Review of Public Comments – Ethical Standards & Best Practices, Competencies

The Patient Advocate Certification Board thanks those of you who took the time to comment on the two documents (Ethical Standards & Best Practices and Competencies, as described previously).  Reading through them, we experienced your passion for our chosen profession, and we found many great ideas to use as we update the documents and prepare to share their final versions.

We also found some themes among the comments and suggestions.  We decided it was prudent to provide some background to you in preparation for the final versions of these documents which will be released over the next few months.

As follows:

  • Use of term “patient advocate”

A handful of commenters were upset with the choice of “patient advocate” instead of “health advocate” or variations. Here is some of our rationale for choosing “patient advocate”.

The key is our definition of “advocate” as one who provides direct service to patients or consumers. (https://pacboard.org/decisions/ See the definition of an advocate, as posted March 2014).

The term “health advocacy” has a far broader connotation and encompasses areas other than direct service with individuals. Health advocacy often includes work in communities to advance well-being and diminish health disparities, as well as policy work, and lobbying for legislation. These areas are outside the realm of patient advocacy credentialing.

This credential is being created for those advocates who work in direct service as described above – specifically with patients who have encountered challenges with the medical system. Thus the title “patient advocate.”

This does not denigrate the work being done by health advocates at all. The work being done by all of you is very important! Someone who focuses on “health” advocacy in the broader term, instead of system challenges (care or cost) for individuals, may decide not to earn this particular certification because its list of competencies may not be representative of their work.

  • Who will want to pursue this credential?

Many of you stated that you did not see yourselves, or the services you offer to patients-clients, in either the best practices/ethical standards or the competencies document. Some questioned why they would bother trying to earn it.

That’s a fair question, and can be answered by explaining that we have not tried to build a credential that encompasses the work that all who identify themselves as advocates do. At least not yet.

It would be impossible to create a one-size-fits-all credential because of the sheer variety of services offered by those who identify themselves as advocates. For example, the knowledge and skills needed by a medical billing advocate are not the same as the knowledge and skills needed by someone who provides hospital bedside services, or who helps develop a list of questions a client should ask the doctor, or mediates healthcare disputes within families.

The Board decided to start by developing this certification for the basic skills that are common to a variety of different advocates who work directly with individuals. From there, further competencies and exams for specialty groups may be identified and developed.

All specialty groups of certified patient advocates will need to prove their understanding of these basics.

As certification rolls out, you will be able to decide whether it’s your time to earn the credential or not. If not, we encourage you to wait until a list of competencies and an exam are developed for your specialty.

  • Providing Medical Services

We received questions from those who are licensed to provide medical care (such as nurse advocates or nurse navigators, cancer navigators and others) about how they fit into this certification.

Those who provide medical services are certainly appreciated, and recognized for serving their patients. Most have spent long careers supporting patients’ needs.

However, patient advocacy, as we have defined it for this credential, is not a medical profession.

When you are practicing under the title “Board Certified Patient Advocate”, especially those who will work privately under contract with patient-clients, you will be expected to refrain from providing medical services.

This does not preclude anyone from providing medical services when they are licensed to do so. They just can’t do so while using the title “Board Certified Patient Advocate.”

  • Testing

Many questions were asked about what format or types of questions will be included on the test given to those wishing to earn this certification.

We have not yet begun to work on testing, so those questions cannot yet be answered.

  • Grandfathering

Several people asked about how grandfathering might take place. Again, we have not made final decisions on this, with one exception.

All advocates wishing to earn their BCPA designation will be required to pass the test that is developed regardless of their longevity or experience as advocates to date.

Any grandfathering will be aimed at helping determine who may be eligible to take the test. No one will be certified without being tested, nor will grandfathering provide any other shortcuts to achieving the certification.

  • Continuing Education

While we have decided there will be a continuing education (CE) requirement for maintenance of this credential, we have not yet determined what that will be or how it could be fulfilled.

  • Violations

The ramifications of any violations to these ethical standards and best practices have not yet been determined.

5 comments

  • Robert Columbia

    Could you clarify what you mean when you say that medical services cannot be provided while using the BCPA title? For example, would it be a violation for a licensed medical doctor who is also BCPA certified to list “Board Certified Patient Advocate” on his website or business card or casually display his BCPA certification documents in his medical office, or is the rule limited to situations where a clinician actively tricks/deceives a patient into accepting medical care by claiming that it is actually patient advocacy?

    For example, could a combined physician/BCPA say, “Okay, now that I am done prescribing treatment for you, let me take off my Physician hat and put on my BCPA one so I can help you understand how to get clarification on your hospital bill. Please sign here to acknowledge.”

  • JoEllen Gonzales

    Hello,
    I want to say “Thank you” to everyone who has devoted their time and energy to establishing the criteria for testing and certification for “Patient Advocacy”. You have done an awesome job.
    I can only imagine the effort that it has taken to create the guidelines and informational documents now available.
    I look forward to actually getting closer to this process coming to fruition for all interested parties.
    Thanks again and blessings…
    Jojo

  • Great job everyone. Looking forward to updates as the process moves forward.

  • Thank you for this follow up information. I currently provide Advocacy and claims support services for families who have long term care insurance. I have been providing this service for a number of years, without charge. In the last 12 months, the amount of service that has been requested of me has been so large, I started charging for the services I provide. This process of being credentialed is very important to me as it helps to define more precisely what it is that I do. Additionally, I want to grow in greater knowledge of how better to serve my families and expand my practice. I am so thankful that this is finally coming to pass. Thank you for your work. I am looking forward to the material. Linda

  • Thanks for the clarifications. You have a huge challenge ahead of you as you bring this to fruition. Keep up the good work and the open communication. Well done.
    MJM

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