And so, you don't know what you don't know, and I think it is our job, regardless of where we're at. And even at this conference, our exhibitors, our sponsors are our participants. We all flip around our badges, this is the only way we're going to fix things. You can't lock these certain people out or certain teams out of the discussion, because then you're robbing yourself of solutions that could happe. And so from us, I think that's also another thing that people love. We're not going to make you pay extra to go hang out in the cocktail area or to stay after and meet the "super secret" advocates. No, the advocates need help, and we need as much interaction and being able to play that matchmaker...we prepare the health care workers when they come. Or advocates, a lot of these advocates are now independent, and they're outside of the hospital, and it's like, come with your challenges and what hasn't been working, and let's share it with the people who can help make the change.
And so, I think...we hear all of these buzzwords, and equitable access...and I think at the end of it, a lot of it has to do with just the understanding. And so, how can we make it easier? And we're working on things, and I think everybody's trying to do a great job, but how do you get a new person into this field, or even a patient, and how do they understand what commercial insurance means, or this is not a bill, and they don't understand what that is, but there's a bill floating somewhere, it's probably at the court getting ready to take their house away. But you know, where do we get at and going on letters, we get the letters that says you've got 2 days to respond, and that was 2 weeks ago, because the mail delayed where I was on some of these things. So, it's like, are we trying to help the patients? Is the system made to fail on some of these things, just to say we checked a box, and are we actually helping the patients? Which, we all are patients.
Madison: [That's the idea that] the 2 things that are certain in life [are] death and taxes. So at some point, we're all going to need to access the health care system, whether it's for a minor cold, an injury, it could be a rare disease, a life-threatening disease, it could be, as birthing persons, it could be because you're having a child...the health care system touches everyone, and even if it's preventative care...I think about, just for an example, contraceptive access, right? So right now, the big issue right now is that Opill is going to be on the market OTC, but because of the Affordable Care Act, it's considered preventative care and it's supposed to be no-cost sharing to the patient, but now you have an OTC product that its entire purpose is to now be for purchase, and that now you don't have to go "see the doctor," but now we're giving somebody something that technically should be free, and we're charging them $19.99. And it's like, what if you don't have $19.99? And the whole reason why we wanted it to go OTC in the first place, and why "free the pill"—which has been trying to get this OTC and get all contraceptive OTC for the past 20 years—is because the most vulnerable in our population that need it and need access to it, don't have access. And the reason why they don't have access is because they don't have the financial resources to get it.
What do we do, right? How do we educate without alarming and then how do we how do we inform without weaponizing? ...I feel like that's what's happening. I feel like it's this "secret club" that only the people that have means have access to and like, "Oh, you, you want to get access to this medication at a discounted rate? Well, we can get you that because we know that you know X, Y, and Z people, and those people know how to navigate the system." Or, [another example is] during the COVID-19 pandemic when we would have these clinics in historically marginalized communities, and it was literally all these people who had computers and cars, and none of the people who were supposed to be there...and the whole reason why we were having it there were able to get it because all the appointments were made online, and it assumed that everyone had broadband internet and had access to a computer. How do you overcome that?
Johnson: I think one of the things that we as a major failure point in health care workers, we're not perfect. I understand we had our hero days, days gone by...but I think one thing that we do—even as a society outside of health care, I think this is kind of universal—instead of providing solutions, we complain. We can tell you everything wrong with the system, I can get on LinkedIn and I can write a scathing review about a payer, a pharmacy, a doctor, I can leave reviews, I can go on ZocDoc and downgrade a doctor and say they're not great. It's the power of the keyboard, right? But that doesn't do anything other than, I think, make me look not great, and I think also drive that negative narrative of the bandwagon, right? "Oh, I didn't enjoy that either. Oh, this is the problem."
So instead of having a complaint with a solution, when you come at it just from a negative lens, that's not going to help anybody. It's not going to help the health care worker, it's not going to help the patient, and it's certainly not going to help in a demographic that needs even more assistance to grow and to flourish. And so, I think one thing...no, we can't change the system tomorrow. I can't change the US government to help US health care, but I can say, "Hey, listen, I don't hate the government. I want to work with them. Here's my ideas to fix this," or "Here's what I would like to see happen in my everyday role."
And so I think, for us to even take a great first step, it's people like Melissa and those that come to our Summit where it's like, "Here's my proposed solution, this is what I've done. Here's where I learned from experience." Instead of just a big complaint fest, and then what ultimately happens when you keep complaining, is you drive patients away from health care. And so, those already marginalized then don't go seek care, and we create a much larger public health problem.
