What Health Advocacy Is, What It Isn’t, and Why Most of It Can’t Be Taught

One of the websites offered by APHA is a listing of all advocacy educational programs (that we know about). There are programs offered by colleges and universities, private programs, organizational programs, mentors, and more. Some require in-person attendance, some are offered online. Their quality varies, and their results vary….

Often I hear from someone who tells me they have looked over the available programs, but can’t find what they need. What they are looking for doesn’t seem to exist. Or, here is what they want to learn, and will I tell them whether such-and-such a program will teach them that?

Typically what they want to know boils down to this: Which program will give them the formula for success? Which one will provide the protocols, and the processes, and the check-off list of things to do? Which one is the magic, silver bullet that will shift them from employment today, to successful self-employment as an advocate tomorrow?

To which I answer: ALL of them. And NONE of them.

Here is the problem: for most of those who ask, they really don’t get what independent advocacy is. They have this idea in their heads that it’s that magical world where they will get to be the advocates they want to be – because they are. “I’ve been an advocate all my life; now I just want to get paid for it,” they tell me. “My hospital won’t let me tell patients what they really need to know, so if I do this on my own, I can change that.” Or other variations on those themes.

Here’s the point I think they are missing: There is no formula for success. There’s no formula for 80% of the work advocates do. Unlike nursing or medical school, or social work education, or other career-focused professional coursework where tried and true processes and procedures are studied, then practiced, then applied in workplaces, advocacy is about creativity, or assertiveness, or alternatives to those processes .

The entire essence of independent advocacy is that we break ‘the rules.’

Or, as I phrased it to one emailer this week:

The strength of independent advocacy is that it’s not beholden to what is; rather, it’s a service that fulfills the promise of what is supposed to be – with experts (advocates) who know how to uncover it and implement it for their clients.

How does that apply to educational coursework and programs?

*Learning to be a successful independent advocate seems to follow the 80/20 rule where 20% of the work is formulaic – there are business-related tasks that will look just like they look for every other business – contracts, record-keeping, marketing, and more. They are vital to the success of your practice, and in the early years, they will comprise more like 50-60% of your work, but in the totality of a practice that lasts five years or more, they take a back seat. Those concepts and processes CAN be taught and learned and will definitely contribute to an independent advocate’s success.*

But the other 80% CANNOT be learned the same way. For the 80%, there is nothing tried and true. They are all about those attributes named above: creativity, assertiveness, and alternatives. Further, they vary from day-to-day, client-to-client, locality-to-locality, even service to service. They are about developing chutzpah, and resources, and instincts. They are about identifying when your client isn’t being given correct information, or necessary information. They are about your radar and bullsh*t meter. They are about your lists of good resource people (most importantly, other advocates with complimentary skills), community options, dangerous hospitals, and bad oncologists.

They cannot be taught. There are no formulas. They must be developed by you, the advocate.

However – what can be taught is when and how to implement these things. So, for example, a course that teaches you how the healthcare system really works (how to follow the money to get what your client needs) – THAT is worthwhile! Basic medical terminology can be useful, or uncovering decent health insurance options, understanding the medical and legal requirements for advance directives, or courses in ethics – THOSE set the stage for your ability to develop the skills to be a successful independent advocate.

Do you see the difference?

The essence of successful advocacy cannot be taught, nor can it be learned. For most of what successful advocacy is, you’ve either got it – or you don’t. If you’re a people person, a good listener, a creative problem solver, trustworthy, self-disciplined, and have chutzpah – then you’ve got the essence nailed.

That said – the essence can certainly be supported by taking courses that steer your thinking and attributes in the right directions. Programs and courses may reinforce what you’ve already got.

Don’t be looking for or expecting to find magic bullets in advocacy coursework. There are no formulas for success. But do look to advocacy coursework to support your already developed skills and attributes to improve your advocacy for those who need your help.

*The APHA Academy covers these concepts and skills. https://APHAdvocates.org/Academy 


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