Systems Insider to Board-Certified Advocate: Veterans, Mental Health, and Real-World Care
Rachel J Nash traces her journey from rehabilitation counseling roles inside large systems (state vocational services, VA, Medicaid social work) to launching a private advocacy practice anchored in ethics, transparency, and patient empowerment. She explains why board certification matters to her—adherence to a code of ethics, continuing education, and clear boundaries such as not serving as a client’s POA—and how her work today focuses on adults, especially veterans and civilians with complex, long-ignored issues. Rachel demystifies VA basics like what a 10% service-connected disability rating enables, why continuity of care and accurate documentation strengthen claims, and how presumptive exposures (e.g., Agent Orange, burn pits) can link later conditions to service. She dives into mental health advocacy, candidly noting her own bipolar diagnosis and using it to frame a practical “cake” model where medication and therapy are only two ingredients alongside sleep, movement, relationships, purpose, and faith. She calls the mental health system the hardest to navigate due to stigma, overmedication, rushed visits, poor follow-through, and scarce beds or step-down programs; her counter is meticulous preparation, written timelines, and modeling collaborative, respectful communication in the exam room. Boots on the ground in the Carolinas, Rachel attends appointments, coordinates across providers and insurers, and insists on clients having “skin in the game” as true partners. Her one big system wish: more doctors with time and latitude to practice real medicine.
Resources Mentioned:
nashadvocacy@gmail.com
704-254-1407
www.va.gov
www.pacboard.org
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TRANSCRIPT
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Host
Rachel J Nash, thank you for being on the podcast.
Rachel-Jaye-Nash
Well, thank you for having me. It's great to hear my middle name, Jay.
Host
I guess you go by Rachel Nash a lot. Is that right?
Rachel-Jaye-Nash
I do, people know me. They don't say Rachel. They say Rachel Dash in my area. Yeah.
Host
that's funny. Kind of like Oprah's announcing you to the to the room or something. The full name. Your you mentioned when we had our first call before the interview that that becoming board certified was a very proud moment for you. Can you talk about your journey to becoming an advocate a little bit and why that was an important milestone?
Rachel-Jaye-Nash
Yeah.
Rachel-Jaye-Nash
Yeah, absolutely. I'm a fierce advocate for board certification and I'll explain why. I certainly have experience prior to that. I went to University School of Medicine. My background is in rehabilitation counseling.
Host
Mm-hmm.
Rachel-Jaye-Nash
And in the jobs that I've had, I served as an advocate. I worked for the state as a vocational counselor.
and I was an advocate. Now, it's a little difficult when you work for systems because you're advocating for 200. I worked for the VA for a short period of time, the federal government, and again, it's a little bit more difficult because you're advocating for 200 and not 10. And then I worked as a Medicaid social worker as well. So I advocated for
young children that had disabilities and worked with their parents to make sure that they had all the services that they needed. So I would call myself an advocate for a long time because advocacy is so important and to be able to help people when you know things that maybe they don't know and to be able to walk them through difficult, you know, channels.
Knowing forms knowing how to complete forms. Some people don't know And some people don't know what to say. Unfortunately when you're dealing with systems, there's words that matter You know, we use jargon that makes no sense to people And I was always Sort of cognizant about those things And always very patient
Host
Right.
Rachel-Jaye-Nash
And that had a lot to do with my personal journey. Because it's not, you know, look, I could have credentials and I can have a wonderful educational credentials on paper, but that's not what makes me special in what I do. That's not what makes me an advocate. But the reason I believe in board certification is because we subscribe to a licensing board.
And we have code of ethics that really matter to never do no harm to a patient, to not hold power over a patient, to not tell a patient what to do. It is about empowerment and we're not there forever. So if I can teach somebody how to do something and all of a sudden they become an advocate in their own world,
That is success. And that is probably my favorite thing to do. So when I say board certification is important, it's nothing to do with being a SNAP. It's nothing to do with me saying, you know, hey, I'm better than other advocates out there. But it's saying that I did the work. I was chosen because of the background that I have in social services. And I studied, of course, for the test, passed the test.
Host
Mm-hmm.
