Private Professional Patient Advocates Week
Profession of Private, Independent Patient Advocacy
Patient Advocacy is a fast
Cited as one of the
fastest growing professions of the upcoming
decade, private patient advocacy is, indeed,
growing rapidly. The healthcare system has
changed to the point where it is no longer
recognizable. As patients become more fearful they aren't getting
the care they need, or are being asked to pay
more than they can afford,
they and their caregivers are increasingly
reaching out to private, independent patient advocates to get the
help they need.
You may recognize private patient advocates
using different terms: health advocates, patient
or health navigators,
case or care managers, doulas and others; all
names that represent someone who works
one-on-one with patients as individuals.
Read more about the growing profession from
US News & World Report, and
How do advocates help
patients and caregivers?
Advocates offer a wide
range of services ranging from accompanying
patients to their doctors' appointments, to
sitting by the bedside in the hospital, to
reviewing and negotiating medical bills - and
everything in between. Here is a master
list of the
types of services advocates offer.
(Note: not all patients' advocates offer all
Some advocates focus on one particular disease
or approach to care. For example, an
advocate might work only with cancer patients.
Another advocate might focus on complementary
and alternative treatments. Still others
have nothing to do with care itself, instead
focusing on the billing and claims aspects of a patients'
The benefit to both patients and caregivers is peace of mind, and
the ability to put their efforts toward healing,
supporting their loved one who needs care,
knowing a professional is handling the important
Why do patients need
advocates? I thought doctors, nurses and
other providers offered those types of care and
Doctors, nurses and other
providers have constraints on their work and
abilities that preclude them from being devoted
to one patient's needs.
Those providers work with hundreds or thousands
of patients, dozens every day. A private advocate
focuses on that one patient at a time who needs his or her
Clinical providers are employed by a practice, a
hospital, or another providing facility. They
derive their paychecks from that organization
and therefore are beholden to that organization
first - and their patients second. (See
The Allegiance Factor) A
private advocate is beholden only to his or her
At the end of a long workday, a traditional
provider goes home, then starts again the next
day with another several dozen patients, trying
to solve their problems. A patient
advocate may be on call 24/7, and the next day,
is still helping his or her individual patient
who has ongoing needs.
Aren't there patient
advocates in hospitals and insurance companies?
How are private advocates different?
Just as providers have an allegiance to their
employer, so do hospital and insurance company
advocates. The only person who can and
will focus solely on the patient is a private,
independent patient advocate.
Who pays for the
patient advocates are usually paid directly by
the patient or his caregiver. Some employers
have begun providing patient advocacy support
to their employees, and some labor unions and
churches are providing this type of support as
well. Insurance and other
payers do not provide reimbursement to private
Not everyone can afford to hire an advocate, but
many can and do. A good metaphor is to think of
private advocates the way some families regard
private education or after-school programs.
Little Johnny or Susie may not get music or
enough sports time in school - both arguably
vitally important for their upbringing. Or maybe
they need tutoring to pass history or math. When
necessary, parents pay for that additional
support and education.
Likewise, when a patient faces difficult
debilitation or a life-compromising (or ending)
illness, a private advocate may seem very
affordable, and necessary. When a patient
or family faces financial devastation from
medical bills that are too high, then a private
billing advocate may be financially lifesaving.
When a patient is fearfully facing life and
death decisions, the cost of an advocate who can
support the patient's decision-making seems
Are jobs available for
those who might choose patient advocacy as a
website addresses private professional advocacy
- those advocates who are self-employed, or work
in small businesses, providing services to
individuals. For those who are willing to
go into business for themselves, or join forces
with someone who is building a private advocacy
business, the sky is the limit.
There are many other forms of advocacy as well,
including hospital patient advocates, advocates
who work with various disease organizations
(often as volunteers) and others. There
are plentiful jobs in those areas, but they are
not considered to be private
professional patient advocates.
How many advocates are
there across the United States?
guesstimate of the numbers of privately paid
professional advocates would be 300 or more in
the US. Hundreds may be training to become
advocates. Still hundreds more are considering
advocacy as a career.
We predict the profession will grow 200% to 300%
per year over the next decade as more and more
citizens demand their services, and as the
number of advocates rises to meet the need.
Aging baby-boomers, and the increasing needs of
individuals trying to obtain care in a confusing
healthcare system (see question about healthcare
reform, below) will fuel the profession.
As of 2014, there aren't enough advocates to
meet the demand in either the United States or
Canada. The fastest growing regions for
the profession are Boston, Washington,
DC-Virginia-Maryland, New York City-New Jersey,
most cities in Florida, Phoenix and Tucson, the
Bay Area of California and Seattle. Most areas
of the US and Canada know little or nothing
about private patient advocacy.
What kind of background,
experience or training do private advocates
choosing private advocacy as a profession come
from many different backgrounds, and have many
reasons for doing the work they do. Some
have been nurses or doctors, became frustrated
with the system that depends on cost-cutting and
reimbursements, and have decided to shift their
focuses to patients as individuals. Other
advocates have not worked previously in
healthcare; instead they found themselves
helping an adult parent, a child or a friend
navigate a medical problem, and now find they
are interested in doing the same for others.
To meet the needs of all these reasons for
choosing advocacy, and therefore the many
different kinds of training they will need, a
number of organizations and universities have
developed courses and programs for potential
patients' advocates to learn their new trade.
Find a master list of courses and programs here.
Two professional organizations exist to provide
continuing education and support to patient
NAHAC, the National Association of Health
Advocacy Consultants and
PPAI (Professional Patient Advocate
Institute) provide support for
advocacy itself (best practices, ethics).
Alliance of Professional Health Advocates provides business support
or private advocates for
legal, insurance, financial and marketing
Are patient advocates
licensed? Or certified in some way?
As of early 2014, no states license patient
advocates, nor is there a nationally-recognized
certification, accreditation or other credential
assigned to patient advocates.
Some of the educational programs offered (see
above) provide a certificate of completion for
those who finish their programs, but those are
no nationally-recognized credentials or
The Myth of Patient Advocacy Certification.
In the absence of a certification, many
advocates subscribe to the
Advocate's Code of Conduct and Professional
How are patient advocates
regarded by doctors, nurses and other providers?
||There is a
range of reaction from providers.
Those who have never worked with an advocate
before have many questions, and may be
reluctant, at first, to work with one more
person in the doctor-patient relationship,
especially one they don't know.
Those doctors and nurses who have worked with
advocates recognize what an advantage it is to
THEIR work. They spend less time having to
re-describe or reiterate their instructions to a
patient, knowing the advocate is there to
facilitate with the patient. Instead of
spending their appointment time with
explanations or long descriptions for patients,
they can rely on the advocate to do that work
Medical professionals who have worked with
patient advocates are some of the
champions of the advocacy profession.
Do you have a question about private patient
advocacy not answered here?
Please contact us.