patient advocate

Dear Corporate Personhood, …

What has been your experience with large corporate entities? Are you just a cog in the wheel or do you have a voice?

I now have experienced the soullessness of corporations. I may be just a little cog in their wheel, but I have an effect.

The recession caught up to my small health care business. We held out for a long time. I will not close my doors, but I do need to supplement my income. So I sought outside employment to lower my debt ratio.

My plan was to work for a company in which I would not get attached. So the large national corporation that offered me a job seemed like a win-win. I would work for them for as long as it took to pay off my debts doing assessments of the elderly and making recommendations to their primary care providers. A public service without the strings.

I did cause some waves, I must admit. I was shocked at the misinformation of this huge national company who hired nurse practitioners and physicians. They clearly did not know the individual state practice acts. Their contracts left much to be desired. I was just protecting myself…but felt it my duty to my colleagues to offer suggestions of change within the corporation to better protect the health care providers.

And after a month of jumping through hoops for them and just a few days before I was to start work, I got a voicemail. Apparently the position no longer existed. Not because I made waves, but because they counted their chickens before they hatched. TheirCaliforniaclient pulled out after waiting five months for them to fill the position.

Hmmm. I felt strangely relieved, yet wondered why? And did not receive an answer, nor closure, nor condolences. I expected more. They were so friendly and available before I got the voicemail.

So I drafted a letter to them…


To Whom It May Concern; 

In an effort to seek closure, I am writing this letter.

As a nurse practitioner with 25 years experience, I have assessed, diagnosed and treated thousands of patients. I have helped birth infants into this world and the elderly and infirmed through death. And I have always been fully present in every healing situation. So with presence, I reached out to those who guided me through the process of employment within this national corporation. And I am grateful to each end every one of them for their kind assistance.

This is my first experience of employment with a national corporation. Corporations may have legal personhood, but this one, at least, seems to have no soul. I have yet to receive condolence, explanation, or compensation.

As an entrepreneur, I have created an entity with soul. My employees are well cared for, listened to, and taken seriously. They are not a means to an end, but the spirit of my practice. I am grateful to be reminded that my choice to open a small business and keep it running during the recession has been best for all of us.

During our long interactions, I do believe that your corporation has benefitted. I was the first part-time employee to bring to your attention the lack of clarity in your contract. Which I was told would be rewritten.

I was also the first who alerted you that your California Nurse Practitioner-Physician Collaboration Agreement does not adequately reflect the state practice act for either nurse practitioners or physicians and thus as written puts both parties at risk. I hope you change this as soon as possible.

I take responsibility for believing in your national corporation, for rushing to fulfill all that was asked of me as a contracted employee, for taking time away from my own business, and paying for legal counsel before signing your contract.

In the month it took to fulfill all that you required of me to prepare for employment—hours of filling out paperwork for credentialing, inoculations for health clearance, submitting to you my banking and identity information—all of which I completed by your deadlines—I have missed out on four weeks of income from the job I refused once I signed on with you.

I am sure your employment process is the same for everyone. Yet I was informed that the situation that happened to me was quite unusual. So I can only assume that you do not have a policy to deal with it.

At the very least, I wish acknowledgment that you have destroyed all my sensitive information.

Clearly it is not meant for me to work with you. If there is a next time, I will insist on a sign-on bonus. Executives with less responsibility for public well being receive sign on bonuses to make it worth their while. Nurse practitioners must have a higher sense of self to be valued by all employers, even national corporations. Especially those that base their profit margin on the services rendered by nurse practitioners.

I serve on the Past Presidents Council of the California Association of Nurse Practitioners representing 14,000 nurse practitioners and will be speaking at the annual educational conference in March regarding business practices. I am grateful for what I have learned in this experience yet am concerned for my colleagues should they choose to seek employment with your corporation.

I hope you make the necessary adjustments to policy so that another potential employee is not adversely affected.

I’m sorry that I cannot recommend your company to my colleagues. I wish you success in helping those you serve—patients.


Deborah Maragopoulos MN APRN BC, FNP

Intuitive Integrative Health

Full Circle Family Health

I have spent my life creating change. Being a pioneer. Walking down unknown paths, finding the pitfalls, and alerting those who might follow. I am an effective patient advocate and a voice for my colleagues. I created change as President of the California Association of Nurse Practitioners. I created change for patients by providing integrative medical choices when I opened my own practice in 1997. And now I am creating change in voicing my concern.

Health Care Reform is needed….for all our sakes…patients and providers alike.

We need choices from the best of conventional and complementary medicine.

We need freedom to choose what is best for us, for our patients, not be tied to insurers’ treatment protocols.

We need to educate our patients especially on the health care choices that are within their control…but first we need to educate ourselves on natural means to healing and how to help our patients heal themselves.

We need to stop creating dependency on prescriptions, on myopic assessments that force the patients to come back over and over milking the system, when time spent educating rather than medicating would heal them and be much more cost effective.

We need to remember as health care providers that we do not heal our patients, but are instruments in their healing process.

We need as patients to empower ourselves, take responsibility for our health choices, and learn to listen to our bodies’ innate wisdom.

We need to work together—patients and providers—with the goal of optimal health and wellbeing.

We need to start NOW!