Compensation for Advisors: What do you know about how much and for what?

[A Former User]

So much to reflect upon and learn from all of you. Thank you.

My share on Being Compensated for PA work stems from an organizational HR perspective for those of us interested and/or passionate in contributing to health care improvements.

There are companies that exist to determine "compensation & policy" concerning it for organizations. Compensation is a field and business on its own and there are companies devoted to & hired by organizations to assist them in determining what to pay people for their work. They also assist in defining what work skills & competencies are required for all jobs in the organization. They also develop a range of pay/compensation scales for various job competencies/responsibilities in an organization. Doubt the health system has done this consistently for PA roles, except maybe for a few engagement positions.

That said, while PA's are not employees, we are the needed/mandated/engaged "expert" providers of our information, knowledge, experiences. We, alone have the other half of the equation that enables the health system to ID the gaps, barriers, what needs to be kept, eliminated, reconfigured and provide improvement suggestions. This happens through our stories and more so with P.A.'s in-depth relaying of benefits, consequences, risks to patients, caregivers, medical professionals and the health system. This PA service knowledge work in engagement with the health system initiatives is still very much in "start-up" mode. Their set up for compensating PA's is not formalized, promoted, nor advertised. There are cases, here and there in various health system "silos" some compensation offered. Again, there is a consistency issue. For most PA's we have been requested to provide input and are acknowledged as volunteers. And, this approach worked initially.

Now, as I see from many PAN members' feedback, based on our short PA work history, what we are/have been requested to do, the amount of time needed from us, the nature, complexity of the health initiative, the skills, competencies, knowledge of those leading the engagement the "volunteer" approach is not satisfactory to everyone. We know the additional skills, knowledge, information, wisdom, literacy and varied perspectives we contribute have quantifiable, quality benefits and value. Some feel there should be compensation for this value contribution.

PA's add is a wide variety of skills, competencies, knowledge (necessary for the work) we use in the initiatives. E.G. communications, i.e. reading, writing, speaking, listening, presentations, teaching, researching, managing differences, providing constructive feedback, problem solving, creative, innovative. Many PA's are very skilled, health literate, language literate, possess skills for collaborating, facilitating, how to conduct/participate in a meeting, availability, time management, aware/use of emotional intelligence, to name but a few competencies we possess. The information about our health care experiences AND our skills, competencies, knowledge, ++++ that contribute value and I believe the health system realizes they are receiving. If we did not provide value our engagement would end with providing our stories.

The issue of compensation, contribution is influenced in our P.A.'s thinking through:

What we can we comfortably contribute: i.e. what current personal responsibilities towards self, others do we have? How about our emotional strength, health wellness? Time availability? Participation method, technology required? Do we have financial resources for travel/expenses and What skills and level (depth,breadth) of skills/competencies will complement the project's objective and achieve its objectives in timely fashion? Can we obtain the skills/competencies if we want to? How? From whom? This is part of my own checklist when considering a call for participation.

Of course I have many more questions about the project itself, which I learned to ask when I realized not all project leaders, facilitators use Best Practices in P.A. engagement. I've been enthused, had expectations, assumptions initially which I did not clarify or inquire about, because I felt I would be advised by the leads early in the project. It took a couple of meetings with 2 projects for the lesson to be learned when I did not inquire about, or verify before accepting the engagements. It felt awful to opt out as a result. Lesson was "duly" noted :)) !

For now the onus is on all of us, as P.A.'s to ask as many questions we can about a project being as specific as possible about our role, the project, objectives and our expectations when questioning the what, how, where and why of our involvement. Then, with this knowledge which I need to make an informed decision, I can choose to volunteer or when my work, skills, knowledge, competencies & nature of the project require compensation.

I deeply respect and feel it very important we each consider our own circumstances, nature of the project and if compensation is one of our requirements. Travel & expenses which we incur as P.A.'s MUST be "ALWAYS" compensated!

Then we need to do what works for us. Sharing and consulting with each other by offering perspectives, knowledge will enable us to continue to evolve....there is continuous learning and improvements to be made by all stakeholders.

Let's keep learning & reflecting. Best - Denyse

[A Former User]

Terrific synthesis of the issues. Thank you Denyse!

[A Former User]

Thank you JoAnne for your comment. PA's are pioneering and blazing new trails in this field. Glad we have such a forum as PAN to share perspectives and spread our views, findings, suggestions and lessons learned.

Best to you

Denyse :)))

[A Former User]

Hey Denyse,

Great to hear your strong voice and wisdom from your immense experience! Did you see the essay I wrote for Longwoods Healthcare Quarterly, back in December? I think it would chime for you --and for other readers of this discussion string.

Here's the link "The Capacity for Patient Engagement: What Patient Experiences Tell Us About What’s Ahead". [Please let me know if there's a pay wall.]

That's a tame title for some of the issues you also raise in your post above. The article was requested for an issue devoted to patient engagement in partnerships "Supporting Engagement-Capable Environments, sponsored by CFHI. I wanted to challenge healthcare professionals who would be showing off their accomplishments.

