From time to time I hear from a patient who complains about a situation that occurred during a hospital stay – usually the spouse or child of a hospital patient.
The great majority of those notes say, “I spoke to the patient advocate in the hospital but they couldn’t do anything for me!”
When I reply, I explain that the hospital patient advocate works for the hospital – not for the patient. Hospital patient advocates usually report to the legal/risk management department in the hospital and get their paychecks from the hospital. They help when they can, but the hospital gives them a line they just can’t cross.
That’s the fact I know. And a couple of times I have met hospital “Patient Relations” people. But until this week, I had never had occasion to try to work with them to help a patient.
This week’s hospital complaint email came from Donna (name is changed) who was a volunteer kidney donor to a friend – not even a relative – just a good friend. She was flown from her home in another state to New York Presbyterian – Columbia late last summer, completed the surgery, and returned home. Since then she has had a number of complications, she has been out of work, and she has been in pain.
One of our APHA members asked me about these differences a day or two ago… So I thought I would share my reply with you.
She had called on a nursing home to see if they had interest in recommending her services to the families of some of its residents. The nursing home director replied that they had a team of geriatric case managers they worked with – and asked what services she, the patient advocate, could provide that GCMs could not.
Since she really couldn’t come up with a useful answer, she asked me if I knew the differences in service offerings….
A few thoughts:
1. The first, obvious answer is that a patient advocate is available to assist anyone of any age – not limited to someone who is elderly, or at least over a ‘certain age,’ as a geriatric case manager would be.
2. Part of the answer depends on who’s paying the tab for the advocate’s or care manager’s services. If the nursing home or the county or state’s social services department is paying the tab, then the GCM is the not the patient’s advocate – she is beholden to the nursing home or the taxpayers. On the other hand, if the GCM’s services are paid for by the family or the patient, then they, too, are performing patient advocacy services.
3. Most Geriatric Care Managers don’t focus strictly on healthcare. Their work is usually broader, at least in the beginning, with some emphasis on finances, housing, and other aspects of life that change as we age.
4. Our APHA member advocate might have stumbled on a good marketing idea, however… but not the way she thought. We can guess that geriatric care managers may not have the skills or the interest in providing some services patient advocates provide every day, such as hospital bedside monitoring, or doctor appointment accompaniment. It could be that patients’ advocates and geriatric care managers are “coopetition.” (Read more about coopetition in The Health Advocate’s Marketing Handbook.
5. One way patient advocates and geriatric care managers are identical: they are both included and invited to participate as members of The Alliance of Professional Health Advocates. As independent practitioners who serve patients, we want to be sure families find the help they need for their loved ones.
Do you know of additional differences or similarities? Please share them with us.
Imagine… you suffer chest pains and are swept off to the ER. The pain meds leave you too groggy to make good decisions. Who will help you?
Or… difficult symptoms result in a diagnosis that leaves you stunned. You leave the doctor’s office remembering very little of what you’ve been told. Now you aren’t even sure what to do next.
Or… you’ve begun to find it confusing to keep track of all your medications. You’re concerned you’ll make a mistake. Which ones are you supposed to take with food? Or on an empty stomach? What about having that glass of wine at dinner – will it affect the medicines you are taking?
Next week you’ll be admitted to the hospital for knee surgery. You have friends who have acquired infections from surgeries – one even died. You can’t advocate for yourself when you’re drugged and in pain… who will sit by your bedside to keep you safe?
Your loved ones live too far away to be much help. Sometimes you just need a ride to an appointment, or someone to run to the pharmacy to pick up your prescription.
These are just a few of many scenarios that require us to find some assistance to be sure we get the best care and stay safe. Whether you have a debilitating disease, a new diagnosis, or you just feel so lousy that you can’t think straight – it’s time to call in a patient advocate to help you.
New patient advocates often find themselves having to explain what they can do to help a patient that a patient or caregiver can’t handle him or herself. Depending on the circumstances, having a patient advocate by your side can actually make – or break – your ability to heal, or even just cope.
Can you think of other scenarios that require a professional private patient advocate? Why not share them in the comments!
Most of these are simple to understand, because this kind of help has actually been around for awhile. The type of patient advocacy that seems most confusing – but can have the biggest impact on your positive medical outcomes – are medical / navigational advocates.
These advocates will sit with you in the doctor’s office and ask questions, or will help you make a difficult medical decision, or will sit at your bedside to monitor your hospital care, to be sure you get the right drugs, or don’t acquire an infection.
Here’s a metaphor to help you better understand why this is important: Fifty years ago, if you wanted to buy a house, you found someone willing to sell, and the two of you worked out all the details. If you needed a mortgage, you got it from a bank or a savings & loan. If you needed a lawyer to draw up the deed, then you hired one.
But over the years, particularly as credit problems started to arise and the legal requirements got tougher, we began to see real estate brokers establish an expertise as the go-between – between the seller and the buyer. These brokers have a much larger bank of knowledge than someone who only buys or sells a home two or three times in a lifetime. They understand the process, know home values, mortgage options, negotiation, legal requirements – they know far more about everything related to the transaction of buying or selling a home than most of us do. Today, very few home transactions take place without a real estate broker to orchestrate them.
Unfortunately, the healthcare system (no matter what country you live in, or what political party is in office) has become so tenuous that patients really do need a go-between to help them navigate. If you are in the US, you have an additional burden dealing with health insurers. Doctors can’t do it alone anymore, nor can nurses. Without that expert to step in and shepherd us, we patients may succumb not to our disease or condition, but to the problems in the system that is intended to help us.
Whether you need help navigating the maze of healthcare — or help with your medical bills, insurance claims, home health, eldercare, a midwife or doula – or even legal help – you can find it at AdvoConnection.