Need to No – Giving Too Much

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One of my favorite things about patient advocates and navigators is that they are very generous, kind and giving people. They figure out what needs to be done, and they step up to the plate to do it.

But one of my frustrations with patient advocates is that some are too generous, too kind, too giving.  Too many have never learned where to draw limits, how to assess when they’ve taken on too much, or are in danger of taking on too much. They just don’t know how or when they “need to (say) no.”

Conversations with two APHA members remind me of this.  And it’s worth sharing with you because it may give you the kick in the backside needed to learn to say no when you know you should.  Sometime before you begin dropping all those balls you’re juggling.

One case is an advocate who I will call Molly.  (We have no members named Molly, so don’t try to figure out who I’m talking about!)  She lamented the fact that she just didn’t have enough work, and was worried about keeping her business afloat – yet – she told me how busy she was with clients. I finally figured out that all those clients were people she was helping for free.  They needed help, they could not afford to pay her, so she just began helping them anyway.

How very generous!  Remarkably generous, really.  And I applaud her for that – except – in effect, she was volunteering her way right out of business.  All her time was being spent helping those folks for free, instead of doing marketing, making phone calls, drumming up some speaking opportunities – tasks that could help bring in paying business.

Not to mention the level of stress  (and loss of sleep) when we are not only overworked, but worried that business isn’t going well.

“But,” you say. “Those people need help too!”  And I agree.  But there needs to be a point where you realize that if you spend your time working for free, and don’t stick to building your business, you will go out of business.  At that point, you can’t help anyone all.  No one. Not on a paid basis OR on a volunteer basis, because you will have to go out and get a job that will make up the difference. It’s not worth it.

The solution?

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It’s the Universe Calling: Time for Plan B

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A few months ago, I was invited to speak in June during a one-day program for members of the Pennsylvania Bar Association on the topic of recovering from a catastrophe.  Attorneys who attend will learn about the things they need to do should something devastating happen in their lives (an accident, caregiving for a loved one, a fire, whatever….)

About ten days ago, I heard from a dear dear friend that he has been diagnosed with a terminal disease. Prognosis, just a few months. I am devastated – my heart just aches for him, his family, and yes, for myself, too.  And I wonder…. he is a small business owner…. what will become of his business and his clients?

Then this weekend, I was approached to review a new book, written by a doctor who, as a result of a devastating car accident in 2005, became a patient himself and dissected all that was wrong with his care.  Included in his story is the fact that he has given up his thriving practice of gastroenterology, a practice which had to take a back seat as he recovered from his injuries.

Which is when (yes, I’m slow….) I realized that the universe was telling me something.  Or at least posing this question:  As advocates, as people who others rely on, how prepared are WE for devastation in our lives and, importantly, how that will affect THEM?

How many of us have a Plan B?

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Why Do You Choose to Be a Patient Advocate or Navigator?

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During the past few years of connecting with patient advocates and navigators, I’ve asked dozens (maybe hundreds) of people why they chose patient advocacy work.

Each person has one, individual, personal answer to that question, but there are an astounding number of similiaries.  Among them:

  • They believe they were cut out to help patients in need.
  • They have had some sort of experience that tells them that whatever they’ve been doing to that point is no longer enough.
  • Working with patients, helping them navigate and find improved outcomes from the healthcare system, feels like a higher calling.
  • They don’t like what they were doing before, whether that meant they worked in hospitals, as school teachers, librarians or for insurers or other payers who forced them to make choices they were not comfortable with.

Among those who have worked in healthcare previously, perhaps as nurses or physicians, perhaps as some other health-related job, they all give an additional reason.  This is the one almost-universal answer I’m given:

  • When they chose nursing (or whatever their previous healthcare job was), they learned to be an advocate for patients.  The evolution to the current healthcare system has taken away that opportunity. Therefore they hope that being an  advocate or navigator will allow them to refocus on what’s important to them – the missing advocacy piece.

Just as striking are the reasons for the shift to advocacy that are missing.  No one ever tells me:

  • They want to earn a lot of money.
  • They are choosing work that is safe and secure.
  • They want to be advocates because they want to take a lot of time off.

I find this so interesting.  I can’t think of any other career that gives people such satisfaction, while at the same time, offering so little perceived security (or time off!)

I say “perceived” – because when done right, owning a business can be very secure. If you have chosen to start a private patient advocacy business, once you can get the ball rolling, it can be very secure.  If you are the owner of the business, including a solo practitioner, no one else can fire you or lay you off!

No big points to today’s post – just a few observations …. and a question for you: Why did YOU choose to become  a patient or health advocate or navigator?  Do you concur with the reasons outline above?  Do you disagree?  I invite you to share your thoughts.

•  Learn more about what it takes to become a patient advocate.

•  Learn more about starting a patient advocacy business.

• • • • • • LEARN MORE • • • • • •
| FOR PATIENTS | FOR ADVOCATES |
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Patient Advocacy and the Allegiance Factor

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As we prepare for Private Professional Patient Advocates Week next week, I’ve been asked by a handful of people what the difference is between a private patient advocate and any other health advocate.

It’s an important question, and the answer is actually quite simple.

The difference between a private patient advocate or navigator, and those found in hospitals, through insurance companies, or other places, is what I call The Advocate’s Allegiance Factor.  It’s based on who is producing the paycheck.

Private patient advocates are paid directly by the patient or the patient’s caregiver and have only one allegiance – to the patient.  The patient’s needs, whether they be medical, navigational, financial or locational – are the prime concern of the patient advocate. Period.

However…

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Who Deserves a Patient Advocate’s Help?

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I’ve wrestled with this question more than once.  It’s the question raised on occasion by those who talk about universal healthcare, and a for-profit healthcare system.  It’s a question asked by those who are concerned that not everyone in the United States has access to healthcare.  It’s asked by almost anyone who asks me what I do for a living.

The question is, “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”

Lots of soul searching, and more than a few conversations have produced the definitive answer to that question.  The answer is:

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