As we kick off 2017, let’s look at the past year in review. What is the status of this profession of health and patient advocacy? How well is APHA serving the needs of patient-clients and its members?
We began 2016 with a similar reality check. The bottom line was that our profession is growing, but not nearly fast enough! The need for our services is so very much larger than the number of people to fill it. That status has not improved; in fact, the need is bigger than ever before.
In that same vein, but without including the more “ancient” history that post included, here are some stats for you to peruse this year, in hopes you’ll see the need to launch your own advocacy practice (if you haven’t already done so) – or expand its scope (if you are already in practice) – in order to be there for the vast numbers of patient-clients and caregivers who need us. Continue Reading →
When President Barack Obama ran for office in 2008, healthcare reform was already an enormous and contentious topic.
In those days, I was invited to speak to dozens of groups of patients and caregivers to help audiences sort out the issues that comprised healthcare reform so they could, on their own, decide which aspects (if any) were important to them. From the concept of “universal” healthcare through a public option, to coverage for pre-existing conditions, to portability, tort reform, free vaccinations to develop “herd immunity,” and many more, we looked at the whole of the topic as objectively as possible.
Before I started each talk, I would challenge audiences to figure out which side I was on by the time we were finished – reform? or no reform? It gave me great satisfaction that a show of hands at the end usually resulted in about a 50-50 split, demonstrating as much neutrality as I had been able to muster. It was somewhat surprising, because I was very much in favor of reform and truly not objective about the subject at all.
What I never mentioned to any of my audiences was this: that the bottom line for patient advocates was that healthcare reform was, simply, job security.
The reason: no matter what became of healthcare reform (and, of course, history tells us it became Obamacare, AKA the Patient Protection and Affordable Care Act or the ACA) – no matter what decisions became the law of the land, Americans were going to be confused by it all. They would be confused about costs, access, costs, access, access, and of course, costs, all of which could have huge detrimental effects on their health and care.
The more confused they became, the more they would need a health or patient advocate to help out.
Thus, job security.
That brings us to the 2016 presidential race, and victory for the candidate who said he will work to repeal the ACA.
No matter what your feelings about the outcome of last week’s presidential election, there are a few things advocates can take to the bank:
The healthcare system will go into further upheaval as the ACA is dismantled.
Patients and caregivers will find themselves more confused and frustrated than they have ever been.
The moneymakers in the system will seek new ways to maintain and grow their own profits, shifting and being shifty, making it even more difficult for patients to get the care they need at a cost they can afford.
The demand for private, independent advocates will grow – even more – and there won’t be enough advocates to help the patients and caregivers who need them.
Yes – all this adds up to even more job security.
We can’t anticipate exactly what changes will be made, but that doesn’t really matter. People are scared and confused now – today – because they just don’t know what to expect. They didn’t know before the election and they feel even less in control now. Even through the ACA, pricing has gone up in most states, and people feel like they are getting less and less for their money. Their confusion and frustration (and anger) is going from bad to worse.
They need help. They want help.
If you are absolutely serious about growing a successful advocacy practice, then NOW is the time to prepare. There will be no better time in history to establish your practice (if you haven’t already) and to expand it (if you’re already in business.)
If you are just getting started:
Be sure you know how to run a business so that you don’t get hung up on administrative tasks instead of helping patients.
Two years ago we asked whether a health/patient advocate can also be a decision-maker for her client in the form of being a healthcare proxy or guardian (the patient-designated person who makes end-of-life decisions for the patient, based on wishes the patient has legally documented). Since the ethics and standards of the original advocate role very specifically state that an advocate WILL NOT and CAN NOT make decisions for a client, would the new role of proxy or guardian create a conflict-of-interest?
The scenario shared was that “Gwen” had been Mrs. Smith’s advocate for a long period of time and they had developed a close relationship. Mrs. Smith, at the age of 90, wanted Gwen to be her healthcare proxy to help determine (if necessary) when it was time to allow Mrs. Smith to die, instead of conceding to the healthcare system’s attempts to keep her alive at all costs.
Could those two roles be performed by the same person? We didn’t answer the question. Instead, we used the opportunity to develop a best practice by asking for input and opinions from those in practice at the time. The question:
Twenty years ago, prior to self-employment and work in patient empowerment and advocacy, I was the marketing director for my local community college.
In so many ways I loved that job. It was different every day and allowed me to meet and get to know people I never would have known in any other way. It required me to get out into the college community to meet faculty, other administrative departments, and students. It required me to have good relations with the press, and because it was during a recession, it required me to be creative and clever to bring in new students. Community colleges attracted so many non-traditional students — those who were older, or had been laid-off, or wanted to change careers; they had such interesting backgrounds and dreams. And the biggest challenge – the advent of using the internet for marketing. Can you imagine? Attracting students by using the cool new surfing tool – the World Wide Web!
As I said… I just loved that job.
But, unfortunately, yes, there was a downside, too.
We privately paid, independent, professional patient advocates “tend to be older, white, female, more highly educated, and have other medical training or past careers in related professions.”
…. or at least that is one conclusion drawn by the surveyors — those who built, issued and analyzed the first National Health and Patient Advocate Survey.*
Both private, self-employed advocates, and employed advocates (hospitals, insurers, employers), were surveyed. Whether or not you were one of the folks who took the survey, if you have any interest in patient or health advocacy as a profession, you’ll be interested in the results. They were issued June 30 – you can download the report from here.
But that’s not the best news from the results… The best news is…