Rachel-Jaye-Nash
And not that tests matter either because I have my own feelings about exams and tests But I did and I did the continuing education that I'm that because health care changes it changes I could say every five minutes things are always changing so to have a licensing board and to have these tenants in place To say you know what I am NOT going to serve at someone's POA Because that would do that would that would be wrong
It's giving me power over someone's health. So I go in it as a partner and I love the certification. think, know, in 2018, the certification came about. It put us on the map. We are a career. And I know there's differing opinions out there and I really do respect everyone's opinion. But for me,
Host
Mm-hmm.
Rachel-Jaye-Nash
This is what works for
Host
That's great. What kind of populations, cause you have experience with the VA and with, you know, children and teens with disabilities. Do you find that that's the population you work with? And that's typically the work you do as an advocate now, or has it changed over time once you went private?
Rachel-Jaye-Nash
Well, I don't work with children. I don't work with children. It's not my scope of practice for sure. In my, most of my career has been working with adults and I feel it would be too hard on my heart to work with children. So.
Host
Sure. So who are you? are you? You know, is it, is it a specific population with specific disorders or do you find that it's a kind of a broader population and you're doing the same few things, you know, again and again?
Rachel-Jaye-Nash
Yeah, I think that's second. Let me give you some examples. I do work with veterans and I work with civilians. So the veterans that I work with are typically combat veterans or typically even Vietnam veterans that came back with things that they weren't aware of that would sort of always be there later in life.
and things that were never addressed. And soldiers of that time period and many of our combat veterans went in and they were taught, you're a man, you don't complain, you have issues, something hurts, you just buck up and deal with it. So those are the men and women that I work with.
Host
Mm-hmm.
Host
When you say buck up and deal with it, are you saying that those problems should have been addressed physically earlier and because they didn't, they kind of have led to either infections or other physical ailments? Are you talking about the mental, you know, kind of anguish? Are you talking about all of it?
Rachel-Jaye-Nash
All of it, all of the above, it varies. There's no person that's alike. So it could be mental health. Obviously Vietnam, what these men saw and what they dealt with, Iraq, Kuwait, Afghanistan, works, these were not men that reported issues. They weren't. But they have come back and in their own way, depending on the personality, they have had struggles. PTSD is an issue.
Host
Sure.
Rachel-Jaye-Nash
back problems, leg problems, pain, different things that they went through have become issues. you know, just for example, if you hurt your knee in combat, then chances are you may have residual issues that are stemming from your first service-connected issue. Does that kind of make sense?
Host
So PTSD is a factor. Tell me how you're working directly with the veterans. What do you typically do? Let's start there before we move on to the civilian population.
Rachel-Jaye-Nash
Alright.
Rachel-Jaye-Nash
The first thing that needs to happen is making sure that they have services in place, that they understand that they have access to the VA. So anybody with a 10 % rating can utilize the VA service and somebody without a 10 % rating will pay copays. Now don't pull me exactly on, huh?
Host
What is the 10 % rating?
Rachel-Jaye-Nash
10 % means that they have a service connection.
They're service connected with the VA. So let's say, you know, I have hearing loss because of my time in service and I get tested and they deem that hearing loss is rated 10%. Let's just say I'm not, I'd have to check it on va.gov because I do, you know, I do study va.gov.
and then they'll say, okay, so you are 10 % rated because this happened in service. So they can use VA services, they can access the VA healthcare system. And even if you don't have 10 %
Host
So 10 % connected, so just to clarify, so 10 % connection refers to the connection of whatever the ailment is to the service. Okay, got
Rachel-Jaye-Nash
Yes, disability. Yes, very good. Yeah. I don't know if hearing loss is 10%, but just that's an example. Right. And then sometimes hearing loss leads to tinnitus and then tinnitus leads to dizziness. It just depends on what the veteran's problems are. Because sometimes there's secondary symptoms.
Host
Right, as an example, hypothetically.
Rachel-Jaye-Nash
from service connection. And there's something called presumption too. So this is one of the reasons I work with the combat veterans. So if you were in, let's say Vietnam, chances are you could have been exposed to Agent Orange. So with Agent Orange exposure, if you've had X, Y, and Z illnesses,
then you can submit those for disability. Now my job...