Madison: Yeah, absolutely, I can't agree with you more, and I really think that when we think about looking at things through a trauma-informed lens, we have to understand that people are coming to the health care system from very different lived experiences, and when I come and I speak to people, they're looking at me as a person of color, as also somebody who is a health care professional, which is very different than, say, if they were to go to a different colleague, right? And then, they don't have an experience of coming from a single parent household, or a household where maybe they didn't have access to transportation all the time, or...there's so many different things that influence whether or not people want to engage in the health care system.
I actually just learned recently about this study that looked at children who had needle phobias and that that actually led them to be less likely to want to be vaccinated as an adult, because they felt like they'd had trauma associated with getting injections—and specifically vaccinations—as a child. And it's like, how do you overcome that when we can do things like numbing creams and giving sweets or candies and things, and making the health care experience more of a positive experience instead of a punitive experience. And then, that actually leads to them having more healthy interactions with health care professionals later on in life, and then that, in turn, makes them want to tell others to seek medical care, right? That was the other thing that we saw during COVID was that when people had positive interactions with the health care system, they were more likely to tell their family and their friends, and then if they had been vaccinated, that the reason why they were vaccinated was because their family and friends were all vaccinated. So, it was almost like a tribal thing, where people were more likely to engage because everyone in their social circle was too.
So I agree with you. I think that we can definitely do more to make the system less scary, and I think the one of the first things you said when we first started this conversation was talking about health literacy. And that's number one, if you don't know the system is the way it is when you try to navigate it, even as somebody who is a healthcare professional, I still have challenges navigating the health care system as the parent of a neurodivergent child, and also someone who's experienced birth-related trauma. So, even me, I can advocate for myself, but how is that going to happen if you've had zero interactions with the health care system and have no idea how it works?
Paige: ...And you know you were talking about the different accessing the care, do they know about it, do they call their friends...and what came to me, I mean, and that's with anything...I have people calling me like, "Hey, is your health system paying for it before I do it?" We do it for everything. Or before you get a tech solution that you're going to implement, or spend money, or a car, you ask your friends and family. Health care is no different.
Madison: So, we have been kind of speaking around this for the last few minutes, but can you please tell me all of the things about the Healthcare Advocate Summit, and just tell me where, when, how can I sign up? …Tell me all the things.
Paige: So, the event is September 3 through [September] 6 this year, and it will be in Las Vegas—your hometown, [Christina]— at Caesars Palace. And so we will be there, we're expecting about 1000 people, of course, that's being conservative and underestimating, we usually blow through those numbers. But when you're selling sponsorships and stuff, we want to be as honest and truthful as we can, so we always overdeliver.
It will be a mix of main stage education and what we heard last year...and we continue to walk around asking people, is they didn't know which room to go to. There were so many good talks, and they're like, "There's too many good talks, I don't know what to go to!" And I'm like, this is great. That means there's going to be those tailored discussions, right? You had 3 talks that you really wanted to go to, you go to the one that you care most about, so now you got a room full of people who cared about that more than the other sessions, and I think it's that dialogue, and being able to build in that dialogue and that's where most lessons are learned. You had pharma people answering and specialty pharmacies, and this is what works in Alaska, and this is what I've done, and that's where you're going to hear what's working and right, educating without weaponizing. Don't go back and use this as "Oh, they found the loophole." No, it's not a loophole, it's called "this is what we gotta do for patient care" as long as it's compliant within the rules.
And so, it's been fantastic. Last year, we had multiple sessions, lots of speakers, and I'd also like to focus on the speakers. A lot of these events are very focused to people who are higher up in their roles, supporting different brands, [those who] have probably a higher title than the person doing the, [for example,] the entry level work. Our whole event is flipping that around, and I think a lot of people when we end up putting out these topics and the subjects is, they're like, "Is this meant for me? Can I speak about it?" And so, while people are submitting, we are empowering and championing all these health care workers who do something awesome at their health system, helping them understand how to deliver it, and this is who they want to hear from.
