Patient Champion: One of the 10 Best Careers for the Next Decade

As people age, the chances of developing serious medical problems rises. Every 66 seconds, someone in the United States develops Alzheimer’s. 1 in 3 people develop Alzheimer’s or other dementia. The odds of having diabetes are almost as bad.

Few life experiences are more traumatizing than needing medical care for yourself or a loved one and finding the system so problematic to navigate that you don’t get the health care you need. These illnesses usually require assistance from someone else, whether a spouse, a relative, or a good friend in getting prescriptions filled and navigating the murky waters of hospital bills, insurance statements and medical claims.

Complex health care problems require guidance from someone who knows the administrative ropes to obtain needed health care and to handle the voluminous amount of paperwork to avoid being victimized by the health care system. Many people feel overwhelmed by a hospitalization, feeling that there is too much information to process, and too many very important decisions to be made. As we age we learn about this happening more and more o a member of your family, a friend, neighbor, or co-worker.

Patient champions or advocates lift the burden of having to deal with doctors, hospitals, and insurers. The field has grown as patients face higher out-of-pocket medical costs and the healthcare system has become increasingly difficult for the average person to navigate. USA Today recommended that in speaking with a doctor when weak or ill, a patient “Bring an advocate.” (February 5, 2007.)

Even with employer-provided health insurance, out-of-pocket spending has increased by more than 50 percent since 2010. As the cost of prescription drugs continues to rise, so does the share of their costs patients pay. Deductibles, for example, have on average increased 2½ times over the past decade. Prescription drugs account for one out of every 10 dollars spent on health care in the U.S and is climbing.

Patient champions — also called patient supporters,  medical billing advocates or claims assistance professionals — emerged as a livelihood some years ago. Patient champions handle negotiations and work to find satisfactory billing agreements. They fight denied medical claims, file appeals, secure insurer authorization for medical care and generally help navigate complicated insurance rules. Some help find medical care, such as specialists and nursing homes.

On the other hand, are you tenacious, sympathetic, good on the phone, capable of respectful firmness and not uncomfortable in hospitals and around sick people?

If your answer to the first question was yes and to the second also yes, you have an understanding of the needs of hospital patients and their families and the personality to help a family in crisis, you can make yourself indispensable to people with needs for this type of help.

To be an effective patient champion, you need to be tenacious, sympathetic, good on the phone, capable of respectful firmness and not uncomfortable in hospitals and around sick people. Patient champions need an understanding of the needs of hospital patients and their families and the personality to help a family in crisis. Patient champions may be employed, volunteers or operate as a business service. Employers will sometimes pay for this service for their employees as this service is becoming regarded as indispensable.

Large medical centers often have patient advocates on staff to help resolve communication difficulties between doctor and patient/family as well as to address issues about food, environmental conditions, staff, etc. These are personnel who may be nurses or social workers. Hospital chaplains also serve as patient advocates. Staff positions for patient advocates are extremely rare in community hospitals and rural institutions. In these smaller health facilities volunteer patient advocates may be in use.

Patients and their families appreciate patient champion services but may be suspect when this service is offered by the institution providing the care offer them. This is one place where the paid advocate makes an entrance. In large urban centers the number of advocates cannot match the need, and here lies the opportunity to get paid for this work.

One out of five baby boomers are single with no children and are unlikely to have a family member to provide this advocacy role. Another niche is children. Advocating for children who are ill requires special knowledge about guardianship rules and child rights. Parents of these patients are often much more emotional than relatives of other patients and dealing with them requires extra skill.

The health care industry is fraught with rules that must be learned and understood. The most complex of these are the rules regarding confidentiality of information. The Health Insurance Portability and Accountability Act of 1996, amended and adjusted, is followed by every hospital and every doctor. For anyone to discuss the health or treatment of a patient they will need to be assured that you have permission from the patient or their legal representative.

When you have jumped this hurdle you will find practitioners who don’t understand your role, see you as interference or perhaps as a challenge to their authority. This is where respectful firmness and tenacity will pay off. You can be perceived as partner, asset, time saver or you can be seen as nuisance, it is not always up to you but every energy directed on behalf of your patient will move professionals in this direction.

