5 Lousy Excuses for Walking Away from an Advocacy Practice – and 1 Very Good One

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5 Lousy Excuses for Walking Away from an Advocacy Practice – and 1 Very Good One

The blame game has been on my mind recently after several emails or phone conversations, plus the results of an exit survey offered when APHA memberships expire. In all cases, people gave reasons (as in, excuses) for why they felt like it was time to give up their practices or let their memberships expire. In almost every case where someone actually started a practice, then decided to step away, they blame some part of their practice that didn’t work out. They wanted to be independent advocates. They certainly expected to succeed when they got started. Their passion and drive were clearly there!  But – they failed. And there is always a reason, or more like a lousy excuse. It makes me sad, because they have given up dreams, because there will be people who don’t get the help they need, and because if they had been more diligent, those negatives didn’t need to happen. Thus today’s post. Because the rest of us can learn so much from lousy excuses!  Here are five of them (in no particular order), along with the reasons why they don’t hold water.  Plus one great reason to walk away – one we can all admire. Here are the excuses I hear, and a response to each. Lousy Excuse #1. Healthcare changes so fast I can’t keep up with it. Seriously? The whole point of being a professional advocate is knowing the basics of the system. The truth is, the basics don’t change that much. The details might change, but they generally adhere to the “follow the money” rule. For the most part, staying in touch with your profession by being part of a professional organization, or subscribing to professional listserves or discussion forums, or reading blogs, or even just the news – these are important requirements for any profession. In that way the amount of change advocates must keep pace with is no more or less than any other profession. And don’t forget – one of the most important reasons someone hires an advocate is because clients fear those changes. It’s worthwhile staying up with…


 

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If an Advocate Launches in the Forest, and No One Hears….

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If an Advocate Launches in the Forest, and No One Hears….

Consider Bertha. Bertha has been knitting since learning how at age 12. She’s a wonderful knitter! She has been knitting for decades – scarves, sweaters, hats, gloves and mittens, socks,  you name it – then giving her creations away to friends, relatives, even grandbabies of friends. Everyone who knows Bertha recognizes her superb knitting skills. Because of her extensive experience, she considers herself to be a professional. Her passion is knitting! So last year, Bertha decided to open a business as a knitting teacher. After all, as much as she knows about knitting, she knows she’ll be a great teacher! After doing some research, Bertha joined an online organization that supports knitting teachers. She has found a ton of information there, and loves to connect with other knitting teachers in the discussion forum. Most importantly, she made sure she was listed in the Knitting Teacher Directory – then sat back and waited for her phone to ring. And waited. And waited. And waited. But – Bertha’s phone rarely rang. Now she’s upset. Why don’t more people call her to teach them to knit? Only one person has inquired, and that was a friend’s daughter, who she decided to teach for free. Bertha hasn’t made a dime. Now, months later, (tap, tap, tap – the sound of Bertha’s foot, as she waits by her phone to ring…) it’s time for Bertha to decide whether being a knitting teacher is going to be her future. As it turns out, Bertha’s experience in establishing a professional knitting education practice is very parallel to the experience of many new advocates. Knitting, like advocacy, is a skill. Both can be learned in many different ways, through many sorts of experiences, from formal education to personal experience, even reading a book or watching videos online. Like learning to knit themselves, many people think they know how to advocate for themselves. Even if they make mistakes, they think they are doing it right. They may not be professional, but they can try. They need to be encouraged to reach out to a professional. If you want to…


 

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Open Enrollment – Confusion Spells Opportunity

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Open Enrollment – Confusion Spells Opportunity

What a MESS Open Enrollment is this year!  No matter where your health insurance comes from – an employer, the Obamacare exchanges, or Medicare – it’s changed up, switched up, and more confusing than it has ever been. YOU, as an independent health or patient advocate or care manager live (and fight) in this world of “let’s make money from patients even if we have to deny the services they need” world. You know what it’s like having to get a treatment, or claim, or hospitalization approved for someone who has inadequate insurance coverage. You know what it’s like when they ask you to help them get a bill reduced, or when the doctor they have been seeing for years suddenly won’t accept their insurance anymore. You know what it’s like when they realize that the hospital they were rushed to in an ambulance isn’t even in their insurance network. You understand their confusion. You may even be confused yourself. This year we’re going to experience the added confusion of the changes the new administration in Washington has made, including reduced subsidies, reduced Open Enrollment period, and the resulting upset when people find out their current coverage is no longer being offered (several of the largest insurers have dropped out of the ACA marketplaces). And that’s just Open Enrollment. What’s going to happen when the reality of 2018 sets in, and we all have to function under the new rules? But – here’s the good news. We are business owners!  As such, we never hear negativity in the word “confusion.” Instead, when we hear the word “confusion” – we hear OPPORTUNITY! Yes – 2018 Open Enrollment is a HUGE opportunity for all advocates – not just those who work in cost side of advocacy (health insurance / medical billing / claims, etc), but even those who work within the care side of advocacy (medical / navigational / eldercare / hospital bedside, etc). HUGE. Why?  Because everyone has to choose health insurance, and most people are clueless about how to go about it even though many have finally figured out that…