Host
right, something like Soma or something like that that comes from Agent Orange, you'd have to kind of file for it, right?
Rachel-Jaye-Nash
Right. Right, right. Or if, you know, you have, let's say, you were exposed to burn pits, which is not Vietnam. It's another, you know, another time period. There are other things that are presumption. And a lot of veterans don't know this information is just not readily available. But my, my role is not to say, okay, look.
I'm going to guarantee you're going to get a disability rating. And I don't do what other people do as far as like a VSO is a veteran service officer. They are the role that does the paperwork. So that's not my role. My role is to make sure that I can help people navigate the process and make it easier. Get them to good doctors that will treat the diagnosis, not the symptoms.
treat the diagnosis and continuity of care when you are trying to prove disability with the VA system matters, which is good because that means you're seeking care and you're continuing your care. Now, there are a lot of hiccups and there's a lot of hills and valleys and that's where I come in to just help them through the hills and the valleys.
because it's a lot, it's a lot for a soldier. It's a lot. You know, they go to a doctor's appointment and I've done this and I've had several appointments with veterans and the doctor says, how are you doing today? And they go, fine. They're not fine. They're not fine. And by knowing their story, by knowing what they went through, either mental or physical, that's when I step in sometimes and say, well, let's kind of...
Host
Mm-hmm.
Rachel-Jaye-Nash
tell the doctor what's really going on. And then the real conversation happens. Also, go ahead.
Host
Right.
Host
I would assume there's also, depending on what the issue is, there's stigma involved, like the mental health issues for soldiers. If they've been taught not to complain, there might be a stigma of even bringing it up. Have you seen that with your population?
Rachel-Jaye-Nash
Absolutely, absolutely. And then we have to remember the Vietnam veterans, they don't really know what PTSD is. I mean, it's even bigger than what we think. We're using an acronym of post-traumatic. What is it? Post-traumatic? Thank you, thank you. Sometimes I just can't get the words out. And they're like, what is that?
Host
stress disorder.
Mm-hmm. Sure, sure.
Rachel-Jaye-Nash
And I was with a veteran who was in his 70s and the doctor explained it. It's not me explaining it. You know, I don't have to be a nurse. All I have to do is know how to bring these people together. And certainly I do my research when it comes to trying to understand the latest when it comes to post-traumatic stress disorder.
Host
Mm-hmm.
Host
Mm-hmm.
Rachel-Jaye-Nash
But the thing is, is we were using, and myself included, PTSD, PTSD, PTSD. You hear this man say, what does that mean? So the doctor explained, okay, when you go into the forest, you see one tree, but there's a whole entire forest. And all of sudden I looked over at the veteran and there's a little tear coming out because it just...
Host
Right.
Rachel-Jaye-Nash
it clicked. It clicked because this was a man that was very isolated. And you know, today he's being treated and he goes to his appointments regularly and it's very important for him. So the most important thing is health. Health is everything else. And once we can determine that there are diagnoses that are related to service, then we work on that as well.
Host
I've noticed, I mean, we've done a lot of these podcasts and the mental health component, not specifically to veterans, just across the board. There aren't a lot of advocates who are comfortable navigating that world. Is that something that you find? I know it's not the only thing you do by any stretch of the imagination, but do you, can you maybe illuminate why some people are uncomfortable navigating it as an advocate?
Rachel-Jaye-Nash
because it's the hardest system. Because it's the hardest, that sounds terrible and I'm not trying to, it is a very difficult system to navigate and it takes time. And I do, we did talk before and I said, I don't know if I should explain that I struggle with mental health myself, but I do have bipolar disorder and I've been always been resilient and I've,
Host
And why is that?
Host
Mm-hmm.
Rachel-Jaye-Nash
I see it as, and I tell people, it is very similar to baking a cake, right? So you have in your cake, you have your, maybe you have medication, depending on what your doctor prescribes, because it's all individualistic. And again, as a board certified patient advocate, I do not tell people what to do. It's all about options. So perhaps you have therapy, but therapy,
Host
Right.
