in the hospital, who depended on our advocacy expertise as a way to make the rough road through disease and debilitation smoother… A patient we had built a comfortable and friendly relationship with, a patient we invested ourselves and our work in…

That patient dies.

And we feel like we have failed.

It’s the nature of advocacy work that patients don’t come looking for us until they have been diagnosed with something that will, perhaps, eventually end their lives.  That’s why they seek our help.  They are fearful, they don’t understand the overwhelming amount of information they are expected to immediately comprehend. They have decisions to make and feel incapable of making them.  They, or the caregiver who better understands their predicament, searches for, and finds, that one person who can help smooth the road…  the advocate.

And it’s our nature, as advocates, to want to rescue our patients from their fears and frustrations, and to save them from all that grief. But as one of my wise patient advocates friend reminded me,

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Doctor Recommendations – Do You? Should You?

January 22, 2011 3 comments

I was more than a little surprised in a conversation this week with an advocate who is not (yet) a member of AdvoConnection.  OK. That’s putting it mildly. I was actually stunned.

“Why do people feel well served by you?” I asked him.

“Because I have a beeline into all the good doctors,” he replied.  And when I asked him to explain further, he said it was because he knew the best doctors to recommend.

[Pause. Letting that sink in…]

In conversations with both long-time advocates, and lawyers, too… and honestly – what makes common sense – is that a patient advocate should never make a recommendation about a doctor.

Here’s why:

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