What is a Patient Advocate?

Navigating the healthcare system can be challenging, especially as the patient. If you or a loved one is seeing the difficulties, you may be asking what is a patient advocate and do I need one? 

WHAT IS A PATIENT ADVOCATE?

A patient advocate is any person or organization that helps the patient navigate the healthcare system. They communicate with the providers to ensure the patient has the most information to make the best decision about their healthcare. Scheduling appointments for MD visits or tests is another way patient advocates can assist the patients they are working with. They can also help set up necessary financial, legal and social support. Some patient advocates are doctors and lawyers who are able to review medical bills and have in depth knowledge of medical procedures to help you choose the best course of action.

WHAT ARE THE TYPES OF PATIENT ADVOCATES?

There are 2 types of paid patient advocates, clinical and private. A clinical patient advocate is someone who is paid for by the hospital, insurance company or organization. Their role will be mostly focused on making sure the patient has their questions answered, next appointments and setting up medical tests to ensure that the process is as smooth as possible for the patient.

Private patient advocates are hired and paid for by the patient as an independent third party to assist with the healthcare journey. They often review medical records and go to bat for the patient if they are being billed by a provider for unnecessary services, or negotiate with insurance companies when necessary medical expenses are not covered. They can seem expensive, but can be worth the money if these services are necessary. This article goes into detail about how to find this type of patient advocate if needed.

CAN I BE A PATIENT ADVOCATE FOR MY LOVED ONE?

If you are reading this thinking about the help your loved one needs navigating the healthcare journey, you can assist them and advocate for them, assuming you have their permission. Below are 6 steps to help at this time. 

• Be present: Your presence at appointments or when the doctor is making rounds in the hospital is the first step to help your loved one. This can be difficult with work and family responsibilities, but having someone in person with the patient makes a huge difference. 
• Provide pertinent medical history: If the patient is unable to provide their medical history, you can provide it to the healthcare team for them. Be sure to include the symptoms that caused the need for this medical care and if these symptoms have ever occurred before. 
• Provide current medications: Having a list of current medications (including over the counter and supplements) the patient is on will reduce the chances of a medication error or drug interaction. Also be sure to mention any allergies.
• Ask questions:Talk with the physician and nurses and other healthcare providers involved with the care of your loved one. Ask questions about the diagnosis and treatment plan. Make sure to get answers in terms you can understand.
• Take notes: Be sure to take notes and ask for clarification when needed. Having a loved one in the hospital is a stressful time and taking notes and asking for clarification will reduce forgetfulness and decrease stress related to unknowns. 
• Make sure the patient's desires are understood: This may seem obvious, but at times in healthcare, there can be so much going on that the patients wants and needs are not considered in the moment. A conversation ahead of time will help clarify the patients desires to ensure healthcare provided is in the best interest of the patient. Advanced directives are a healthy way to plan for unexpected medical circumstances and to think through them before the situation is too stressful to think clearly as a patient. The AARP has state specific advance directive forms.

WHY IS PATIENT ADVOCACY IMPORTANT?

 There are times when due to medical conditions or stress, our loved ones are not able to absorb complex medical information given in the hospital or clinic setting. Fear or embarrassment can take over and they may freeze and forget to ask a very important question. Or shock can occur and very little or no understanding of the information provided by the medical team can sink in. These situations lead to increased anxiety and depression which lead to worse health outcomes. Being there as an advocate for a loved one can make all the difference and allow them to work through, process and understand the direction of their medical care so that they can make the most informed decision that is best for them.

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Take care, keep mom safe and have a great day!

Winn