Conversation With Patient Advocacy Influencer Christy Snodgrass @christyprn

Christy Snodgrass is a registered nurse, turned healthcare reformer and patient advocate. While working in the hospital she witnessed firsthand how the complexity and lack of transparency in healthcare placed a huge burden on healthcare workers and patients. She has since built a social media platform of over 800,000 followers where she sheds light on these issues and provides the public with resources to help them navigate our difficult healthcare system.

Christy represents a new generation of advocates, and her platform has already gone a long way toward exposing the need for advocacy. This brings us to another reason we’re featuring Christy. The Healthcare Advocate Summit in Las Vegas is quickly approaching, and one of the benefits of the summit is the chance to learn about the profession, even if you’re not yet an advocate. This season 2 finale episode provides a different perspective of the profession from the standpoint of someone who uses social media to promote Independent Patient Advocacy for the benefit of the entire profession. 

Transcript

Introduction

You're listening to the Patient Advocacy Network Podcast, presented by Greater National Advocates. It's just gut-wrenching sometimes. Like, if it's sad and they're crying, I might cry. Amazing how many doctors do not even want to treat somebody who has Medicaid. Medical system is about making money. And I said, so are you hiring more nurses, or are you just telling each nurse to work harder?

Christy Snodgrass

If you don't know me, my name is Christy. I'm a nurse that quit my job at a hospital to work full-time with organizations working on healthcare reform. If we ever want anything to change, we've got to fight like hell to make our voices heard. Sometimes the only way that we're able to convince them that the issue is actually an issue is by continuously shoving examples of it in front of their face. 
Our data can only go so far, but the stories of real people who have suffered the real consequences of medical debt is what pushes that over the finish line.

Host

That's our special guest, Christy Snodgrass, and we're excited to have her on the Season 2 finale of the Patient Advocacy Now Podcast. If you're a loyal listener, you know we've been spotlighting a lot of the boots-on-the-ground advocates who work face-to-face with patients every day, fighting for safe, coordinated care, and making sure care teams are talking to each other and to their patients. In this episode, we're mixing things up to discuss public awareness for independent patient advocacy and the need for everyone to work together. 
Christy walks us through her journey from nurse and case manager to advocate and social media influencer. She's accumulated over 800,000 TikTok followers with her irresistible and funny straight talk about the dirty little secrets within our healthcare system. She uses her platform to reach a new generation of patients, informing them about their financial rights and the importance of independent healthcare advocacy. 
And with the Healthcare Advocates Summit in Vegas quickly approaching, we wanted to highlight the importance of bringing new advocates into the profession. The summit is a great opportunity for anyone interested in learning about patient advocacy or considering it as a career. We asked Christy how she made the jump because there are some great advocates out there who just don't think they're ready. 
Here's what she told us.

Christy Snodgrass

So what I did initially when I decided I wanted to move into advocacy is I literally got on Google and was like, healthcare advocacy group search, like, and just looked what is out there and what do I personally feel like my values align with. And then I would send them an email or I would look for employees of theirs on LinkedIn and I would send them a message and say, hey, not I want you to hire me, but here I have five hours a week. Let me volunteer for you. 
Oh, I see you don't have a nurse on your staff. Can I give you a clinical perspective for this product you're building? Just reaching out, reaching out and offering my time for free, which I know not everybody can do, but if you can, making that connection. 
Once they met me and I was able to get to know their organization and offer my advice or write their newsletter or whatever, they saw value in what I could provide. And then I was just able to build off of that from there.

Host

I think that's great. And so just leverage what you have as you reach out. So if you're a designer, talk about that if you're good at writing, if you're just good at organizing people, you know, just volunteering, which leads to more work and more opportunity and also getting to know the field more as well. 
Sounds like a great way to just get your hands dirty.

Christy Snodgrass

Absolutely. And the other thing is, I reached out to a lot of organizations just asking if I could learn. Many of these organizations want the public to know what they're doing. 
So I would reach out and say, hey, I saw this thing that you posted. I'm really interested in that. Can you take a 15 minute meeting with me and just tell me about it so I can tell everybody else, like I want to do that for you. 
So I ended up, I think my first year that I was at this, I ended up meeting with like over a hundred different organizations, just asking questions and trying to learn because there's so, so much to learn in advocacy. And there's so many areas where I was like, I didn't even know that that was a thing or an option. It was surprising. 
And I was able to make a lot of connections that way and build an actual career from there.

