Patient Advocate Certification: Ask the PACB

podcast and resources belowAPHA Expert Call-in

June 2019

Join us for this call to learn what’s new and what’s on the horizon with Patient Advocate Certification. We’ll answer questions like

  • How can BCPAs earn their CEs to maintain their certification?
  • What organizations now recognize certification from the PACB? (are there hospitals or non-profits accepting BCPA certification to fulfil an employment requirement?)
  • Will there be changes to the requirements for becoming certified by the PACB? If so, what kinds of changes?
  • Will there be changes to the certification exam in the future? If so, what kinds of changes?
  • How can I participate in PACBoard activities?
  • What other changes might we see in the future?
  • How can I stay updated on PACBoard decisions?

 

headset Podcast Available: 29 minutes   Note!  Please save this to your own computer to listen. Attempting to listen from the APHA website server may crash the server.
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What Biases Don’t YOU Recognize?

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


What Biases Don’t YOU Recognize?

As advocates, we all quickly become familiar with, and embrace, and share with clients, our Code of Ethics.* Of course, there are many tenets to the code, but primary among them is the very specific statement and belief that while acting as a professional patient advocate, we will never make decisions for our clients. We work to help them make their own decisions, we respect the decisions they make, and we assist them to be sure they are carried out. I’m sure, as you read that statement, you are nodding your head in agreement. YOU would never violate that tenet, would you?  You are 100% committed to making sure your clients are making all their own decisions, even in difficult times. And yet… I received an email recently from a person who wants to start building an independent advocacy practice. In outlining her reasons for wanting to do so, she made this statement: I am passionate about patient care and ensuring that quality vs quantity of life is always respected.  Pardon me, advocate, but your bias is showing!  That said… I’m quite sure she would not recognize it immediately as being a bias. Do you? Well – it’s right there in black and white, “quality vs quantity of life is always respected.” … I have to ask, what if your client wants a longer life at any expense?  What if his preference is quantity, rather than quality? Do you then lack respect for that client?  or do you try to change the client’s mind? or do you decide not to take that person as a client because you feel differently? (Do you even know what that person really believes?) Pardon me, new advocate, but please take another look at our Code of Ethics!  It’s not up to you to impose your preferences on your client. It’s incumbent upon you to ask questions, listen carefully, hear between the lines, and determine your client’s wishes. And then, of course, it’s up to you to help the client work toward his/her own preferences. (I am sure that if I would point this out…


 

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Ac-cen-tu-ate – the Negative?

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Ac-cen-tu-ate – the Negative?

It’s time to take a trip with the Way-Back Machine to a song many of us heard when we were kids – because our parents played it on the radio or record player. We all sang along! With lyrics by Johnny Mercer, and sung by Ella Fitzgerald (that’s Ella in the photo above), the song “Ac-cen-tu-ate the Positive” became popular in the mid-1940s, with its very (yes) positive message of how we should focus our lives.. on the positive side, of course. So, of course, leave it to the healthcare system to ask us to think VERY differently about how that word “positive” is used… because when it comes to medical test results, “positive” is probably NOT a good thing. In other words, if your doctor sends you for a test, you probably do NOT want those results to come back as “positive.” Why?  Because positive test results indicate that you have developed, or do suffer from, or are the victim of, whatever you were tested for.  Examples: If you are tested for Lyme Disease, and the results are positive, then yes, you do have Lyme Disease.* If you are tested for diabetes, and the results are positive, then yes, you do have diabetes.* If you get an MRI for a tumor, and the results are positive, then yes, you do have a tumor.* None of those diagnoses are positive news for anyone! Conversely, if the test results come back negative, then whatever your doctor suspected he or she would find, was not found. That is usually a positive outcome, even if the medical system calls the results “negative.” Why do we say “probably not a good thing” instead of “definitely not a good thing?”  Because sometimes getting an answer is a good thing, even if the answer isn’t something you wish it would be. If you have strange symptoms and the test results are positive – then you finally have a name for those strange symptoms, and possibly a treatment way forward, which may feel like a good, positive thing even if you would not want that diagnosis. If your test results are negative, then you don’t have a name for your symptoms, and probably no easily determined treatment either. That might feel frustrating, a negative emotion. *That little asterisk up there next to those diagnoses represents an important – very important – step that all newly diagnosed patients…


 

 

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Less Becomes More: Where Subtraction Has Positive Results

