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November 19, 2012

MTs as Patient Advocates
By Mary Anne Gates
For The Record
Vol. 24 No. 21 P. 26

Medical transcriptionists (MTs) seeking a career change may be well suited to patient advocacy. Transitioning to a new career and helping someone navigate a major illness or accident are similar because both often require traversing unfamiliar territory. Nevertheless, MTs considering becoming a patient advocate must ask themselves whether they can find a viable career while helping someone during a difficult time.

Patient Advocate Defined
Most people know someone who has experienced a traumatic injury or battled a lengthy illness. It’s during these times when someone might mention enlisting a patient advocate. However, many people do not know who to ask, what tasks an advocate performs, or the cost of hiring an advocate. Conversely, those wishing to enter the advocacy field may need answers to the same questions.

“I’m conceptualizing a patient advocate as someone who accompanies a patient through his or her illness process, troubleshooting where problems may arise, helping the patient make complex decisions, interceding with providers as necessary, and interceding with insurance companies as necessary,” says Elizabeth French, a lecturer and assistant director of academic affairs in the department of health behavior at the University of North Carolina at Chapel Hill Gillings School of Global Public Health.

According to various health and academic professionals, the need for patient advocates appears to be growing. However, the question of how these professionals should be compensated remains a sticking point. “I would say that there is a pressing demand for them, but the issue is how do we get it reimbursed? Only when a patient advocate can get reimbursed by insurance companies for the work he or she does will it be a viable career path,” says French, who acknowledges the education and experience practicing MTs bring to the table. “It’s very likely that a medical transcriptionist will have gained an on-the-job understanding of the health systems they work in, the ways patients navigate through health systems and a working knowledge of problems patients confront.”

Earning a Living
Hospital-based patient advocates are often part of the patient satisfaction team. French says the relationship to patients in these settings can be complex because the advocate is a hospital employee and therefore must navigate between the needs of the hospital and the needs of the patient.

Hospitals aren’t alone in hiring advocates; some areas of specialized medicine use them to benefit both the healthcare team and the patient. Typically, this type of venue sees fewer patients, but those it does treat have more complicated medical issues.

“Patient advocates are being hired by so-called boutique healthcare organizations. In these settings, a group of physicians may decide to limit the number of patients they see in exchange for a set annual fee,” French says. “The physician is better able to handle patients with complex care needs while patient advocates do the time-consuming information seeking and extensive communications with patients that are a necessary part of such practices.”

Though some advocates are compensated, they don’t have a credential to back up their expertise. “To date, there is no universally recognized credentialing body or stand-alone credential for the patient advocate,” French says. “However, the Professional Patient Advocate Institute, a recent start-up group, is going great guns toward standardizing best practices and disseminating resources, skills, and training. They’re an organization to watch.”

Essential Attributes
Besides a dedicated desire to help people or previous healthcare experience, MTs need other characteristics such as curiosity and diplomacy to become a patient advocate. Ideal candidates need to be curious, passionate, and compassionate about alleviating human suffering. They must possess a high level of self-awareness and an ability to speak diplomatically and effectively in highly charged, emotional settings, French says.

Becoming a volunteer can help an eager MT become well equipped to be a patient’s best friend on a difficult journey. “Gaining exposure and experience through volunteering as an ombudsman or as part of a care team for someone suffering from a terminal illness would be a good starting point,” French says. “The individual should choose a volunteer opportunity that is highly organized and provides good training for its volunteers. That will give the transcriptionist an excellent window into the kinds of skills and personal temperament important to the patient advocate.”

Advocate Values and Competencies
As the concept of patient advocacy continues to grow, medical facilities, academia, and other institutions have begun issuing principles in an effort to provide guidelines aimed at achieving the best possible outcomes. “Working collaboratively with colleagues, we codified a set of values that guide our efforts in patient advocacy,” French explains. As a result, the Gillings School of Global Public Health has set forth the following values:

• Respect the context, values, and preferences of each person, group, and community served.

• Be an agent of productive, positive change.

• Adopt an idealistic attitude.

• Find, use, and share the best quality knowledge available.

• Promote and protect patient rights.

• Practice personal transparency regarding motives, limitations, and conflicts of interest.

“It’s not just a matter of what knowledge someone has; it’s an ability to step back from one’s own personal values to really hear what’s being asked,” French says. “A patient advocate seeks to help the individual while seeking change in the environment, making it more hospitable for the patients and very frequently the employees of whatever health system they’re working in. Advocates will get burned out quickly if they don’t come with the belief that things can be improved for the individual and the system.”

From these values come a specific set of competencies, featuring the following:

• Identify and support each person, group, and community while respecting their context, history, values, and preferences.

• Build capacity for others (eg, patients, families, support networks).

• Ably, fairly, and honestly represent others.

• Communicate effectively.

• Facilitate access to support.

• Know personal limits.

• Understand how the healthcare system works.

• Recognize and disclose conflicts of interest.

— Mary Anne Gates is a freelance writer based in Fort Wayne, Indiana.


Where to Learn More
Information about patient advocacy can be found in several places, including the following:

• Project Compassion (www.project-compassion.org), a North Carolina-based support program

• Sarah Lawrence College (www.slc.edu/graduate/programs/health-advocacy/index.html), which offers a stand-alone graduate degree program

• The Center for Patient Partnerships at the University of Wisconsin (www.patientpartnerships.org)

• The Professional Patient Advocate Institute (www.patientadvocatetraining.com)