“I’ve done advocacy for friends and loved ones all my life. Now I just want to get paid for it!”

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I wish I had a nickel for every time someone told me “I want to join the Alliance of Professional Health Advocates because I’m good at advocacy, I’ve done it for years for friends and family, and now I just want figure out how to get paid for it.”

Honestly?  Sometimes those words make me want to scream, because I know they will never make that leap.

The problem is, no matter how simple the answer, no matter how many opportunities they have – the majority of people who can make that statement will never be paid for independent advocacy work.

Why not?

The answer is actually very simple (it’s only four words!), and is provided below.

First, let’s examine who these folks are and what has brought them to this point.

Most nurses who want to become independent advocates (and others too – don’t want you to think I’m picking on nurses!) have spent an entire career working for an employer, in a workplace that has very specific, pre-prescribed, rarely changeable rules. Rules for everything, ranging from how to answer the phone, to exactly how to do their work, how much time they were allowed to spend doing it, and sometimes even what they were expected to wear. If someone broke a rule, it could have dire consequences for many others, including patients (who could get sicker or die) and other personnel, who would look down on the rulebreaker as if he or she was someone to be disdained. If a problem needed a solution for which there wasn’t already a rule, then a new rule was created.

If you are one of those workers, then you understand well how the rules are double-edged:

  • Rules make it easy to know what is expected, even when they make it hard to do the work the way you would want to do it.
  • The rules work for many or most of the patients who need help, but when they don’t work, the result can be devastating.
  • Working within the rules makes collection of a paycheck a regular thing, but it may leave you feeling as if you have failed some of your patients.

And so it is: a workplace with lots of rules, that discourages and inhibits independence and free-thinking, produces a regular paycheck. You never have to ask for it. Sometimes it goes up, sometimes it goes down – but it’s always pretty consistent, and you get paid.

By now you’re beginning to see the problem with getting paid for helping family and friends… Working independently represents a shift to independent advocacy with no rules. And the need to create one’s own paycheck for something that has always been done for free.

Most of the folks who tell me that’s why they want haven’t made the leap to the fact that the paycheck isn’t going to appear, because there isn’t a paycheck-granting entity that exists to support that work. To be independent advocates, doing the work the way they want to do it, means they will have to ask for that money themselves directly from the people they expect to pay them – patients (clients) or caregivers.

Yes – it’s that simple:  They can get paid when they ask for the money (there are the four words!).

But it’s that complex: most advocate wannabes have little or no ability to ask.

It IS hard to ask for money!  For a variety of reasons, including the fact that we were taught as children that it is impolite.

Even more so, asking for money makes us feel as if we are asking to be judged. In particular, many nurses have spent a lifetime in a workplace that devalued their contributions, making them feel demeaned and not worthy. Therefore, they have little or no ability to understand how valuable they are to the patients who need their independent thinking – and therefore they find it so very difficult to ask for money – because they aren’t comfortable with the judgment aspects of asking.

“If you think I’m worth it, you will pay me money.  But I’ve spent a lifetime being told I’m not worth it. Therefore I can’t ask for money because I am afraid you’ll say no, and prove the others were right.” (Or something like that – some armchair psychology here.)

Therein lies the crux of the problem.  In fear of judgment (and adhering to childhood lessons) – the very people who can help patients in the ways they desperately need help won’t ask for money, won’t get paid, and therefore cannot commit themselves to full time, independent advocacy.


Now you see why I want to scream when I hear those words!

Over the years I’ve provided many tools for getting past that hurdle of being afraid to ask for money. From “how tos”, to rationale, to figuring out value and how much to charge – all that. (You’ll find them linked below.) But what I can’t do is to rid people’s heads of those ill-conceived (even if well understood) voices in their heads that make them feel as if somehow they should not ask for money because they may not be worthy.

So I challenge you today!  Get over it!  Your skills are needed desperately by patients and caregivers!  You can save lives!  You can prevent financial ruin!  Those voices in your head are wrong if they tell you you’re not worthy!  Your advocacy is badly needed!

You ARE worth it!  and so – yes – it’s time to do the advocacy work you’ve done all your life – and it’s time to get paid for it.







  1. Marc Berlin  June 18, 2020

    Thank you for this article. It really does makes me think more about doing advocacy as a business.
    Well written.


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