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You Need Patient Advocacy


By Tiffany Matthews

Healthcare in the U.S. is broken and only getting worse. Here are just a few examples of why:

-Of the $3 trillion spent on healthcare annually, $1 trillion is wasted;
-Many doctors are providing too much unnecessary treatment;
-Providers are paid for quantity of care vs. quality of care;
-Healthcare costs are through the roof for everyone; and
-Many patients are not aware of their rights and responsibilities within their healthcare.

Many people settle for the care they get from their healthcare providers when they should not. If you ordered a cheeseburger and got a hamburger, wouldn't you take it back? Do you use that same tactic in your healthcare? Maybe not. You're not alone, most don't.

Have you ever had an experience at a doctor or hospital that was uncomfortable or frustrating? Had errors on your bills? Left a doctor's appointment feeling puzzled? Many experience this every day. I'm here to tell you that you don't have to deal with poor treatment.

Advocacy is a patient-centered method that can address many of the ills of America's healthcare delivery, spending waste and inefficiencies.

Being a social worker for 20 years in many areas of healthcare, I've seen plenty happen to people who were uninformed or didn't know what to say, do, or ask. Many times, negative outcomes were preventable.

What is patient advocacy?

This means championing the cause of meeting a patient's needs and desires during their healthcare journey. This could mean speaking with doctors on a patient's behalf, facilitating communication between healthcare providers, supporting a patient's end-of-life wishes, correcting an erroneous bill, helping with insurance claims and so many other things.

Advocates also have focuses such as billing, insurance claims and appeals, specific diseases (cancer, Alzheimer's, stroke), or getting and keeping good care (like me). There are professionals such as hospital advocates, patient navigators and nurse navigators in healthcare facilities to assist patients with their needs while they are in the hospital.

If you hire a private advocate (one with no corporate/non-profit interests) and pay them directly, their job is to go to the mat for your best interests. If you want to know where the loyalty of any advocate is, find out where their paycheck comes from, and you will have your answer. It's not always with the patient, unfortunately.

Insurance does not cover advocacy (so private advocates must be paid out-of-pocket), as the government has not regulated our profession. Anyone can say they are an advocate because of this, even my sixth-grader, no matter what their level of experience is. Make sure to check their education, skills and experience before hiring them. Ensure that they are the right fit for your specific needs.

In advocacy, intelligence is not a substitute for experience. Many very sharp people have called on my services because they didn't know how to handle their healthcare situations, some after making matters worse. They alienated the healthcare providers or they were labeled as "troublemakers." Communication shuts down between families and providers - which is an awful scenario that does not help the patient's interests. Advocates can assist you in a situation such as this, and many others depending on their specialty.

Healthcare is a business and you are a consumer. Further, you are responsible for your own healthcare. Patients have to take care of themselves and yield to a provider's orders, as they are the experts on healthcare. Yet, patients have the right to question any medication, test or procedure proposed to them. Patients must do their part to have good health, as they are the experts on themselves. One cannot drink and smoke heavily and expect a miracle cure for their body after abusing it.

Healthcare spending can decrease once patients learn to use the healthcare system correctly, and a good private advocate can show you how to do that while saving you time, money and frustration.

Not only individuals and families can benefit, but corporations and non-profits can save by enlisting an advocate's services. It will show their employees (especially those that are caregivers or have chronic illnesses) that there is a more efficient way to experience healthcare treatment, and possibly solve problems which can increase productivity!

The benefits of hiring an advocate can be priceless. Let one assist you in handling the business of healthcare, while you concentrate on the most important role - being a patient.

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