Since I first wrote on this topic in April 2009 and February 2010, things have moved quickly on multiple fronts. I receive frequent inquiries about training and job opportunities and will try to address them here.
Patient navigation and patient advocacy as a new and emerging profession is gaining attention, both in the media and in the popular lexicon, because it fills so many gaps in the current American health care system.
You may have seen from my Patient Navigator website how I came to be a patient navigator (advocate, medical mentor, cancer coach) as a second career. A March 2011 profile in MORE magazine offers more information both about my own journey and about patient navigation generally. A radio and press interview I’ve given are posted on the Patient Navigator homepage to further elaborate on patient navigation as a new field offering services on many levels.
Key Developments
In terms of the profession of patient advocacy, the most exciting thing to have happened in the past couple of years was the August 2009 launch of The National Association of Healthcare Advocacy Consultants (NAHAC), the professional association representing private patient navigators and advocates. NAHAC is committed to developing guidelines on best advocacy practices, ethical standards for health advocates, educational and professional development content to assure high professional standards and public awareness of those standards.
NAHAC membership is open to those who are interested in the field of healthcare advocacy. They may be prospective advocates, medical professionals, consumer advocates, academicians, researchers or people involved in policy and legislative efforts.
I am Vice President of NAHAC and we have held two national conferences in our short 18 months of existence – November 14-15, 2009 in Berkeley, California and the November 4-6, 2010 in Washington, D.C. which I chaired. Members of NAHAC can listen to podcasts of all the speakers and workshops from both conferences. I encourage prospective advocates to join NAHAC to learn and to become part of our growing network.
Another key development is a company called AdvoConnection, founded by Trisha Torrey in 2009 to create a national directory of patient advocates and a way for consumers to find them. Since then, AdvoConnection has added many marketing and business development services for its members. Trisha has written extensively on the business side of becoming an advocate. Her recent summary of the evolving work of advocates is useful and contains other links to learn more. She offers a membership for folks considering this profession.
The Landscape
But to those just hearing about patient navigation or advocacy for the first time (and for many of you realizing that what you’ve been doing all these years has now been given a name), I want to paint a brief picture of the larger “navigator” landscape in which advocates work.
Hospitals
An increasing number of hospitals in the U.S. and Canada employ navigators to help patients manage their hospital stays but don’t extend services beyond discharge. Those hospitals usually require nursing degrees and frequently work with breast cancer patients (because there is funding available from private foundations such as Susan G. Komen). A hospital based-patient advocate works for the hospital which is quite different than the interests that private advocates represent.
Organizations
The American Cancer Society trains navigators in some cities to work with underserved populations. They get funding, in part, from the NCI program to train navigators.
The National Institutes of Health, National Cancer Institute is funding several patient navigator pilot projects across the U.S. in underserved and minority areas and trains navigators working in those projects. A Colorado hospital is one of those projects and they conduct training.
Much of this work is based on the model set by the pioneer in breast cancer patient navigation Dr. Harold Freeman in Harlem to develop community-based navigator programs. His program offers training to some individuals, groups and non-profits seeking to work to narrow disparities in access to cancer care.
Training, Certification and Credentials
Patient navigation/advocacy is a new undertaking that has really gained traction over the past three years.
The key point is that there is no nationally recognized license, credential or certification at this point in time. Patient advocates are not regulated by states nor is there any credentialing requirement for someone to say they are a patient advocate or navigator. If you are considering a certificate or training program, please read the important article posted here that goes into more detail.
NAHAC foresees that there will come a day when a nationally recognized credential is required and part of our mission as the professional organization is to set the standards, best practices and code of ethics for this industry.
That being said, there are plenty of organizations and institutions offering some kind of patient advocacy certificate or credential. Most have sprung up in the last year or two.
I am listing some of them but I have no recommendation or insight on any of them in particular beyond what folks have mentioned to me. Here is an additional list, prepared by Trisha Torrey, that also lists training programs.
The University of Miami offers the nine-month Alfus Patient Advocacy Online Certificate Program.
The oldest formal health advocacy program in the United States, the Sarah Lawrence College Master’s Program prepares students for a variety of types of advocacy careers, including assisting individuals, focusing on community health, or working in health policy.
Dr. Harold Freeman’s program in New York City offers training to some individuals, groups and non-profits seeking to work to narrow disparities in access to cancer care.
The University of Wisconsin at Madison offers a Consumer Health Advocacy Certificate program.
Cleveland State University offers a Patient Advocacy Certificate Program.
The Integrative Medical Clinic Foundation and Sonoma State University in California offer a Patient Navigator Certificate Program with an Integrative Health specialty.
I have personally taken the credentialing program offered through the Society of Certified Senior Advisors and recommend it highly. For anyone planning to work with the elderly in any capacity, this training will help you immensely.
Joanna Smith, the CEO of Healthcare Liaison who is also the President of the National Association of Healthcare Advocacy Consultants, offers training workshops for how to become a patient advocate as well as a full credentialing program for medically trained individuals.
Locally, in the Washington, D.C. area, the Smith Farm Center for the Healing Arts offers community patient navigation training.
What Does It Take To Do This Work?
Most of us who do this work come to it through our own experiences dealing with the health care or elder care system (whether as a patient, caregiver, nurse, social worker, etc.) In most cases, there is no specific background or education that is required. I have found that a passion for helping others, good research, communication, interpersonal and organizational skills as well as the ability to be creative in finding resources and solving problems are what it takes.
However, earning a living from this work is a different story. Patient advocate Trisha Torrey wrote an excellent article about job prospects for patient navigators/advocates. My basic advice to folks is that unless you have another source of income, don’t expect to earn a living wage quickly if you set out on your own.
For more on setting up an advocacy business, you can check out this guide.
How To Join Our Efforts Now
In order to connect folks throughout the U.S. who are interested in this field, I have formed a virtual “Patient Navigator” working group through LinkedIn, the professional networking site.
Please consider joining my LinkedIn group as we collaborate to build this profession. Just go to LinkedIn to set up a profile and then ask to join the Patient Navigator group. Please include an explanation of why you’d like to join the group. This way I can get to know allies around the country and hopefully grow our network and collaboration. It’s a good way for everyone to make contacts.
Please add your comments or additional information to this post!
Thank you.
Elisabeth Russell, Founder and President, Patient Navigator, LLC
February 20, 2011
