What is patient advocacy, really? Is this service for me? –Melanie J., Bloomington, IL

A patient advocate is a consultant who supports a client with a variety of needs, both in a medical setting and at home.  They may be a medical professional, a social worker, or a lay person with experience with chronic disease or with helping a loved one navigate their own health journey.

In a medical setting, patient advocates can accompany clients to doctor appointments or outpatient rehab sessions.  As a result, they can communicate with medical staff and family members about the patient’s ongoing condition, medical compliance and related concerns.  They can also help with the filing of insurance and medical claims.  Through home visits, they develop a relationship with the patient and monitor health progress by taking vitals, overseeing the correct use of medical supplies and equipment as well as keeping track of medication usage.  They may also make suggestions for physical changes to the home environment to ensure safety by assessing fall risk and potential hazards due to limited mobility.

Ultimately the patient advocate can serve many functions, but their primary function is to advise and assist throughout the treatment process. Patient advocates are often vital for major decisions in the change of care or environment, such as when it is too risky to have a patient living alone, or when to begin worrying about quality of life over aggressive treatment. Ultimately, it is the job of the advocate to help patients and their families navigate the healthcare system.

Is it in my best interest to utilize a private patient advocate, even when advocacy has been assigned through my insurance already? –Carlene G., Peoria, IL

While any patient advocate will help in navigating through tough medical struggles, both at home and in the hospital, it is important to note that there is often times a level of loyalty toward the wishes of whoever is ‘footing the bill,’ so to speak.

For instance, an insurance appointed advocate will likely have some level of the insurance company’s interests in mind. While it is unlikely they would ever provide bad or dangerous advice for the patient, they will likely have the reduction of cost to the insurance company in mind.

Advocates can also be appointed by the hospital itself, but they may also have their own goals in mind. Many hospitals receive a small penalty for patients being readmitted to the hospital within a certain period, and a hospital appointed advocate may have this or other things in mind when recommending a course of action.

While the difference may be slight, being the sole employer of a patient advocate does insure that their allegiances lie solely with the patient and their families. Perhaps just receiving a consultation from a private advocate to supplement your appointed advocate would suffice, but it is definitely something to keep in mind.