 

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How to Edit Your AdvoConnection Directory Profile

AdvoConnection Directory logo

Keeping your AdvoConnection Directory profile listing refreshed should be something you do on a regular basis. You may want to add a reminder to your calendar for a once-a-quarter or twice a year review.

When it's time to update or edit your profile:

  • Log in to the Profiles section of the AdvoConnection site.
  • You'll see a link to your profile and an edit button off to the right. (See the red arrow in the image at right.)
  • Click on the edit button, and you'll see the form you used when you first set up your profile.
  • Go ahead and make all your changes.
  • Hit "SAVE CHANGES" at the bottom.

Here are some help files, and some FAQs to help you:

If you are having trouble adding an image, then send it along to us. We'll get it added for you. Send an email to:  admin@aphadvocates.org.  Include:

  • a link to your profile
  • and tell us which image should be the "listing thumbnail" which is the image next to the name of your advocate practice.
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SAFE! … or Maybe Not?

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SAFE! … or Maybe Not?

Safety has been on my mind this week. It’s one of those concepts that, when related to patient advocacy and care management, can be applied in so many ways, with not so many easy answers. What kind of safety?  Physical safety, of course.  AND financial safety. Whose safety?  Your clients’ safety, of course.  AND yours. The questions aren’t so much about what is safe, or what isn’t.  The questions are about judgment, timing, and consequences, and recognizing safety issues when the problems are obvious – vs – those times that are less obvious that we might miss all together – and what will happen if we aren’t paying attention. My safety consciousness was raised recently during a session with the Patient Advocate Certification Board, as we worked on questions for the upcoming exam. It was like one of those V-8 moments, as we all beaned our foreheads with the heels of our hands and said, “Wait! We haven’t included patient safety!” Yes – patient safety – among the LAST attributes we should ever skip for advocacy knowledge and action!  Yet, as extremely important as it is, it had not been included in the list of competencies. We had missed it.  (We corrected that missing piece immediately. See the PACB post on this topic.) But it got me thinking…. In what ways do we advocates need to be attentive to patient safety for our clients. And what might we be missing? And that got me thinking further…. In what ways do we advocates need to be cognizant of our own safety? And what might we be missing? Some safety “rules” are so “look both ways before you cross the street” that we hardly give them thought. Most smart advocates realize, for example, that they should never consider driving a client to an appointment. It’s potentially unsafe for the client (what if they fall? what if they slam a finger in the car door? what if you’re in an accident on the way?)  It’s also unsafe for the advocate because if any of those things happen – that’s a lawsuit. Some safety…


 

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OK, But What’s the Question?

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.

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OK, But What’s the Question?

In my previous life as a speaker and writer on patient empowerment issues, I received email, even postal mail (meaning, yes, someone paid for a stamp!) from patients who were being challenged in some way by the healthcare system. Sometimes I would hear from 8 or 10 people in a week, 25, 30 or more a month. Their stories were often sickening and terrifying. At the least they were frustrating to read (even more so to live through, I’m sure) and at most their experiences had been life-threatening. And those were the ones that didn’t tell the tale of a loved one who had already died. People were desperate. They needed care or relief of some sort. But they either couldn’t find appropriate care, or they couldn’t afford what they were being told was necessary treatment. Sometimes their notes or letters were brief with just a paragraph or two. But most of the time they were quite long, very detailed, and too often, they just rambled. The record was an email – yes email – which seemed to go on and on and on. Just to see how long it really was, I copied the whole thing, then pasted it into a Word document.  If I had printed it, it would have been 33 pages. Yes – desperation and great frustration. My heart broke for them all!  What astounded me was this:  the grand majority of the emails never contained a question. Looooong explanations of hurdles and wrong-doing. Frustrations outlined in finest details…. But I often was not sure why those folks had reached out to me. I didn’t know what help they were seeking. I didn’t know what to do for them, if anything. I had no idea what they expected of me. Maybe they just wanted me to sympathize. Maybe they just needed to know someone was paying attention? But it most always turned out they expected me to help them in some way. They wanted advice. They needed a helping hand. But – how was I supposed to know what they wanted if they didn’t tell me? I was never sure how to even respond except to write back and say, “I’m so sorry to hear your story. What are you hoping I can do for you?”  What I wanted to say was “Hey!  I can’t read your mind!” All this gets me wondering…. How often do…


