12 years. While on the one hand, 12 years seems like a looong time, on the other hand, it has gone by in the blink of an eye.
I’m referring to the 12 years I’ve focused my professional life on building the profession of independent health and patient advocacy, having made the decision in 2007 to begin building an online presence for advocates through the AdvoConnection Directory website. It eventually launched in Fall 2009* and evolved to become The Alliance of Professional Health Advocates.
So I’ve been giving thought to what I consider to be our biggest successes, biggest failures, and biggest surprises during this time, and that’s what I’m sharing with you today. These are my own opinion, of course! You might make other choices. See what you think:
• Biggest Independent Advocacy Success in 10 Years – a Tie
1. As a profession, our biggest success has been…. our success. We have never had to convince anyone that our profession should exist. Private, independent, professional advocacy is a perfect example of a service that has evolved to fill a need, one that continues to grow larger, with wider gaps to fill.
You know this from your own experience. The minute you explain what you do for a living, everyone agrees it’s a great concept. Most then launch into a story that begins with something like, “Where were you when….?” illustrating how well they understand.
2. Our second biggest success is the development and launch of a nationally recognized and respected certification for patient advocates in private practice through the Patient Advocate Certification Board. I feel this is one of my biggest personal achievements, having been one of the foundational builders of the certification. When the profession itself looks back in another decade or two – it will point to certification as one slingshot that helped advocacy fly.
• Biggest Independent Advocacy Failure in 10 Years – Another Tie
1. The first failure is the flip side of our success. Everyone understands the independent advocacy concept, but not every patient understands how they can benefit from working with a private advocate. Even when they get it, too many erroneously think they can’t afford it. The problem is further exacerbated by the fact that there aren’t enough advocates to meet the need anyway. Over time this supply and demand problem will become more balanced, but it’s taking longer than any of us anticipated.
2. The second failure is that too many potential advocates have tried and failed, or have never tried at all to build a practice. Too many potential advocates don’t realize, or don’t want to realize, or are blind to, or ignore, or in some way gloss over the fact that the words INDEPENDENT or PRIVATE are a part of the title!
Too many advocate-wannabes become overwhelmed by the idea that they need to create a practice, build a business, and market their services to do this work.
Supporting Numbers: Over the years, APHA has enrolled more than 4,000 members, most who have come and gone. Today we have about 600 members, and somewhere between 300 and 500 advocates run an independent practice.
I’m not sure how to plug this dike of unrealistic expectations and ostrich playing. Throughout APHA, including this blog, the practice-building books, the workshops we teach, the articles and checklists we provide, the conversations we have, and the emphasis of needing to start and run a business is all right out front.
Our APHA commitment: we will continue to lead advocate-wannabe horses to success water… despite the fact that too many will continue to choose thirst over success.
• Biggest Surprise in 10 Years
It’s not a surprise that there aren’t enough advocates. Review of the history of the legal profession shows that it took at least hundreds of years to build, so how could we expect less from patient advocacy?
And it’s not a surprise that so many people have tried and failed to develop an independent advocacy practice. After all, according to the US SBA (Small Business Administration) 30% of businesses will fail in their first two years. And that’s for business concepts that customers or clients understand and embrace… we aren’t even there yet. If it was easy, then everyone would do it.
The biggest surprise to me is that so many individuals who are so passionate about the concept of advocacy believe that since they know how to be advocates, they will therefore be successful as independent advocates.
But they don’t know what they don’t know. (Just like our clients.)
And, I’m sorry to pick on nurses and doctors who choose advocacy – but as a group, they are the biggest offenders. Most believe that since they’ve spent a career in healthcare, they understand how to be an independent advocate. Never mind that advocacy is not a medical pursuit. Never mind that advocacy requires creative problem solving (there are no formulas, no “if this, then that” rules in advocacy), never mind that they have spent their careers making decisions for patients, the antithesis of what advocates can ethically do, never mind that starting and running a business has nothing to do with a clinical career…
(It’s a little like believing that since I can drive a car, I know how to build an engine.)
As a result, we’ve got that ostrich thing going on with too many advocates starting out with their heads in the sand, certain they know what they are doing, and instead – going out of business.
So Where Do We Go from Here?
Simple / not simple. We capitalize on our successes. We minimize and eradicate our failures.
I ask you, because you have passion for this profession, to help with that.
- Wherever you go, talk about professional advocacy, your role, asking others what they know about it, too. Educate those who need to know more. Provide them with resources and your contact information.
- Invite others to participate! Whether it’s other potential advocates, or medical providers who can benefit, or certainly potential client-patients who will find improved journeys through the system… just talking about advocacy is one thing. Inviting others to be a part of it is a great next step.
- Do a good assessment of your readiness to take on the business needs as well as the advocacy needs of being successful. The practice you save may be your own.
*Next year (2019) will be the 10th anniversary of the launch of APHA / AdvoConnection and the birth of advocacy as a professional pursuit. I hope I’ll be able to report that our independent advocate wannabes are quenching their thirsts – to even bigger successes!