The Most Expensive Business to Start

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It’s entirely possible to start a new business on a shoestring. We know this, because every publication worth the paper or website it’s published on tells us so:  Forbes, USA Today, Entrepreneur, all of them.

It requires time, grit, determination, attention to detail, great word-of-mouth – oh – and money! More about this in a minute.

The truth is – the concept of starting a business on a shoestring depends on the size of your shoes and therefore, the length and strength of their laces. It certainly doesn’t hurt if they are made of solid-gold, and you can sell them for your seed money.

If you hear a sarcastic edge in this post, it’s for good reason. It’s born of frustration, the feeling that I’m shouting into an empty cave.  I’ve just heard from one more person who has closed up her advocacy practice because she can’t afford it anymore; this on the heels of a conversation last week with one of our APHA Mentors who asked me, “Why do people think they can start an advocacy practice with no investment? Why do they think they can do it for free?”

Good questions. GREAT questions. And sadly, representative of too much reality and too much failure. And, for today, it means I’m going to try to provide this reality check one more time.

Let’s look at that shoestring for a minute. 

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

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Yes, Part II, as promised in our first installment last week when we began with the first four attributes of successful advocates.

Find Part I of the Dirty Dozen.

Which of these describe you and your abilities?  Which of them don’t?  Where do you go from here? Do your own assessment! 

 

Part II:  Abilities of Success Health/Patient Advocates and Care Managers

5. Health and patient advocates and care managers have an intimate understanding of the healthcare system. 

Important – I do not mean you must understand medicine. In fact, you really don’t need to understand medicine – as in diagnosis or treatment – to be successful. That’s why you don’t need to be a doctor or nurse or have another clinical background to build a successful advocacy practice. Successful advocacy is about understanding THE SYSTEM, not medicine.

You must understand how to work the system to get your client what she needs. That may mean you know the least expensive MRI locations, or it may mean you know how to get an appointment with Dr. Specialist.  It may mean you know how to work with insurance reps to get a claim approved, or it may mean you know how to find better pricing for Mrs. Smith’s prescription drugs. Maybe you need how to access a hospital’s chargemaster, or line up DRGs, CPTs, and RVUs.

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When Passion and Reality Collide

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Over the years, I have connected with thousands of people who intend to become independent health advocates and care managers, and 99.9% of them have one thing in common:  their choice of health advocacy as a career is a result of their passion for helping others.

They are caring individuals with skills for navigating some aspect of the healthcare system. They are empathetic, and those they will help recognize their empathy right away.They aren’t looking to make a fortune in business. Instead, their rewards will come from knowing they have helped to improve the quality of other people’s lives.

They probably don’t even realize that their passion can make a huge contribution to their success!  Research results released by Ernst and Young show that companies that operated with a clear and driving sense of purpose, beyond the goal of just making money, outperformed the S&P 500 by a factor of 10 between 1996 and 2011.

That’s the good news. That for those who establish health advocacy / care management practices, their focused passion may increase their chances of success and increased income.

But let’s dwell for a moment on that word “may.”

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Charge More! It’s Good for Everyone (Including Your Clients)!

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It’s the question I’m asked by newbies more frequently than any other:

How much can I charge?  (BTW – what they really mean is – How much can I make?)

To answer those questions in 2014, I posed these questions:

  • What is it worth to find someone who can provide quality to a life that has little or no quality because of health problems?
  • What is it worth to find someone who can save you tens of thousands of dollars, or to prevent you from going bankrupt?
  • What is it worth to find someone who can alleviate your fear and provide peace of mind?

The answers were straightforward:

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What the Presidential Election Results Mean for Patient Advocates

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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.)

Here’s how.

If you are just getting started:

If you’ve been in business for awhile:

For all professional advocates:

riper

What are you waiting for?

LEARN ABOUT APHA MEMBERSHIP | FIND MORE REASONS PATIENTS NEED ADVOCATES

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Carly Simon, Ketchup and an Advocate’s Secret Sauce

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Many readers of this blog (members of The Alliance of Professional Health Advocates) know we’ve been burning the candle at both ends trying to complete the build of the new APHA membership website.  Short of raising my two daughters, I think it’s the biggest project I’ve ever undertaken – just enormous – hundreds of resources and thousands of pages – and I’m happy that it is now complete! (Or at least as close as it will ever be – these things are never truly complete.)

