A Deep Dive on Jumping In: How We Begin the Patient Advocacy Intake Process

Targeted isn’t really what I do.

I have had the occasional client over the years who hopes for, wants, expects, maybe needs, one or two “small” services. They want coaching for a single appointment. They are looking for someone to manage only the billing side of their healthcare life. They need information about this one procedure.

On some level, I absolutely love the idea of narrowing the focus of what you want me to do. I see myself as an independent contractor on the project of your life – so I want you, the client, to be in charge of what I tasks I take on.

But experience has taught me that I won’t get the results you deserve without the process that works for me. You are already dealing with a fragmented system that only looks at one tiny piece at a time, and you are running into problems or you wouldn’t have called me. In order to be different than the system that isn’t working for you, I need a more comprehensive picture. That means I need to sit down with you (in person, over Zoom, through a phone) and talk about your life. It may seem silly, irrelevant, annoying, invasive, or disjointed. It is not.

Let me take a moment to talk about a book I read as a young person that’s left an impact on me. Flowers for Algernon is about a boy who slowly gains (then loses) superhuman intelligence. As he reaches the peak of his IQ, he is devouring books, solving problems and making connections, and he realizes that all of things we call separate subjects (math, physics, dance, theology) are just different buckets drawn from the same well. It’s all one thing.

“It’s amazing the way things, apparently disconnected, hang together. I’ve moved up to another plateau, and now the streams of the various disciplines seem to be closer to each other as if they flow from a single source. Strange how when I’m in the college cafeteria and hear the students arguing about history or politics or religion, it all seems so childish. I find no pleasure in discussing ideas any more on such an elementary level. People resent being shown that they don’t approach the complexities of the problem—they don’t know what exists beyond the surface ripples.” ― Daniel Keyes, Flowers for Algernon

Anyway, that’s how I see advocacy. It’s all different faces of one thing. We all have layers. We all contain multitudes. We mostly see the surface ripples in our own lives while missing the deep undercurrents.

The woman who is concerned about billing issues also needs a way to discern which hopeful-sounding treatments are worth chasing and a way to trust her own power to choose. The one who wants records reviewed also needs durable medical equipment and insurance that works and adaptive hobbies.

So I always believe in finding out what your layers are, at least the top few, before I get to the issue you think is the most pressing. And you, the client, are usually right about what the top priority is. The thing is, you can’t ask for something extra if you don’t know you need it yet or if you don’t even know it exists. You can’t perform your own gap analysis of your life. That has to be done by an outsider.

So that’s why I absolutely insist on a long first appointment. It’s where the magic happens. It’s where I find out why you are lying on the floor at home writhing in pain instead of going to the hospital (again). It’s when I learn who you are and what matters to you, so that I can help you protect it from a system that can eat people’s souls, even if it keeps their bodies alive.

Of course, I don’t always ask exactly the same questions to everyone. I have clients of all ages and genders and abilities, and their lives have different areas of focus. Of course, I’m happy to skip any questions that the client doesn’t want to discuss. But I will ask. I’ve found a way to get people to tell me about who they are, and I’m not willing to compromise that. If you want me to help you, I need a window into your life.

I’m sure other people can do it differently. But I can’t. My advocacy brain is comprehensive. It looks for everything, all at once. It’s exhausting, sure. I sometimes forget things, which sucks. But my brain also lets me be a little bit closer to magical – that’s why I can get results you may not have expected. Because so much of the work is about how you, the unique and special individual, interact with the big system and all of its moving pieces, I need to understand more about you.

And I get that it can feel scary to be vulnerable. I promise to earn it. It can be uncomfortable, but the trade-off is that you get someone who can look at everything – the whole picture of you – and figure out where to push and pull and poke to get your quality of life improved.

I don’t do a targeted introduction appointment anymore, and I think both me and my clients are better for it.