Claudia K. Nichols

Because the rise of patient navigators ““ also known as healthcare advocates ““ is only recent, it’s hardly surprising that some doctors greet a hitherto unknown “advocate” with some wariness.

Dr. Mark Friedman’s blog post on advocates is an excellent introduction to this growing field. However, many physicians have mixed feelings about these so-called advocates on their medical teams.

Those clinicians who have not yet worked with the “new kids” are unsure how to respond, and the newly-introduced “navigator” may be greeted with reactions ranging from cordial but cautious optimism to icy silence.

Yet professional patient advocacy arose partially as a result of countless fatal, preventable errors; soaring healthcare costs; and a complex, dysfunctional, and fragmented healthcare system ““ issues doctors are fully aware of and would like to change.

There may be a Gregory House living inside all physicians, but the cold reality of daily practice takes away the luxury of time. Appointments and consultations are rushed affairs, hindering information exchange. Hospitals and out-patient clinics are typically understaffed and they relentlessly search for ways to cut costs ““ often to the point of compromising quality of care.

The incomprehensible prevalence of 50,000 to 200,000 annual and fatal adverse medical errors, essentially unimproved 12 years after documenting the travesty, has turned hospitals into the deadliest places in the country. Medication errors, hospital-acquired infections, falls, wrong-site surgery, and retained foreign objects after surgery continue to plague the healing profession. Then, when we learn that the U.S. is the most expensive healthcare system with only variable effectiveness, the idea of having a watchful, professional partner at our side begins to seem like a rather good idea.

So how can doctors and patient advocates work together to deliver improved healthcare quality?

The ultimate goal of the advocate is to empower patients to make optimal decisions about their health. Among the many services they provide, advocates may compile patient histories, perform research, clarify therapeutic advice, compare costs of procedures and tests, help obtain second (or even third) professional opinions, promote patient education through improved health literacy, encourage treatment compliance, help with transitional healthcare from hospital to rehabilitation, be alert for mistakes, observe the patient’s family system, facilitate and document conversations about advance treatment planning and medical surrogates, help with insurance issues (including Medicare and Medicaid), and facilitate effective communication between healthcare practitioners and the patient.

Healthcare advocates are most effective at their vocation when recognized by physicians as valued members of the treatment team. This may require a cultural change in the practice of medicine. There is no time like the present.

Claudia K. Nichols is a healthcare advocate and Certified Senior Advisor ® (CSA) who founded Pilot Health Advocates. She currently chairs the Education Committee of the National Association of Healthcare Advocacy Consultants.

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