The Option of Saying “NO”

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Several months ago I wrote about the tendency of big-hearted advocates to over-extend themselves with volunteer work; that when someone needs their help, but doesn’t have the means to pay them, they don’t know how to say “no.” We looked at some of the ways to get past that inability in order to keep our businesses moving forward.

Truth is, that is only one of the circumstances where “no” is the right answer.  That’s true whether it is us, as professional advocacy business owners who must choose to say no, or whether we must help our clients choose “no” if it is possibly the right answer for them.

The business “no” is not unusual and will seem very simple once you understand it.

But the client “no” is often overlooked – and you truly owe it to your clients to not only understand it, but to help them understand, and sometimes embrace it, too.

Here’s a business “no” example:

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Insurance Reimbursements? Not Exactly a Pot of Gold

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A recent post from a member advocate in our AdvoConnection Forum asked if any of our members have experience with working with self-funded insurance to offer patient advocacy services.  Wouldn’t that be a great way to establish a big client, with a pot of money that was ready to be paid to private patient advocates?

There were no replies to the question.  That doesn’t mean that no one has experience with these reimbursements. It just means that no one replied to the question.  BUT – the reasons no one replied may be a version of the following:

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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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Can a True Patient Advocate Be Paid by Someone Else?

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Several questions have come my way recently about what kinds of job opportunities might exist for patient advocates.  I refer people to an article I’ve written elsewhere, but the real answer is – to be a true advocate, you must analyze who is paying for your services, and what your responsibility will be to them.

Finding an Employer

In 2011, most of the job possibilities for patient advocates are found either with hospitals or insurance companies.  Hospitals have, for a long time, employed patient advocates, sometimes called patient representatives, who are tasked with helping patients.  And word comes from an AdvoConnection member, through our Forum, that beginning in 2014 with healthcare reform, insurance companies will be required to have patient navigators on their staffs if they want to participate in insurance exchanges. Some have already begun to hire advocates.

But here’s the problem with those jobs.

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What’s the Difference Between a Patient Advocate and a Geriatric Care or Case Manager?

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One of our APHA members asked me about these differences a day or two ago…  So I thought I would share my reply with you.

She had called on a nursing home to see if they had interest in recommending her services to the families of some of its residents.  The nursing home director replied that they had a team of geriatric case managers they worked with – and asked what services she, the patient advocate, could provide that GCMs could not.

Since she really couldn’t come up with a useful answer, she asked me if I knew the differences in service offerings….

A few thoughts:

1.  The first, obvious answer is that a patient advocate is available to assist anyone of any age – not limited to someone who is elderly, or at least over a ‘certain age,’ as a geriatric case manager would be.

2.  Part of the answer depends on who’s paying the tab for the advocate’s or care manager’s services.  If the nursing home or the county or state’s social services department is paying the tab, then the GCM is the not the patient’s advocate – she is beholden to the nursing home or the taxpayers.  On the other hand, if the GCM’s services are paid for by the family or the patient, then they, too, are performing patient advocacy services.

3.  Most Geriatric Care Managers don’t focus strictly on healthcare. Their work is usually broader, at least in the beginning, with some emphasis on finances, housing, and other aspects of life that change as we age.

4.  Our APHA member advocate might have stumbled on a good marketing idea, however… but not the way she thought.  We can guess that geriatric care managers may not have the skills or the interest in providing some services patient advocates provide every day, such as hospital bedside monitoring, or doctor appointment accompaniment.  It could be that patients’ advocates and geriatric care managers are “coopetition.”  (Read more about coopetition in The Health Advocate’s Marketing Handbook.

5.  One way patient advocates and geriatric care managers are identical:  they are both included and invited to participate as members of The Alliance of Professional Health Advocates.  As independent practitioners who serve patients, we want to be sure families find the help they need for their loved ones.

Do you know of additional differences or similarities?  Please share them with us.

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