Years ago, in my salad days, I took a new marketing job after being interviewed by a gentleman who seemed as nice as anyone I had ever met in a workplace. It didn’t take me long to learn my new boss’s friendly smile, and the words that came out of his mouth, only masked a hidden agenda that he hoped naive-me would help him fulfill.
The first clue that things were not as they seemed came when I was asked to sign off on some media invoices, in effect, giving Accounts Payable my approval to pay the agency that had submitted them. Even though media invoices didn’t fall within my purview, I reviewed them with the intent of signing them… after all, my boss had asked me to sign them. I just needed to know what I was signing. It didn’t take me long to realize the numbers didn’t add up. A couple of phone calls, and a little due diligence uncovered the distinct probability that the agency that submitted the media invoices was paying my boss under the table. Of course, if HE signed those approvals, there would be evidence against him – that’s why he had told ME to sign them.
I was so upset at the revelation that it made me sick – literally sick to my stomach. After a lot of fretting and soul searching, I took the invoices back to my boss, and made some feeble excuse about why I could not sign them. He grabbed them out of my hand, very upset with me. “I didn’t tell you to review them! I only told you to sign them!” he exclaimed. It wasn’t the only time he wasn’t happy with me, but wouldn’t or couldn’t provide a plausible explanation.
It was the first time in my life that I realized that someone else was trying to “use” me for his own hidden agenda. I’m sure there had been times someone had used me before – but naive-me wasn’t aware of it then. Over the next few years this scenario was repeated a handful of times – never anything I could prove, but always just disturbing enough.
Eventually I changed jobs, then later started my own business knowing that my own agenda is the only one I ever care to dance to.
I was reminded of that experience recently when I was contacted by a patient who knows of my work through About.com (now called VeryWell.com), but didn’t realize I also work with APHA. She sent me a half dozen emails in one day. She left three messages on my toll free phone number (which, by the way, is reserved for advocates and media and expressly states that patients should not leave messages because I will not help them by phone. She was clearly desperate for help.)
I returned her email, sent her a few links appropriate to the questions she had asked, and suggested she connect with a patient advocate through the AdvoConnection Directory.
She not only replied to my email, but phoned me twice more. She told me “there’s nothing in those links that helps me! I need YOU to talk to me! Someone with YOUR STATUS is the only way I can get what I need!”
I replied once again by email, suggesting again that she needed an advocate to help her sort out the issues, in order to get the help she needs.
Her reply was, “I tried talking to a patient advocate, but,” (and these are the telltale words….) “She wouldn’t do what I told her to do!”
Bingo. A hidden agenda.
The woman wasn’t really seeking the help she purported to be seeking. She was looking for someone to do “what I told her to do.” There’s a huge difference.
Our work as advocates doesn’t mean we do what we are told to do. Our work as advocates is guiding our clients toward what they need, whether or not they realize it before we begin. Our work as advocates isn’t about being a patsy. Our work as advocates is about steering the client’s ship toward smoother waters.
Not recognizing a client’s hidden agenda can create a challenge, but even worse, can become dangerous for us advocates. We need to attempt to uncover any expectations a client has, whether or not they realize they have them or not.
Not all hidden agendas are bad; sometimes they are just innocent wishes or unrealistic expectations. For example, a wish for an impossible outcome – a client knowing she has been accurately diagnosed with a terminal disease but expecting that, since she has hired an advocate, the disease will go away. That’s less a hidden agenda, and more wishful thinking or an unrealistic expectation. That’s not what we’re focusing on here.
Other hidden agendas are more difficult to deal with, like the agenda of the woman who contacted me (in the story above.) It turns out she had asked the advocate who wouldn’t do what she asked to pretend she was a lawyer and write a letter to a doctor stating that she was going to sue him, even though the client had no intent to file a lawsuit. She wanted the advocate to execute her sham.
Still others may be illegal, or at least border on it. Those that involve money schemes are the best examples. Hiding assets in order to qualify for certain medical care subsidies is illegal, of course. But think of the consequences if you are the advocate who fills out and signs the forms that don’t disclose those assets – even if you didn’t realize they existed.
Here are some do’s and don’ts for assessing potential clients’ needs in order to uncover possible hidden agendas (or even impossible expectations.) The key is to uncover manipulative behavior and words.
