How to Launch Successful Rheumatology Patient Advocacy Programs

The staff will be doing the footwork of signing up patients, so they need to be as dedicated as you are.
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Editor’s note: This is the second installment of a two-part series showing how a busy office-based practice can incorporate patient advocacy into its standard workflow. In Part 1, we looked at the reasons for incorporating patient advocacy into your practice and offered an outline for implementing it. Part 2 amplifies the concepts explored in Part 1 and offers additional tips to improve your success.

Many patients feel they lack an effective mechanism for expressing their concerns and don’t feel they have a voice in the policy decisions that affect their health. That’s where patient advocacy can—and should—meet your rheumatology practice.

Start Small

Implementing a patient advocacy program doesn’t have to disrupt your office procedures—at least not much. Here are several tips for making the process run smoothly in your office:

1. Do your homework—again. It’s important to check your particular state laws and regulations. We thought the Insurance Commissioner answered patient complaints, but in our state, the Attorney General is a better avenue. Your state may be different, so you need to know where patients should call when they have complaints. Resources for this information are your State Medical Society or Medical Board.
2. Involve the staff as activists. Schedule time with your staff to explain the importance of patient advocacy. Validate the staff’s importance in the advocacy process as part of the patient care team. The staff will be doing the footwork of peddling the advocacy program and signing up patients, so they really need to be as dedicated as you are. We recommend you emphasize some or all of these important considerations:
   1. Your staff is part of the arthritis care team, with the new ability to help patients—even outside the clinic—by having the patients become advocates.
   2. Insurance and government policies affect your practice income and overhead and, therefore, directly affect your staff. It’s in their personal interest to mobilize patients to fight payment cuts and additional burdensome regulations that magnify overhead. Who knows? They could be working toward their end-of-year bonus.
   3. This process is not a big burden in time or resources; it takes only a few minutes per patient. Emphasize that small investments of time now may result in big benefits later, when patients are signed up and fight against the cuts slated for your services or the additional administrative burdens that threaten your practice.
   4. Navigate through the websites you will use, and show staff how to enter data quickly and efficiently. Suggest staff leave website registration pages open as tabs in their Web browser so they can quickly access them.
3. Realize the importance of redundancy. We are all human, so mistakes are made. At the time of screening, have the staff ask if the patient got a copy of the letters. If a patient didn’t get papers at check-in, give them copies where they are worked up or in the exam room. Ensure they receive a paper before leaving. Be sure they are given the opportunity to sign up several times before leaving your office, but don’t be obnoxious or heavy-handed.
4. Tag the patient’s chart for advocacy identification when they are signed up, or otherwise identify them as an advocate. This identifies players on your advocacy team and offers a chance for follow-up conversations. Your staff can ask patients who sign up if they have any specific items of interest that they have seen on advocacy websites. For patients who haven’t signed up, you can make a second offer to help. Again, it’s important to offer an opportunity and not to demand that patients get involved.
5. Recognize that not all patients are “wired.” We practice in a mixed environment of technology and rural agriculture. I was surprised to find that 40% of my patients have no e-mail address. Providing a handout with postal addresses and phone numbers accomplishes two important goals: First, it offers a means for advocates who prefer to write letters rather than send e-mails. Second, it means that no patient feels left out, and everyone can have a sense of solidarity. I think this esprit de corps is important.

Go Big

Once you see how well the process can work, you may decide to expand your advocacy message into different parts of your practice.