Host

Where do you think we're failing in spreading the word? I mean, being part of greater national advocates, we're always looking for how, like where can we do better in terms of education and spreading awareness?

Christy Snodgrass

Yeah. So I, one of the things that I noticed right off the bat when I wanted to get into this field was I had never heard about it before. And that was true for, I would say 90% of the organizations that I met with that first year. 
I'd never heard about them. I didn't know that they existed. And I think the reason for that is, is that organizations tend to be a little bit more traditional and we're not like, we don't have huge marketing budgets, right? 
So we can't be everywhere. So these organizations would be at conferences or, you know, going to doctor's offices and that's not where people are. That's not where the me's of the world were. 
You know, we were, you know, scrolling TikTok or on Instagram or, you know, whatever. So that's why I decided that avenue to get to my generation of healthcare workers. And I still do that a lot today is like, where are people? 
Cause I'm going to go to where the people are instead of asking them to come to me.

Host

And what do you find keeps you motivated? Cause there's a lot of, I mean, especially with social media and spreading awareness, it's kind of an ever hungry beast and there's tons of content you have to put out. How do you avoid burnout in this space and how do you keep yourself motivated?

Christy Snodgrass

Yeah. So I'm not going to lie. I am not the type of person who would ever outside of this, want to have a large social media platform. 
It was a means to an end for me. So I number one, don't read my comments almost ever. I, I don't want to know. 
Okay. The internet is a wild place. So when I was reading my comments, I was burning out at the speed of light. 
So I try not to, I try not to read my comments. I try not to take to heart what a random person is saying on the internet. But beyond that, I very much view any of what I'm putting out as a means to an end. 
I am trying to spread awareness. I am trying to get the person who will never be at the healthcare conference, who will never read that flyer that was in their doctor's office or whatever. I'm trying to get to essentially the most vulnerable populations of patients and of healthcare workers who really need this information. 
And I take breaks when I need to. I don't. I don't have to do it. 
I don't have to do it. I'm trying to get people to understand what's happening. Something that was really surprising. 
Moving from the healthcare clinical field to healthcare advocacy. Was that. The moral injury can be just as high as. 
If not higher. The difference is I had an employer. You know, Putting that more injury. 
and now I have myself. I have myself who, you know, I really, really want to help people. And now I have this avenue where I can go as hard as I want. 
So taking that time and restraining myself and saying like, I'm pushing too hard is difficult, especially when you see how big the need is.

Host

Yeah, breaks are huge. But keeping hold of that focus seems like it's a good kind of North star for you to keep you on point. Do you find that you look up to others in the field? 
Are there other influencers? Are there organizations? Are there podcasts that you kind of listen to? 
Tell me where, you know, do you draw on it or do you, are you really just solely relying on your clinical background?

Christy Snodgrass

No, so there are organizations that I tend to partner with and do work with all the time that kind of hold me accountable and not just to the work that I'm doing, but to taking care of myself and pouring back into myself. I try to surround myself with organizations like Dollar 4 and Don't Clock Out. There are tons of organizations who have these truly great leaders that care about people. 
And I try to kind of bounce my ideas off of them as often as possible and take breaks when they're like, hey, Christy, you look like, you know, you look like you could use a little rest. So yeah, there are definitely organizations out there that I try to align myself with and not necessarily model myself after, but at least take direction from.

Host

Yeah, I mean, I know that at Greater National Advocates, we'd love to partner with you on stuff. You have a great kind of head on your shoulders. How familiar are you with GNA?

Christy Snodgrass

I'm pretty familiar. I met Brad, I wanna say right, he was one of those 100 organizations that I talked with in my very first year. So I am a huge fan. 
I refer patients to Greater National Advocates as often as possible. I'm just, this is such a necessary organization in this space, especially when patients have like nowhere else to go.