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Less Becomes More: Where Subtraction Has Positive Results

I spent the weekend gardening. It’s spring, after all. Since my last assault on my garden last Fall, many plants got leggy, or died, or just needed rehab of some sort. Unlike many of my neighbors (and maybe you, too!) what I love most about gardening is finishing it. It feels so good when it stops! What was unique about my weekend gardening is an observation I made; a good metaphor to share with you, in hopes of providing some inspiration on a service you can provide to your clients. (Yes, this is what happens when I’m pulling weeds. I get thinking about other, more important things!) No – I don’t expect you to do your clients’ gardening! But follow along with me and it will make sense. Last Fall I prepped my plantings for winter. One shrub had just grown way too big for its space, so I hacked the heck out of it. I removed branches that reached too far or had leaves only on the tips, and reduced its size by almost half. (I wish I could tell you what kind of shrub it is – but I can’t remember the name. You can see it in the photo.) This spring, for the first time, I was rewarded with some beautiful blossoms on it! We’ve never had blossoms on this shrub! While it’s difficult to see in the photo, the blossoms are a pretty lavender color, about one inch in diameter. For the first time, it’s no longer just a gold-ish colored shrub. It’s a flowering shrub! I got thinking, as I pulled those weeds, that those blossoms were the result of SUBTRACTION. Had I not removed all those limbs, we would not have reaped the reward of flowers. Less became more. That’s the metaphor for a service every independent care advocate should offer to a client because for this particular service, SUBTRACTION can improve their quality of life. It addresses a problem that is so prevalent that it even has its own name: polypharmacy. Polypharmacy is the problem of taking so many different drugs and supplements…


 

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Simon and Garfunkel – an Anthem to Advocacy

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Simon and Garfunkel – an Anthem to Advocacy

OK, yes, I’m dating myself…  One of my favorite Simon and Garfunkel songs is Bridge Over Troubled Water. I’ve been humming it repeatedly over the last few weeks, and last week, we let the advocacy world know why. When you’re down and out When you’re on the street When evening falls so hard I will comfort you (ooo) I’ll take your part, oh, when darkness comes And pain is all around Like a bridge over troubled water I will lay me down Like a bridge over troubled water I will lay me down The lyrics – are like an anthem about advocacy, aren’t they?  The idea that one person can help another person by creating a bridge over the problems, to make the path to the other side smoother. It’s the work advocates do every day, proudly, passionately, and most often with incredibly positive results. Beyond the lyrics, the metaphorical bridge goes even further, which is what has prompted the song to run through my head most recently. So – what happened last week? Last week we announced the first ever ICOPA… the International Conference on Patient Advocacy – supporting that bridge through collaboration: International Conference on Patient Advocacy October 3 – 5  •  Chicago Notice those words used to describe the conference:  “Navigation, Collaboration, and Solutions” followed by “The Rising Tide Floats All Boats”… once again making me think of a bridge… I want to focus for a moment on that word collaboration. What will make this conference unique is the fact that it’s a recognition that ALL flavors and niches of advocates will come together to discuss improving their service to clients and patients.  “All flavors and niches” means not just independent advocates, but hospital advocates, insurance advocates, non-profit disease focused advocates – anyone who calls him or herself an advocate according to the PACBoard definition: “A patient advocate is a professional who provides services to patients and those supporting them who are navigating the complex healthcare continuum.” Collaboration, in this case, describes building advocacy bridges. It is the recognition that there are so many roles for advocates…


 

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Spare Yourself Grief: Get It In Writing

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Spare Yourself Grief: Get It In Writing