Along the way, I’ve learned a few lessons about how to approach the work that can help you, too. And here is the bottom line to those lessons:

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Of Heroes, Trust, Discord, Arrogance, and Karma – Part II

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Last week I shared with you two stories of my physician heroes, why they are my heroes, their relationship to my work in patient empowerment and patient advocacy, and why you, too, should emulate their actions; their professionalism, their behavior, and the actions they each took to buck a dysfunctional system.

It’s all good, and true to karma, what went around came around – today good comes back to them. They both have stellar reputations within the community and among other physicians worldwide. Well-respected. Well-deserved reputations.

Which takes us to today, and the karma that has come around to one of the doctors who did not behave well.

I mentioned last week the very arrogant oncologist who led my misdiagnosis odyssey.  His arrogance was apparent in so many ways. When one of the lab reports referenced an additional missing lab report, not only had he not realized it wasn’t present, but then (after I figured out, and alerted him that it was missing), he told me he was sure it would make no difference anyway. (It did.) When I insisted on a second opinion before starting chemo, he yelled at me – I had no time to waste! I needed to start chemo immediately! (I didn’t.)  When I asked if there wasn’t some other form of treatment that might be effective, he admonished me for second-guessing him – how dare I! That I needed to stop looking on the internet for cures! (OK – he might have been right about that one, but I sure as heck didn’t believe that at the time, and it’s a d*mn good thing I kept looking!)

Once it was proven that he was wrong (as in – I didn’t die !), rather than simply own up to his mistakes or apologize, he instead wrote a three-page letter to me explaining how he had taken all the right steps in my case. Excuses and more excuses. Never mind that (had I not sought a second opinion) I would have gone through chemo for no reason. Never mind that, once I survived chemo, I would have suffered side effects for the rest of my life. And certainly never mind that on the other side of chemo, this very arrogant and condescending doctor would have been considered a hero for curing me of an incurable form of lymphoma. A paper would have been written about it, and future patients who really did have SPTCL would have received the chemo I received – and they would have died because it wasn’t really the right protocol.

(And – don’t forget – he would have made a LOT of money from treating me with chemo I didn’t need.)

Just a few years later, karma came back to bite him in the backside. Continue Reading →

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Preventing Our Own Brexit, Saving Our Clients and Advocacy Practices

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The whole world was fascinated last month by Brexit: the vote in Britain to leave the European Union. Would they leave? Wouldn’t they?

But to me, the most fascinating part was what happened the next day. Once the vote had taken place and the (bare) majority had voted to leave the EU, those who had voted to leave began to learn the real truth of what they had chosen, and realized they had been duped.

Yes, duped. Because the leaders on the “leave” side immediately disclaimed the promises they made. Ooops! they said!  No, we can’t really apply the billions of dollars we send each year to the EU to healthcare. We didn’t really mean that!  We lied to you because we wanted you to vote our way!

How could those politicians make all those promises they never intended to keep?  How did the majority of a citizenry fall for it? Why, now, do many of those citizens who voted to leave the EU wish they could take back their votes, because they have changed their minds?

Brits can blame themselves – period – for not being smarter about reality. They voted for something that wasn’t true or possible because they believed and shared what they heard and read, never vetting possibilities or veracity.  They Facebook-liked, and shared, and re-tweeted, and Instagramed, and discussed in pubs, all that misinformation, disinformation, political venom, disdain and hostility – never fact-checking, never discerning the truth.

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They simply passed on messages that supported their own wishes or philosophies – even when they were lies.

… Exactly like we Americans are doing today with our presidential election and its issues.

It had quite the ripple effect. Because they shared all those lies and vitriol, the world became a more dangerous and unstable place. (Just what happened to your 401K the week after Brexit?  My point is made.)

So what does this have to do with health and patient advocates?

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