Host

You know, I've watched you tell your story on other podcasts and I know you can talk for hours on it, but I like to kind of boil things down quickly for people in case they haven't had a chance to really get to know your story or you're new to them. So if it's okay with you, I wanted to kind of just play one of your TikTok videos. It's two and a half minutes where you kind of go through some of the highlights and we can kind of dissect it from there. 
Is that cool?

Christy Snodgrass

Absolutely. I was on a floor that was not oncology. And I was like, this is not where I got hired onto. 
What's happening? And they were like, oh, this is a new graduate nurse program. Come to find out from the other nurses that none of the other floors had enough experienced nurses to train a new nurse. 
I did three months of that and was thrown onto the oncology floor with zero oncology training. Day one, a doctor asked me to go do a procedure that I have never done. I turn and I look at my charge and she says, just go. 
Six to eight months in, I was charged nurse. Eight months in, I was already training new nurses. Eventually I ended up getting chemotherapy certified. 
The moment for me was when I was the charge nurse with a bunch of new nurses. I had a full load of patients myself. Half of them were med surge and I was doing all the chemotherapy in the hospital by myself. 
I was running back and forth. I had a near accident that happened and I just stopped and I thought I could have hurt someone and I could have lost my license for things that were totally preventable. Shortly after that, I was given chemotherapy to one of my patients who was very recently diagnosed with cancer, automatically got hit with crippling debt. 
He said, if I would have known that I would have lost all the savings, everything that I had by just one hospital admission, I would have just stayed home and died. So I'm sitting here and thinking, this healthcare system is not taking care of me. I'm burning myself out, trying my hardest to take care of the patients, but no matter what I do, they can still be ruined by one hospital admission. 
So something's gotta change. That's when I switched to case management. I learned about reimbursement systems of the hospital. 
And I said, you know what? People need to know about this. And not only do people need to be educated, but we need to start doing things a lot differently and we need to be very loud and very bold about it. 
I've been partnering with organizations for the past two years. We do everything from boots on the ground advocacy to advocating for policy change, to healthcare worker advocacy. I feel like I'm being more of a nurse now than I was ever allowed to be at bedside. 
And that's almost what's really sad to me. I'm not one of those people who wanted to be a nurse to segue into something else. I wanted to be a nurse, but unfortunately we have a system that is not designed for nurses. 
So I'm doing what I'm doing now so that eventually whatever generations of nurses come behind us, we'll have a system that's designed for them.

Host

Okay. Lot in that two and a half minute clip. A lot in there.

Christy Snodgrass

It is, yes.

Host

To me, there were two or three highlights. One was some serious lack of resources in the medical field, which probably led to a crazy amount of burnout. And then the second thing I saw was this lopsided, really not so patient-centric care-focused economic system that was a kick in the pants. 
Is there something that I'm not seeing? Kind of those were like the two key points that I think probably drove you to go into advocacy.

Christy Snodgrass

Definitely. And you're right, John, the moral injury in healthcare is high. And I think that people started to take notice of it finally during COVID, but it was happening way before then. 
So what's happening with nurses and doctors is that we've been severely, severely under-resourced for a very long time. However, during COVID, we were in the public's eye at a level that we have never been before. So the public finally saw that we didn't have masks, we didn't have resources, we didn't have our meds, we were running short-staffed. 
And it was like, oh my gosh, what is happening? Like, what is the quality of care if this is how our doctors and our nurses are running? And we are sitting there like, this is how we've been for years and years on end, it's just the first time you're seeing it. 
So from there, it gave a lot of nurses and doctors a platform to kind of jump off from and talk about this stuff for the very first time because the public was seeing it for the very first time. So that allowed me to create a social media platform where I started talking about these issues and then it just took off from there.

Host

Yeah, and that social media platform primarily is on TikTok. The username, if you didn't catch it in the video, if you're listening to this is ChristiePRN, is that right? Correct, yes. 
So one thing since we kind of got onto the social media, I think one of the benefits of what you do in your space is you probably get a tremendous amount of comments and feedback and so you kind of see the same questions or insights or shock from people across the globe again and again. What are some of the things that you were like, oh my God, another person is sending me the same video or the same question? What are the normal things that you hear constantly?