As the director of AdvoConnection and its associated websites, I hear about so many patient and caregiver complaints, problems, hurdles and – dare I say it – atrocities. Among the most frustrating and egregious I hear way too often;  that is, with advance permission from their insurer, someone underwent a test, a procedure, or surgery, or saw a specialist, only to be told later that the insurer wouldn’t pay for it after all. Wh-a-a-a-t??  If this has happened to you, you are probably vigorously nodding your head. It happens all the time!  If you have not yet had the experience, then your eyes may be wide open in horror!  And I’m here to tell you the same thing could happen to you. So let’s see how we can prevent that! It’s actually not too difficult, but might be more or less so depending on what the permission needs to be, and how soon you need to get it.  The first thing to know is that there is very little black or white with insurance companies. Sometimes getting permission is just a matter of the day of the week, the time of day, or even the customer service rep you talk to. (BTW – as an aside – insurance customer service reps sometimes call themselves “patient advocates”  Really? Who are they advocating for?  Themselves, of course!  Not you! So don’t be fooled.) Not that your insurance plan doesn’t have parameters – it absolutely does. But there are so many gray areas, that one person might interpret coverage one way, and someone else might interpret it another. So the key here is that you are seeking a promise of coverage ahead of time, before you undergo, or purchase, or visit something related to care.  To do that, you call your insurer to get that promise. Ideally all this will take place weeks before your medical care takes place. You may need that much time. Even if you don’t have that much time, take care of this as early as possible, because this work on the front end will possibly save you a great deal of grief – and money – afterwards. Begin by asking your provider what the “CPT” and “DRG” Codes are for whatever you are seeking coverage for. A DRG (Diagnostic Related Group) is a code for your diagnosis. A CPT (Current Procedural Terminology) is the code that describes exactly…


 

 

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Assessing Value: The Cost of Meat and Potatoes

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Assessing Value: The Cost of Meat and Potatoes

An Open Letter to an Advocate Who Questions Her APHA Membership Received last week from Esther (not her real name): If you would please clarify a few things I’d really appreciate it.It’s time for my PACE membership to renew and I am trying to decide whether to spend that money. I want to have my name listed in your directory in the future, but your Premium membership is quite out of my budget. . Do you not offer beginner discounts? Secondly, I currently am an unemployed family caregiver and have no income. A basic renewal at $49, which is more in my budget, is only for 6 months time, why not a full year? And it really lacks access to the meat and potatoes of your site which would most benefit me starting out in this line of service. So as you may have gathered, I’m at a crossroads for renewing at this point in time. I’m trying to understand the real value in APHA membership for me. Perhaps you have other financial options for people in my situation? I do look forward to hearing from you. My reply to Esther: You are not the first person to ask me about discounting the price of membership. In fact, I have been asked that for years. Because I want you to understand the answer thoroughly, I will simply direct you to a post that includes the answer and its reasons. You asked about a “beginner membership” – that is exactly what the PACE membership is, at less than half the cost of the “regular” membership which is the Premium. PACE stands for Patient Advocate Career Exploration. It’s for people who want to learn more about the profession, but aren’t yet committed to it. Once committed, the right membership is the Premium, and that opens the door to all the benefits we make available. You asked about the “real value” – and my answer is this: it has taken us a great deal of time, and some major expense to develop the resources we offer to advocates. You asked specifically about the…


 

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Atychi-what? Overcoming Atychiphobia

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Atychi-what? Overcoming Atychiphobia

Over the years, dozens of professional advocate wannabes have talked to me about fear, including Fear of failure Fear of doing the wrong thing for a client Fear of failure Fear of losing their savings Fear of failure Fear of making a mistake in their work Fear of failure Fear of standing up to authority Fear of failure If your fears stand in the way of your success, then you have only two choices: You can either give up and decide not to move forward with your dream of becoming a successful, professional, independent advocate. Or … you can work to overcome them. Because…. Atychiphobia is the word for a persistent fear of failure. In the past, I’ve also described it as the paralysis of analysis – the idea that you can’t move forward because your analysis of what might happen is failure. If you are in the “give up” group then don’t bother reading the rest of this post. This post is written for those who are brave enough to face their fears; those who know their advocacy is vital to the patients they will help, who dream of helping people professionally to improve their health care and cost outcomes, and is therefore worth the effort to overcome their fears. I hope that means YOU! If you are fearful of any aspect of starting and growing a professional advocacy or care management practice, then it stems from only one thing:  the inability to control an outcome. Pause. Think about that. Repeat:  Fear stems from feeling as if you cannot control an outcome. What I’m not going to do here is psychotherapy. We’re not going to figure out WHY you are afraid. Instead, what I am going to do is give you a different way to look at your fears, and I’m going to suggest to you that YOU can control how you think about them. Therefore YOU can face your fears head-on – and overcome them. Let’s begin with one of those fears at the top of this post:  the fear of losing one’s savings.  Let’s break it down:…


 

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“When I’m Sixty-Four” and If I’m Alone….

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


“When I’m Sixty-Four” and If I’m Alone….

