Monday, October 13, 2008

Do You Need a Health Care Advocate?

Health advocacy is not a new idea, however, with the ever increasing complexity of the health care systems of the world, it is fast becoming a specialized area of expertise. So what exactly does a health care advocate do? The possibilities are varied, but, in a nutshell, a health care advocate is a liaison between patients, their families, and members of the health care profession or its systems of administration.


When a person is ill, especially with chronic, debilitating or critical and complex conditions, an advocate is a welcome intermediary who can help a patient and/or their family make complex medical decisions or sort through the complexities of health insurance coverage issues. Also, because an advocate is most likely going to be a medical professional who is familiar with the medical community, he or she can make unbiased recommendations for care in a variety of settings, with a variety of providers. An advocate should possess "insider information," and be able to, without conflict of interest, help a person or family choose quality care providers/organizations/facilities, and get assistance from insurance companies when insurance issues arise.


Why would you need a health care advocate? Aside from the aforementioned, the biggest reason I can think of is that a person who is not well indoctrinated in the workings of the human body, and doesn't understand diagnostics, treatments, and current standards of care may have difficulty negotiating through even the simplest of medical problems. So when a person has more complex health issues, in order to arrive at totally informed consent, and receive a balanced and unbiased opinion about how to proceed, an advocate may be useful.

Remember-during times of illness emotions can run high and out of control. Decision-making skills and capacities are compromised. An advocates job is to present facts and truth without emotion, giving you a balanced, hopeful approach, so that decisions are made that are in the patients best interest.

Do you, or someone you know need a health care advocate? If you're not sure, here are some things that may help you decide:

1.) You believe the physician responsible for your care is not responsive to your needs and concerns, or you believe that you need other treatment and he/she will not refer you to a specialist.

2.) You wonder whether you are on too many medications.

3.) People who care about you are telling you to seek out another opinion, but you don't know where to go.

4.) You have a loved one in the hospital and you aren't getting answers to your questions about their condition or their medical care, or you need help understanding what is happening or is going to happen in the days ahead.

5.) You need help mapping out long term care plans for yourself or a loved one.

6.) Your insurance company is denying care, and you need to know what to do, or what alternatives that you have.

7.) You need help because you cannot afford to pay for your medications.

These are just a few reasons to hire a health care advocate. While any one of the aforementioned reasons, standing alone, could be handled by yourself, just imagine what it would be like to have to manage several of these things at once without having expert knowledge.

While there is a cost to retaining a health care advocate, the savings realized in time, energy exerted and frustration are all well worth the expenditure. The realization that you or your loved one have access to privileged information and help negotiating specialized care are priceless. Don't hesitate to use an advocate: you'll be glad that you made the call.

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