Part IV: The Dirty Dozen Skills, Abilities, and Attributes of Successful Health and Patient Advocates and Care Managers

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And, finally, the fourth and last in our series of skills, abilities and attributes that all successful advocates and care managers must.

We’re wrapping up with 3 additional concepts that are important to the success all private advocacy and care management practices.  Yes – I know the total will be 16 (and we promised only a dirty dozen!) – see Part I about my inability to count 🙂 )

Which of these describe you and your abilities?  Which of them do not?  Where do you go from here?

Do your own assessment! 

 

14.  Never forget  your Allegiance. Allegiance is the foundation of a private, independent advocate’s or care manager’s work; that is – because the patient or caregiver (or someone else whose sole allegiance is to the patient) hires you, your entire focus is on what’s best for him or her.

That is the one major distinction between private, independent professionals and those who work for an organization that profits from the healthcare system. Hospital advocates, insurance advocates – their allegiance is to the companies and systems they work for. While their hearts may be in the right place, and patients may THINK they are being helped, these system-paid advocates are too often, even frustrating to them, unable to offer the best help.

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Like Putting Ponze in Charge of My Retirement Savings – a Rant

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I live and work in Florida now. For the first time in my adult life, I live in a state where there’s a real possibility that my vote in the upcoming presidential election will make a difference. As a result, when I sit down to watch TV in the evening, I see a constant barrage of the most objectionable commercials. This candidate bashing that candidate. “Facts” that aren’t facts. Claims that have been disproved over and over again. Detestable.

You may be surprised to know that THOSE commercials aren’t the ones that upset me the most!  In fact, I no longer even hear or see them. I sort of gloss-over, or just get up and do something else.

<Beginning of Rant>

I’ve noticed, however, that during the past week, a new sort of horror has crept into TV commercial-dom.  That is – health insurance plan commercials, heralding the arrival of open enrollment, and featuring all new ways to dupe the public!  THOSE commercials are the ones that upset me even more.

Why?  Because they feature smiling faces, they make claims that they have “thousands of doctors” in their network (they all do, or they wouldn’t be in business), or that people with their insurance can get free preventive care (we all can – it was mandated by passage of the ACA/Obamacare), or that their plans are low-cost (no they aren’t – none of those plans are low-cost), etc.

But the part that really fries me – and the impetus for today’s rant – is one insurer’s claim that their customers can enjoy free consultations with the insurer’s “care managers“… As if that is some benefit to them!

Seriously?

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Breaking the Rules

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If you think about it for a minute, rule-breaking plays an enormous role in the life of a patient advocate.

Rule breaking – is one reason (even if it’s not the only reasons) we exist – a problem we fight. One reason we are hired.

Rule breaking – can be a success tactic – one way to win the fight.

Rule breaking – is one of the major factors that separates private, individual professional advocates from our hospital and insurance counterparts – the distinction that often makes the difference to patient-clients’ outcomes.

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Twisted Words Put Me Off

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Within the past few weeks, I have had one phone conversation, and have exchanged an email, with two different people who are hoping to and working to become advocates, both exchanges which resulted in very negative takeaways on my part.

And then I wondered – how many of the rest of us do this same thing, even if we never intend to come across the way we do? And if we do it, no matter how unintentionally, does it give patient advocacy a bad name, or a black eye?

Those twisted words are actually a response, or the intent of a response most of us run into every day. All that is required to fix it is a slight difference in response which results in a huge difference in the impression it makes.

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Enemies? No, But With an Important Distinction

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fistpumpA recent email exchange with an APHA member highlighted a point we don’t make often enough, and one you need to embrace so you can discuss it with potential clients. The problem is – she used it to leap to an errant conclusion, one that demands clarity.

In her email, she mentioned that she was considering joining a different professional organization, one that focuses on hospital advocacy, teaching hospital advocates how to do their jobs.  She stated that the other organization

“has multiple affiliations with those purported enemies of true patient advocacy, patient relations departments.”