Rachel-Jaye-Nash
is not what it always seems. You have to have that right fit. It may take you a while to find that. You don't want to feel biased. You don't want to feel judged. We live in a world of stigma. And as a patient advocate, I have seen it firsthand in my working world and my professional world as a patient advocate and in my personal world.
So I do recognize that exists and that might not exist in other areas. When you go and get, for example, when you have, let's say you have a knee surgery and you get a new knee and you get a knee replacement, you don't have stigma around that. But if you go to the hospital to seek help with mental health,
Stigma just starts.
Host (18:03.8)
So you're saying that stigma exists even in the medical profession with the doctors and nurses.
Rachel-Jaye-Nash
Absolutely, because they can read what medications you're on. Yeah. And I have seen where they focus.
Host
How do you, give me some example of how that'll actually manifest with a patient where they see the medication, then what happens from there? They're dismissive of other symptoms or what, I mean.
Rachel-Jaye-Nash
issues aside. So let's say I go in and I have pain somewhere and they happen to see that I have this has happened. I'm not saying this is this is not it's not a blanket statement this happens everywhere. And when mental when they find out that that person has mental health issues based on the medications that becomes their focus.
And that's not been.
Host
So what's your role as an advocate if you start seeing that happening?
Rachel-Jaye-Nash
to make sure that the symptoms of the problem at hand are very, very clear, written out and communicated. And we push the mental health aside and we continue to talk about the symptoms that the person is having at that point in time.
Host
and
Host
Mm hmm. It's almost as if you're saying that the the the people with mental health issues are looked at as perpetrators instead of victims by some of the hospital staff.
Rachel-Jaye-Nash
Yeah. that, and in fact, I believe that people with mental illness are the victims, not the purpose. And I don't see myself as a victim. Let me just get that straight. I'm not a victim. Yeah. Yeah. I am not a victim. am definitely a very resilient person. Every time I have fallen in life, it has been a blessing. I have gotten up. My greatest gift is that's my greatest gift is falling up and getting up, falling up and getting up. And that's what I do for my clients.
Host
Sure. Neither do I, by the way, for the record. I think you're doing great.
Host
Mm-hmm.
Rachel-Jaye-Nash
even more important than, like I said, all my credentials that I have. That is my gift. But that there is such stigma in our… I've worked in places where I could hear my coworkers talking about people with mental illness and say, don't want to help that person because that person has bipolar disorder. And I just kind of look and I kept it quiet because I didn't want them to stigmatize me.
Host
Mm-hmm.
Host
Right.
Rachel-Jaye-Nash
I was worried about my own reputation.
Host
Yeah, or if you have a bad day and then someone's going to write you off as you have bipolar. mean everybody's allowed to have a bad day until you're labeled with a diagnosis with a mobile health condition, yeah?
Rachel-Jaye-Nash
Absolutely. So back to the cake, the cake, and I'm gonna just take, I know I'm all over the place. The cake, the therapy, medication, if that's possibly, you can be on medication, and this is my opinion, you can still believe in holistic care. You may have to because of clinical need be on certain medications.
Host
and the rest of No, I'm glad you're still back there.
Host
Mm-hmm.
Sure.
Rachel-Jaye-Nash
And then you can have, you can still have functional care, holistic care, walking is good, exercising is good, making sure that you have a good source of friendships, maybe not a lot of friendships, who knows, whatever's right for that person. And faith, if faith is important to that person, then that's great. Hobbies are great. And you know, just...
Host
Mm-hmm.
Rachel-Jaye-Nash
all the layers are really important, not isolating, compliance with medication, good sleeping habits. So we get so caught up in just medication and therapy. And those are just two ingredients. And I do find that with mental illness that doctors have become symptom treaters. I'm gonna treat the symptom.
Host
Right.
Host
Mm-hmm Not the person
Rachel-Jaye-Nash
Before you know it, you see people on too many meds and they're no longer functional and they become the face of mental illness.
Host
Yeah.
Host
There's also, how do you reconcile the idea that people are being prescribed too many medication with, or too much medication, I should say, with the reality that there's also a psychiatrist shortage? Is one connected to the other?
