Oh, It Was Nothing, Really

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blond business woman hiding her face on white backgroundAs advocates working for clients with grave medical problems, or clients who battle their insurance companies to get what they need for their care, or could lose their entire financial foundations due to overwhelming medical bills, our work results in lifesaving and quality-of-life saving outcomes every day.  That’s what we do.

And then, when someone thanks us, way too many of us deflect the compliment. “Oh, it was nothing, really.”


It’s as if we are embarrassed to have been thanked, even though we are – secretly – pleased.

This disconnect in our response to being thanked and recognized came to mind twice over the past few days. It was a topic during our marketing workshop in Seattle, and then last evening, it showed up on the news in the form of a story about teaching girls about self-esteem by teaching them to brag.

Yes – seriously! – teaching them to brag!  Imagine that!  Especially imagine that in the same world where most of us were taught strictly and purposefully NEVER to brag. “It’s not polite,” we were told. People will think less of you if you do!

Little did your parents know when when they taught you not to brag (and yes, we need to recognize that this was beaten into the psyche of girls in a much larger way than boys) – that they were setting us up to fail in business.

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Saving Your Clients from Jerks, Crooks and Malintents

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(Apologies for the lists that no longer work in this post. In early summer 2014, About.com deleted almost 1000 posts and articles I had written. The points below are still valid, but I wanted you to know why the links may not produce what you expect.)

I’m angry. And I’m appalled, too. And I think that you, as advocates, can be effective gatekeepers, guarding your client-patients from these kinds of providers.

fingerI’ve just finished blogging at About.com about two situations that have come to light recently. A third belongs here, too – from the general news.

  • The story of an orthopedic surgeon who practices right in my own backyard, replacing and resurfacing hips. He has been accused (and has lost his job, and his hospital has been sanctioned) of waiting until his patients were anesthetized, then whacking them on the buttocks and calling them derogatory names. Yes, seriously. He has now left the hospital where all that took place, but has simply taken up residence in a hospital a few blocks away – meaning – he and his obnoxiousness are still performing surgeries everyday. What a jerk!  (And – I have to wonder – how is it that he did hundreds of these surgeries and none of the other OR staff reported him? How did they sleep at night?)
  • The story of a now-patient advocate whose wife died of bone cancer several years ago.  She underwent spinal surgery and it went badly – very badly. The husband (who is now a member of APHA) tried to reach out to the surgeon after the surgery, but the surgeon refused to speak to him. So, on the suggestion of his counselor, the husband began to blog about his experience. Immediately, through her attorney, the surgeon asked him to remove the blog posts from the web, and he did. But a few years later, the surgeon sued him for defamation! I’m sorry, but any surgeon who would refuse to speak to the spouse of a patient who had suffered at her hands, and who would, years later, sue the husband for trying to get past his grief – THAT is a malintent.
  • The crooks are those doctors who are committing fraud in several ways, from conducting unneeded tests and procedures just so they can make more money, to stealing from the government (our taxes) and from your clients’ pockets.  They are the doctors who are committing Medicare fraud, or they are balance billing or upcoding, all of which are illegal. These doctors are crooks, plain and simple, stealing patients’ health and money, and because they do it on a grand scale (stealing from payers), they are stealing from us all.

So what does this have to do with patient advocates?

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RIP Ramona – With Appreciation for The Lessons She Taught Us

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Ramona – whose real name was Rosemary – has died. She did it (mostly) her way.

I first shared Ramona/Rosemary’s story with you a few months ago.  She had contacted me through my About.com work asking me to help her die. After a heinous surgical medical error many years ago, she could no longer be treated to provide (by her own definition) any quality to her life, so she wanted to put an end to her misery. Her primary care doctor, fearful he would be arrested, refused to help her.

After thinking about it long and hard, I decided that determining our own time and place to die can might be considered the ultimate in patient empowerment. So I helped Rosemary learn more about options, legalities, how to make decisions, support (especially in the form of a private advocate) and more.

Included in my efforts were posting Rosemary’s request to two of the listserves I am part of, including the APHA discussion forum. I hoped members might come forward to provide additional resources. There were many great ideas posted – all of which were forwarded to Rosemary.  And, immediately, one of our members wrote to me describing a woman she was working with who turned out (you guessed it) to be Rosemary. I was so very relieved to know that Rosemary had an advocate helping her!

Over the next few months, I touched base with Rosemary about once a week. She never committed to what her plans were, but she stopped replying in mid-March. So I wrote to the advocate* I knew had contact with her, and sure enough, Rosemary was in hospice, days away from death, with her advocate by her side. Her advocate then notified me just a few days later that Rosemary had passed – intentionally, yes – and peacefully.

Later I learned a few things from her advocate:

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Contractors, Kick Backs and Clarity – That’s Why We’re Here for Advocates

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(updated January 2017)

We’ve seen fireworks in the APHA Forum before.  And we’ve dealt with them. The beautiful thing about the Forum is that allows free conversations on every topic imaginable. But of course, as with any group of highly intelligent, motivated and capable people, we’re not always going to agree.  We experienced that again this week.

One of our very active and valued members had visited her attorney to work on her contracts. She raised the idea of working with independent contractors, and her attorney immediately advised her against it.  As she reported in the Forum, “He advised me to steer clear due to federal anti-kickback statutes. This is in part because I’m a licensed clinician (NP). But it seems anyone else who is contemplating the use of subcontractors should probably vet it with her or his attorney, especially if you plan on taking a cut.”

Here’s the GOOD and USEFUL part of her report – that she suggests others should discuss and vet the use of subcontractors with their attorneys.  Amen. So right. Great advice.

The problem with her post, however, is that it does not apply to 99.9% of APHA’s members who are working with subcontractors. There are two reasons for that, on which I elaborated in my reply in the Forum. The problem, of course, is that information that doesn’t apply might keep someone from trying a successful approach to business.  Others chimed in with their thoughts on the subject. It became somewhat contentious. And it most definitely required clarification.

Here’s what we can learn from this sort of exchange:

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Asking WTWTTCH Helps to Overcome the Paralysis of Analysis

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Geschockte Seniorin hält ihre Hände in ablehnender Haltung vor sichHaving just returned from the APHA Business and Marketing workshops in Tampa, and in reviewing my notes and questions from attendees, I’ve come to a new conclusion about why many people have so much trouble pulling the trigger to actually SAY they are in practice – the formal hanging of their shingle, as it were….

Regular readers know I call this the “paralysis of analysis” – that inability to take the last steps.  I’ve written about it here, and I’ve made recommendations here, and in both those cases, I’ve made a pretty thorough case for why advocates should not be so afraid to take those last steps.

My new thinking actually shifts the direction a bit…  whittles it down to a singular fear that I think represents the great majority of paralysis of analysis…. that is, that….

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