Alone, But Not by Yourself

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“But she is so upset with me now!”

That was the response from an advocate who wrote to me after an unpleasant encounter with a former client. Even though they had not worked together for more than a year, the client had contacted the advocate to ask for copies of her medical records.  The client knew the advocate had acquired them when they worked together, she needed them, and she didn’t want to pay for them again.

Fair request, certainly. The advocate should have been able to turn them over to the client quite easily, either electronically or on paper….

Except that once their work was finished and several months had passed by, the advocate had deleted them from her computer.  As she explained to me, she didn’t want someone hacking her computer and getting records they should not have, so once she deleted them, they would not be able to do that.

I asked the advocate, “Didn’t you back them up somewhere first?  In the cloud? or on an external hard drive not connected to your computer?” 

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8 Ways Your Advocacy Practice May Be Like The Giving Tree

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(Channeling the Plain White T’s here…)

The book is a childhood classic, Shel Silverstein’s The Giving Tree. It tells the story of a tree that gives all it has to a boy as he grows from little boyhood to adulthood. From providing shade and a place to climb, to allowing the boy to sell the apples it yields, to finally letting the boy (now a man) cut it down to build a house, and later make a boat out of it. In the end, when the tree has nothing left to give, “Boy” simply sits on the Giving Tree’s stump to rest.

givingtreecover

Not everyone is aware of the great controversy that surrounded The Giving Tree when it was published.  Such diverse groups as those who study children’s literature, Christian groups, and psychologists still today debate the meaning of the book. Some believe it is the perfect example of how one can show love through giving. Others believe the boy became abusive to the tree because all he did was take, and never gave or shared. Still others think it is one of the saddest children’s books ever written.

I was reminded of this book recently after hearing from Natalie (not her real name), who was resigning her APHA membership. She can no longer sustain her practice, and had to close it down because, as she explained, she just can’t find clients who will pay her to advocate for them.

I asked Natalie what marketing she had tried. Her reply: “I don’t have time for that. I’m too busy helping the people who can’t afford to pay me.”

Come again? 

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Can an Advocate Do More Harm Than Good?

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Yes, sadly (although rarely) a patient advocate does more harm than good.

I was reminded of this recently when I heard from one of our Alliance members who was picking up the ball from another advocate (not an APHA member) who had totally messed up the work a client-patient needed to have done – an advocate who had actually made the client’s situation worse.

The problem-creating advocate had been working with her client through a hospitalization. As far as we know, that work went well. Her core business is medical-navigational advocates. However, later, when the client’s hospital bill arrived, the client asked the advocate to help him appeal several items the insurer had denied, then to attempt to reduce the hospital bill.

I don’t know all the details. What I do know is that the advocate in question had never filed an insurance appeal before, and had never negotiated a hospital bill before, but she attempted to do both for this client, and she failed at both.

The client, frustrated and upset, reached out to the APHA member-advocate to ask for help. What the member told me was that it was too late. Only one appeal was allowed, and the hospital billing department had dug in its heals because the first advocate had become verbally abusive.

Yikes.

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Broken Hearts Remind Us to Show Sympathy and Empathy

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joey

Joey Eisch, the 12-year-old son of friends of ours, was a major goofball with an enormous smile, a contagious laugh, and a sheer love of life.The photo above gives you a sense of him. It was taken at his parents’ wedding just two months ago – a wedding my husband and I attended, where we had a few minutes to spend with Joey. Just such a happy dynamo of a boy.

Then, on Friday, July 24, Joey was killed while riding his bicycle

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A Second Opinion Isn’t Good Enough

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I’ve stewed over this for years, since 2013 when he was first arrested. But ever since Farid Fata was sentenced to 45 years in prison (ONLY 45!) for fraud, I’m like a dog with a bone. I just can’t let go.

dogbone

Last week I took at look at the Farid Fata case. He is the (former) oncologist who sentenced 553 people to their death or a lifetime of illness or financial bust by lying to them – telling them they had cancer they did not have, then treating them with chemo they didn’t need and ruining their lives. The 45 years he’ll spend in prison were not for the heinous crimes of destroying their health, instilling fear, breaking their hearts and stealing their hard-earned money. Rather he was penalized for defrauding Medicare and insurance.