Rachel-Jaye-Nash
would guess, I would guess so. I bet you it is. Yeah. But there are psychiatrists too that are great that that do not over medicate, discuss side effects and symptoms. And that's what we really need to understand. And that's what I try to teach people that you go in, you are your own CEO of yourself.
Host
So it sounds like a lot of your advocacy and your style of working with clients is teaching them and empowering them to be their own advocate as well.
Rachel-Jaye-Nash
and
Rachel-Jaye-Nash
Absolutely, absolutely. I don't think we were intended as patient advocates to just be there forever. And I almost feel like it's taking advantage of people. You know, we always want to, we always, there are some people that need more help than others. But we certainly, we certainly don't want to take advantage where we're keeping all of this stuff to ourselves.
We want to share. I want people with mental health related issues to be not like me personally, but help other people kind of sort of pay it forward.
Host
Mm-hmm.
Host
I have one more question about mental health and then we'll kind of go to the rest of your practice. You mentioned and we kind of glossed over that it's the hardest system. Why is it the hardest system?
Rachel-Jaye-Nash
because it's broken, it's terribly broken. That's why. And you know, when people hire me, I make no promises at all. I make no guarantees. And if it's something that I know that I can't help with because it's terribly broken, I say, I can't help. I can't think of what that, you know, they're sort of, huh?
Host
Say more about how is it, for someone who hasn't navigated it, how is it broken? What does that mean it's broken?
Rachel-Jaye-Nash
That's a good question. For somebody that hasn't navigated it.
Host
Like, let's say I, you know, I'm here and I don't have anybody in my family who has mental health issues and you're kind of looking at it going, I don't understand. What do you mean it's broken? Like when I go to the doctor, if I have a broken leg, they put it in a cast and they send me on my way. What's the big deal?
Rachel-Jaye-Nash
Well, they don't with medications when it comes to psychotropic medications and anti-psychotics, it seems as they just play around with it. Here, let me give you 10. I mean, to me that's broken, right? And they kind of seems like they forget about you. And then you're on all these medicines and medications and how can you function?
Host
Mm-hmm.
Host
What do mean they forget about you?
Host
So there isn't a lot of follow through when it comes to caring for the patient on the medical side, often in the mental health space. Is that what you're?
Rachel-Jaye-Nash
You have to be very assertive. But when you don't feel well and you have mental illness, how assertive can you always be until you're well? Right?
Host
Okay.
Host
Right. That's great point.
Rachel-Jaye-Nash
You know, so that's that's what makes it broken. We also have a lack in this state that I live in in South Carolina. We have a lack of
We don't have a lot of treatment centers. It's very hard to get a bed. It seems like it's all based on if you have the right insurance or if you don't. The treatment centers are just to stabilize you. You go there. They're going to give you a cocktail of medications. Then they're going to send you home. And then you don't see.
Host
Mm-hmm
Host
Right.
Host
So it sounds like if they just send you home, there's a revolving door effect where you're just gonna kind of end up back there pretty soon.
Rachel-Jaye-Nash
Right, right, that is true. And then you don't see a lot of step down programs, you know, where someone comes home and they're kind of doing a little bit better. Who's working with them to ensure that their medication is compliant?
Host
Thank
Got it.
Rachel-Jaye-Nash
Who's working with them to say, okay, now you need to start getting out of your house. You know, I remember a time in my life where I never wanted to leave my home after work. You know, I never wanted to leave my home. I just, I wanted to be left alone. I canceled appointments. I stayed to myself the best that I could, you know, and, you know, I felt, I felt,
I felt depression, you know, and now I have to kind of fight through it. This is something that I've learned. There's more to just medication and there's more to just therapy. It takes effort, it takes work, and it is sometimes like a full-time job. And when you have practitioners that don't understand that, they just throw medications at the problem. And they're overworked. I've been in appointments with people where I had to tell the psychiatrist to read the chart.
Host (27:28.3)
Right.
Host
Yep.
Host
Right.
Rachel-Jaye-Nash
because he was looking at medication that this person wasn't even on. And I said, you know, please, please read the chart. And, you know, he said, okay. And then he did, he's like, okay, all right. So those things, you know, those things happen. You know, these I've seen, I have seen five minute appointments, five minute appointments. And, you know, that's why I always tell people look.
