Doing What You Love Right Into a Hole

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businessmodelEach week I’m contacted by a handful of people who have just begun thinking about becoming professional patient or health advocates. Often they share long stories – many paragraphs or several minutes long… describing years of advocacy for a loved one, or a resumé full of nursing experience, as if they need to convince me that they would make a good advocate or they run the risk of not hearing back from me.

These long, heartfelt messages are about the intersection of passion for advocacy – and the wish to use that passion to make a living. Advocacy fits them. They love it!  They’ve been doing it for a long time. They have enjoyed their journey as advocates so far, have usually been frustrated in some way by a system that wants to thwart good outcomes for patients, they see how it can improve, and now they want to be advocates in this very different, independent way – and be paid for doing it.

But I worry about most of them.

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Death, Dying, Unhappiness and Misery Have Been on My Mind

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deathandmiserySeveral weeks ago I was contacted by Ramona*, a woman in her 50s who is leading what she considers to be a horrible, no-quality life. She is tied to machines for all but about 2 hours a day, she needs regular surgeries to stay alive, she can’t eat food (liquids only), there is no prospect for improvement, and she has no family… She has no hope, and she wants to die.

She has tried discussing options with her doctors, but to no avail. She wants to stop her treatment, enter hospice care and receive palliative care instead. That should be her right!  But because they CAN keep her alive (and, of course, can keep taking her money and her insurance – for years) her doctors will not discuss hospice with her, nor have they provided any other options.

She has also tried contacting doctors in right-to-die states, but since she does not live in those states, they will not talk to her.

So she reached out to me, asking me if I could help her figure out what to do. After all, is determining our own death, perhaps, the ultimate in patient empowerment?  Whether it is or isn’t, there are so very many details and questions to be concerned with ranging from possible mental health issues, to the law, to one’s religious beliefs, to actually making it happen if that’s the ultimate choice.

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All Dressed Up With Big Places to Go

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highwatersWhen I was a first grade teacher (which, I dare say, might have been before some of you were born), I got a huge kick out of one observation I made in early January every year.

My observation was that my students returned after the holiday break – and once again – their pants were long enough to cover their ankles.

Now – OK – for those of you who are too tired to interpret that – it meant that before the holidays, they had grown so much since the beginning of the school year that their britches were too short. We called their before-the-holiday pants “high waters”! I’ve heard they are also called “flood pants” – you get the picture. The fact that they had been given new clothes as holiday gifts meant that, indeed, they had grown.

(And here’s a blast from the past…  they were wearing those high waters over their underoos. 🙂 )

So what does that have to do with patient advocacy?

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Confessions of a Failure

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Think of the business people you know to be highly successful. They may represent different kinds of businesses, even non-profits. They probably represent different sizes of businesses – from a one person solopreneurship to multi-national conglomerates. They likely do entirely different things from manufacturing and selling products to offering personal services – and everything in between.

What is the first thing most of them have in common?

Most of them, at one time or another, have failed. Some of their failures are highly visible – and legend (think Donald Trump running for political office.)  Some of their failures are never to be spoken of (meaning we have no idea what they are.) In some cases they lost millions of dollars or years of time.

What is the second thing those who failed have in common?

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Why Being Too Helpful Will Destroy Your Advocacy Practice

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cowAs the director of an organization for private, independent patient advocates, this time of year is full of big excitement – and big disappointments, too.

Today is January 12, and I’m excited to tell you that 32 new private advocate wannabes have joined Alliance of Professional Health Advocates just since the first of the year. For each one who eventually goes into business as an advocate, we can anticipate that they will help perhaps 100 client-patients in the next 5 years – potentially 3200 people (plus their families) who will enjoy better medical outcomes, or save plenty of money because they were helped. Remarkable! Especially exciting when you realize that so many people now have the opportunity to succeed at a new career, and so many MORE people will see better outcomes.

( I should mention, however, that the number of advocates needed is ten thousand times that – at least!)

But on the flip side, there’s disappointment, too. The new year always brings some soul searching, and soul searching often produces a handful of folks who decide that they just can’t cut it as private, independent advocates. Their hearts and advocacy abilities are willing and capable, but they just can’t get enough business to keep them in practice. So, sadly, they decide to throw in the towel. They take a job somewhere else or some just retire. Some decide to start a different kind of business for which (I predict) they are also doomed to fail. You’ll understand why in a moment.

Let me emphasize – for these folks, leaving private advocacy is not about being an advocate or love-lost for the profession. They may be no more or less capable of being outstanding advocates than when they got started early in their career exploration.

What they haven’t learned, though, or at least they haven’t embraced, is the fact that being a successful, independent, private patient or health advocate or navigator is less about being a good advocate, and more about being a successful business owner and marketer. No matter what type of business they decide to start, they won’t be successful if they don’t become smart business owners.

In many cases, advocates fail as business owners because they are just too helpful. TOO helpful!  It’s our nature, and it’s often what gets us in trouble. In particular for those new advocates who come from nursing backgrounds or anything bureaucratic in nature, learning that time = money is a tough lesson. It can stand in the way of our abilities to succeed.

Are you too helpful?  Here are three ways that being too helpful will put you out of business:

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