Patient Advocacy and the Allegiance Factor

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As we prepare for Private Professional Patient Advocates Week next week, I’ve been asked by a handful of people what the difference is between a private patient advocate and any other health advocate.

It’s an important question, and the answer is actually quite simple.

The difference between a private patient advocate or navigator, and those found in hospitals, through insurance companies, or other places, is what I call The Advocate’s Allegiance Factor.  It’s based on who is producing the paycheck.

Private patient advocates are paid directly by the patient or the patient’s caregiver and have only one allegiance – to the patient.  The patient’s needs, whether they be medical, navigational, financial or locational – are the prime concern of the patient advocate. Period.

However…

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MORE Magazine Article – Blessings and Missed Opportunities

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One of our AdvoConnection members, Elisabeth Russell, is featured in the March issue of MORE Magazine.  The story of her journey toward becoming a patient navigator is worth reading.  I dare you not to choke up when you read about her daughter’s diagnosis and treatment results.  A true blessing – and very well written.  (Thank you MORE Magazine!)

But there were some real mistakes in the sidebar information – and they need to be pointed out.  Potential patient advocates and navigators can get the wrong picture from what’s there.  At this point in our growth as a career, it’s important these facts be set straight.

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Who Deserves a Patient Advocate’s Help?

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I’ve wrestled with this question more than once.  It’s the question raised on occasion by those who talk about universal healthcare, and a for-profit healthcare system.  It’s a question asked by those who are concerned that not everyone in the United States has access to healthcare.  It’s asked by almost anyone who asks me what I do for a living.

The question is, “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”

Lots of soul searching, and more than a few conversations have produced the definitive answer to that question.  The answer is:

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Can a True Patient Advocate Be Paid by Someone Else?

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Several questions have come my way recently about what kinds of job opportunities might exist for patient advocates.  I refer people to an article I’ve written elsewhere, but the real answer is – to be a true advocate, you must analyze who is paying for your services, and what your responsibility will be to them.

Finding an Employer

In 2011, most of the job possibilities for patient advocates are found either with hospitals or insurance companies.  Hospitals have, for a long time, employed patient advocates, sometimes called patient representatives, who are tasked with helping patients.  And word comes from an AdvoConnection member, through our Forum, that beginning in 2014 with healthcare reform, insurance companies will be required to have patient navigators on their staffs if they want to participate in insurance exchanges. Some have already begun to hire advocates.

But here’s the problem with those jobs.

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Patients’ Advocates in Hospitals – Going to the Line

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Updated March 2017

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.

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