What? I was so taken aback! Enemies? How on earth would anyone construe that hospital patient relations personnel are enemies of private patient advocates?

Let me be clear.  THEY ARE NOT.  Not even close. Those words should never be in the same sentence.

But somehow she had drawn that conclusion, causing me to examine why she had done so.  And while I can’t explain the leap she took, I did identify the genesis of her idea, confirmed by subsequent email exchanges, as follows:

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Health Advocacy Ethics – Conflict of Interest? Or Important Service?

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elderlywomanA recent conversation with a handful of knowledgeable people, people I respect a great deal, yielded two different outcomes – either a loud “yes, of course!!” or a loud “no, no way!” So I want to know what YOU think. As a prelude to the story – the question I will ask you at the end is:

Should Gwen become Mrs. Smith’s healthcare proxy? Can she ETHICALLY make that shift? (We are not asking a legal question here – only a question of ethics.)

Mrs. Smith is 90 years old and until recently was quite healthy.  She is alone; her husband died many years ago, and they never had any children. She has a few nieces and nephews, but hasn’t seen or heard from any of them in years.  She lives in the country and has no neighbors nearby.  Even her close friends from church have all passed away. Gwen has been Mrs. Smith’s health advocate for several years now, accompanying Mrs. Smith to doctor’s appointments, lab tests, and whatever was needed for her care. About three years ago, Mrs. Smith was hospitalized for a brief time;  Gwen sat by her bedside and was a liaison between the hospital staff and Gwen for the duration. Over these years they have become very close. Mrs. Smith trusts and values Gwen’s opinions more than anyone else on earth and thinks of her almost as the daughter she never had. Now Mrs. Smith has asked Gwen to help her make the healthcare decisions that she will designate in her advance directives.  Included is a request to Gwen to become her proxy – that is, the person who will, if Mrs. Smith becomes incapacitated, make any decisions that regard end-of-life care on Mrs. Smith’s behalf. (“Proxy” is one term used – others could be agent, representative or power of attorney.) Continue Reading →

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The Real Cost of Selling One’s Soul

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I heard from a friend that he recently sold his start-up business after years of building it to do just that.

Wow!  I was so impressed!  “Take a break!” I replied. “I can only imagine how much work that was and how much money you must have made!”

Yes, he told me. It was a LOT of work and he is exhausted. But, he confided, he really didn’t make much money in the sale.

What?? I was flabbergasted… Then I learned why. It seems that he and his partners, in order to raise the money they needed to make their business so enticing and salable, had given away most of the company to investors – first angels, then later venture capitalists – so that by the time they sold it and all those investors took their chunks of the profit, there was little left for the original idea guys who had started the venture. (ouch!)

It got me to thinking.

Over the years, I have been approached by businesses that want to “support” my work. The first time it was a pharmaceutical company that wanted to pay me to speak to patients diagnosed with the diseases their drugs treated, teaching those patients about empowerment principles, and (oh, by the way) about the great work their company was doing. The offer came very early in my patient empowerment career and I was really hurting for income. I was so hurting that I didn’t know if I could keep doing the work I wanted so badly to do! Their offer was extremely tempting. I gave it some serious thought…

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Asking WTWTTCH Helps to Overcome the Paralysis of Analysis

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Geschockte Seniorin hält ihre Hände in ablehnender Haltung vor sichHaving just returned from the APHA Business and Marketing workshops in Tampa, and in reviewing my notes and questions from attendees, I’ve come to a new conclusion about why many people have so much trouble pulling the trigger to actually SAY they are in practice – the formal hanging of their shingle, as it were….

Regular readers know I call this the “paralysis of analysis” – that inability to take the last steps.  I’ve written about it here, and I’ve made recommendations here, and in both those cases, I’ve made a pretty thorough case for why advocates should not be so afraid to take those last steps.

My new thinking actually shifts the direction a bit…  whittles it down to a singular fear that I think represents the great majority of paralysis of analysis…. that is, that….

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