Monday, March 3, 2014

Patient Advocacy: Healthcare on your Side

Patient Advocacy: Healthcare on your side

   by Martine G. Brousse
Healthcare Specialist, Patient Advocate, Certified Mediator


As Trisha Torrey, the spokeswoman for patient advocacy and founder of the Alliance of Professional Health Advocates has noted, advocates have not been receiving the recognition for the successful work they have done on behalf of patients. For this reason, and to bring attention to this new but growing profession, she has declared the first week in March as "private Professional patient Advocates Week". 

As a Patient Advocate (one of a few hundreds in the U.S.), I spend, it seems, as much time getting the word out and explaining what I do than actually working on cases! Though the need is great, patients and their caregivers are unaware of the services advocates may offer, and that help, in many forms, is available. 
Whether locating that perfect nursing home for Grandpa, reviewing and negotiating down excessive medical bills, accompanying far away Mom to appointments, or helping a torn family find a united course of action in face of a serious diagnosis, advocates can provide the necessary knowledge, support, compassion and skills. 

Some advocates may specialize in researching treatment options and educate you on a new condition, while others provide in-home nursing care or hospital beside monitoring.
While I deal mostly with financial matters (finding assistance for cancer patients, handling medical accounts, appealing insurance payments or auditing and settling bills), some of my peers can advise you with end-of-life decision making, can guide you when applying for disability or other benefits or can research home birth alternatives. 

It is a sad but true fact that patients are not receiving the supportive care, detailed explanations, extensive reviews of conditions, treatments and options, or financial solutions from their medical providers that they often require. Navigating alone the intricacies of this vast and complex U.S. healthcare system in its various forms, can take a large emotional and financial toll. Medical providers are so stressed by time constraints and financial concerns that they and their staff are unable or unwilling to address more than the basic inquiries from patients. They in turn are left to face and try resolving multiple complex intricacies and details, often at the expense of the most important: their health. 

Who has time to learn a coding system to be able to read statements, or can understand an insurance policy at first glance? What are all your treatment options if the physician does take into account your preference or needs, or how this will affect you? How does a patient express to his loved ones and medical team that his choice should be respected despite their objections? 
A patient advocate is trained, and usually has extensive experience, in finding solutions, bringing clarity and understanding to a situation, removing obstacles and overcoming mistrust through collaboration.

Private patient advocates work on behalf of clients, as they are hired and paid by them, but also seek to find ways to involve all parties in the solution-seeking process. In fact, advocates often act as mediators, working toward an equally acceptable and beneficial agreement, with mutually respectful interaction and improved communication. 
And while hospitals and insurance companies count advocates on their payroll, patients are unlikely to be their primary focus, especially in a dispute, as this person will tend to the other side's interests above all. If you went to court, would you trust the opposing attorney to safeguard your rights? 
Personal advocates are often not welcomed by medical providers or billers out of fear and ignorance. But their growing number and influence will hopefully reverse this adversarial stand once more positive resolutions reflect their value.  

Patient Advocacy is still too new a profession to have a specific certification, training or licensing process. Most are using their background in nursing, medical billing or mediation as the first step of a new career. Using their experience and skills on the side of patients is their way to stop being part of the problem.

When hiring an advocate, consider matching your specific needs with the area of expertise offered by different individuals. Due to the lack of a nationally recognized set of credentials, many abide by a set of conduct and professional standards which promote integrity. Details at:

APHA, the association founded by Trisha Torrey, keeps a list of vetted member advocates and  their credentials. Consult it to locate the most appropriate or skilled professional, or to learn more about the different ways we can assist you.

Consider hiring a private professional patient advocate next time you need to argue with your insurance company, require support finding info or financial assistance for a newly diagnosed condition, wish to have a local trustworthy person supervise a loved one's care or negotiate bills. A small financial investment can usually turn trouble into solutions and worry into peace of mind. It might also just save you a lot of dough too!

©  [2016] Advimedpro.
©  [2016] Martine G. Brousse.
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