For a patient to be effective as a "patient representative" within a health-related organization, work and more than just accepting an honorific title is required. I argue that for a patient to be most effective as a patient representative requires different types of background knowledge and commitment than being a "patient advocate". Patients need to be cautious about how, when, and where they take on an official role of either an "advocate" or "representative", if they truly want to be a positive influence on health outcomes.
Keywords: oncology; patient advocacy; patient representation.