Back in 2004, I was between husbands, and in my early 50s. As silly as that may sound (“between husbands”), the truth was, I spent 18 years with that status, between divorce and remarriage… and I was alone. “Alone” is the key to today’s post. Back in 2004, I was also diagnosed with a rare and terminal lymphoma. Yes – terminal – and yet here I am writing about it in 2019. You can read the story in its entirety here. Obviously it didn’t turn out to be terminal. But it did launch an entirely new career, and profession, and sparked today’s topic about being diagnosed with something horrible, and being alone. Of course, back in 1967 when John Lennon and Paul McCartney wrote “When I’m Sixty-Four” neither of them was alone, and yet the lyrics indicate they might have been putting themselves in the shoes of someone who was. Even though I wasn’t in my 60s at the time of my misdiagnosis, believe me, i was just as frightened as I would have been then. I had no one to turn to who could be my caregiver. No one who would hold my hand through tests and appointments. No one who could rationally think through the conflicting pieces of information I was receiving. No one to help me sort out the bills and insurance. No one I could trust and rely on (or not feel I was imposing on) …  I was solo. I was alone. There was no one I knew of who I could ask to help me out. All these years later, the emotions and struggles that arose during that time still haunt me. Today the landscape for “solos” is different. If you are alone, and fear the challenges healthcare is already presenting to you, or those that may arise in the future, then you have options I didn’t have in 2004. In fact, there is major movement in this area – professionals who study and learn more about how to help “Solo Seniors” or “Elder Orphans” or even younger people who are alone and need assistance (my situation at the time) and are facing medical care without a handholder or guide… The best metaphor I can think of to help you understand is this:  to prepare for your older age and your demise, you’ll work with an attorney to help you plan your estate, or…


 

 

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Starting Out? Why a Non-Profit Practice Is NOT the Right Answer for You

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


Starting Out? Why a Non-Profit Practice Is NOT the Right Answer for You

This is a question – or a statement – I hear frequently from those who wish to be independent health or patient advocates who are considering which business formation they need to set up to be independent.* After considerations of LLCs, or S-Corps or others, they tell me they want to establish a non-profit, then ask me if we offer resources to help them. Fay is one such advocate wannabe. She asked, “Do you have any advice for establishing a non-profit or not-for-profit agency to help patients?” Unfortunately, her question was being asked for the wrong reasons. Why? When asked why they think a non-profit is the right answer for them, I hear a handful of replies: “So many people need help but can’t afford to pay for help. Establishing a non-profit would mean I don’t have to charge them.”  (A fair statement – and a solid answer, but requires a follow-up – see below.) “I have only ever done advocacy as a volunteer, so I want to keep doing it that way.” (Also a fair statement, but not helpful to this advocate – see below.) Fay’s reply to me was the one I hear most often: “I hate asking for money, so if I set up a non-profit, I won’t have to.” (A fair assessment of ask-for-money fears, but a ridiculous overall statement about business formation.) The point being… almost every advocate-wannabe who asks about setting up a not-for-profit organization believes that will mean she can deliver advocacy services at no cost to the patient. She may also believe, then, that she can continue doing advocacy work as a volunteer – because she will still get paid by the non-profit organization. The problem is, those who think a non-profit is the cure to the “asking for money” aspects of business, haven’t yet thought of this question:  Where will the non-profit organization get ITS money? The leap not made is that a non-profit is just as much a business as a profit-making business is. Both require business skills; both require asking for money. Here’s Where Fay Went Wrong To begin…


 

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How Does a Patient Choose the Best Advocate to Hire?

This post was published at, and has been shared by the APHA Blog.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


How Does a Patient Choose the Best Advocate to Hire?

