The Advice That May Tick You Off

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In 2012, I blogged about this very topic. One ticked-off reader then attacked me on Twitter. A day later, both she and another member of The Alliance of Professional Health Advocates left the organization, both citing the post.

Ouch.

But it was good advice then, and it’s still good advice today. So at the risk of provoking additional readers, I’m going to wade into those waters again. Since most of us are self-employed, in the process of either starting or growing a professional practice, you’ll find that this advice will serve you very well, even if it IS maddening or frustrating to you.

Why now?  Why this timing? What is it about this time that compels me to offer this advice again?

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Goldilocks, Dad and Finding Care That’s Just Right

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My dad retired in the 1980s. In addition to his pension he had also earned health insurance coverage for the rest of his life. Over time, as you can imagine, the actual value of that insurance became more and more evident; In all likelihood, it was a many-years-of-life saver, because he lived until 2012.

But then, I think his health insurance may have killed him, too.

Dad retired early at the ripe old age of 60, because when he was 59, he was diagnosed with prostate cancer. His resulting surgery did not successfully remove all the cancer cells, so Dad then dealt with that cancer for 24 more years. His cadillac health insurance, which covered everything you can imagine – and then some – and which required only a $3 co-pay for anything, served him very well for decades.

Or did it?

In fact, a review of Dad’s last two years of life indicates that having that excellent health insurance in all likelihood contributed to his death.

Here’s why:

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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.

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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.

Yikes.

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