A patient advocate is someone who works for the benefit of patients and their families during medical crises or hospitalization.
With so many visits to specialists when a medical problem arises, an advocate can “connect the dots” and speak to all the physicians to make sure everyone is up to date with the patient so nothing falls through the cracks.
In essence, a patient advocate can coordinate care among all the physicians. A good advocate communicates with the patient, the physicians, nursing staff, and insurance companies. As the health care system becomes increasingly complex with technicalities and types of insurance, the advocate helps individuals navigate the system.
Why You Need an Advocate
When you’ re distressed or vulnerable, you may not be effective at listening to what the health care provider is trying to convey to you. Having someone explain it after is invaluable. In fact, you may not be effective in responding to the medical staff about your needs, either.
Individuals need an unbiased person to speak on their behalf while providing guidance, friendship and emotional support. Advocates help make choices and empower patients with access to relevant information.
Types of Advocacy
There are several types of advocates with various niches.
- Patient Advocates/Navigators – The responsibilities of a patient advocate are many and can include:
- Medication reviews and coordinating various drugs
- Explaining diagnosis and treatment options
- Liaise between all the specialists that the patient is seeing so they know what was diagnosed, which treatments were given, and which tests were done or are pending
- Assistance in monitoring in-hospital
- Medical record reviews
- Accompaniment to doctor’s appointments
- Aiding in comprehension for the patient
- Health care Mediation and Conflict Resolution – A health care mediator seeks to facilitate an agreement between all the involved stakeholders, i.e. various family members, medical staff and friends. Situations broached mainly deal with type of treatment, end-of-life issues or disposition of the patient. The mediator will confer with health services, professional staff and all involved family members to get everyone in agreement for the issue at hand.
- Shared Decision Makers – These advocates assist patients in making their personal health choice based on their beliefs and values.
- Health Exchange/Marketplace Navigators – With all the confusion swirling around various Affordable Care Act exchanges and health sign ups, these advocates help their clients opt for the insurance plan that both satisfies the patients and complies with the ACA individual mandate.
- Medical Bills and Claim Reviewers – These advocates negotiate with insurance companies, hospitals, doctors’ offices and others who are sending out medical billing. They help individuals with charges and determine if they are correct or overbilled. They also help with insurance forms.
- Senior/Legal Advocates – These professionals deal with estate planning, end-of-life issues and living wills, among other legal challenges that individuals may face.
- Statutory Advocacy – This follows government legislation that advocacy be provided under such laws as the Mental Health Act and the Mental Capacity Act. Independent Mental Health Advocacy (IMHA) – supports a patient during ward rounds, care reviews or appeals and help them understand their rights and their treatment. Independent Mental Capacity Advocacy (IMCA) – helps a patient with care decisions and treatments. They also provide support on accommodation and in cases where there is deprivation of liberty.
- Hospital Patient Advocates or Representatives – Hired by the hospital, these professionals help patients, caregivers and their families during the hospital stay and ensure everyone is satisfied with the care that is being received.
- Health Coaches – These patient advocates aid in modifying lifestyle choices to achieve wellness and improve their state of health. Education, nutritional and exercise counseling and motivational techniques are employed.
Employers of Patient Advocates
Patient advocates work for:
- Hospitals – serving the patients while they are admitted
- Social Service Agencies – for client outreach
- Insurance Companies
- Private/Freelance – serving the clients themselves
How to Find a Patient Advocate
If you are seeking a private advocate, you may contact a trade group.
There are three trade groups for private advocates currently:
- The National Association of Health Advocacy Consultants
- PPAI (Part of Decision Health which teaches advocacy courses)
- The Alliance of Professional Health Advocates
Another approach is to contact a university that offers a patient advocacy program.