As the director of an organization for private, independent patient advocates, this time of year is full of big excitement – and big disappointments, too.
Today is January 12, and I’m excited to tell you that 32 new private advocate wannabes have joined Alliance of Professional Health Advocates just since the first of the year. For each one who eventually goes into business as an advocate, we can anticipate that they will help perhaps 100 client-patients in the next 5 years – potentially 3200 people (plus their families) who will enjoy better medical outcomes, or save plenty of money because they were helped. Remarkable! Especially exciting when you realize that so many people now have the opportunity to succeed at a new career, and so many MORE people will see better outcomes.
( I should mention, however, that the number of advocates needed is ten thousand times that – at least!)
But on the flip side, there’s disappointment, too. The new year always brings some soul searching, and soul searching often produces a handful of folks who decide that they just can’t cut it as private, independent advocates. Their hearts and advocacy abilities are willing and capable, but they just can’t get enough business to keep them in practice. So, sadly, they decide to throw in the towel. They take a job somewhere else or some just retire. Some decide to start a different kind of business for which (I predict) they are also doomed to fail. You’ll understand why in a moment.
Let me emphasize – for these folks, leaving private advocacy is not about being an advocate or love-lost for the profession. They may be no more or less capable of being outstanding advocates than when they got started early in their career exploration.
What they haven’t learned, though, or at least they haven’t embraced, is the fact that being a successful, independent, private patient or health advocate or navigator is less about being a good advocate, and more about being a successful business owner and marketer. No matter what type of business they decide to start, they won’t be successful if they don’t become smart business owners.
In many cases, advocates fail as business owners because they are just too helpful. TOO helpful! It’s our nature, and it’s often what gets us in trouble. In particular for those new advocates who come from nursing backgrounds or anything bureaucratic in nature, learning that time = money is a tough lesson. It can stand in the way of our abilities to succeed.
Are you too helpful? Here are three ways that being too helpful will put you out of business:
• Bad Business Practice 1: Giving away the farm (AKA, why buy the cow when you can get the milk for free?) Mrs. Smith calls and tells about the trouble her husband is having, and we helpful, generous advocates reply by asking, “well have you tried this? what about this? I would try this…” Mrs. Smith says “thanks very much” and hangs up the phone – and… hey! What happened? She didn’t hire you!
The problem here is that you already told Mrs. Smith what needs to be done, or at least how you would approach the work. Now she can do it herself or get a friend to pitch in. Why would she pay you?
The better conversation with Mrs. Smith would be, “Yes, those are things I can help you with.” or “Yes, I’ve handled situations like that before.” And then to ask whether she would be willing to work with you, whereupon you explain how you work and tell her you’ll need a signed contract.
• Bad Business Practice 2: Free assessments (AKA, why buy the cow when you can get the milk for free?) Being a smart business owner means you don’t give away free time. You can give away free pens, or free magnets. You can even do some public speaking for which you don’t get paid. But you don’t do work for free – not even as a volunteer.
I hear of so many advocates who promote their free assessments. They spend an hour or more with a potential client, tell them (in person or on paper) what needs to be done and how long it will take to do it, then ask about signing a contract – and it doesn’t happen. They do free assessments because they think it will be promotional enough to at least get someone “in the door.” But with few exceptions, it fails miserably. It’s not only costly in time, but it’s costly emotionally, too. We feel rejected.
So why doesn’t it work? Because, In effect, they’ve just done the bulk of the legwork and intake work – for free! So why WOULD someone pay for it? Bad Business Approach #2 is really just BBA #1 on steroids.
Instead, if you feel as if you want to use an assessment as a promotional tool, you can charge for the assessment, then rebate it later if the person does hire you. (“Mr. Anderson, I charge $399 for doing your assessment which you will own when we are finished. Then, should you hire me to do the work for you, I will subtract that $399 from my invoice.”) There are a handful of other ways to do this, too. But the bottom line is – don’t give away a free assessment.
As far as donating time as a speaker – it’s not such a bad idea. You have an opportunity to meet one-on-one with people who may hire you, and as long as you aren’t TOO helpful, you’ll be able to connect with them later. Quid pro quo – your future opportunities balance the no-fee presentation.
Volunteering? Once you are in business as an advocate, that’s a major no-no with few exceptions. We’ll address that another day.
• Bad Business Practice 3: Not charging for all your time (AKA, why buy the cow when you can get the milk for free?) These are the situations where you do have a client under contract, and then you don’t charge your time against the contract properly. For example, you and Mrs. Nelson have a contract that calls for 12 hours of work. But now Mrs. Nelson thinks you are her new best friend, so she calls you every day to chat – 10 minutes, 30 minutes, sometimes an hour. But when you give her the bill, you’ve not accounted for any of that time. In effect, she got your services and best thinking for free. When you put her bill together, you realize that the 12 hours you’re charging her for really amount to more like 18 or 20 when you include phone time. That’s 6-8 hours of non-billable time that you could have spent working for another client, or marketing to find more clients. You become resentful. She continues to blissfully dial your phone number.
The better approach here is obvious. Account for your time, and manage your clients’ expectations so they know that’s what you are doing. “Mrs. Nelson, I enjoy our chats each day, but if we spend more than 5 minutes, I need to charge the time against our contract. What can I help you with today?” You’ve put her on notice. Now be sure you do track that time and add it to the invoice. You may want or need to do the same for email. Mrs. Nelson will think twice before she consumes your time needlessly.
Now you see why the very best advocates in the world will fail if they don’t employ smart business practices. And sometimes smart business practices feel like the antithesis of what we think we need to do as smart advocates.
The good news is that learning, and learning to implement smart business practices doesn’t have to be difficult as long as you take the time to read, practice, ask questions, discuss, and incorporate what you’ve learned.
Good, effective, successful advocates are made – not born. If you feel your business skills are at a deficit, take a look at this list of resources to help you.
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