Independent Advocacy’s Three-Legged Stool of Success

In response to one of the most frequently asked questions I get as the director of The Alliance of Professional Health Advocates – I might be providing an answer you don’t expect.

That’s OK! Because if you don’t expect it, then you may hear it even more clearly than you otherwise would. And that can only be good.

I hear the basic questions in a number of formats:

  • Do I need to get a degree or certificate to be a patient advocate? Followed by, “what degree?” or “what courses do I need to take?”
  • Do I need to be certified to be a patient advocate? or Do I need a license to be a patient advocate?
  • I already have a degree in ______ (healthcare management, or nursing, or other system-related credentials) – so do I need to study anything else?

The answer that may surprise you is this:

You aren’t asking the right questions.

You don’t NEED any of that.

There are no specific degrees or credentials you must have to be a good, effective, independent patient advocate. It’s not about degrees, or certificates, or licenses, or formal education.

For today, all you need are these three things:

  1. A solid and basic understanding of how the healthcare system really works and the ways to get around it. NO, not the way it formally educates you that it works. Instead, the follow-the-money nature of the system and everything that entails.
  2. A solid and internalized-embrace of independent advocacy ethics.
  3. A willingness to learn and execute the business basics of starting, growing, and managing a practice: from legal to insurance to marketing and other aspects, too.

Like the three-legged stool, if you are missing any of those supports, you will fall over, and fail. Tough words, but true. And ignored by too many.

The problem is this: so many newbie advocates think that because they have been nurses (or physicians) for decades, they are prepared to be advocates – they are not.

Or because they have been managing hospital systems, or physician practice billing departments, they know how to run a billing practice – they do not.

Or because they shepherded Mom or Dad or Aunt Louise through cancer and learned their ways around the system, they can now do it for others – they cannot.

Or because they have finished a degree or certificate in advocacy or something related, they are prepared to open their practice doors – they may or may not be prepared.

At least – NOT until they can support all three legs of the advocacy practice stool! And that’s the must-do: focus on strengthening all three legs.

Therefore, that’s the key to the right education: ramping up to strengthen those legs, figuring out what you don’t know – and then pursuing the right education and support.

So how do you figure out what you need?

There are a few ways to do that.

  • First – when looking at that three-legged stool, most of us have a good idea of what’s lacking in our education and experience. If you’ve been a doctor or nurse or other practitioner, then you probably know the basics of the way the system works, so the only question is whether you can figure out all the follow-the-money aspects that help you tactically employ the system for a client. Or – if you have never run a business before, well, then, you now know you’ll need to ramp up on your business knowledge.
  • Second – you can take a look at this article about how to figure it out. It will walk you through your gap analysis and help you fill the holes.
  • Third – attend an event with other advocates and ask them about what they needed to be successful. We recommend the APHA Summits. (of course we do!)
  • Fourth – ask the same sort of question in a discussion forum with other advocates. APHA members – this is a great question to ask in APHA Connect! (of course it is!)
  • Fifth – if you realize you need help for one or more of the specific legs, here are some resources to help you:

Knowledge of the healthcare system:


Business knowledge:

Please, please, please don’t try to succeed in practice without good strong support on all three legs of that stool!

That balance is crucial to your success.


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