I’ve been working on updating the AdvoConnection Directory website because it was time, because search engines look favorably upon updates. And because my not-frequent-enough review of the site’s analytics produced a big surprise! A surprise I’ll share with you here today. To be clear – no changes were made to the actual search and profile areas – those all belong to our listed advocates who make those changes themselves. Instead, I edited and updated the support pages – everything from the homepage to the About Us page to the “how to choose and interview an advocate” page. For some background:  I monitor and track the advocate listing pages diligently (and encourage our listed members to monitor their own – we provide them with stats each month.)  I know people are finding our advocates in the Directory in HUGE numbers (examples: 16,000+ in January and 15,500+ in February, a shorter month, of course). However – true confessions here – as in “do as I say, and not as I do” – I rarely look at the analytics on the basic site pages.Just not something I make time for… although as I learned this week – I should!  Because I was actually very surprised by what I learned. What I found: First, that beyond the profiles, the MOST accessed page is the one entitled, “How Much Does It Cost to Hire an Independent, Private Advocate?”  That really wasn’t a surprise… Found on the other pages is supporting information like master list of services advocates provide, an About Us link, lots of blog posts to help patients become smarter and savvier… So what elicited such surprise? That the SECOND MOST accessed page is the one called, “How to Interview and Hire a Patient Advocate“.  I don’t know why it surprises me… but it does. (Honestly, I expected the list of services to be at the top and it’s not.) More importantly, it made it obvious to me that I needed to point this out to all of YOU, because it informs you of what questions will be asked when people reach out to…


 

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PracticeUP! Introducing Online Courses for Advocates and Care Managers

podcast and resources belowAPHA Expert Call-in

February 2019

Starting and growing a successful advocacy or care management practice requires so much knowledge, and so many resources. Business skills, advocacy background, resources... While APHA provides support for so much of what we need to know, that doesn't mean it's easy to learn it all.

Examples:

  • APHA might give you an overview of public speaking - why it's important, and the major steps to making it happen. But how can you learn how to master those steps?
  • APHA might suggest you develop a newsletter for potential clients, but just how are you supposed to develop it, and where do you get the content and email addresses you need?
  • APHA might explain about why contracts are necessary, but how do you actually talk to a client about a contract, and convince them to sign it?

Enter PracticeUPOnline.com - a new website, launching in early 2019, that will provide you with online learning: courses you can take online, that will teach you step by step how to accomplish those necessary tasks, and how to develop those necessary skills for building the advocacy practice you have planned for. We'll talk about the courses being developed, the teachers who will be involved, and the marvelous cost benefits for APHA members (many courses will be free!)

Trisha Torrey, founder and director of APHA, and the developer of PracticeUP! will be our guest.

 

headset Podcast Available: 42 minutes Note! Please save this to your own computer to listen. Attempting to listen from the APHA website server may crash the server.
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A Riddle: When Is the “Best Doctor” Not the Best Doctor?

This post has been shared by the AdvoConnection Blog. It was written with a patient-client audience in mind, but might be useful to you, too.

It is provided so you can find it in a search here at myAPHA.org, but you'll need to link to the original post to read it in its entirety.

Link to the original full length post.


A Riddle: When Is the “Best Doctor” Not the Best Doctor?

… followed by a second riddle: When Is the “Best Hospital” Not the Best Hospital? Everyone loves a good riddle. I think it’s because the answer is often clever, maybe a play on words. We chuckle (or groan!) at the answer, and sometimes the first riddle will trigger a handful more… just fun. I wish I could tell you these two are clever, chuckle-inducing riddles, too. Unfortunately, not only aren’t they funny; they can be deadly. There are two circumstances under which the description of “best” in relationship to medical professionals or facilities needs to be reconsidered. Circumstance #1: “I need knee replacement surgery, so I’ve chosen the best ortho surgeon in town!” my neighbor Joe told me after putting up with a bum knee for years. I had to ask him, “What makes that ortho the best? And why?” Joe’s reply was that he asked around and “Everyone told me to call him.” What Joe couldn’t answer was “why?” And as it turned out, after a bit of research, the “best ortho surgeon in town” did have great ratings and a good track record – for shoulder surgery. Now that may not seem like too big a stretch – if that surgeon is good at replacing shoulders, he might be good with knee replacement surgery, too… But – how can we know? It’s a little like saying that just because your auto mechanic has a great reputation for rebuilding a transmission, it means he might also do a great job replacing a broken axle, or fixing your steering. Or if a lawyer is good at drawing up your last will and testament, she might also be able to keep you out of prison…. But how can we know that? I think we all want “the best” when it comes time for our care, but we must be sure we’re comparing apples to apples, and applying that label under the right circumstances. So – back to riddle #1: when is the “Best Doctor” not really the best doctor? When his or her area of specialty is really something else. A very important distinction. Circumstance / Riddle #2: The answer to riddle #2 will also inform our question about the “Best Doctor” but it’s probably more likely you’ve had this experience in relation to your local hospital. When Joe first went in search of an ortho for his knee replacement, he…


 

 

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