Host
huh
Rachel-Jaye-Nash
Write down your questions ahead of time, something very simple. And always have a list of all the medications that you're taking. Just these basic things are really important. there are times where I have been with, that been in appointments where I could see that the practitioner was talking down to them. And that happens, that never feels good.
Host
Mm-hmm.
Host
Mm-hmm.
Sure. What drew you to moving off of mental health for a second? What drew you to this line of work to begin with back when you were doing vocational counseling?
Rachel-Jaye-Nash
I think I was, I think I had an advocate in my life. I think that's what drew me to advocacy. I think I was sort of destined to be an advocate because of my own experiences. I had a rare and complex disease when I was young and nobody believed my mother and she was able to get me to Johns Hopkins and they were amazing. But what led to a delayed diagnosis is interesting.
Host
Mm-hmm.
Rachel-Jaye-Nash
Because when you have one delayed diagnosis, then it sort of impacts other areas. So then I became an IEP kid, a kid that was, you know, had an IEP and they really didn't know what was wrong with me. They just knew that there was something wrong and they labeled me as learning disabled. That's, you know, I'm 53. So that's what they did back then. They didn't, they didn't diagnose autism and ADHD and all of those things. You were
It just seemed like you either were learning disabled or you were normal. And I guess I wasn't normal. And I had that label. I really hated that label. I was a very shy kid. And I would take all of my problems home. So I guess my mother was the brunt of my problems. And when I was in high school, I met an advocate who
who just believed in me and I didn't believe in myself. didn't have the skills, I didn't have the confidence. know, being labeled is not good for someone's confidence. It's not good for someone's confidence. So she was amazing. She was an insider. She was an administrator at the school. Just took a liking to me. And I stayed in touch with her and I just always knew intuitively.
Host
No, not at all. Yeah.
Rachel-Jaye-Nash
that I wanted to be not her, but I wanted to be my own her. And, you know, I am, my passion is, is, is advocating for people. So they, you know, they, are able to get what they, you know, what they should be getting, you know, but I also talk to people about expectations too, what we can really expect.
Host
Your own group. Yeah.
Host
Right.
Rachel-Jaye-Nash
and what is possible, what is possible and what is fair.
Host
So, you you talk about the way you speak to new potential patients. Maybe this will be kind of a fun exercise. Let's say I came to you and I said, I don't know if I need an advocate. I know I'm struggling in, I don't really understand what an advocate does or, or if there's a difference between one advocate for another, but let's say I come to you and I say, you know, I've, I've had this pain in my leg.
and I can't walk and I have to stay home and they don't know what's wrong with me and they've tried a bunch of things and I just feel like I'm at the end of my rope and I can't get my own doctors to return my calls or emails anymore. What can you do to help? How would you approach the situation if I was the client coming to you?
Rachel-Jaye-Nash
Well, first of all, I want to listen because listening is so powerful. And I think that was probably my biggest fear today because I knew that I would be on the hot seat because I do like to listen. Yeah. Yeah. Well, I would ask questions for questions. I ask so many questions that people can't even believe the questions that I ask. I would want to know broadly would be more. Tell me, you know, how long have you been in your home?
Host
nothing.
Host
Well, yeah, we could talk broadly. don't have we don't have to make it a mock interview or anything, but tell me how you would approach that.
Rachel-Jaye-Nash
What doctors are you seeing? What are they saying? What are the diagnoses? What, you know, I want to dig, I want to dig in there and see what's really going on to my best ability. And what I pride myself on is when I, when I do work with my clients, I know their story and the doctors, unfortunately, it's not their fault. I love our doctors. I'm an advocate for our doctors. You have to be in this, you know, they're, they're angry.
Host
Right.
Host
Mm-hmm.
Rachel-Jaye-Nash
to in so many ways. They're not making these calls, but I want to know them so well where I know their story. And I want to make sure that this person is vetting me, but I'm vetting him too. I'm vetting him too. Yes. Yeah. Yeah. So that's
Host
Mm hmm. And making sure it's a good fit on both sides. That makes sense. How do you feel when it's a good fit as an advocate? What should people be looking for who are looking for advocates and saying, I've, know, maybe I interviewed two or three. How do I know which one is the right fit?
