Surprising Wisdom from Chipotle Will Make Your Day

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About once every five or six weeks I splurge on Chipotle for lunch. Love it – guacamole and all (Have you tried their corn salsa? Yum.)

On my most recent visit, I did something I had never taken the time to do.  I read the take-out bag. That’s right. If you have never purchased take-out at Chipotle, you may not know that there is a great deal of what looks like plain old text on the bag. I had never paused to read it, assuming (uh-huh) that all that text was just promotional in nature – and who has time for that?

But I was so wrong! 

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Twisted Words Put Me Off

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Within the past few weeks, I have had one phone conversation, and have exchanged an email, with two different people who are hoping to and working to become advocates, both exchanges which resulted in very negative takeaways on my part.

And then I wondered – how many of the rest of us do this same thing, even if we never intend to come across the way we do? And if we do it, no matter how unintentionally, does it give patient advocacy a bad name, or a black eye?

Those twisted words are actually a response, or the intent of a response most of us run into every day. All that is required to fix it is a slight difference in response which results in a huge difference in the impression it makes.

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Misleading Headline Provides an Opportunity

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This week the Chicago Tribune featured patient advocacy as a growing trend – a marvelous exposure to private advocacy for the uninitiated (uninitiated = most of the known universe).  Several of our APHA members were mentioned in the article and for the most part, it was an excellent representation of the status of private advocacy.

Except for the headline:

tribheadline

Now, most of us are intelligent enough to know that headlines are created to suck in readers, and too often, intentionally focus on some point that doesn’t really represent the story – just draws those readers.  And so it was with this headline, too.

It’s unfortunate, because too many of us are guilty of seeing a headline and drawing conclusions, without ever really reading the story. There may be millions of Chicago Tribune readers who saw only the headline and didn’t read the story, and therefore won’t consider contacting a private patient advocate because – as per the headline – they think it will be too expensive to pay for that help. 

Sad, but true.

But that headline did one thing very well. That is, it gave us a good opportunity to explore the concept of “costly” – and turn this negative into a positive. 

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Enemies? No, But With an Important Distinction

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fistpumpA recent email exchange with an APHA member highlighted a point we don’t make often enough, and one you need to embrace so you can discuss it with potential clients. The problem is – she used it to leap to an errant conclusion, one that demands clarity.

In her email, she mentioned that she was considering joining a different professional organization, one that focuses on hospital advocacy, teaching hospital advocates how to do their jobs.  She stated that the other organization

“has multiple affiliations with those purported enemies of true patient advocacy, patient relations departments.”

What? I was so taken aback! Enemies? How on earth would anyone construe that hospital patient relations personnel are enemies of private patient advocates?

Let me be clear.  THEY ARE NOT.  Not even close. Those words should never be in the same sentence.

But somehow she had drawn that conclusion, causing me to examine why she had done so.  And while I can’t explain the leap she took, I did identify the genesis of her idea, confirmed by subsequent email exchanges, as follows:

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Do Advocates Have a Duty to Report Dangerous Patients?

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Warning! This will be one of those posts you think back to from time to time, because the answers aren’t clear or easy, and the stakes are so high.

danger

A few weeks ago we all watched the news about 150 people who lost their lives as their plane crashed into the French Alps; a tragic loss of life which we learned later was caused by the co-pilot, who had intentionally crashed the plane – suicide by one – mass murder of 149 others.  Horrible, tragic, and just so very, very sad.

It’s easy, of course, to dismiss the young pilot as crazy – depressed, suicidal, truly an example of mental health gone awry.  But if you’re like me, the next thought that pops into your head is a question, “Could it have been prevented?”

Once I learned of the pilot’s mental health issues, and the fact that his doctor had written a note to keep him from working, I wondered how exactly that had taken place. Writing a note isn’t the same as actively reporting to the authorities (whoever those authorities might be) unless a copy of the note was delivered to those authorities… (And as an aside, I wonder if the doctor stopped at handing the patient-pilot a note telling him not to fly, and didn’t report it to the right authorities, and if so, how does he sleep at night?)

But even more importantly, what are the rules or laws in the US? Is there any responsibility to report a patient who is dangerous to himself, or certainly others? Could a provider be held legally responsible if he did – or didn’t – report?  How does HIPAA affect the assignment of responsibility? If there is a duty to report such a patient, where is the line drawn? How does that reporting take place?  And how does one decide whether a patient is truly dangerous to someone else, or just him/herself – or even truly dangerous at all?

…..(sidebar)

I’ve been there. I’ve reported.

When I was a first grade teacher, many (many!) moons ago, teachers were mandated to report suspicion of child abuse among our students. One of my students, David, repeatedly came to school with black and blue marks, or a sore arm…. I would ask him how he got hurt and he had a new story every time — including the day he came to school with a black eye. When I asked him how he had gotten a black eye, he responded, “My mother said I fell down the stairs.”

And then I knew I had no choice but to report David’s situation. I was so upset to be put in that position! I was in my mid-20s at the time; still wet behind the ears. My hesitancy was a fear that when I reported it, David’s life would become even more difficult for him. Would he be taken away from his mother, perhaps thrown into foster care? If so, would that be a good thing in the long run? Or?

But none of those questions were mine to ask or answer. The law was the law. And I reported David’s injuries to state authorities.*

…..(end of sidebar)

Healthcare Professionals and the Duty to Report

So out of curiosity, I went looking for answers to my questions about providers and dangerous patients, and I learned something I had never known before, even after ten years of helping patients become smarter about navigating their care.

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