And so, we get a lot of people and a lot of submissions, and there's a mix, we got industry insights, we've got health care workers...but people kind of want to hear from their peers of what's working and they feel normal when somebody who is in their same type of role in this space...it's challenging, and they just want to be acknowledged. And so from the speaker standpoint, I'll say, and just the topics, it's been so great seeing all of these different health care workers, and not even just that, it's telling them this is how you put it on your CV, and now you've spoken at a conference, and you can get paid more on fair market value, and this is how you can go and do advisory boards and speaking, and so, we all love our jobs and nobody did this for either Elizabeth or I, and it's like, look, here's your trajectory on how you can still be in your job—because we don't want you to leave your role if you don't want to—[and ]how you can supplement your passions elsewhere, and it starts with just coming to the table and talking. And so, from the standpoint from the conference, it's going to be the mixture of very micro events as well as the large scale, because as you get bigger—we've been to all those conferences that feels like Disneyland, you can't even get through the corridors to where it's at—and I want to make sure that the feelings that we felt the first year, second year, third year, they're leaving with their new friends, and they're reporting back to us on you get great minds together and what projects they're now doing together, and what education series, and how they're helping out their community. And so, when you look at outcomes in what's happening, somebody going home and saying, "That prior off that sat for 6 months, I just got it approved within 24 hours of coming home."
...And so, that the whole conference and us being able to do these things, how do you make it not so long, but long enough? How do you have them come for the education, stay for the networking, the community? And we want everybody to feel welcomed, and as you can tell, I just love talking to everybody and I love a lot of friends, but you know, I'd get to these conferences, I'm like, "Okay, who can I go to dinner with?" Well, everybody's getting comped by their company, and I'm here on my own dime, and I feel kind of out of place. Elizabeth will tell you, I am the friendly one, want to make sure everybody feels okay, Elizabeth is there to help me run things. But Elizabeth, anything you want to add?
Johnson: Yeah, I'm the business side, she's the personal side. So, I know we're co-CEOs in this, but she's brevity and she's the sweet one. But you know, the first year, it was a lot of our close friends that we had made through industry [that attended] and last year, it was so much fun to meet new people. And I still every day learn there are other people like me out there, and they're passionate, and this isn't hustle culture, this isn't just a side project. This is passionate individuals that want to make a real difference and want to not just punch a clock, they want to derive change and satisfaction in other jobs. And so, it's an awesome uplifting group when they get together.
And one of the reasons we do our conference right after Labor Day, one is many people have that ability to travel around then, the rates in the hotels are a lot cheaper, so we're trying to be as cost-conscious for the attendees that are coming. If you're an industry, yes, you have a whole different budget than someone who works—like me—in a private practice or someone in a hospital. So, we try to build this event not just on what you're going to get out of it, but to make it as reasonable for your employer to be like, "Hey, I support you in this," because when your employer says yes to something like this, that can be life changing for you and a reward to employees. That feels good, me learning, me developing, me helping my system. Whatever it is, that feels important, and that's a really big factor too.
Paige: I was just going to add 1 thing because you brought up the health care workers. I never wanted to go into sales, I'm selling every day this, and I love it. And so, I think a good sales person is somebody who is passionate about something, comes off naturally, authentic, and this is what we do. And so, we look at every angle and every lens, we're trying to make sure that sponsors and exhibitors find value. And we will turn you down and say, you don't belong on the floor, you belong in the rooms and the discussion. I want you to continue to come, and we don't want to just take people's money, that isn't going to get that ROI and the value. Then you've got the people who are coming from the health care facilities and independents, and they're letting us know their boss won't give them PTO to come to the conference. They have to pay on their own. So now we're selling to the hospitals on why they should come, helping justify, you see a lot of these letters like [saying] "Hey, here's a letter show your boss." No, we are jumping on the phones with their team, I'm showing them, asking them numbers on how are you treating, are you using copay cards? Are these like actually showing them that we're more than just an event to have a conference, so we're empowering those health care workers that used to be me, that nobody helped me out figure this solution. Now we figured it out. Now we're selling to the hospitals, "This is why you need to send your person, don't just send your top person. I need the person who's on the phone with the payers and filling out applications."
And then, to everybody else, we've got patients...you throw in the word "health care advocate," and you talk about the patient journey, and I've read lots of articles, you can't talk about [it] unless you have the patients there. And so, we're very clear on our mission of what we're trying to do, of support those who are navigating the patient journey alongside the patient. We are all inspired, the patient stories are what drives us, but putting patient stories on stage is important, but we're already engaged. How can we fix this? And so, I think some of those conversations is just on what a health care advocate is. We—Elizabeth and I—have gone through this year after year...sometimes getting beat up on, "you can't use that word, you work in a hospital," or [something else]. And we all are healthcare advocates.
