The field of health advocacy also has deeper roots in the voluntary organizational sector of society, where early health advocates typically advocated for a cause, not an individual. These health advocates preceded hospital patient advocates and are part of a long history of American involvement in social organizations.  They were activists in social movements and voluntary associations, including civic organizations, women`s associations, and labor organizations, and in early non-profit organizations specific to the disease such as the American Cancer Society (founded as the American Society for the Control of Cancer in 1913) or the March of Dimes (founded as the National Foundation for Infantile Paralysis in 1938). In the first half of the 20. In the nineteenth century, these lawyers came to work in other professional ways, often as social workers, lawyers, public health nurses or doctors. They were the progressive “new women” of Hull House and the Children`s Bureau, the American Association for Labor Legislation, which led the leaders of the national health insurance movement in 1919, the nurses who worked with Lillian Wald to advocate for health care in need through the Visiting Nurse Services, (1893) or with the Maternity Center Association (1918), advocating for maternal and infant care for poor immigrants. They received their professional training in other disciplines and then applied it to health. [Citation needed] By 2010, nearly two dozen organizations had begun offering certificate programs, workshops, and diplomas in patient or health advocacy. Every year, more and more organizations, including colleges and universities, offer programs that meet the needs of the many people who turn to careers in patient and health advocacy. Some patient advocacy groups receive donations from pharmaceutical companies.
In 2015, 14 companies donated $116 million to patient advocacy groups. A database that identified more than 1,200 patient groups showed that in 2015, six pharmaceutical companies donated $1 million or more to individual groups representing patients who use their drugs, and 594 groups in the database received donations from pharmaceutical companies. Fifteen patient groups relied on pharmaceutical companies for at least 20% of their sales in the same year, and some received more than half of their sales from pharmaceutical companies. Recipients of donations from pharmaceutical companies include the American Diabetes Association, Susan G. Komen, and the Caring Ambassadors Program.  The American Nurses Association (ANA) includes advocacy in its definition of nursing: sometimes the patient and their family hire a patient advocate from a registry such as advoConnection. In this case, the lawyer can be a trained and experienced nurse, doctor or nurse who helps the patient in the hospital or at home. They receive medical records, ask questions, keep notes, help patients make their own difficult medical decisions, and review and negotiate medical bills. As global health systems became increasingly complex and the role of care costs continued to place a heavier burden on patients, a new profession of private professional advocacy began to take hold in the mid-2000s.
At that time, two organizations were created to support the work of these new private practitioners, professional patient representatives. [Citation needed] The National Association of Healthcare Advocacy Consultants was established to provide broad advocacy support.  The Alliance of Professional Health Advocates was created to support the activities of a private lawyer.  The Patient Advocate Certification Board (PACB) is the national body that develops a qualification for the patient advocacy profession. PacB defines a patient advocate as “a professional who provides services to patients and those who support them as they move along the complex continuum of health care. Lawyers work directly with clients (or their legal representatives) to ensure they have a voice in their care and information to promote informed decision-making. Lawyers may work independently or in medical settings or other organizations. They serve individuals, communities, disease-specific populations and family caregivers. “Patient advocacy is a healthcare specialty that deals with advocacy for patients, survivors and caregivers.
The patient`s representative may be a person or organization, often, but not always, that deals with a particular group of disorders. The terms “patient advocate” and “patient advocacy” can refer to both individual advocates who provide services that the organisations also provide, and organisations whose functions extend to individual patients […].