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.
One of our AdvoConnection members, Elisabeth Russell, is featured in the March issue of MORE Magazine. The story of her journey toward becoming a patient navigator is worth reading. I dare you not to choke up when you read about her daughter’s diagnosis and treatment results. A true blessing – and very well written. (Thank you MORE Magazine!)
But there were some real mistakes in the sidebar information – and they need to be pointed out. Potential patient advocates and navigators can get the wrong picture from what’s there. At this point in our growth as a career, it’s important these facts be set straight.
I’ve wrestled with this question more than once. It’s the question raised on occasion by those who talk about universal healthcare, and a for-profit healthcare system. It’s a question asked by those who are concerned that not everyone in the United States has access to healthcare. It’s asked by almost anyone who asks me what I do for a living.
The question is, “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”
Lots of soul searching, and more than a few conversations have produced the definitive answer to that question. The answer is:
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.
Sooner or later, it happens to every patient advocate or navigator who works with patients on the medical aspects of their care (as opposed to other forms of advocacy, like billing or legal advocates).
One of “our” patients – someone whose hand we have held, who we have protected from problems in the hospital, who depended on our advocacy expertise as a way to make the rough road through disease and debilitation smoother… A patient we had built a comfortable and friendly relationship with, a patient we invested ourselves and our work in…
That patient dies.
And we feel like we have failed.
It’s the nature of advocacy work that patients don’t come looking for us until they have been diagnosed with something that will, perhaps, eventually end their lives. That’s why they seek our help. They are fearful, they don’t understand the overwhelming amount of information they are expected to immediately comprehend. They have decisions to make and feel incapable of making them. They, or the caregiver who better understands their predicament, searches for, and finds, that one person who can help smooth the road… the advocate.
And it’s our nature, as advocates, to want to rescue our patients from their fears and frustrations, and to save them from all that grief. But as one of my wise patient advocates friend reminded me,