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Clearing Up a Misperception About Patient Advocacy
In an email conversation recently with the administrator of a new advocacy program (which will open up to new students in Fall 2013), I was asked where I saw the role of health and patient advocates within the healthcare system. I had to think about that for a few minutes. I decided that I don’t see advocates as being “within” the healthcare system at all. Our role is actually from the outside, looking in – and that’s where our successes for our patients can be found. Here’s why: The necessity of advocacy services comes as a result of the dysfunction of the system. Because the system is so dysfunctional, it requires a positive force from outside it to manipulate it in different ways to improve patients’ outcomes. (I’ve talked about this disruption before.) If all we did was work inside the existing dysfunction, then I don’t think we could be very successful. Now don’t get me wrong. I’m not suggesting that understanding how to work within the system isn’t necessary – it is, absolutely. Truth be told, the better you, the advocate, can use the system, the better chance you have of determining the workarounds necessary for your client.* But that’s not the same thing – being a part of the system isn’t the same as getting what you need out of it. Here’s a metaphor: you have a car so you can get from here to there. In order to run well, your car needs an engine, a steering mechanism, and wheels. But you don’t have to be part of that system to get the most out of your car. You don’t have to build the engine, change the oil yourself, or replace the tires in order to use your car to get you from one place to another. YOU are the driver, relying on maintenance and repair only when necessary. Surprisingly, many advocates don’t understand this point. And when they don’t, I wonder whether they have found the best outcomes for their clients. Here’s a little test I give a soon-to-be advocate when he or she contacts me…