 

 

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Our Second Out of Network Campfire – BYOM!

 

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They’re Not Us. We’re Not Them. The Difference Is Defined by Consequences.

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They’re Not Us. We’re Not Them. The Difference Is Defined by Consequences.

Those of us who stay on top of patient advocacy-related news got a jolt from this headline, “Patient Advocacy Groups Rake In Donations From Pharma.” Just the jolt itself suggests that a few clarifications need to be made about our work as independent, private patient advocates. This is a topic I have written about several times in the past, but because it has big ripple effects, and because some of the people you connect with may be confused, you’ll need to clarify for them, so it bears repeating. It’s about allegiance. And it’s classified in the same sphere of conversations and objections as these: But the hospital has a patient advocate and I can talk to her for free. So why should I pay you? I got a flyer in the mail from my insurance company and they offered a patient advocate to help me for free! So why should I pay you? Anyone who has begun marketing a private advocacy practice has heard these sorts of objections. Like all roadblocks found in the healthcare system, I’m going to suggest you walk through the right answers with them, because it applies in all cases. This is the way to overcome their objections. You Get What You Pay For The hospital advocate’s allegiance is to…. the hospital. That’s who pays her. While there may be many things she can accomplish for a patient or caregiver, at the end of the day, her real job is to keep the hospital out of hot water. In most cases (95+%) she works for the Risk Management (legal) department of the hospital, and her hospital allegiance will only allow her to go so far to help a patient or caregiver. So ask, “What are the consequences of tapping into the hospital-paid advocate?”  An independent, private advocate has no such constraints. Fairly new on the landscape is the insurance company employed advocate – the one on the other end of the phone (“Ask a nurse!”). And yes, that’s who pays her. But remember, the goal of the insurance company is to make as much money as…


 

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Mr. Pareto, Mr. Juran, Mr. Koch, Garden Peas, and Your Care Management Practice

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Mr. Pareto, Mr. Juran, Mr. Koch, Garden Peas, and Your Care Management Practice

Chances are you’ve never heard of the three gentlemen named in today’s post title: Vilfredo Pareto, Joseph Juran, or Richard Koch. Nor can you imagine how they – and garden peas – relate to advocacy. Yet, the principle they have in common affects your work and ability to succeed, especially in the early days of your practice building. Unfortunately, most newly minted advocates not only don’t realize that, but they ignore it – at their peril. So what principle am I talking about? This post is intended to light a fire under you if who can’t figure out why you aren’t succeeding in practice despite the fact that you know you are a great advocate. Your excellent advocacy abilities may be getting in the way of your success if you think you can rest on them alone. How the 80/20 Rule Affects Your Health Care and Cost Management Practice Yes – that’s what Pareto, Juran, Koch, and garden peas have in common…  they are all related to the 80/20 rule, also called the “law of the vital few” or the “principle of factor sparsity” as follows: Vilfredo Pareto, an Italian economist, was the first to describe it when he observed that 20% of the pea plants in his garden produced 80% of his garden pea crop. Joseph Juran, an American management consultant, was the first to publish the observation, which he named after Pareto. Author Richard Koch wrote the book, The 80/20 Principle which applied the Pareto Principle to business. Their observations are vitally important to our success. In fact, if you ignore the 80/20 Rule in your work-related decision making, your business may fail. For example, It’s very likely that: Only 20% of the phone calls you receive will be eligible candidates for the advocacy services you provide. 80% will not. (How to regard this: recognize that, on average, only 1 out of every 5 potential client contacts has the possibility of yielding a contract, so don’t get discouraged if they aren’t all possibilities!) 80% of the reading and study you do won’t affect business decisions you make. But…


 

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What Happens When You Go Home from the Hospital?

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.


What Happens When You Go Home from the Hospital?

