How to Get a Job as a Patient Advocate

Identified as an up and coming career by media such as NPR, the New York Times, Entrepreneur Magazine and US News and World Report, becoming a patient advocate may be the next great career choice. However one of the biggest questions that needs to be answered is: can you get a paying job as a patient advocate?

Unfortunately, that can prove difficult. It's actually quite hard for a patient advocate, also called a health advocate, to get a job with an organization that provides a paycheck and benefits.

Let's look at the reasons why:

• The need for patient advocates is a relatively new phenomenon. Until the past decade, most patients felt as if they were getting the care they needed, they trusted their doctors, medical errors were barely considered; in short, there was not a perceived need for advocates.
• Up to that point, most patient advocates were employed by hospitals. While there are questions about the allegiance of hospital advocates, they have served (and continue to serve) in a customer service-type capacity to help patients and families who have complaints with their care or some other problem with their hospital visit. While many are committed to improving the hospital experience for the patients they work with, these advocates must remain loyal to the source of their paychecks—the hospital.
• Until recent years, there has been little opportunity for someone to get a degree or credential in patient advocacy. Some colleges or universities offered masters degrees or other higher level degrees, but they were aimed specifically at someone who already had a bachelors degree, usually a science or medical focused degree.
• Patient advocates represent another layer in care. Insurers won't pay for an advocate because they believe that is just one more expense they are unwilling to bear.

Who Has Been Helping Patients Get the Care They Need?

Beyond the recognized medically-trained caregivers like doctors, nurses, physician assistants, nurse practitioners and others, there has been another group of professionals who have helped patients navigate their care. Social workers, usually degreed in social work, often called case managers or caseworkers, have assisted patients and their families make transitions such as hospital to nursing home, or hospital to rehab unit. They have been advocates all along, but they haven't used that name.

Social workers/case managers are usually employed by the state or county they work in, although some work in private practice. As such, they are often viewed as patient advocates.

When there was no professional to assist them, patients have relied on family members and friends to help them out.

The Patient Advocate Employment Landscape Today

As mentioned above, hospitals do hire patient advocates, although hospital advocates don't provide navigational handholding in the same way an individual advocate working privately might.

Some new opportunities are beginning to pop up, too. The more unsettled health care becomes, the more need there is for patient advocates, and the more organizations are looking at hiring patient advocates. As patients become increasingly frustrated with too-short appointments, leaving their doctors' offices with remaining questions, and frustration over their experiences with their payers, they are looking for the assistance of professionals who can help them navigate their care and/or help them manage their bills.

As a result, some organizations are beginning to hire patient advocates to serve large groups that may identify the use of advocates as a way to save healthcare dollars. For example, XYZ Advocate Company might contract with a large corporation to provide advocacy services to the corporation's employees. That corporation is interested in keeping its employees healthy, not losing them to sick days or to personal days while they stay home with a sick loved one. So XYZ Advocate Company will provide advocacy services to those employees, through either their insurers or human resource departments, to keep them healthy and at work.

Few companies exist to provide individual advocates to individual patients. Patients typically don't understand the need to pay out of pocket for the services of an advocate unless they have deep pockets, or believe they are desperate for the help. Patient advocates tell me of their frustration when they know they can help a patient who makes an inquiry, but the patient decides against hiring the advocate once they learn they'll have to pay for the service themselves. As a result, with no established revenue stream, not many companies have been able to establish roots in the individual advocacy business.

How Can You Get a Job as a Patient Advocate?

Over time, more opportunities will become available for advocates who want to be hired by advocacy companies. The more confusing health care becomes, and with the advance of healthcare reform, advocates will become more necessary, and more appreciated.

Learn more about how to become a patient advocate to improve your chances of being hired. This information includes current degree and training programs for patient advocates and information about whether advocates need certification or credentials.

If you can't find a company to hire you as a patient advocate, you may be interested in starting your own patient advocacy business.

Here is a list of larger companies that hire patient advocates (If you know of additional companies that should be on this list, please contact the Patient Empowerment Guide.):

• Health Advocate, based in Philadelphia, Pennsylvania
• PinnacleCare Private Health Advisory, based in Baltimore, Maryland
• Care Net, based in San Antonio, Texas
• The Karis Group, located in Austin, Texas
• Concerto Health Partners, located in Los Gatos, California.
• CarePlanners, located in New York City.
• Kinergy Health, located in and around Washington, DC
• Innovative Care Management, located in Portland, OR.

Check back on occasion to find updates to this list of companies.