Christy Snodgrass

Well, I think as a nurse, just hearing that other nurses outside of my own little bubble were going through the same thing that I was going through with leadership, with short staffing, with resources. I mean, we all kind of knew, but we didn't know we were all suffering at the same level essentially because historically nurses and healthcare workers have been viewed as martyrs, right? We are supposed to give and give and give and even if we're short resource, even if we don't have what we need, we're doing it for the patient, right? 
So we aren't allowed by our hospitals or by our organizations to speak up and say, hey, this is subpar quality of care and we're burning out and getting morally injured and we need help. We haven't been able to say that because there's a lot of retaliation in healthcare and I think that's another thing that people were surprised by, not us, but the general public. We're really surprised that nurses and doctors are speaking up and saying, hey, this is not safe for the patient is not really allowed within the healthcare industry because then that falls back on the hospital or the leadership.

Host

So I think- So what's the actual mechanism there? Sorry to interrupt you, but as someone who doesn't work in that space, what's the mechanism to muzzle the nurses and the doctors? Is it a threat of being fired? 
Is it disciplinary action?

Christy Snodgrass

It is disciplinary action. We're already short-staffed in working under conditions, but you can work under worse conditions always. So you could get the weekend shift or the crew that you don't really wanna work with. 
There is a number of things that management can do to make your life worse. And the ultimate retaliation is firing and firing happens a lot for reasons that you might not exactly know why you were fired or they might say that you were a minute late and you're like, okay, show me the paperwork and then the paperwork doesn't exist. They'll find a reason if they need one. 
And then the other thing is, once you get fired from one job, it's hard sometimes to get hired onto another job because you're relying on that previous employer to give you a recommendation, to tell the new employer how you operate clinically. And if they don't like you, then that can make your life really difficult.

Host

Yeah, it sounds like it. And prior to firing, some of the things that you were talking about about making your working conditions worse, those are things that can be done and there's no tangible evidence that it's being done maliciously. You'd have to actually prove it. 
So there's a lot of manipulation they can do there, which is sad.

Christy Snodgrass

Right, right. The other thing is, a lot of nurses in order to get out of the worst working conditions will try to climb the ladder. And if you are a nurse or a doctor who is constantly bucking the system and going against what is required of you, then you're not gonna get those opportunities.

Host

You mentioned the word martyr, which is super interesting. So from a psychological, emotional perspective, if you're a martyr for your kids, everybody kind of gets it, right? Because you're always gonna love your kids. 
But as a nurse, is there a point because these are, at the end of the day, yes, everybody has that human connection, but they're not family. And so is there a point where it switches to apathy and you just stop caring so much?

Christy Snodgrass

Absolutely. So I've talked about this before briefly, but it's a really hard subject to bring up, especially with the public. But when nurses go into burnout, one of the end stages and most dangerous forms of burnout is when you reach that apathetic stage. 
And I would say that I was definitely in that stage before I left bedside. And it's not that we are giving subpar care. It's not that we don't care about the patient. 
It's that really hard and difficult emotional things are happening to us on a daily basis and you can't feel anything. And the way that affects you even outside of the hospital can be extremely dangerous, not only for the patient, but for the nurse and their mental health. And that's why you have mental health issues as well as high suicide rates among healthcare workers.

Host

So that might be a good sign for a practicing nurse to start considering changing things up. If they start feeling, first, I mean, mental health, obviously a big red flag, but if you do find that callousness, that numbness coming in, would you say that's a time where you're like, maybe consider either a career shift into advocacy or changing things up or working at a different, something to make it so that that doesn't kind of have a cloud over your head?

Christy Snodgrass

So when you start to feel nothing, so when you start to have a lack of feelings, that is a good indication that you need to move. However, there is culture within healthcare that the better you get at becoming a healthcare worker, the less you should feel. And I was actually told this by a lot of my superiors is like, oh, once you've been doing this for a few years, this isn't gonna affect you so much. 
Like you'll have a handle on your emotions, right? And I think often we mistake having a handle on our emotions for apathy and not feeling any emotions at all. And that's when it gets pretty dangerous.