Maybe you had surgery, or some sort of exploratory procedure. You might have been battling an infection, or maybe you were just there while they ran an assortment of tests. There are many reasons you might have been hospitalized. And now it’s time to go home from the hospital. Now what? The thing is – during your stay in the hospital, there were people around to take care of you. Your nurses stopped by a few times each day, and would even arrive after you pressed your button. The doctor (maybe yours, but probably not) stopped in to check on you. Your surgeon stopped by to look at your incision. Other therapists may have dropped by. Maybe you had visitors, too. But now you’ll return home and you may be fending on your own. If you are lucky enough to have an attentive and present spouse, partner, or other loved one, then this may not be a problem for you. But what will you do if you don’t have someone right there to help?  If you live alone, or your loved one works all day, then it won’t be so easy for you. Who will fill your prescriptions? Who will bring food to your house or do the shopping? Who will drive your car? Who will help you get to the bathroom, or get dressed, or fix meals, or do laundry, or …?  At first you’ll be wobbly and weak. Who will do those things until you get your sea legs back? Who will keep track of the kids, get them off to school, put them to bed at night, nag them about their homework? Who will feed the cat, or dog, or parakeet?  Who will let the dog out (then back in, then back out, then back in… you know what I mean!) Who will answer the door when well-meaning (or nosey!) neighbors stop by? I often hear the statement, “If I need a patient advocate, I’ll just work with the one in the hospital!”  But what if your need is outside the hospital?  Or – a difficult situation that happens every day – what if you are the child of the patient, and Mom or Dad lives elsewhere, has been hospitalized, and now you need someone to keep track of that transition home? Call a patient advocate, and if you can, call him or her BEFORE you are…


 

 

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My Person! My People! Building Partnerships, Expanding Your Practice

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My Person! My People! Building Partnerships, Expanding Your Practice

Are you a TV watcher?  I am. Big time. I love TV.  And because of that, more often than I care to admit, I draw inspiration from TV shows and characters. (As a side confession here, we’ve been binge-watching The West Wing, and have found that comparing it to today’s presidential politics is like marrying whiplash to an out-of-body experience. Right? But I digress….) Today we’re going to draw inspiration from three very different, very diverse TV personalities or characters:  weatherman Al Roker from the Today Show, Elmo from Sesame Street, and Meredith Gray of Gray’s Anatomy. Stay tuned… we’ll return to them in a moment after a word from… Partnerships. Yes – that’s today’s word: partnerships! If Elmo was here, that’s what he would tell you. Today we are emphasizing the concept of partnership and collaboration. This is a topic I’ve raised before, but it definitely bears repeating. In the past few weeks I’ve had several reminders of this, when I’ve heard questions from new or wanna be advocates and care managers such as: What do I do if someone asks me to do something I can’t do? My client asked me to get her insurance claim approved. Who do I call? Where can I take a course in medical billing adjustment and negotiation? If my client wants me to research clinical trails, where do I start? So what it is all these questions have in common? They stem from two ideas that require rethinking: That one advocate can or should perform every service a client needs. He or she should not because they cannot possibly be competent in all areas of advocacy. That learning how to perform a difficult service such as medical bill reconciliation, or claim resolution, or shared decision-making can be learned from taking a course. Taking a course is a great start, but observation and practice are also necessary before making promises to a client. There are three important reasons those ideas require adjustment. It is against our Health Advocate Code of Ethics and Standards to perform work outside one’s competencies. If you aren’t skilled…


 

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Entrepreneur: It’s Not a Dirty Word

This post has been shared by the APHA Mentor's Blog. It was written to help you start and grow an advocacy practice.

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. Find the link to that post at the end of the excerpt.

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Entrepreneur: It’s Not a Dirty Word

 

This post was contributed by Linda Adler, Pathfinders Medical, a mentor for those who are building an advocacy practice. “But I’m not an entrepreneur!” That’s the response I often hear when I first introduce the concept to some of my students or mentorship clients. They remind me that their motivation to be an advocate is borne out of their desire to use their experience to help others. They tell me their goal is to provide a service: and that they aren’t necessarily business people. Granted, those of us here in Silicon Valley probably throw the word around a little too much. And sadly, there are far too many examples of 20-somethings coming up with an idea, raking in millions, only to go out of business a year later. I’m certainly not suggesting that any of you try that, nor am I suggesting that labeling one’s self an entrepreneur is going to make you one. But, starting a business is an entrepreneurial venture: and becoming an advocate is all about business. So if you can start to think like an entrepreneur, doors will start to open. And clients will come your way. So what does it mean to be an entrepreneur?…


