advocate bad practices – APHA Blog : The Alliance of Professional Health Advocates

Preventing Our Own Brexit, Saving Our Clients and Advocacy Practices

The whole world was fascinated last month by Brexit: the vote in Britain to leave the European Union. Would they leave? Wouldn’t they?

But to me, the most fascinating part was what happened the next day. Once the vote had taken place and the (bare) majority had voted to leave the EU, those who had voted to leave began to learn the real truth of what they had chosen, and realized they had been duped.

Yes, duped. Because the leaders on the “leave” side immediately disclaimed the promises they made. Ooops! they said! No, we can’t really apply the billions of dollars we send each year to the EU to healthcare. We didn’t really mean that! We lied to you because we wanted you to vote our way!

How could those politicians make all those promises they never intended to keep? How did the majority of a citizenry fall for it? Why, now, do many of those citizens who voted to leave the EU wish they could take back their votes, because they have changed their minds?

Brits can blame themselves – period – for not being smarter about reality. They voted for something that wasn’t true or possible because they believed and shared what they heard and read, never vetting possibilities or veracity. They Facebook-liked, and shared, and re-tweeted, and Instagramed, and discussed in pubs, all that misinformation, disinformation, political venom, disdain and hostility – never fact-checking, never discerning the truth.

They simply passed on messages that supported their own wishes or philosophies – even when they were lies.

… Exactly like we Americans are doing today with our presidential election and its issues.

It had quite the ripple effect. Because they shared all those lies and vitriol, the world became a more dangerous and unstable place. (Just what happened to your 401K the week after Brexit? My point is made.)

So what does this have to do with health and patient advocates?

Continue Reading →

18
JUL

advocacy business, advocacy ethics, advocate bad practices, client services, common sense, decision making, media, money, patient advocacy, patients, professional standards

brexit, disinformation, misinformation

When Clients Lie

Posted by: Trisha Torrey

Years ago, I hosted a radio show where I had the opportunity to interview medical providers from many specialties about their work with patients. One of the recurring themes was that “Patients lie.”

Now – you might wonder why that would become a theme, but the answer is quite simple. It was important to discuss it during the show because smart patients need to know that their providers assume they are lying as a part of the diagnoses or treatment they provide. (Good advice for smart advocates, too.)

Here are some examples:

An anesthesiologist told me that patients are always asked how much alcohol they drink. Whatever answer the patient gives, is then (at least) doubled when it comes time for the anesthesiologist to determine how much anesthesia to administer during surgery. (An honest patient may not receive enough anesthesia based on that “doubling.”)
Endocrinologists ask their diabetes patients whether they are watching their carb intake. The patient may say “yes,” but when the provider sees an A1C value that is too high, they just assume the patient has lied instead of seeking another cause for that too-high A1C. (That’s problematic if there truly is another cause.)
Many primary doctors and nurse practitioners told me that when they ask a patient if she smokes, and she says no, they may not believe her if she has a history of smoking. (An honest, smart patient needs to be aware that untrue judgment is being made.)

So what does all that have to do with patient advocates?

Continue Reading →

9
MAY

advocacy business, advocacy ethics, advocate bad practices, advocate best practices, client services, common sense, decision making, doctors / physicians, health advocates and navigators, legal questions about health advocacy, media, patient advocacy, patients, professional standards

Mixed Messages Are Just a Lawsuit Waiting to Happen

Posted by: Trisha Torrey

A few weeks ago, I wrote Fool Me Once, Shame on You, But Fool Me Twice about the problems that can hurt patient-clients which also hurt our profession because they violate our ethical principles and best practices. Those problems range from advocates working beyond their own abilities to help clients because they may not have the experience or education to do so, to selling medical products on their websites, and others.

Today we’re looking at the promised Example #2 of this problem in hopes of a hard stop. That problem: the danger of mixed messages.

As stated in the Fool Me Once post,

I fully expect that some of you will be appalled, possibly upset with me, because you’ve not thought of these as violations or misrepresentations. Some of you innocently don’t realize these transgressions; but now, as of reading this post, you are on notice…. please look at this not as judgment, but as a time for correction.

Mixed Messages

Sometimes our words and behavior – vs – what we as private patient advocates can do ethically, even legally, are in conflict. Sometimes subtle, sometimes more blatant, it’s those mixed messages that will cause an advocate to be sued one day and, frankly, it will be his or her own fault because it is easily preventable. Further, when that advocate is sued, his or her liability insurance, which is purchased specifically to pay for legal assistance, will look at these mixed messages and refuse to provide that cost support for legal needs.

What’s that lawsuit-provoking mixed message?