Host

Being that there's different ways to be an advocate and one of them is, for example, financial, or one of them is just coordination. I think one of the things we don't hear enough is that people don't need this medical background to become an advocate. What would be your kind of motivation to people to look into joining the field?

Christy Snodgrass

I talk about this, I don't talk about this enough, but I have people reach out to me all the time and they're like, okay, what course should I take? What degree should I get? How do I like do what you're doing essentially? 
And the thing that I want people to know is like organizations who are working on healthcare reform don't need a certain degree. I don't need a nurse or a doctor or this or that certification. Like, can you put together slide shows? 
Can you write a monthly newsletter? Like that's what I need help with. And people tend to think that they need to have this big qualification or this thing solved before they can move into advocacy. 
And I'm like, no, you just need to have availability and the desire to help. And we can plug you in almost anywhere.

Host

As you can see, Christie is a huge cheerleader for the profession and she always takes the opportunity to encourage folks to enter into advocacy even if they don't have a clinical background or a degree in a medically related field. We asked Christie about her role as a hospital case manager, the pressures of carrying such a massive caseload and how hard it's always been for nurses to speak up about patient safety, workplace apathy and moral injury.

Christy Snodgrass

Before I moved into advocacy, my last job that I had was a case manager in the hospital. And it was my sole job to make sure that the patient moved through the hospital experience safely and went home safely and had all the resources they need to be healthy and succeed. I had no idea that any of you existed. 
I work closely with an organization called Dollar 4 that helps enforce hospital charity care policies. I did not know that my patients could apply for hospital charity care to pay their bills. I didn't know that it existed. 
And it was my entire job in the hospital to know these things and take care of these patients or at least that's what it was presented to me. But when you are employed by the hospital, the hospital is in charge of what information you do or don't know or what resources you can or can't give. And it can be a little difficult. 
I'm not saying that every advocate in the hospital is not looking out for the best interest of the patient or anything like that, but they are accountable to an employer. Whereas an independent advocate is only accountable to their client, which is the patient.

Host

That's a big difference.

Christy Snodgrass

It is a huge difference, yes.

Host

I think also one thing that just strikes me hearing this is if you're the case manager on behalf of the hospital, your caseload is probably huge. And so you can't spend the kind of time even if you wanted to educating yourself on certain things. So the censorship is gonna get in the way because you're overworked. 
Whereas if you are independent, you can spend more time with the client.

Christy Snodgrass

Absolutely. So there were multiple times in the hospital where I had a caseload of like 72 patients for the day. So I'm like going and trying to flip through charts. 
Yes, exactly. So there's no way that I could know exactly what stage each patient is at, what they needed. There's no way that I could get on the phone and like fight with an insurance company. 
I just didn't have the time of day. So when you're stretched that thin, you're barely doing the bare minimum.

Host

And- I would imagine with 72 patients in a day, could you even interface with all of them? I mean, some of them you're probably not even talking to.

Christy Snodgrass

Absolutely not. So they would put us in charge of floors. They would say that this whole floor and this other whole floor is yours. 
If a patient needs anything, they're coming to you. So I cannot actively look at every patient. I would reactively, oh, this patient needs to go home today. 
Do they have everything? And then I'm scrambling trying to make sure that do they have this at home? And did their insurance improve this? 
And it was very reactive as opposed to focusing on a single patient and making sure that they are actually moving through their hospital experience safely.

Host

Although the independent patient advocacy profession is growing and maturing, Christy made sure to stress the need for all advocacy organizations to work together in order to break up silos and encourage collaboration and partnerships within the advocacy profession.

