Role of the Patient Advocate

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The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality cites patient safety as one of America's most pressing health care challenges. Difficult to manage and complex in scope, patients cannot handle the many facets of illness alone. A patient advocate acts on the patient's behalf, assuming other aspects of the illness's burden. According to the National Patient Safety Foundation (NPSF), "A patient advocate is a supporter, believer, sponsor, promoter, campaigner, backer or spokesperson." The article, "Patient Advocacy: Barriers and Facilitators," on Biomedcentral.com further clarifies, "Advocacy is usually employed by someone powerful on behalf of someone who has no power...Failure to do so may put the person's rights, welfare or basic needs in danger."

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Types

The patient advocate role has a range of meanings and responsibilities. A patient advocate is often a spouse, child, mother, father or a trusted friend who assists with care. In recent years, necessity increased the number of professional advocates employed by institutions and individuals. According to the National Patient Safety Foundation, "Hospitals usually have professionals who play this role called patient representatives or patient advocates. Social workers, nurses and chaplains may also fill this role." Past health care experience, contacts and medical institution knowledge make professional patient advocates invaluable. The website, HiringAPatientAdvocate.com reports, "A patient advocate may also have general or specific knowledge of health care's maze of rules, regulations, terms and procedures. A patient advocate may have gained this knowledge through their career or have earned a professional degree in patient advocacy." Medscape.com also points out the title "patient advocate" applies to workers in managed care. "At one end, some health maintenance organizations (HMOs) call their utilization review staff patient advocates. These are the people who process (and sometimes deny) requests for financial coverage of various interventions such as hospital stays and surgeries. At the opposite end, some consumer groups that oversee and challenge managed care decisions also call themselves patient advocates."

Responsibilities

According to Consumer Reports.org, "(Patient advocates) can help get an elusive doctor's appointment, research treatments, file medical paperwork, or persuade an insurance company to cover a procedure. They might also stand in for faraway relatives by accompanying an ailing person to appointments or sitting at a hospital bedside. Some advocates work privately, on a case-by-case or hourly basis. Others work at no charge or are supplied by employers as part of benefits packages." Patients dictate the advocate's level of involvement based on particular needs. Some advocates assume broad responsibility while others perform specific duties.

Considerations

The New York Times cites Sarah Lawrence College's Health Advocacy Program director, Laura Weil, who says, "Patient advocates have been around for decades, but in the last few years the profession has gained more momentum and acceptance. Now everyone seems to agree that you need help navigating a fragmented and technical health care system that is not always friendly." Select advocates who are assertive, inquisitive, proactive, trustworthy, honest, calm and concise communicators.

Significance

According to the New York Times, "Perhaps most important, patient advocates assist with continuity of care, ensuring that critical medical information is given to new providers and helping patients connect with ancillary personnel when employment, financial, legal or other issues arise." With the increasing number of medical mistakes, the role of the patient advocate is paramount. The website PatientsArePowerful.org states, "A study was done that revealed that it is the 'Type A' personality who usually ends up leaving the hospital earlier and in better shape than those amiable types, otherwise known as 'Type B' personalities." The fast growing need for advocates is a bad sign, according to Sean Clarke, the Associate Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. As told to the Arizona Daily Star, Clarke says, "It signals that people are losing faith that hospitals can provide safe care. It's a clear statement that the system is broken, and instead of fixing it, you have to hire someone to get you through it safely."

Warning

If a representative from a health institution or another company claims to be an advocate, that does not mean the individual protects the patient. According to the New York Times, "It is better to avoid advocates who might have a conflict of interest that could compromise patient care. Thus, using an advocate employed by the hospital or insurance company may not always serve the patient's best interests." The suggestions of these patient advocates may be influenced by an institution's goals. The Arizona Daily Star recommends that patients never "enter a hospital, an emergency room, or any other medical facility without competent, assertive help by your side at all times...Even doctors and nurses on the front lines of the system will tell you that today. As hospital care grows increasingly complex and medical errors kill some 100,000 Americans every year." Whether the advocate is family, a friend or a professional, an extra pair of ears and eyes never hurts.

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