 

 

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What Do You Believe? Why? A Marketing Proposition

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What Do You Believe? Why? A Marketing Proposition

What do you do for a living? What sort of business do you run? That’s a classic business question, and those who understand marketing and PR, and have been in business during the last decade, might respond to the questions with their “elevator pitch.” If you’re not familiar with that term “elevator pitch”, you should be. An elevator pitch is a 10-20 second (yes, second!) overview of your business, so-named because you should be able to deliver it to a fellow passenger in the time it takes you to share an elevator ride to the top floor of a not-very-tall building. I’m the founder and CEO of Jane’s Advocacy Services in Terre Haute. We provide health care support and navigation services for older patients who need someone to hold their hands. Unlike hospital patient advocates or social workers, we can be there 24/7, at home or in the hospital. We provide peace of mind to our clients and their concerned adult children. Thing is – elevator pitches are just so 2008! They may still have their place but they have mostly been replaced… A few years ago, I introduced you to the concept of “narrative.” I first heard the term while watching an episode of Shark Tank, when Troy Carter asked a hopeful investee, “What’s your narrative?” Now – here’s what captured my attention… the woman manufactured socks. Yes, socks. Big deal! I mean, they were cool socks, I grant you. But Shark Tank cool? And then she told her story, her narrative. It was heartbreaking and hopeful. It captured hearts and minds. And the Sharks couldn’t invest fast enough… all based on her narrative. Advocacy is the kind of business for which narrative can be incredibly powerful! So many of us do the work we do because of our own experiences dealing with the healthcare system for ourselves, or for others. By helping others, using the skills and empathy we have developed, we find joy, possibly catharsis, and often career. My work is about patient empowerment and patient advocacy. In 2004, I was diagnosed with terminal lymphoma and given…


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An Update on Patient Advocate Certification (2017)

podcast and resources belowAPHA Expert Call-in

September 2017

Many advocates and those who are considering advocacy as a career have interest in becoming certified in their profession. Recognizing the importance of certification for both advocates and the patient-clients they serve, the Patient Advocate Certification Board (PACB) has been working to develop that certification since late 2012.

And now – we’re close! The PACB anticipates offering the first certification exam in early 2018.

Of course, advocates have many questions about everything from eligibility to be certified, to specifics about the test, to locations, costs, recertification, and much more.

To help you understand our progress, and the steps still to be taken, the PACB invites you to participate in this update call-in. Hear more about the development of the certification, what it will mean for you and your practice, the answers to those questions and many more.

 

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Wind, Rain, Destruction – and Metaphors

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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.

Find the link to the entire post at the end of this excerpt.


Wind, Rain, Destruction – and Metaphors

APHA members received a note from us this week with some expectation management. That is… we’re prepared, and are hunkering down, for Hurricane Irma. Our offices, located in Central Florida, will likely lose power over the next few days as Irma makes her way through; meaning, of course, that office communication may come to a standstill until power is restored. Honestly – it’s like knowing you’re about to get a tooth pulled. There’s pain before, you know there will be pain after, and you’re just waiting for it to be over with so you can get on with life, but with that additional dread of not knowing exactly what kind of pain you’ll be dealing with in the aftermath. What??  Like getting a tooth pulled?  Yes – metaphorically – that’s exactly what waiting for a hurricane is like. Take it from me! As we’ve watched weather models and meteorologists on TV, and as we’ve seen what friends and neighbors have posted to social media, I’m struck by how effective metaphors can be to help someone understand something they have not experienced themselves. Huge, in fact! I’ve spoken and written in metaphors all my adult life. I credit my teacher training for that (8 years of my early career as an elementary grade teacher). Metaphors were a good way to teach math, history, and other subjects. Describing history in terms that were more current and understandable to them, or rewording math problems, could help them get past learning blocks. As I scroll through previous blog posts, I find metaphors in abundance: How to Avoid P*ssing Off the Doctor in One Easy Step The Most Expensive Business to Start The Birdcage: How to Ruin a First Impression … and many more. One of the metaphors I use most frequently is one you should keep in your explanation arsenal, too. That is, a description of independent, private patient advocacy: When you need legal help, you call a lawyer. When you need tax help, you call a tax accountant. When you want a great haircut, you visit your hairdresser. When you professional need help…


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