When Passion and Reality Collide

Over the years, I have connected with thousands of people who intend to become independent health advocates and care managers, and 99.9% of them have one thing in common: their choice of health advocacy as a career is a result of their passion for helping others.

They are caring individuals with skills for navigating some aspect of the healthcare system. They are empathetic, and those they will help recognize their empathy right away.They aren’t looking to make a fortune in business. Instead, much of their reward will come from knowing they have helped improve the quality of other people’s lives.

They probably don’t even realize that their passion can make a huge contribution to their success! Research results released by Ernst and Young show that companies that operated with a clear and driving sense of purpose, beyond the goal of just making money, outperformed the S&P 500 by a factor of 10 between 1996 and 2011.

That’s the good news. That for those who establish health advocacy / care management practices, their focused passion may increase their chances of success and increased income.

But let’s dwell for a moment on that word “may.”

For some, but not all, their passion will become the foundation to their success as private advocates. Unfortunately, the “but not all” represents the great majority of these wonderfully passionate and empathetic people. Further, and sadly, the “but not all” people will end up feeling burned, possibly bitter, frustrated and may even cause them to go broke.

That’s the point where passion – and reality – have collided. And no one – NO ONE – who has so much goodness in his or her heart should ever end up burned, bitter, or broke.

It’s just not right or fair. But I see it over and over again.

Wouldn’t It Be Nice?

Remember when you were a teenager in puppy love? Oh! You couldn’t stand to be away from the new person in your life! You knew you would love each other forever – and it was the rest of the world that was getting in the way of that love! They thought you were too young, but you knew better! If only you could run away together…

The passion was there, yes. The reality wasn’t. You couldn’t run off together because that would cost money and family upset, or because you didn’t have a car or a credit card, or…. Eventually you split up and moved on. (And decades later checked each other out on Facebook 🙂 )*

The collision of passion and reality (and hormones) of puppy love is parallel to solely using passion as the foundation of your business, while ignoring the role that money and income must also play to support your success.

Without balancing passion and money, your practice will fail.

How does that happen?

It often begins when advocate wanna-bes identify a target audience who needs them:

I live in a rural area where people don’t have the means to get the what they need from their doctors.


I want to help inner city mothers who don’t understand the role of nutrition in pregnancy.


I want to help mental health patients who are getting the short shrift from the system.

And this email I received just last week:

I love my work with the uninsured and under-insured…. And frankly, I resent helping the wealthy avoid their co-pays.

These people have have identified holes in the system, the target audiences who need those holes filled, and as importantly, they have identified the fact that they have the skills and ambition to fill those holes. They know where the need is; voids they are willing to fill.

Ignoring Reality

Unfortunately, that’s where their reasoning begins to fall apart. That’s the moment their passion collides with the reality that the target audiences they have identified probably have no money to pay them.

But they go forward anyway, ignoring the lack-of-money reality. These are the ostrich-playing advocates. They think that if they stick their heads in the sand, they will be the advocates who can establish and maintain their practices based on passion alone.

They do so ignoring all the good advice about the BUSINESS end of advocacy by pretending it doesn’t apply to them. People need them even if they can’t afford to pay for services, so the advocate does the work for free. After all, the advocates’ rewards are far greater when they HELP! When people THANK them! When a client gets what he needs or wants!

It’s OK, right?

No. It’s not OK. Because when the bills come due there is no money to pay them, or the life-partner begins to question why they aren’t making money in their business, or a call comes from someone who CAN pay, but time commitments to the non-payers stand in the way, or variations on those themes.

The Lesson

Passion must be balanced with the ability and efforts to keep your business afloat. All the passion in the world won’t prevent failure unless you approach your business with a focus on deriving income.

No one is saying you need to plan to make a killing in business. What I AM saying is that if being an advocate COSTS you money instead of MAKES you money, you won’t last long. 

And – a real eye-opener: if you are forced to go out of business, think of the hundreds of people who will never get the help they need because you aren’t there to help them?

So – yes – let your passion lead! But be just as passionate about finding target audiences who can not only benefit by working with you, but can afford to pay you, too. Approach your business as just that – a business. Be capitalized. Manage your cash flow. Charge enough money. Collect from your clients at the appropriate times.

Once you have become successful, and your practice is standing on its own two feet, THEN you can supplement your paid work with unpaid, more-like-volunteer work for those who can’t afford your services. Unfortunately, if you try to do it the other way around – working without pay before establishing your practice – then YOU will become that advocate who is burned, bitter, and broke.

Don’t be the advocate who buries her ostrich head into the ground. Don’t let your passion and generosity ruin your ability to be a successful independent advocate. Let it instead be the driver to your success, complemented and supported by good financial business practices.

Because YOUR success becomes the patient-client’s success, too. And that’s the real bottom line.



*Yes – there are some teenage love matches that extend for decades and to that I say hurray! They lasted because the two people involved figured out how to deal with their reality while keeping their love alive. A good lesson for independent advocates.

2 thoughts on “When Passion and Reality Collide”

  1. Thank you Trisha. Many great points that can’t be stressed enough. Prior to setting up my practice I practically memorized your books. To this day I still reference them. Many of the tabs and highlighted areas are great memories of lessons I would soon learn with my own practice.

  2. Thank you for this great post. It hit right at home with me and has given me a better direction on how to take on my new business venture.

Leave a Comment

Your email address will not be published. Required fields are marked *

APHA Blog : The Alliance of Professional Health Advocates
Scroll to Top