This post was contributed by
Elisabeth Schuler

Often people are drawn toward patient advocacy because in their own lives, they helped family members or friends struggling to overcome obstacles or find solutions as they navigated an illness, chronic disease or the transitions in the life of an elderly parent. Many come out of those experiences passionate that others going through the same thing should not have to “learn the hard way” and determined to use their newfound knowledge to help others.

This was certainly my story. My young child suddenly faced a life-threatening diagnosis and there was no one who gave me a roadmap. I had to master quickly a completely unknown universe as we began the journey through her illness. At that time in 1998, I was thriving in my first professional career working as a Foreign Service Officer for the U.S. Department of State. Fortunately, I realized that my skills and training as a diplomat – the ability to learn new issues quickly, to conduct cross-cultural negotiations, to excel in written and oral communications – were perfectly suited to help me to navigate my daughter’s illness and a medical bureaucracy that can be mind-boggling in the best of times.

In the ensuing years, as more and more people came to me for advice, I realized that I wanted to make a business out of helping people navigate our crazy healthcare system. I felt confident that I had the skills needed to master the substance of the issues that would arise.

What I also realized immediately was that I had no business skills. Zero. I had been a public servant my entire career. We work for the taxpayers of this country. We don’t charge for our knowledge. We don’t send invoices after a meeting or project is complete. The mindset in which I had worked was service to the country, not to making money. It would take me many years to overcome this.

So I set my mind to learning what it takes to launch and run a small business. (This was in 2003-2004, before AdvoConnection and The Alliance of Professional Health Advocates). So I bought a book called “Start Your Own Business” published by Entrepreneur Magazine. I found it thrilling and tried to teach myself what I needed to know to get started. I felt sufficiently equipped to move forward and with great enthusiasm officially launched my company in October 2004 (while still fully employed at the Department of State with two young children). I moonlighted for the next five years in the business.

Looking back, I had good entrepreneurial instincts. Back then, the “profession” of patient advocacy/navigation did not exist. I had a fascinating experience making it up as I went because, well, I was a pioneer and it was tremendously exciting. I had the financial resources to get up and running (no loans needed) and worked from a home office. Start-up costs were minimal. I wasn’t worried.

But I made mistakes. I never charged what my services were worth. I gave away too much information. I paid contractors too much. I lost money the first few years after I went full-time (starting in 2009). I attribute this lack of focus on making money to my first career as a public employee. It was hard for me to charge what I was worth. I let my passion overrule any business rigor. I really wasn’t “in it for the money,” I told myself. But I make the mistake of selling myself short. I succeeded in my business, but I always had another source of income. Winging it as I did for much of the time, I probably would not have succeeded financially without my “day job” income and later my State Department pension.

That’s now water under the bridge. It was worth it. I worked hard to build the profession and I’m finally now charging what I should for my years of experience and track record.

There are now plenty of resources to help someone who wants to start a business. I tell anyone contemplating a patient advocacy practice to take the business part seriously! Do your homework. Use the many resources available to members of the Alliance of Professional Health Advocates and the National Association of Healthcare Advocacy Consultants. Take advantage of Small Business Administration programs to help entrepreneurs and small business. Check out SCORE (the Service Corps of Retired Executives). Learn what programs exist to help women and minority-owned businesses; many are community-oriented. Learn about marketing, social media, networking. Work with a local bank, a CPA and a good attorney. Build your business team.

Bottom line: passion and business rigor should get equal billing. That’s your key to success.

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