Being a patient champion or advocate is not for faint of heart. If you are willing to be awakened on occasion in the middle of the night and capable of dropping everything to address a crisis this may be for you. You will feel good when a patient get the services he or she needs and their health improves and you may well suffer along with patient and family as conditions cause a decline in health status. The positives far outweigh the negatives.

Many large medical centers have patient advocates on staff to help resolve communication difficulties between doctor and patient/family as well as to address issues about food, environmental conditions, staff, etc. These are personnel who may be nurses or social workers. Hospital chaplains also serve as patient advocates. Staff positions for patient advocates are extremely rare in community hospitals and rural institutions. In these smaller health facilities volunteer patient advocates may be in use.

Patients and their families appreciate patient champion services but can be suspect when those providing by the institution providing the care offer them. This is one place where the paid advocate makes an entrance. In very large urban centers the number of advocates cannot match the need, so hes where paid advocate have opportunities.

This is becoming a pressing need for aging Boomers, one of out five of whom are single with no children. Another niche is children. Advocating for children who are ill requires special knowledge about guardianship rules and child rights. Parents of these patients are often much more emotional than relatives of other patients and dealing with them requires extra skill.

The health care industry is fraught with rules that must be learned and understood. The most complex of these are the rules regarding confidentiality of information. The Health Insurance Portability and Accountability Act of 1996, amended and adjusted, is followed by every hospital and every doctor. For anyone to discuss the health or treatment of a patient they will need to be assured that you have permission from the patient or their legal representative.

When you have jumped this hurdle you will find practitioners who don’t understand your role, see you as interference or perhaps as a challenge to their authority. This is where respectful firmness and tenacity will pay off. You can be perceived as partner, asset, time saver or you can be seen as nuisance, it is not always up to you but every energy directed on behalf of your patient will move professionals in this direction.

Being a patient champion or advocate is not for faint of heart. If you are willing to be awakened on occasion in the middle of the night and capable of dropping everything to address a crisis this may be for you. You will feel good when a patient get the services he or she needs and their health improves and you may well suffer along with patient and family as conditions cause a decline in health status. The positives far outweigh the negatives.

Tips for Getting Started

• If you’re not a skilled negotiator, take one or more courses.
• Volunteer to assist a friend, acquaintance, or relative. This can provide your first testimonials.
• Community colleges and nonprofit organizations are developing training and certification programs to fill this growing need.
• You have a headstart if you’re already a medical professional, social worker or insurance expert.
•  But the experience of having managed your own frustrating path (either for yourself or as a caregiver) through the medical system provides you with credibility

What Can You Earn

Patient Champions/Advocates can bill for their services on an hourly basis (up to as much $100 an hour) or on a retainer basis where you bill for as much as five or ten thousand dollars up front and take care of everything without further billing. If salaried, the pay ranges from $11.90 to $22.57 an hour, but pay can rise with experience, according to PayScale.com.

Best Ways to Get Business – Promotion is a large part of your marketing plan.

• Developing several presentations and offering them to the local Chamber of Commerce, Rotary or other business associations where busy adults of an age where their parents or older siblings are apt to be in need of services like yours.
• Writing article or a column for newspapers or websites or both. Develop a Facebook business page.
• Creating a website so out-of-town adult children can easily locate you and that offers the sense of assurance you will provide the attention their loved one needs; post  testimonials, which you need to be sure to get from past clients.
• Personal and social networking in groups with professionals, such as financial planners, doctor, lawyers, pastors, and social workers who will have clients and patients in need of your service.
• Developing relationships with emergency room personnel and the staff of critical care units will bring referrals.
• Joining or even starting a local association of patient champions/advocates.
• Writing columns for local newspapers, writing a blog.

Trade organizations

• Alliance of Professional Health Advocates; https://aphadvocates.org  operates Alphas Advocates;  www.advoconnection.com/
• RN Patient AdvocateRN; www.patientadvocates.com
• Patient Advocate & Professional; patientadvocateinstitute.com

Related Professions

• Alliance of Claims Assistance Professionals:claims.org
• Medical Billing Advocates of America: billadvocates.com

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