- Trust your gut. If details seem a bit off base or part of a story surprises you, then delve further.
- Watch body language (if possible) or listen to tone of voice. If the caller seems particularly anxious, or pushy, try to determine whether its an attempt to be manipulative, or whether s/he is worried about a health issue. Using hedge words, or suggesting a key decision can be dealt with later might also be clues.
- Figure out what isn’t being said. Are they asking for one thing, because they believe that logically what they hope for will follow? For example, are they asking you to get copies of their medical records because they think they will be able to make changes to them later? Their real intent may be to try to amend their records with information that isn’t true or to remove something they don’t want discovered by insurance or a spouse. Try to get to the root of their questions by asking, “What are you ultimately hoping to accomplish?”
- Flattery might be a clue. If someone tells you, “My friend Adrienne told me you saved her life!” – that’s one thing. But if you are told, “You are so smart and clever, I just know you can do this!” that might be a clue that they are simply flattering you to get you to do something you might choose not to do.
- A very practical approach is to ask, “If you could have your perfect outcome tomorrow, what would it be?” The answer will clue you in to whether or not it’s a possible outcome. Assessing the steps required to get there will uncover any unrealistic expectations, or more to the point, a possible hidden agenda.
Dealing with hidden agendas can be time-consuming, frustrating and cannot be good for your business unless you identify them, then dispose of them quickly, whether or not you eventually work with the client. That said, the life lesson I’ve learned is to avoid manipulative people as much as possible. I just don’t need that kind of grief.
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Excellent post, Trisha. I only have one thing to add — you’d said, “she asked to pretend she was a lawyer and write a letter to a doctor stating that she was going to sue him, even though the client had no intent to file a lawsuit. She wanted the advocate to execute her sham.
Still other [requests] may be illegal, or at least border on it.”
The situation you’re describing isn’t just borderline illegal, it’s FULLY illegal, at least when I was the recipient of a similar sham. About 10 years ago, a man in England who owed me several hundred dollars for a shipment of my books, decided to turn it around and try to sue ME (long story). He got letterhead and envelopes from a local legal firm and carefully altered the names of the founding partners and other employees, and then posed as one of the partners. He said his “client” was suing me for breach of contract, unless I agreed to pay $3000 up front to settle.
I ignored the letter from the “partner” and contacted the real legal firm instead, to see if the letter had come from them. Nope. The guy in England was arrested a couple of weeks later for impersonating a magistrate.
So besides the obvious ethical violation of writing a sham legal letter, it’s a legal violation too. Don’t ever get caught up in something like that!
I am a new professional advocate but have been a healthcare provider for decades. I know how to say “no.” But this is a new area for me, and am not sure how to proceed. A well-educated client, who is fairly well-informed but with no healthcare background whatsoever, is sure she knows her diagnoses (pleural), what drugs she needs, etc. She spent over an hour telling me all about it, and of the many doctors she has seen–some of whom refuse to see her in the future. She would like to have parts of her medical record revised that suggest she has “psychological” issues. Other than control issues, I don’t think her issues are necessarily psychological, but I am concerned that she has hired me so she can tell me what to do! I can help her legitimately–I already have a good idea of how to get her medical concerns addressed–but need to establish who is the healthcare practitioner and who is the patient. Can I get control of this relationship right from the start and keep it? Or should I bail out while there’s still time?
V – a few thoughts, although I’m not sure there are solutions.
First – you can’t establish that you are the healthcare practitioner because you aren’t acting in that capacity – you are the consultant and she is the client. It may seem like semantics, but changing the conversation may help her see how she has to change her view of the situation. (You might ask her, “Do you want to hire me to help you get what you need? Or just to do what you tell me to do?)
Second, she can’t revise her medical records anyway – she can only ask for an amendment, and especially in the case of mental health, they don’t have to comply: http://patients.about.com/od/yourmedicalrecords/a/howtocorrect.htm
Whether you should bail or not depends on your own gut feeling. Do you see the possibility of resolution? Or will this just frustrate you while you could be out there finding a client whose situation can genuinely improve?
Thank you for your response, Trisha. I am grateful that you so graciously share your expertise with us neophytes. I am confident that a resolution is still possible, but will be on alert for red flags going forward.
PS: Just received a copy of your marketing book. Can’t wait to start reading it!
Thanks again,
VF