Rachel-Jaye-Nash
Well, for me, when someone has skin in the game, even now, if they're sick, they can still have skin in the game. But if they, you know, they don't wanna do anything themselves, we're partners. We're partners. Who knows you better than you? You. So they have to have skin in the game. And then when that happens, or even if parents have skin in the game, right? Because they're their child, their adult child.
Host
Mm-hmm.
Host
Right.
Rachel-Jaye-Nash
is struggling. That's okay. That's okay because I understand that.
Host
Does it sometimes happen in the reverse too, where it's adult children taking care of their elderly parents?
Rachel-Jaye-Nash
Yeah, it does. It does. So, you know, so I want I want to know that, you know, they're not going to see me. And I say, look, I don't do everything. We are a team. So for me, no, might be different for other advocates. And that's OK. But for me, I love the team approach. You know, now, I don't mind doing the bulk of the work, of course, they're hiring me.
Host
Right.
Rachel-Jaye-Nash
But that communication piece is really important because we're complaining. If you think about it, we're complaining about the system not communicating. You know, they have all these little tasks and doing all these things, but nobody ever communicates. So for me,
Host
Is that you have to put it in a bucket then because you talk about all the communication is most of your work kind of the medical coordination kind of understanding how to communicate with the doctors, how to get them in the right appointments and things like that and working with them to understand or other other aspects of it as well that I'm not seeing.
Rachel-Jaye-Nash
Interesting question.
You know, I do go to a lot of doctor's appointments with people. So that is one. And I model, you know, and I don't purposely model, but I model the relationship building to the best of my ability. Now, it doesn't always work wonderfully. It just depends. You've got gatekeepers, you have different personalities, but, you know, I try to model that. And I, you know, I have...
Host
Mm.
Host
Right.
Rachel-Jaye-Nash
I have worked on the insurance side and helped recover money. And I think I've had my hand in quite a bit of it.
Host
Mm-hmm.
Host
Yeah, I'm assuming that when people start trusting his advocate, they ask for help in every area that comes up because you because the relationship has been built. You mentioned you go to doctors appointments. I guess another question I have for you is do you find that you know what percentage of your work is done over the phone or virtually versus actually in person?
Rachel-Jaye-Nash
Mm-hmm. Right.
Rachel-Jaye-Nash
most of it's in person because I like people.
Host
So you kind of stay in the South Carolina region then, is that right?
Rachel-Jaye-Nash
North Carolina, well, I'm on the border of Charlotte. So I'm about 20 minutes from Charlotte, even though I'm in South Carolina. I've had a couple cases that were completely virtual based on the need and something that I knew that I could do. quite frankly, that surprised me in some ways, you know, because I thought that I would have to go visit this person.
Host
Okay. Gotcha.
Host
Gotcha.
Host
Yeah.
Rachel-Jaye-Nash
And that was in the plan, that was in the contract. But if we could avoid it, that was the best thing for the client, for the guarantor.
Host
Mm-hmm.
Yeah.
Host
Yeah, listen, not every advocate is like that. You are boots on the ground in person in the often in the doctor's office with the patient. Not every advocate does that. That's unique in and of itself.
Rachel-Jaye-Nash
And I love to write. I love to write. I love it.
Host
What do mean by that? What do you love to write?
Rachel-Jaye-Nash
I love to write, I always tell people that when you say something and you make a, let's say you file a complaint and it's this way, it goes nowhere.
Host
Mm-hmm.
Rachel-Jaye-Nash
But once you put some.
Host
So you like to paper the paper, file and really kind of make sure I think that's, it's so important.
Rachel-Jaye-Nash
I do. I do. Things start to change. Things start to change immediately.
Host
So you're documenting the case. I mean, that puts accountability on the insurance, on the medical practitioner, even keeps the client accountable, it seems like, because you have a written date stamped kind of timeline of what's happening.
Rachel-Jaye-Nash
We will.
