“Without doubt, you have to leave the comfort zone of base camp and confront an entirely new and unknown wilderness.” -Stephen Covey

Stephen Covey’s best-selling book, The 7 Habits of Highly Effective People was first published in 1989 as a business and self-help book. Covey presents an approach to being effective in attaining goals by aligning ourselves to what he calls “true north” principles. I was inspired reading this article by Melissa McAllister, to go back and read the principles behind the book to see how we might apply them to our advocacy work.

HABIT 1: Be Proactive

The first habit that Covey discusses is being proactive. I cannot think of a more apt description of patient advocacy – in order to be effective, we must be relentlessly proactive. Carolyn Thomas, a heart attack survivor, and author of A Woman’s Guide To Living With Heart Disease, tells the story of how her cardiac symptoms were dismissed when she was first admitted to the ER. She wonders had it been her daughter or sister experiencing the same symptoms, what would she have done? The answer: “screaming blue murder to get the help this other person deserved, with no thought whatsoever of being labelled as “difficult”. We need to be as strong and as diligent about getting help for our own medical needs as we’d be if we were trying to get help for our loved ones.”

HABIT 2: Begin with the End in Mind

Habit 2 suggests that, in everything we do, we should begin with the end in mind. We should envision the end result clearly and work with purpose toward achieving our vision of optimum care for ourselves and others.  One of the best ways to incorporate Habit 2 into your life, according to Covey, is to develop a Personal Mission Statement. Consider creating a Mission Statement to put your advocacy goals in focus and make your vision a reality.

HABIT 3: Put First Things First

In order to be effective, we must learn to prioritize our day-to-day actions based on what is most important, not what is most urgent. This means learning how to say no in order to focus on our priorities. As Covey puts it, “The key is not to prioritize what’s on your schedule, but to schedule your priorities.”  Dee Sparacio, author, blogger and ovarian cancer advocate, recently wrote on her blog about taking a step back from her heavy work-load of advocacy activities to focus on her priorities. She outlined a list of questions to help her decide which activities to prioritize:

• How effective am I at doing that work?
• Am I the only one doing that work?
• If I am the only one can another advocate/person do it?
• How much does the work benefit other survivors/patients?
• How many people are effected by the work I do?
• Do I ever regret having agreed to do the work and feel that way when I am doing it?
• Does the work ever prevent me from doing other things – like hang out with my husband, grand-kids or dog?
• Does that work bring me joy?

These questions can be helpful for us to look at our own activities and decide which advocacy roles we want to put on the top of our priority list.

HABIT 4: Think Win-Win

In our advocacy work, we will inevitably find ourselves in a situation where our wants and needs conflict with another’s. In order to practice this habit, we must commit to creating Win-Win situations that are mutually beneficial to each party. While recognizing this might not always be possible, this habit reminds us that we must at least try to understand the other person’s point of view and work if possible towards a mutually satisfying outcome.

HABIT 5: Seek First to Understand, Then to Be Understood

Communication is one of the most important skills we can develop. While many advocates can speak well, how many of us are good listeners? Listening and hearing are not the same things. Most people listen with the intent to reply, not to understand. Poor listeners are unable to separate their own needs and interests from those of others. They are more likely to interrupt and to jump to conclusions about what the other person is saying. Active listening requires critical thinking skills and emotional intelligence.  Developing the ability to listen deeply allows us to respond with an open minded empathy to another’s situation. We are less inclined then to interpret the other person’s words solely from our own perspective and frame of reference.

HABIT 6: Synergize

Synergize is the habit of creative cooperation. Covey describes this habit as one in which the whole is great than the sum of its parts: “It’s a process, and through that process, people bring all their personal experience and expertise to the table. Together, they can produce far better results that they could individually.”  From our own advocacy work, we know this to be true. We are stronger together. When we bring our collective voices, skills, and experience together, we achieve more. Covey points out that valuing differences is what really drives synergy: “When people begin to interact together genuinely, and they’re open to each other’s influence, they begin to gain new insight. The capability of inventing new approaches is increased exponentially because of differences.”

HABIT 7: Sharpen the Saw

Habit 7 is focused around taking time to renew our resources and health to create a sustainable long-term environment for our advocacy work. “Sharpen the Saw”, writes Covey, “means preserving and enhancing the greatest asset you have—you.”  In our desire to effect change quickly we can easily burn-out. Renewing ourselves physically, spiritually, emotionally and mentally will help us practice each of these seven habits more effectively. 

Some Final Thoughts on Being an Effective Patient Advocate

 I asked some of my favorite patient advocates to share their thoughts on what makes an effective advocate. Here’s what they told me.

“Passion, persistence, patience. Self-leadership, clear vision, courage (at least sometimes!) ‘We’ attitude, optimism, hope, trust, belief in basic goodness. Ability to listen, collaborate, cajole, criticise (constructively), take criticism.” – Anne Lawlor, Founder, 22Q11 Ireland

“Knowing when you need to talk about your personal view or experience and when you need to garner input from other patients. Nobody’s voice speaks for everyone.” – Alison Fielding, Chair Cardiomyopathy UK

“Passion, tenacity and balance. If you don’t have a passion for what you do, you tend not to give your all. Tenacity for it is inevitable that someone will tell you no or close the door in your face. When that happens you must remember your passion. Balance because you need a life.” – Anne Marie, lung cancer patient and blogger at These Are My Scars

“Perseverance, stand your ground, listen, don’t be afraid (to ask questions or admit you don’t know something) – remind others you want the same.  Understand your goals, what are you trying to achieve and why.” – Julia, co-founder #BCCWW

“Passion, commitment, belief in what you are doing, being a voice for not just you but many, speaking out, assertive, having your opinion doesn’t matter if it’s unique, a great communicator and networker, good listener, resilience and determination.”  – Jo Taylor, Founder, After Breast Cancer Diagnosis

As you can see so many of these responses echo the 7 habits above.  Patient advocacy requires self-belief and a clear vision for what you want to achieve. Above all, it requires dedication, persistence and commitment. I am so proud to be able to work among such passionate patient advocates. The work is hard and often goes unnoticed, but your reach and impact is immeasurable.

Marie Ennis-O'Connor

A Stanford Medicine X e-Patient scholar, Marie Ennis O’Connor is an internationally recognized keynote speaker, writer, and consultant on global trends in patient engagement, digital health and participatory medicine. Marie’s work is informed by her passion for embedding the patient voice at the heart of healthcare values. She writes about the experience of transitioning from breast cancer patient to advocate on her award-winning blog Journeying Beyond Breast Cancer.

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