The Coaching Model of Patient Advocacy
Dealing with an illness is one of the most frightening situations a person can face. Though we experience the world through our bodies, the details of how they function are largely mysterious to us. When our bodies refuse to behave as they should, we feel an uncertainty about our lives that can easily change into panic and despair. The decisions we make about our health are of critical importance, and when our bodies have been weakened, our problem-solving skills are also weakened, just when we need them most.
Navigating the modern health care bureaucracy requires knowledge that most people don’t have. When we take on the role of a health advocate for a patient in need, our job is to educate them about the obstacles they face, to engage them in discussion to determine their needs and to empower them to make the best decisions about their own care. We are not there to represent or make choices for our patients, but rather to help them find the tools they need to reassert control over their lives.
Advocacy vs. Representation
It’s important to remember that only legally designated representatives can make decisions for a patient. Family members, attorneys, and certain caregivers might be given these responsibilities, but advocates usually are not. Representation carries with it legal and moral liabilities that can complicate the situation for everyone involved: the patient, the family, the health care providers, and the advocate. Health care providers will not discuss a patient’s care with an independent advocate. Advocates should not directly engage with any service provider associated with the patient’s care. This includes handling money, speaking to insurance agents and signing any sort of document. The patient should always be the conduit for information that passes between the advocate and the service provider.
The Advocate as Coach
The best way to think about the role of an advocate is as a coach. Regardless of whether their subject is tennis, public speaking, or career planning, coaches provide their clients with three things: tactical guidance, advice on strategy, and emotional support. When the time comes to act, it is the client who must swing the racket, deliver the address, or land the job. Similarly, the advocate, through discussion, suggests options, provides context and helps the patient find solutions to problems as they arise. For example, a patient might confess to feeling anxious or scared before a procedure. The advocate and patient might then have a conversation about the pros and cons of sedatives, and talk about who the patient might ask for additional information. The most important skill an advocate can cultivate is that of listening, which will allow her to respond appropriately to the patient’s needs.
