Happy 10th Anniversary to AdvoConnection! Gifts for You, and a Challenge, Too

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Happy 10th Anniversary to AdvoConnection! Gifts for You, and a Challenge, Too

They have been the fastest, most exhausting, most rewarding, and most humbling years of my life… And they result in a story in which the universe has played quite a large role. On September 18, 2009 – ten years ago this week – the AdvoConnection Directory was launched. Just the directory. Here’s what it looked like: Nothing like today’s directory!  No, 10 years later, we’ve kept up with its growth, we’ve kept up with technology – AND we’ve kept up with MEMBERS. It might surprise you to learn that having members wasn’t even in the cards when we first launched. The original intent was simply to provide a means for patients to find help. They could search and find one of the 30 – yes! only 30! – advocates who had listed themselves in the directory.* No members?  Not really. We had listed those people who self-described themselves as advocates, never realizing how quickly they would become overwhelmed by the number of people who needed their help. Nor did we realize that most were volunteers. As volunteers, with requests to work 24/7/365, many while maintaining other jobs, they could not sustain the work. Which is when the universe kicked in. Many readers of this blog know that my work in advocacy resulted from a heinous misdiagnosis in 2004. À la “hell hath no fury” – my total disgust with the healthcare system resulted in my work as Every Patient’s Advocate. Eventually I realized that if many people were doing the work I was doing, then many, MANY more patients would benefit. The AdvoConnection idea-seed took root in my head. The original AdvoConnection logo. Notice the link instead of the APHA logo in the middle. Here’s when I realized the universe was speaking to me, when I realized that what advocates needed was NOT about advocacy – most already know advocacy and know it well. What they really needed was help starting and growing a business so they could SUSTAIN their advocacy work! Make a living at it! Do good by doing well in business! So what does that have to…


 

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All We Really Need to Know About Being Good Advocates We Learned in Kindergarten

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All We Really Need to Know About Being Good Advocates We Learned in Kindergarten

As children across the US and Canada start kindergarten this time of the year, I’m reminded of Robert Fulghum’s book, All I Really Need to Know I Learned in Kindergarten, a classic, published more than 30 years ago. I’ve actually written about advocates and the kindergarten principles before, years ago, as applied to some real negativity we were experiencing as a profession then. But today’s piece is updated, much more positive, and contains some further advice not shared then. So much of this kindergarten wisdom is appropriate to our successful running of an independent advocacy or care management practice – no matter whether it’s back-to-school time or not. So, with a nod to author Fulghum, let’s review. 1. Be Respectful and Expect to Be Respected in Return This is 360o advice: be respectful of others, and expect them to return the same. Now, you might respond “Yeah… Duh! Of course!” but I’m constantly amazed at the stories I hear about disrespect in relation to advocacy.  I’ve heard about: Advocates who are disrespectful to providers, and on the flip side, advocates who don’t command respect from providers, not politely correcting them when those providers are less than respectful to them. Advocates who are disrespected by clients. That is unacceptable patient behavior. Advocates who talk baby talk to older people, or call them “honey” or “sweetie.” … and more. If advocates are to continue on our path toward become among the MOST ETHICAL of professions, we must always be respectful, and command respect in return. 2. Make Friends Early in advocacy, it seemed there was a great deal of tension among the pioneers who were starting this new profession. Further, many advocates were faced with providers who did not want them “interfering” in their relationships with patients. Now, 10 years in, I hear very little of that – at least not like we used to. In fact, as I observe advocates, whether it’s in the APHA Discussion Forum, or at our PracticeUP! Bootcamps, or at other events, the camaraderie is impressive, extremely helpful, and just plain delightful!  In particular, when advocates gather…


 

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The Surgical Assembly Line

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.


The Surgical Assembly Line

When I think of an assembly line, two images pop into my head: The I Love Lucy Chocolate Factory episode where Lucy and Ethel are trying to wrap chocolates (and eat them too!) and can’t possibly keep up. My high school history class, when we learned about Henry Ford’s invention of the concept of an assembly line, where hundreds of cars were being assembled in one day. It revolutionized manufacturing, helping companies produce much more than ever before. I thought of both when I read about this surgeon, Brett Greenky, and his assembly line of hip and knee replacement surgeries – 14 in a day, and 3 at one time – and the $2 million malpractice suit he lost because he ruined a patient’s quality of life. Mistakes were made. He couldn’t keep up. Assembly line surgeries have been going on for years, ever since surgeons – and the hospitals and day surgery centers they operate in – followed the money: the more surgeries, the more income. The shorter the wait for a patient, the better chance they would choose to have surgery. And of course, it’s a lot less expensive for one surgeon with one paycheck to do more surgeries, than it is to hire more surgeons and have to pay more paychecks. In fact, “assembly line surgery” or “production line surgery” isn’t a new concept, nor is it a bad idea. In particular, academic medical centers, where student surgeons are learning their trade and honing their skills, have operated in assembly-line-surgical fashion for years. They are very efficient, of course. There are even awards for surgical efficiency when built as production lines. Further, if you think about it, “division of labor,” making sure that the person most skilled with one aspect of a surgery performs that one aspect, while another professional more skilled at another part of the surgery is performing that aspect, can be highly beneficial to a patient, improving quality. The problems crop up when efficiency becomes more important than effectiveness and quality; when the almighty dollar becomes more important than the patient’s outcomes. It turns out that Brett Greenky operated for 14 hours that day he messed up his patient’s hip replacement. No matter how skilled a surgeon he was, he must have been too tired to do a good job. When personnel are tired, it’s not just a problem with the mechanics of the…


