How a Medical or Health Advocate Can Help

Most people, that is most patients, are at a decided disadvantage when dealing with the healthcare system. Doctors have studied for years to amass a body of knowledge that allows them to understand medicine and make informed decisions about how to care for their patients. They go to college for four years where most aspiring doctors study the scientific foundations of medicine. They then go through four years of intensive learning in medical school to learn the basics of medical knowledge, and then three to eight years of on the job training as residents or fellows to become proficient in their specialties. How is even a highly educated person without the above background expected to interpret and understand the intricacies of medicine that go into understanding their disease, evaluating treatment options, and working toward their own health?

Even the simple process of signing a consent for surgery or a procedure can be overwhelming and have serious consequences. Lack of a truly “informed” consent is much more common than most people realize. Did your surgeon explain all the options, both surgical and non-surgical, for treatment? Do you understand the potential risks and complications of the procedure and how often they occur? How will the surgery change your life and how your body functions? What are the best case and worst case scenarios? What can I expect if I don’t have surgery? These important questions and their answers often go unasked, are poorly explained, or are misunderstood. This New York Times article recommends that patients are accompanied by an “advocate” to be a second set of eyes and ears and an “accessory brain” to help you understand and process the information that your doctor conveys to you. The actual process of informing the patient is the discussion that takes place prior to surgery between the patient and the doctor. Unfortunately this discussion often takes place immediately before surgery when the patient is anxious, uncomfortable, and not in a frame of mind to fully comprehend the factors that go into making an informed decision. A medical advocate would know that this discussion should take place well in advance of surgery and is there to be on your side, to be your advocate, and to look out for your interests and health. A qualified medical advocate can take notes, understand the medical technicalities, and go over these issues at another time in a more relaxed and comfortable setting.

There are also many other ways that a knowledgeable and qualified medical advocate can smooth your interaction with the healthcare system and help to ensure your safety and health. A trained physician acting as your advocate will understand your medical history and the implications that it will have on your health decisions. He or she can participate in discussions with the medical professionals providing your care and make sure that the proper questions are being asked and the answers understood. Medical advocates can also guide a patient to providers that they know are highly competent or that have access to advanced treatment options. Many treating physicians only refer their patients to other doctors and providers that they know on a personal basis or who are working within their institution. An effective medical advocate will have contacts at a wide number of institutions that are geographically distinct or in different “health systems” and will may also have “inside knowledge” of results and complication rates. Having a medical advocate puts this information at your fingertips in a way that can have a positive impact on your treatment and that will allow you to make informed decisions. Your medical advocate may also coordinate your care, schedule appointments, organize your medical records and test results, and be a resource for you as a knowledge base to understand complex medical terminology, treatment options, and test results. The task of caring for an aging parent with chronic or acute medical issues can be overwhelming emotionally and time consuming as well. A physician medical advocate can alleviate this burden with their time, knowledge, and compassion.

In this article columnist Jane Brody makes a very strong case for having an advocate on your side and the significant difference that it may make in treatment outcomes, particularly when hospitalized. She discusses not only the important role that a medical advocate can provide as a “link between patients and their health care providers” but also the more mundane and necessary function of dealing with insurance companies and hospital billing offices when care is denied or payment issues arise.

All in all, there are many benefits that can be realized by working with a medical or health advocate whether you or a loved one is healthy or facing a serious medical diagnosis. In an increasingly complex healthcare system having a medical advocate on your side can make all the difference to your health.


J. Stephen Stein, M.D.