Monday, May 01, 2006

Patient Advocates to protect you from your healthcare system

KevinMD posted this entry about the newest brand of overpaid consultants, "patient advocates".

It is amazing to me that modern healthcare has gotten to the point where there is a general perception that we need to pay people to protect us from our doctors and other healthcare institutions.

Most surveys of patient satisfaction, contrary to popular belief, actually show that patients usually like their doctors and feel confident in their care. It's the nature of the parameters that they work under that makes people feel the need for protection.

For example, the article in the Boston Globe that Kevin linked talks about hiring private nurses to attend to patients while they're in the hospital. This is undoubtedly because of the very real concerns patients and families have about medical errors. Unfortunately, and I'm sure most patients are unaware of this, there have been a number of tragic cases of poor care that arose because of inattentive, poorly screened or incompetent private nurses whose presence gave the hospital's nursing staff a false sense of security and fostered less dilligent care.

The article was amusing on one level in that it described the work of one advocate, a Dr. Gwendolyn Stritter, who runs a telephone-based advocacy practice. She's an anesthesiologist who decided to "branch out" into clinical advocacy. She charges $300 for an initial two-hour visit, reviews cancer patients' medical records and finds the latest treatments for them:
"She reviews their medical records, combs six to eight online physician databases to find the latest research, then talks to the researchers who've done the studies. She also attends major cancer conferences with her patients in mind."
Maybe it's just me, but if the patient's own oncologist isn't doing the legwork himself (and with the benefit of a subspecialist's added experience), that patient needs a lot more than a "patient advocate"...how about a new doctor (or at least a second opinion)?

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3 Comments:

Anonymous Moof said...

From a patient's perspective, health care is becoming more and more frightening by the day.

I had my insurance company call me a few weeks ago - offering me one of their professional "patient advocates" ... I asked what an "advocate" does, and what I was able to understand reminded me of an HMO ... ... "you call your advocate before you accept treatment" ... (protecting me from my docs?) ... since I don't have an HMO, I let them know what I thought about their offer. I'm a CRF patient, and I know they'd like to "rein me in" somehow ... not going to happen!

The system is in freefall, and it's going to get a lot worse before it gets better ...

May 01, 2006 7:05 PM  
Anonymous Anonymous said...

Patients are always going to be at a disadvantage. They do not have the same level of knowledge as the physician. Lack of knowledge often means that laypersons can't even ask the right questions, let alone understand the answers.

When people are sick, in pain or reeling from a scary dx, it is hard for them to advocate for themselves. Family members - assuming there are any available - may not be in a much better position to be the advocate.

Now let's throw in the fact that physicians often are too overloaded to spend much time with patients. Continuity of care with specialists, nursing staff, etc. is a constant challenge. And need I mention the chauvinism that often seems to afflict health care professionals - the attitude that the patient doesn't know what she's talking about so it's OK to ignore it. This attitude almost literally cost me my right arm, but I digress.

I'm not sure that paid advocates are necessarily the route to go. For one thing, they are probably out of reach financially for those likely to need them the most - the poor, the vulnerable, the elderly. For another, their usefulness will probably depend on who's paying for them, the patient or the health plan.

I've seen the system up close and personal, however, and it isn't pretty. Do patients need to be protected from the system? Yes, often they do.

May 05, 2006 4:16 PM  
Anonymous Anonymous said...

Does anyone reading this have previous experience with making an accident claim? A friend of my mother recently had some complications when giving birth. It wasn’t her fault and there weren’t natural complications but were due to someone else. If seen companies that deal with compensation claims but don’t know if there are grounds for claim of medical negligencein a birth injury claim! Has anyone ever heard of anything like this?

July 01, 2008 7:53 AM  

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