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What is a private patient advocate?

A private patient advocate (PPA) helps you navigate the healthcare system and manage the process of obtaining quality care. Sometimes called patient navigators or health care advocates, your advocate provides one-on-one guidance and assistance eliminating barriers to timely diagnosis, treatment, and supportive care.

Private patient advocates offer many services. These include:

  • helping you understand your test results, diagnosis, and doctor's recommendation
  • obtaining expert opinions
  • researching more effective treatment options
  • accompanying you to visit your doctor
  • educating you and your family about your condition
  • creating a centralized health record
  • protecting you from medical errors
  • providing emotional support and encouragement 

  

The answers you need

A qualified private patient advocate will consult with your providers and do the research to answer the most important questions about your care:

  • What are your health objectives and the key requirements for achieving them?
  • Is your doctor the best type of doctor to treat your specific condition?
  • Does each of the doctors treating you actually have the specific type and amount of experience that qualify him/her  to give a truly expert opinion?
  • Are all tests and procedures recommended by your doctor necessary and appropriate?
  • Were you diagnosed correctly, according to published guidelines using all available diagnostic data and taking into account all other potentially relevant facts ?
  • Do you feel your doctor understands your concerns, priorities, and preferences?
  • Are your doctor's recommendations in accordance with evidence-based standards?
  • Are all of the clinicians involved in your case working collaboratively with each other as a team?
  • Have you received all the information you need to make truly informed  decisions?
  • Have you been offered the latest more efficacious treatment?
  • Are you aware of all your options and do you understand the pros and cons of each?
  • Are all relevant aspects of your health and your specific circumstances being addressed?
  • Does everyone involved in your care understand your needs?
  • Is everything being done to make you comfortable?
  • Are you receiving the adequate emotional support?
  • Have your received sufficiently detailed information about your progress and the effectiveness of your care?

A PPA is not a doctor and does not give medical advice. Instead they help you evaluate the advice you receive in an informed logical manner.

Private patient advocacy is a new profession for which official credential standards are currently being defined.

PPAs have different areas of expertise such as health insurance, researching treatment options, patient safety or specific conditions such as diabetes.

PPA services are ordinarily not covered by health insurance although more plans are beginning to cover the cost of a private advocate..

 

Why do I need a private patient advocate?

Is it necessary to have one? Complexity, fragmentation, and other factors have led to a health care system that falls short in delivering care that is patient-centered, evidence-based, and safe. Patients must somehow navigate this system and make decisions about treatment choices with barely an understanding of their illness.

They also face a real danger of mistakes and unnecessary treatment. Your chances of receiving an incorrect diagnosis is about 50% according to a Veterans Affairs Medical Center study. The likelihood that you will be harmed by a medical error is so high that such errors are now the third leading cause of death in the US. There is no guarantee that your doctor will offer you the most advanced treatment options. There is however a 60% chance that your doctor may recommend something officially deemed useless or harmful, according to the Mayo Clinic.

A private patient advocate has the skills to deal with the health care system on your behalf and protect you from these risks.

Your doctor wishes he could spend more time with you.

In 2/2013 American Public Media's Public Insight Network, asked 24,000 doctors "What one thing would transform the way you practice medicine?" Above all else doctors said they wanted more time — time to talk with patients, think through difficult diagnoses, and to analyze data showing whether patients are doing better. A private patient advocate changes this in four ways  by:

  1. Requesting more time with your doctor
  2. Ensuring you make the most of your visit by preparing questions and information ahead of time and accompanying you.
  3. Doing some of the things your doctor may not have time for such as thoroughly explaining your condition and treatment options, and explaining test results
  4. Following up with your doctor via email or phone to obtain or submit additional information.

This way a private patient advocate helps you get the most out of your doctor's expertise while reducing the risks associated with excessively short office visits.

A Partner

A private patient advocate can be invaluable in making the right decisions that lead to the best outcomes for you or your loved one. They foster a decision process that is goal-oriented, logical and evidence-based so that you can feel confident about your choices

A private patient advocate treats your problem or goal as theirs. Confronting life and death situations such as cancer can be overwhelming for many. If unable to cope with a diagnosis which, left untreated will result in death, decisions aren't made and important treatment is not received. Often it is the intolerable effect of the advancing cancer which eventually forces one to deal with it. By then, however, one's options are more limited.

A private patient advocate understands this and is able to stand with you and assist you in confronting difficult issues promptly and properly. A private patient advocate provides emotional support, procures the best information and opinions about your case, and manages the logistics of obtaining the best treatment available, their goal being to truly change the outcome for the better.

What "private" means for you

Private, professional health advocates are defined as those advocates who work directly for patients, their families and caregivers, and not through an intermediary such as a hospital, insurer, or other person or organization that may have conflicting interests.

Patient navigators whose services are made available to you free of charge may be employed by an intermediary. The hospital's navigator is unlikely to suggest a second opinion or provide a review of treatment options that are not in the hospital's interest. The advocate provided by the insurer is not likely to suggest additional tests, a second opinion or newer treatment options.

Only when the advocate is employed directly by you will your health be the single priority driving the advocate's efforts.

More about patient advocacy

 

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