How to find a good patient advocate

Consumer Reports News: May 05, 2008 12:17 AM

In 2004, Edward Moskowitz was hospitalized near his home outside Miami with internal bleeding, but after a week he was worse, his daughter Sandy Tepper says. That's when he became a human pinball. Over the next seven weeks, he was sent to rehab, grew worse, was transferred by a new doctor to a different hospital, then was bounced for insurance reasons to a second rehab facility (at 2 a.m.), despite his daughter's attempts to intervene. Ordered to physical therapy a few days later, he struggled from his wheelchair and fell to the floor, dead of apparent heart failure. He was 84.

What if someone had been there to ask the right questions and ease the family’s trauma? Enter the patient advocate, part of a growing field. Advocates, who are often former nurses or other health professionals, link patients and the health-care system. They 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.

Unfortunately, finding good advocates can be dicey. There's no licensing or credentialing process specific to health advocates, and no regulatory body oversees them, says Laura Weil, interim director of the master's program in health advocacy at Sarah Lawrence College in Bronxville, NY, the nation's only graduate program in health advocacy. But it makes sense to follow these guidelines:

For someone who's employed: See whether his or her benefits include patient advocacy. Many large employers contract with companies such as Health Advocate, the nation’s biggest employee-based advocacy firm, staffed by registered nurses and benefits experts.

For someone in a hospital or nursing home: Ask whether there’s an in-house patient advocate who mediates between families and staff members. (But be aware that such advocates are on the institution’s payroll.)

If a chronically ill person can’t get care: Contact the nonprofit Patient Advocate Foundation, which provides free mediation services on a case-by case basis. The Web site includes resources to help navigate insurance issues as well as patient chats.

To hire a private advocate: Get a résumé, check references, and ask what experience the person has with similar cases. Obtain price estimates in writing.


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