 

 

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Self-Centered and Unbusinesslike

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Self-Centered and Unbusinesslike

Suppose I go to my favorite pizza shop and this conversation takes place: Me: I would like a pepperoni pizza with black olives, onions, and extra cheese. Johnny the Pizza Guy:  Sure! I’d be happy to help you with this pizza. But first let me tell you all about my pizza experiences – the reason I like to make pizzas. When I was little, we went to my grandmother’s house for dinner every Wednesday. My grandmother always made meatloaf. She made meatloaf with ground beef and always made gravy and mashed potatoes to go with it. It tasted good. It was filling. Then one Wednesday after eating dinner at Grandma’s (and realizing that it didn’t quite taste the same) my brother got really sick and started to throw up. Then the rest of us started to get sick, too. My mother was worried, so she took us to the ER, and sure enough – Grandma’s meatloaf, which had been tried and true and never changed… Well. She had made it with pork this time, the pork hadn’t cooked through, and we all got food poisoning. So now I make pizza. Me: Seriously? I come in here to order a pizza and I have to listen to that story? Forget it. I don’t want your pizza anymore. Now, of course, not only will I not get my pizza, but I have to figure out what to do next, and make all new arrangements for dinner! I know. You think I’ve really lost it now, but bear with me to see how this applies to you, as an independent advocate. Earlier this week I heard from a long time, very successful advocate, one whose instincts and processes I trust implicitly. I’ll call her Rose Marie (not her real name!). Her report to me: At a recent doctor’s visit with a top orthopedist, the surgeon said he is seeing a lot of advocates these days and he isn’t loving the experience. His words were “they make it more about them than the patients”.  OMG. I cringed. I groaned. And I realized this is…


 

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Going on Offense: Who Deserves an Advocate’s Help?

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Going on Offense: Who Deserves an Advocate’s Help?

“Only rich people can afford an advocate.” Or: “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?” Or: “Not everyone can afford an independent patient advocate. It’s unfair some people can’t be helped.” Anyone who has worked in advocacy or care management has heard one or more of these statements, or at least one from the same playbook. It’s an objection meant to put us on the defensive, as if, since private advocacy can’t be provided to everyone, then we shouldn’t provide it to anyone. Don’t let anyone put YOU on the defensive this way!  It’s a foolish argument. Here’s why: We’ll begin with a simple statement:  anyone who needs an advocate or care manager, anyone who is challenged by the healthcare system (whether or not the patient even realizes he or she isn’t getting what is needed), anyone who could enjoy a better outcome than will happen with no assistance from an advocate…. deserves the support of an advocate. Few people would disagree with that statement. The foolish question is whether everyone deserves the help of private, independent advocates. It’s foolish because the answer is obvious – of course everyone also DESERVES the help of a private advocate! The question is whether they can afford to PAY someone to help. And, sadly, not everyone can afford such a service. That’s true!  Not everyone who needs an independent advocate can afford to pay for an independent advocate. But is that unusual?  Not at all!  There have always been people who could, or could not, afford what they need and want. Not everyone who needs a home can afford a home. Not everyone who wants a college degree can afford a college degree. Not everyone who needs a lawyer can afford a lawyer. Etc Etc Etc NO ONE CLAIMS – ever – that since not everyone can afford a home, or a college degree, or a lawyer – therefore no one should have them!  It’s just understood that not everyone can. It may not be…


 

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Treat Your Human Body Like You Treat Your Car

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.


Treat Your Human Body Like You Treat Your Car

My friend Janet has a bad wound on her leg. It has been there for two months, and just looks worse and worse. Now it looks so bad she doesn’t even want to leave the house. “What does your doctor say about it?” I asked her. “I’ve been back to him five times!”, she responded. “He keeps giving me antibiotics, but it doesn’t seem to get any better.” “Five times???” I asked her, incredulously. It was time for “the talk” with Janet. … the talk in which I use my auto mechanic metaphor; the one that goes like this: You’re headed to work, and all of a sudden you car starts up with a squealing noise right under the hood. You take it to your mechanic who tells you he’ll fix it, and to come back to get it tomorrow.  You pick up your car the next day, and aren’t even halfway home when it begins squealing again. So you turn right around and return to your mechanic. “It’s still making that noise!” you tell him.  “OK – sorry – leave it with me and pick it up tomorrow.”  The next day you return to pick up your car again. Your mechanic apologizes, says he’s sure he’s got it this time, and sends you on your way with what you believe is your non-squealing car. You get all the way home – no problem, no squeal.  But the next morning you leave for work and – arghgh! – your car is squealing again! Now – your mechanic, who you love so much it’s like he’s part of the family, has had two opportunities to fix it, has sworn both times it was fixed, but you still have a squealing car.  What do you do? It has cost you time and money to no benefit so far. But should you return – again? – to your favorite mechanic? Can you trust him THIS time?  The answer is… (drum roll….) IT DEPENDS. It depends on how negative the impact is on your life if you keep going back. In the case of my car, I MIGHT go back one more time and tell him “I’m willing to give you one more chance, but then, I hope you’ll understand that I’m going to have to try someone else if you can’t get rid of that squeal this time.”  But in the case of…