Christy Snodgrass

Most advocates pick one piece to hold onto and they work on that, which I love because they build their expertise, but we're a little bit siloed. We're not, I feel, effectively coming together to work on this as an overarching picture. And when we're each working on our own little thing, sometimes it's hard to back up and see the bird's eye view of like, okay, is this gonna work out overall in the overall picture? 
So it can get a little disjointed. I guess where I see the issue personally is everybody has their own idea of what will solve our healthcare system, what will solve these big, big problems in our healthcare system. And sometimes each group is not willing to accept that maybe there's another way. 
Maybe there's multiple ways to fix our healthcare system. So what I found is there are some groups of advocates, not specific advocates, but groups that will say like, okay, unless you are doing it this way, I'm not gonna support you. Or I'm not gonna participate. 
And what ends up happening is we're all doubling up on the same work because we are all accomplishing the same goal, but in a slightly different way. Whereas if we were able to support each other and bring awareness to these other organizations, it might happen quicker. I think that a lot of organizations are coming together. 
I think we're beginning to be less siloed and I love that. I don't personally go to many conferences. I do keep up with organizations, but the bulk of my work is reaching outward to healthcare workers and patients to try to bring them in. 
I think we're really missing those key stakeholders. When I met with all these organizations in the very first year that I was doing this, something I realized right off the bat is there were not a lot of clinical people in this space. And there were also not a lot of people who have experienced what it's like to be on the other side as a patient as well. 
And I'm sure maybe patient advocacy specifically might be different, but these healthcare reform organizations in general did not have these stakeholders. So I'm actively trying to recruit more of those populations to come into this space and add their voice because it's so incredibly valuable. In doing my work over the past few years, I feel like all roads lead back to how we pay for healthcare here in America, what we subsidize in healthcare. 
And everybody who works in my industry, healthcare reform, we all work in different sectors, but we're all ultimately working on healthcare payment reform because what you throw your money at is what you value, right? So nurses right now are not subsidized in healthcare. Healthcare doesn't really reimburse for nurses or care about them. 
And it's not even reimbursing nurses, but what we are putting our healthcare dollars towards needs to change. The private insurance system is bloated beyond belief and needs to change. I don't know, and I can't say with confidence that that's exactly what changing our payment system is going to look like. 
I know everybody has their own ideas, but we need to start thinking harder about where our healthcare dollar is going and where we want it to go. Because I don't think anybody on either side of the spectrum agrees that our healthcare dollar is being used wisely.

Host

And what's interesting to me is you have this clinical background as a nurse, but you speak so openly about finances. What kind of advocacy work do you find yourself doing or talking about more if you're not doing as much and you're busy spreading the word? And do you do the clinical kind of medical guidance part of it, or do you find that you've kind of really stayed in the lane of case management and kind of the financial end?

Christy Snodgrass

I've stayed more on the financial end than I have the clinical end. Again, it is my belief that once we sort out the financial end of things, it'll be much easier to do the clinical end of things. Organizations, especially large organizations, or should I say corporations, which most of our healthcare is now, won't move until you move the money. 
So I could spend all my days trying to reorganize the clinical aspect of healthcare, but it's not gonna be valued or implemented by organizations until we move the dollar.

Host

Do you have any words of wisdom or advice for the patients and the loved ones who might be listening? Maybe they have no interest in becoming an advocate, but they do struggle with navigating the healthcare system.

Christy Snodgrass

Yeah, I mean, there are many organizations out there willing to help, but like I said, they might not be readily available. Just going to Google and saying like, okay, funds for this specific disease or patient advocacy organizations, if you can get connected with an independent patient advocate, please, please do it. I think that a lot of patients are relying on what's right in front of them, especially in the hospital. 
And they think that that is their only option. It is never a bad idea to get a second opinion from somebody outside.

Host

Absolutely, that's speaking our language. So we're right there with you. Christy Stodgrass, thank you so much for joining us. 
Is there anything, anywhere you wanna direct people to kind of, other than your TikTok, to kind of be invited into your own personal world?

Christy Snodgrass

My TikTok, my Instagram, that's the place that I put out all my content. I do have a few resources. My website is a little outdated, but that is healthcarereformed.org and patient and healthcare workers can access that for, a lot of different healthcare resources are on that website. So they can check it out.

Host

And I'm assuming your TikTok handles the same as your Instagram?

Christy Snodgrass

It is, yes.

Host

Okay, thank you so much. We'll put that in the show notes for everybody as well, in case you missed it. But just to say it one more time, it's ChristyPRN. 
So it's at ChristyPRN on Instagram and TikTok. Thanks again for being here. It was a lot of fun and insightful.

Christy Snodgrass

Absolutely, thanks for having me.