Rachel-Jaye-Nash
the history of it, the dates, know, what the struggles are, what the symptoms are, what is happening and what's not happening. Who we spoke to, I always teach people if you don't write it down or you don't document it, didn't happen.
Host (38:51.5)
Right? Well, let. Let's let me let me ask you a question. I ask a lot of advocates and if you don't have an answer right off hand, that's OK. So take you could take a second to think about it. But if you could make one big sweeping change to the medical system that you feel like you know if I gave you a magic wand and said you get one wish for the medical system to help people, what do you think it would be?
Rachel-Jaye-Nash
guess it goes noob.
Rachel-Jaye-Nash
We need more doctors. We need more doctors.
Host
a great answer. Why do think there's such a shortage? Do you think we're not attracting people to enter the medical field in the same way as we used to?
Rachel-Jaye-Nash
Yeah, they're burned out. They used to take the time. I was treated at Johns Hopkins as a youngster for many years, I want to say it was about maybe 10, 11, 12, I don't know what the time, because I was young.
Host
Mm-hmm.
Rachel-Jaye-Nash
My goodness, they would spend all day with me. These are world-renowned doctors and they would touch me and they would they would touch me. They would look at my fingernails. They would have me walk. They would put paint. I mean, I just have memories of this. They were like my family. I would bring them tomatoes. My mother's like, bring them tomatoes or your some things. Bring them to your doctors. I really love these. I couldn't wait to tell them stories.
Host
Right.
Host
Yeah.
Rachel-Jaye-Nash
You know, they were.
Host
It seems like you're filling in a lot of that gap as the advocate. You're building that relationship that doctors don't have time for anymore in many ways.
Rachel-Jaye-Nash
Yeah, and they want to they want to I really believe yes in every profession We have a bad apple. We have bad apples But yes, I am you know, and I worry about you we nothing against nurse practitioners because they're great too But you know, there are some online people out there that just went specifically online and there's nothing like you know, the the medical doctor that has
Host
Yeah, of course.
Rachel-Jaye-Nash
has that education with diagnostics and what they went through. We definitely need more doctors. And they get burned out quicker because they're being told, they're not allowing, they're so gifted and they're so smart. And they're not allowed always to think critically. You've got pharmaceuticals that are saying, hey, hey, use these.
Host
Yeah.
Rachel-Jaye-Nash
You've got insurance that's saying, this is the way we're going to do it because we're not going to pay for it. Even though this person might need it, this person might need the medication. We're not doing it. So they have to fight insurance too. Then they have the administrators that are saying money, money, money, money, money, money, not people. And then doctors say, you know what? I didn't go to medical school for this. You know?
Host
Right.
Rachel-Jaye-Nash
I went because I care about the patient.
Host
Yeah, you're right. I've heard it from many doctors that I've spoken to. You're absolutely right that that that shift has changed with the the admin and the kind of the bottom line mentality of a lot of the healthcare system. If someone wants to work with you directly, you seem so helpful and they're in especially if they're in the in Carolinas, what's the easiest way for them to get in touch with you?
Rachel-Jaye-Nash
And nurses too, mean nurses too.
Rachel-Jaye-Nash
Google, of course, they can call me at 704-254-1407. They can reach out to my email if you're able to post that here. Nashadvocacy, nashadvocacy at gmail.com. I would say one of my biggest, the reason I'm still in business is word of mouth. Is word of mouth, that's why I'm still here.
Host
Yeah, what's your email? Say it online then.
Host
Great.
Rachel-Jaye-Nash
as an entrepreneur, as a new entrepreneur and a patient advocate. I'm a good patient advocate, but learning to be a business person too, and that's new for me. That's new.
Host
Yeah, it's it sounds like it's new for a lot of people in the medical space where, like you were saying, you wanted to you got into it to help people. then unfortunately, part of the way the world works, you have to learn the other aspects as well.
Rachel-Jaye-Nash
Yeah, really do, really do.
Host
Well, Rachel Nash, thank you so much for sharing your story and some brilliant insights. I really appreciate your time.
Rachel-Jaye-Nash
Thank you, thank you so much, I appreciate you.