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4
APR

advocacy business, advocacy certification, advocacy ethics, advocate bad practices, advocate marketing, client services, decision making, health advocates and navigators, legal questions about health advocacy, patient advocacy, professional standards

mixed messages

Fool Me Once, Shame on You, But Fool Me Twice….

Posted by: Trisha Torrey

From bold-faced lies to misrepresentation – facts that aren’t facts, withholding information, skirting the code of ethics, and shades of truth – honesty and the advocacy business have been on my mind. I’m eager to hear your opinion on the subject, too.

My thought process was actually triggered by something that has nothing to do with advocacy at all, something that seems relatively innocuous, but then, maybe not-so-innocuous at all: the purchase of a 5-lb bag of sugar to bake holiday cookies last December. Now a 5-lb bag of sugar has always been a 5-lb bag of sugar and has yielded a certain number of batches of cookies. I’ve been buying 5-lb bags of sugar all my baking life, so I grabbed the bag off the shelf at the store as I do every December, knowing that cookie baking was in my near future.

Except that this time, that 5-lb bag of sugar was (you guessed it) only 4 lbs! It didn’t cost any less, but it had 20% less sugar in the bag. Yes, it was labeled correctly, and no, I had not read it carefully enough. But that is SO FAR beside the point. Old habits die hard.

So now? I will never trust that store again when it comes to purchasing sugar – or anything else that I have trusted to be of a certain size. Sugar isn’t the only problem. Many other kinds of foods, including cereal, frozen vegetables, orange juice, pre-packaged produce and meats. A pound is still a pound, but a package that has always been a certain size is rarely that size anymore. Fool us all! That cummupence got me to thinking about other places in life where things are not what they seem to be. For example – the healthcare system. For people of a certain age or older, the healthcare system was always accessible and available, provided what we needed when we needed it, through kindly and knowledgeable providers, and at an affordable price (or no cost at all.)

But now, in 2016, that healthcare system no longer exists – not in the US anyway. Period. No patient accessing the American healthcare system can trust any portion of it anymore. We expect 5 lbs of sweet care, and we’re not getting it…

We’ve been fooled once, twice – and now it seems – will continue to be fooled forever…

… which is why people need patient advocates. So, in a way, that “Fool Me Once” led to a new profession in which we are all keenly interested. While we love the work we do, it is sad, in a way, to think about why we are called upon to do it. People can’t trust the system, so they hire us to reclaim the honesty.

My thought process then turned to patient advocates ourselves, and the foundation upon which we are building our profession. Recently I have had conversations with advocates that suggest to me that our foundation is being chipped away at by some practicing advocates. Among us are people who are, sometimes innocently (sometimes not-so-innocently) violating the honesty, ethical standards, and expectations our profession demands, even if we have no formal way to demand them yet.

And that’s a problem. We’re very new, and we have only one chance to make that positive, ethical, above-reproach first impression. When some advocates aren’t on board with that approach, it becomes a problem for the entire group of us – those of us who are trying to right the healthcare system wrongs described above.

I’m going to provide two examples – one this week, and one soon – and some of you will see yourselves. I fully expect that some of you will be appalled, possibly upset with me, because you’ve not thought of these as violations or misrepresentations. Some of you innocently don’t realize these transgressions; but now, as of reading this post, you are on notice – now you will.

Whether or not you’ve violated your ethics intentionally or innocently, please look at this not as judgment, but as a time for correction. Continue Reading →

7
MAR

advocacy business, advocacy certification, advocacy ethics, advocate bad practices, advocate education, common sense, decision making, legal questions about health advocacy, money, patient advocacy, patients, professional standards

conflict-of-interest

Step Aside Pollyanna! There’s No Room Here for You

Posted by: Trisha Torrey

This is a message with a little tough love for some of the folks I encounter – Pollyannas – who are choosing advocacy as career move.

Sorry Pollyanna – but there is no room for you in patient advocacy. You have a choice: you can either learn to overcome your inner Pollyanna or you can find yourself another profession. Pollyannaism can too easily get in the way of the professionalism required of good, competent advocates, and can result in deficient service to clients.

The Pollyanna Advocate

Pollyanna is a fictional character from children’s literature, who is known for always being positive – too positive. Her default is to trust blindly. She is foolishly and naïvely optimistic.

To be clear – I do believe there is plenty of room for optimism in advocacy! Clients are happier and well-served by an advocate or care manager with a friendly smile and a positive outlook on life.

But that’s not the same as the Pollyannaism of blind trust or naïveté. The negative effects of being a Pollyanna in the advocacy business range from substandard client service and outcomes, to advocates going out of business.

Here are a few real-life advocacy and care management examples:

Continue Reading →

2
NOV

advocacy business, advocacy ethics, advocate bad practices, advocate best practices, client services, common sense, decision making, media, patient advocacy, patients, professional standards