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Paula Gregorowicz, owner of The Paula G. Company, helps you discover and successfully create the work you are meant to do in the world. Through the p...
 
 
 
 

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Do You Need a Patient Advocate?

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It seems as if not a day goes by that we don't hear about another medical horror story. With the health care system being in various degrees of disrepair, it is even more important for patients to get the support they need to navigate complex diagnoses and treatment. Even if you are a savvy patient, when you are ill, you are at your most vulnerable. A medical maze that was already overwhelming is exponentially more frightening and confusing. It's not uncommon for regularly strong, empowered people to go into "helpless patient mode" when faced with a health challenge as Gloria Feldt shares in this article.

So what can you do?

The New York Times article "After Diagnosis, Someone to Help Point the Way" tackles the subject of hiring a professional patient advocate to help you navigate your way through the complex medical maze. You may have heard the title patient advocate when you or a loved one has been admitted to a hospital, but his is not the same as hiring your own, independent patient advocate:

Just bear in mind, Ms. Weil cautioned, that an advocate paid by your company or employed by a hospital may have to represent competing objectives. "Know the agenda of the person who is helping you," she said. A hospital’s own advocate, for instance, may not be allowed to suggest another institution or physician where you might find better expertise for your particular medical condition.

If you want to be certain that an advocate has your best interests in mind, be prepared to hire one independently - and to pay out of pocket for their services. Expect to pay either an hourly rate of $150 to $200 or a flat fee for a specific service.

This added expense is typically not covered nor reimbursed by Medicare of insurance plans. Yet it may be a financial investment well worth making, a matter of life and death. Unfortunately, for those with low or no income entertaining the idea of hiring an advocate is not even an option.

So what can a patient advocate help you with?

Walletpop has an excellent article on avoiding medical nightmares and lays out the following ways an advocate might help:

According to Elisabeth Russell, founder and president of Patient Navigator LLC and vice-president of the National Association of Healthcare Advocacy Consultants, an advocate can, among other things,

  • deal with the paperwork to make sure you pay only what you owe
  • coordinate medical care, setting up appointments, arranging transportation
  • tap into community social services
  • negotiate with medical providers and insurance companies
  • coordinate home care with friends and professionals
  • assure communications among health care providers, insurers and the patients
  • explore alternative therapies

A misstep in treatment or communication can result in injuries or even death. You owe it to yourself to get support. Trisha Torrey of Every Patient's Advocate offers a number of articles and her book, The 10 Mistakes Every Patient Makes, to help you sort through the maze before you find yourself ill.

One of the challenges in hiring a patient advocate is the lack of a credentialing or licensing body. One of the best ways to find one is through a referral from a friend or trusted colleague. Otherwise, you need to evaluate an advocate's credentials and ability to help you on your own. Some things you want to check include:

  • What is this person's background? Do they have formal medical training? What level of medical understanding do they possess?
  • Is it easy to communicate with this person?
  • Are they good negotiators?
  • Are they persistent?
  • Do they guarantee confidentiality?
  • Do they possess a solid understanding of medical claims processing?
  • Are they experienced with various aspects of of hospital claims administration, diagnoses, and the language of medicine?
  • Are they empathic and caring?
  • Are they persuasive?

Here are some additional resources to find the help you need:

Do you have a health care horror story to share? Have you ever hired a patient advocate? If so, what was your experience?

Paula Gregorowicz, owner of The Paula G. Company, helps people make wiser decisions through the power of Intuitive Intelligence(tm). She helps people break free from the tyranny of their own minds that hold them back from their greatest success and best lives. If you are searching for a way out of of

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paulag01 15 pts

Hi Patty, Thank you for taking time to reply. There are some many excellent people within the medical community that truly do try to help patients navigate and do their utmost to deliver great service. Unfortunately the system makes it hard for even the best and most willing to do that...

Appreciate you sharing your views from being actively involved in these situations, nothing like a front-lines report to add value to the conversation.

Warmly
_Paula

Paula Gregorowicz
The Paula G Company
http://www.thepaulagcompany.com

Learn 5 Steps to Move from Fear to Freedom ( http://www.thepaulagcompany.com/feartofreedom ) (free)

Nobody wants to be Ethel 23 pts

The other good thing about patient advocates is that they have the resources to research a physician's background. Now in the state of Colorado you can go to the state legislating board for providers DORA.gov and look into a physician's background, malpractice suits filed against in past etc. This came about because of an unnecessary surgery that a surgeon performed on one woman's son that resulted in death. The family was told it was an emergency surgery and trusting the doctor went ahead with it. Hindsight they found out the surgeon was not reputable and the surgeon eventually was dismissed from the hospital. They won a malpractice suit.

It is a scary place out there- the medical community. I educate people daily about taking an interest in their cares. Some people get it, some people don't.

Patty

natdalton7 5 pts

Nobody wants to be Ethel This was a great post about patient advocates. I had heard the term before but for one of my classes in school we were asked to do a little more research on what it is that patient advocates do. I appreciate your comment as well as this great post! Keep the great info coming. (http://www.patientadvocategroup.com)

Nobody wants to be Ethel 23 pts

My hospital has a patient advocate who listens to complaints or miscommunications between patients and caregivers. As a careprovider-Nurse Practitioner- I see the are pros and cons of a patient advocate.

I am pretty up front and candid about my patient's care and treatment plans. I would rather the patient come to me if they don't understand what is going on. I have gotten teams of doctors together for families in explaining complicated treatments plans. I works.

My mother was ill last year and I ended up going to many appointments as all the different specialists muddied the waters in terms of recommendations for treatment that conflicted with other doctor's recommendations. My parents, both in their 80s struggled with sorting out all the information and medications. I was the voice of reason and their advocate and asked clarifying questions to help.

But I have also seen patients who have difficulty with how the system of hospitals, billing, benefits etc. work and they take it out on caregivers like it is our fault. They complain to patient advocates blaming caregivers for a lack of understanding of the system.

The other problem is when people with personality disorders or mental illness slam providers or write letters to governing boards and waste these officials' time with their distortion of reality. These advocates for the public good still have to sort out the true from the false complaints.

If one thing is broken about our health care system is that there are not enough providers who are medical case managers: providers who help the patient sort through all the medications, diagnoses, symptoms, ability to care for one self at home, etc. I do that everyday in my job. BUT there are too many medical specialists who sit in their ivory towers of practice and spout their wisdom and expect the patient to be so grateful that they had that expert advice. You don't get your hands dirty practicing that way. Caring for people is a messy job and takes education of patients to better care for themselves.

Patty