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

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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:

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Alone, But Not by Yourself

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“But she is so upset with me now!”

That was the response from an advocate who wrote to me after an unpleasant encounter with a former client. Even though they had not worked together for more than a year, the client had contacted the advocate to ask for copies of her medical records.  The client knew the advocate had acquired them when they worked together, she needed them, and she didn’t want to pay for them again.

Fair request, certainly. The advocate should have been able to turn them over to the client quite easily, either electronically or on paper….

Except that once their work was finished and several months had passed by, the advocate had deleted them from her computer.  As she explained to me, she didn’t want someone hacking her computer and getting records they should not have, so once she deleted them, they would not be able to do that.

I asked the advocate, “Didn’t you back them up somewhere first?  In the cloud? or on an external hard drive not connected to your computer?” 

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8 Ways Your Advocacy Practice May Be Like The Giving Tree

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(Channeling the Plain White T’s here…)

The book is a childhood classic, Shel Silverstein’s The Giving Tree. It tells the story of a tree that gives all it has to a boy as he grows from little boyhood to adulthood. From providing shade and a place to climb, to allowing the boy to sell the apples it yields, to finally letting the boy (now a man) cut it down to build a house, and later make a boat out of it. In the end, when the tree has nothing left to give, “Boy” simply sits on the Giving Tree’s stump to rest.


Not everyone is aware of the great controversy that surrounded The Giving Tree when it was published.  Such diverse groups as those who study children’s literature, Christian groups, and psychologists still today debate the meaning of the book. Some believe it is the perfect example of how one can show love through giving. Others believe the boy became abusive to the tree because all he did was take, and never gave or shared. Still others think it is one of the saddest children’s books ever written.

I was reminded of this book recently after hearing from Natalie (not her real name), who was resigning her APHA membership. She can no longer sustain her practice, and had to close it down because, as she explained, she just can’t find clients who will pay her to advocate for them.

I asked Natalie what marketing she had tried. Her reply: “I don’t have time for that. I’m too busy helping the people who can’t afford to pay me.”

Come again? 

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Can an Advocate Do More Harm Than Good?

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Yes, sadly (although rarely) a patient advocate does more harm than good.

I was reminded of this recently when I heard from one of our Alliance members who was picking up the ball from another advocate (not an APHA member) who had totally messed up the work a client-patient needed to have done – an advocate who had actually made the client’s situation worse.

The problem-creating advocate had been working with her client through a hospitalization. As far as we know, that work went well. Her core business is medical-navigational advocates. However, later, when the client’s hospital bill arrived, the client asked the advocate to help him appeal several items the insurer had denied, then to attempt to reduce the hospital bill.

I don’t know all the details. What I do know is that the advocate in question had never filed an insurance appeal before, and had never negotiated a hospital bill before, but she attempted to do both for this client, and she failed at both.

The client, frustrated and upset, reached out to the APHA member-advocate to ask for help. What the member told me was that it was too late. Only one appeal was allowed, and the hospital billing department had dug in its heals because the first advocate had become verbally abusive.


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Don’t Let These Headlines Be About You

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It happened again this week.  And as I first suggested last Fall, Ripped from the Headlines…. a Warning for Health Advocates, Too we advocates need to pay attention. This isn’t one of those “Oh, that won’t happen to me” moments. It’s easily preventable, and only very wise to do so.

I’m referring to attacks on real estate agents, this time in St. Petersburg, Florida. Two agents showing homes just a few miles apart were attacked at gunpoint, tied up, and robbed – and traumatized.  I don’t think any of us can imagine the horror.

The perpetrator has not been caught (yet) – he’s still out there.  And I guarantee you that today there are real estate agents showing homes by themselves to individuals they have never met – because they all think it can’t happen to them. Fools.

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