Madison: Absolutely. I'd love to see a board, if you guys could put up a board and people could write what thing that they were able to accomplish since attending last. Kind of how you were saying, how they got that prior auth covered that had been sitting there for 6 months, it'd be so cool to just see what do you plan to get out of the conference, or what have you gotten out of the conference in the past. That would be really cool to see.
Paige: [It’s] like you just saw my notes on what we’re planning on. What makes you an advocate...you'll be the first one to fill it out. But yeah, absolutely. I think bringing...the patients that we help and the health care workers' stories, and I think this year we're really going to drive home on what is a health care advocate, and opening the conference with some type of video or interview, just to set the stage right. Who are the people in the room, who are you going to interact with over the next couple of days? And when you calculate it out—because I calculate out everything—we are stealing thousands of hours of people's lives to come to our event, and if we don't figure out how to make this in a way that's valuable for them...[we're] away from our families, I'm flying my kids to who knows what state so my family can take care of them so we can even be there, like we're taking time away [from people] and time is so valuable. This is a very conference-heavy world, [there are] conferences every week. And so, how can you "out care" some of the other events out there and make sure that they can leave with something and feel inspired?
Madison: Oh my goodness, I could talk to you lovely ladies forever, not to mention the fact that I feel so blessed that I was able to get both of you guys on the same call at the same time, because you are so incredibly busy.
Before we kind of wrap up the conversation, I usually like to ask this question of my guests: If there was something you could tell your younger self, what would it be and why?
Johnson: Oh, this is one of my favorite questions, even to use like an icebreaker at a meeting. But I would certainly tell my younger self—who really thought that she was going to be a doctor and that was how she was going to change lives—having been on the other side now, there's so many other ways to make a difference in a patient's life, and the more creative you are about it, the more outcomes that you have. So, I wished I would have been a doctor, but now, oh, no way.
Paige: Mine's kind of on the same thread...I was supposed to be a pharmacist, that was my end goal, right? You have this trajectory, life happens, and these things...and I've been a pharmacy tech, and I've stayed it, and sometimes I wasn't as vocal about it because I didn't want it to withhold me from conversations or being at certain tables. And now I am so proud that I just stuck to what I wanted to do, my passions in just making sure you're authentically you, and I think with anything, be you. If you don't feel it, listen to your instincts. And I make fun of this, if they always say, "Bring a seat to the table," well, if that doesn't work, bring a table, your own table. I mean, it's been at the point where I think we built our whole building with the table, providing all the other people, and their chairs, and ask them what color and treats they want when they sit there.
Johnson: Melissa didn't give me a chair, by the way, I just sat on the table and said, "I'm here to stay.”
Paige: So, you know, make the difference and find those people, and I think...it is really hard to find genuine people who don't think that somebody is after them in any reason, right? And I want to always empower, there's a huge group out there, let us introduce you to their friends. But you know, for me, if I was to tell my younger self something, it's just keep going, when 1 door shuts, another will open. Or in my case, I brought a lot of dynamite, and I never got caught. So now here I am.
Madison: Okay, so I'm pretty sure that my audience is going to want to find how to follow you, how to connect with you, so please tell the audience where they can connect with you online, social media, websites, all of the things, and we will include all of those links in the show notes.
Johnson: Find me on LinkedIn, that’s the easiest place.
Madison: Melissa is on LinkedIn, too? And I think Summit has its own page?
Paige: Summit has its own page, I'm usually the one replying really funny things and [being] very personable on that page. So, drop something there, and you'll know it's me [based on] the way I respond.
Johnson: Healthcare Advocate Summit has more than just LinkedIn, we have Facebook, we have Twitter, we have Instagram…Melissa [made] a TikTok. I mean, we’re hip, we’re relevant.
Madison: Well, ladies, this has been such an extraordinary conversation. I'm so glad that I've had an opportunity to highlight this incredible Summit that's coming up in September, I look forward to the ability to amplify your message and elevate your incredible voices, and I'm just truly grateful for the work that you're doing. I know that the people that you've helped and will continue to help will benefit from your blood, sweat, and tears, and I'm so glad that you all met each other and are just combining your forces for good.
Johnson: Thank you so much for having us.
Paige: Yeah, thank you.
Madison: All right. Well, this has been another episode of Public Health Matters. Again, I am your host, Dr. Christina Madison, also known as the public health pharmacist. Please continue to follow us and check out the Pharmacy Times Pharmacy Focus podcast series for more episodes. And remember, public health matters.
You can learn more about Healthcare Advocate Summit and follow on social media:
Connect with Melissa Paige and Elizabeth Johnson on LinkedIn!
