Defining patient advocacy in the post-quality chasm era.

atient advocacy is a concept that generally refers to efforts to support patients and their interests within the context of the health care system. As discussed in the issue brief that introduces this issue of the North Carolina Medical Journal, amore specific or applied definition of patient advocacy is difficult to articulate, in part because the term has been used inmany different ways. For example, the role of advocate is often ascribed to certain professions, especially the “helping professions” of nursing and social work. Others associate patient advocacy with particular kinds of care, such as mental health or palliative care, inwhich vulnerablepatients’ autonomy maybe in jeopardy.Athirduseof patient advocacy is todenote the work of policymakers, legal professionals, and activists who work to improve health care for people marginalized by socially stigmatizing diseases such as HIV. Given the variety of contexts in which the concept is used, research can help us better explicate patient advocacy, a task necessary for advancing both scholarly and applied efforts to improve health care quality. Our research goal was to explore the concept of patient advocacy as defined by those known as leaders in advocacy practice. Specifically, wewished to gain a better understanding of the personal and professional roles associated with patient advocacy as well as its primary goals, methods, rewards, and challenges. Toward this end, we surveyed a national sample of leaders in patient advocacy practice in 2005, using a confidential, online questionnaire known as the University of North Carolina Patient Advocacy Survey.