Beyond the obvious disturbing and distressful aspects of this case, beyond my personal bias about misdiagnosis, and certainly beyond my real sympathy for the victims, is a big concern I have for advocates. Misdiagnosis, whether intentional or not, is happening with more frequency as doctors are spending less time with their patients. It is no stretch to see the responsibility for determination of a correct diagnosis as falling more squarely on the shoulders of advocates.

Despite the fact that we are not doctors or diagnosticians, our role in making sure clients get the right answers will become even more prominent as time goes on. For many reasons we can NOT afford to get it wrong!

Last week’s post was about the steps private advocates would have taken that would have prevented their clients from falling for these intentionally imposed misdiagnoses. Four steps. Four services advocates know to perform. Each by itself could have stopped a client-patient from being misdiagnosed.

But the bone I can’t let go of actually stems from a comment made by one of the post’s readers, Cindi, in reaction to one step – seeking a second opinion.

“Fata was many patients’ second opinion. He offered a better solution…. To assume none of his patients sought a second opinion is insulting…”

For one thing, it never occurred to me that Fata would have been the second opinion oncologist, and would have ended up treating people who had already received an opinion. It should have, but it had not.

But secondly, the more I think about it, that very fact proves that 

…a second opinion is no longer good enough.

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How Professional Patient Advocates Would Have Stopped Farid Fata

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On Friday, Dr. Farid Fata was sentenced to 45 years in prison in the state of Michigan.

If you read or watch the news reports you would think the reason behind his long sentence had something to do with the fact that he had diagnosed 500+ people with cancer they didn’t really have, told them they needed chemo, then treated them for those cancers they didn’t have. As a result many died, some will deal with the aftermaths of unneeded chemo for the rest of their lives, some are ruined financially in medical debt, and worse.

The headlines read things like,

Michigan doctor gets 45 years in prison for hurting patients

Farid Fata, Doctor Who Gave Chemo to Healthy Patients, Sentenced to 45 Years in Prison

Doc Told Hundreds of Healthy People They Had Cancer

He did do those things. Horrible, cruel, heinous crimes against those victims and society that hit way too close to home for me.  He is a despicable human being and deserves many more than 45 years in prison, in my not-so-humble opinion.

But here’s what most of us are missing:

Fata wasn’t found guilty, nor will be be imprisoned, because any of those people suffered. He isn’t paying the price for anything related to the heartbreak, fear, mental or emotional anguish he put those patients and their families through. His legal-guilt has nothing – NOTHING – to do with the physical, mental or emotional horrors of his crime.

No. Instead he is going to prison because he defrauded the government and Blue Cross-Blue Shield out of money. His crimes were money crimes. According to CNN, “He pleaded guilty to 13 counts of Medicare fraud, one count of conspiracy to pay or receive kickbacks and two counts of money laundering.” According to the Detroit News, the amounts total $34 million.

Could Fata have been stopped?  Yes, he most certainly could have.

In fact, I will go out on a limb and say that all 553 patients could have avoided what happened to them. Every one of them could have gotten the care they needed, and avoided the care they did not need … Continue Reading →

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Just Where Is that Privacy Line?

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This week we were contacted by two major TV news outlets requesting interviews with advocates – one a national broadcast outlet, the other in Chicago. As we do when we receive these requests, we immediately alerted those Premium members who are on our Opportunities & Alerts notification lists so they could respond if they fit the profiles. In both cases, the media were looking to talk to APHA members – and even more so, client-patients of our members.

These requests came on the heels of a post in the APHA Discussion Forum expressing concern over problems that could be caused by having a Facebook page. The poster was worried that if a patient asked a personal health question on the advocate’s Facebook page, it would cause a HIPAA privacy violation, and she didn’t want to run that risk.

Then came an email question from a member: how can we, as advocates, claim we value client privacy, then turn around and expose them to the media? Of course, the underlying point to the question is about exposure for our own advantage, to promote our advocacy work.

Two great questions! And inspiration for today’s blog post.

The answers aren’t difficult to understand, but there are a few moving parts, as follows:

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Leading By Example

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Long time readers of this blog know that when it comes to private advocacy, I preach the gospel of learning to run a business.  I know – it seems counter-intuitive sometimes. But it’s true; that being a successful business owner is often less about being good at the core business, products and services one offers, and more about practicing good business tenets.

So, I have spent the last week leading by example. And today, I am so very ready to get back to working with advocates instead! 

 

APHA Members may remember the announcement a few months ago:

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