Just a little reality check, especially thinking about recent criticism of patient partners all being from the same demographic. There's a reason --and that's the recruitment constraints. We are expected to fit into a convenient pseudo-staff slot. At least too much of the time. I think, finally, that is beginning to change.

Best wishes to you. Cheers, Carolyn

[A Former User]

Agree, Carolyn.

They want diversity but block the means to attain it. Even what's happening currently, I don't see how it's sustainable over the long term, never mind grow and develop without stable infrastructure. (Funding, accreditation, etc.

Love the conversation.

[A Former User]

Hi Carolyn;

Much appreciate your comments and reference to the link which I had not previously seen but now have read and printed out for much more "in-depth" consideration/reflection. My first pass observations are you have hit "all" the "nails" on the "heads" as to the current barriers frustrating all stakeholders in their attempts to effectively and successfully partner to implement "quality improvements" in our system.

As with health treatments, where there are "best practices" to follow, so too, are there best practices in collaborating, partnering, co-designing with patients in setting and achieving goals. These "best practices" "exist", with sound "evidence" and when appropriately implemented, they work. As the health system provides the "Patient Engagement" leaders, initiators, teams, their role, (expected by patients) is to consciously choose and be accountable to themselves and patients in using them. Realizing the benefits when working together can/will reinforce their use.

A consistent approach, orientation & demonstration of best practices across "all" projects/working sessions would facilitate understanding, needed/wanted by all stakeholders. The best practice of 2-way stakeholders' constructive feedback post each group working session would minimize current frustrations, motivating and enabling us to make progress. Additionally this feedback practice would enable us to quickly identify progress and/or what we need to change/modify to achieve our objectives, desired outcomes. Win-win-win.

My concern is without a plan, a consistently applied approach, both patients and health professionals will lose their motivation to maintain involvement, not put forth their best efforts (especially patients who are already burdened with illness or caregiving +++) and more time & money will continue to be wasted on the health system. Who suffers? Our aging population, their children, taxpayers who pay the bills and our whole society which becomes much less productive. These "Best Practices" are "not optional" for success. They are, through years of research pre-requisites for all stakeholders-PEOPLE in any organization who work together to achieve a quality, cost effective, sustainable organization.

Continuing to reflect, thanks Carolyn,

Denyse

[A Former User]

I’m a UBC health mentor and have been since 2012. I asked about health mentors maybe getting access to MOA (Museum of Anthropology) at the student rate. I also asked about us being able to buy (pay for ourselves) HM branded jackets. Neither has happened.

we used to get compensated for bus/parking to orientation & the January meetings and had access to the internet hub & library. All these things have gone away. We current are not being compensated at all. I’m not sure why, but I’m not thrilled about it. Most of it wasn’t costing the program anything.

[A Former User]

Oh and I should also say I’m the first and only patient advisor on the Medical Imaging Advisory Committee. I’m not being compensated anything for that either-not even my transit costs. (I commute an hour to downtown Vancouver from my home.) The entire committee aside from me are MDs & Ministry people, some of which are flown in to the meetings and I’m assuming all of which are being paid to be there.

[A Former User]

Hello Lelainia.... great to meet & hear from you and much appreciate you sharing your "experiences".

These make me think, we, as PA's, in whatever form/title we adopt/are given, are having PA "silo-ed" experiences, which is a significant current reality (silo-ed health care) we are trying to correct within the current health systems and which we experience when patients/caregivers. Our current PA "treatment" is in need of re-ALIGNMENT i.e. coordination, integration, and consistency for what and how we contribute to improvement initiatives for one "simple" reason. The health systems defined and articulated how they they wanted to work with us - "partners" collaborating on improvements.

In my dictionary, thesaurus, "partner" is defined quite differently from the treatment i.e. behaviours, actions towards PA's by our health systems since starting improvement work. This current treatment does not communicate, translate and/or leave a perception we are true partners. If there was a comprehensive, compassionate understanding of the impact of our "partnership challenges" i.e. 24 hour caregiving, draining of financial resources & emotional, physical effects, am sure health systems' behaviours, actions would reflect it. Wonder how many consultations were held with potential PA's to determine what we would require to "partner & be successful" in Patient Engagement Projects? Again, "nothing for us without us" comes to mind

A big "Thanks" to PAN for enabling us to exchange experiences, perspectives, opinions and have these discussions. Interested to learn more from PA's across the country and maybe even, dare I say, form critical mass to educate, inform our health system colleagues on a consistent definition of & treatment of partners and the values, principles that will better support our engagements.

[A Former User]

I am definitely late to this conversation, but appreciate all the various perspectives. The Society I am involved with (IMAGINE Citizens Collaborating for Health) is cycling back into these discussions again, prompted this time by an external group that actually wants to make some sort of contribution to acknowledge the value that our group brings to their efforts (and our collaborative efforts).. Because we are a formal group (and therefore don't actually refer to ourselves as 'advisors' but rather partners or citizens acting more or less independently.. but that is not relevant to this discussion I don't think. What we bring to tables if valued by others and hence the compensation question arises periodically. I do not have time just now to adequately digest all the contributions in this discussion stream, but will reflect further and share as we go forward. The collective struggles of folks in this discussion reflect how complex the challenge is!

[root]

This post is deleted!

[root]

hi