 

 

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The Search Meter, Customer Service, and Fulfilling Your Need to Know

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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.

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The Search Meter, Customer Service, and Fulfilling Your Need to Know

In your pre-advocacy lifetime, you may never have thought you would be dealing with “customer service.” And yet, now that you’ve started working with clients, that’s what you’re required to do every time you interface with a customer (client) in any way: in-person, through phone calls, or email, or even postal mail. Your website represents customer service. Even the signature on your email is a form of customer service. Most new business owners who have never before lived in a customer service world believe that all they need to do is listen and respond. But that’s really only a start. Today we’re going to look at finding ways to provide customer service that provide an experience with you and your practice that may be expected, or may instead be totally UNexpected, or provide a delightful surprise. Of course, in these posts I’m all about providing examples…  Do as I DO and not just as I say!  Here’s an example of how we, through the myAPHA membership website, provide that customer service in a way you might not have expected. Cue the Search Meter Whenever you need to find a piece of information, fast, there are two ways to do a search in the myAPHA.org membership site: One search bar is at the top and bottom of every page. Input here will search every article, podcast, post, blog post, etc available to members. The other is a search of the Discussion Forums to find topics previously discussed. Hundreds of searches take place on the site each month because our savviest members have realized that whatever needs to be found, is most quickly found by using the SEARCH function. In most cases – maybe 99% – they find what they need and possibly MORE than they need. But sometimes they don’t find what they are looking for! Enter APHA customer (member!) service: What most members don’t know, and may find to be a delightful surprise, is that we track those searches to be sure we are providing material and information our members want and need, as long as it’s appropriate to provide…


 

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Earning Continuing Education Credits (CEs or CEUs)

APHA members who must maintain certain licenses or certifications do so by earning "continuing education credits", also called "CEs" or "CEUs" (the U means "units.")  Some medical professionals earn "CMEs" (Continuing Medical Education Units).

BCPA: Board Certified Patient Advocate

The BCPA certification is earned by advocates who pass the exam given by the Patient Advocate Certification Board.

To maintain their BCPA certification, APHA members may earn CEs by taking courses at a discount at APHA's sister site, PracticeUP!Online (online courses). When a course listed at PracticeUP! lists the availability of CEs, it means that course has been pre-approved for a specific number of CEs, which varies according to the course.

Other Certifications

Hundreds of certifications, and therefore the need for CEs and CEUs are available and appropriate for advocates. Included are certifications such as

  • CCM*
  • CSA*
  • CMC*
  • CASWCM*
  • CSWCM*
  • and others.

If you need to earn CEs or CEUs to maintain these certifications, the team at PracticeUP! Online will help you with the material you need to get those credits or units approved. Learn more at the PracticeUP! Online site.

*These certifications are also accepted when applying to be listed in the AdvoConnection Directory.

 

 

 

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Coloring Outside the Lines

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Coloring Outside the Lines

When people ask you what you do for a living, what do you – as an independent health / patient advocate, or care manager — reply to them? It would be simple to say “I am an advocate” which, then, may require further explanation. That further explanation would likely include examples of the kinds of work you do (I attend doctor appointments with seniors. Or, I manage medical bills and negotiate them when they are too high. Or I help people figure out what their own choices are for treatments… or…. ) That further explanation is always valuable, especially if the person asks you additional questions – meaning you have engaged them. And they often do!  They also tend to launch into stories on their own, beginning with “Where were you when….?” and then relate some horrible situation they or their loved one found themselves in. At that point you know they understand. But this week, during a conversation with a gentleman who wants to jump into “our” world, I found myself telling him… What advocates are more often called to do is to color outside the lines to get their clients what they need. And a phrase was born – a phrase all independent advocates can use in a variety of situations, as follows: “What is the difference between what you do, and what I can get from the patient advocate in the hospital?” Hospital patient advocates are required to follow the hospital’s rules. They work for the hospital. Their allegiance is to the hospital. But sometimes what patients need doesn’t fit inside specific rules. So as an independent advocate, what I do is get you what you need in whatever way it needs to be done. I have the ability, and the liberty, to color outside the lines if necessary. “Why can’t I just advocate for myself? Why do I need to hire someone to do it for me?” You don’t have to hire someone! Of course you can advocate for yourself! But do you know the specific aspects of healthcare where you can apply the pressure that…


 

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