The September edition of Navigator News includes articles on: Understanding Palliative Care; The Fine Print of your Insurance Policy; and Food Science Part 1. We welcome your feedback!
A recent survey revealed that 91 percent of physicians surveyed practice defensive medicine – they regularly order more tests and perform more procedures than are medically necessary in order to protect themselves from the possibility of being sued for medical malpractice.
This survey, by a team of researchers from Mount Sinai School of Medicine, confirms that the fear of being sued is very real and pervasive throughout the entire spectrum of medical practice.
In addition, those surveyed responded that the “overwhelming majority of physicians support tort reform to decrease malpractice lawsuits and that unnecessary testing, a contributor to rising healthcare costs, will not decrease without it.”
Defensive medicine is expensive, inconvenient to both doctor and patient, compromises the relationship between provider and patient, and has no basis in evidence-based medical practice.
Unfortunately, the practice of defensive medicine decreases patient access to health care, and increases costs of healthcare for everyone. Some patients are left in the lurch as physicians avoid the sickest patients, or those requiring higher-risk procedures, in order to reduce their exposure to malpractice suits.
A 2008 study by the Massachusetts Medical Society found that 83% of its physicians practiced defensive medicine at a cost of more than $1.4 billion annually in that state alone.
To me, $1.4 billion in one state translates at a conservative estimate to at least $30 billion annually throughout the country.
I find the dollar cost of the practice of defensive medicine disturbing. I find the cost of the doctor-patient relationship, in which the physician views every patient as a potential lawsuit, rather than a person in need of healing, frightening and discouraging.
More medicine is not better medicine. Evidence-based, patient-centered medicine is better medicine.
Submitted by guest editor Debora Harvey
Yesterday, I drove onto the freeway and headed to my first client appointment of the day. As the line of cars ahead of me snaked down the on-ramp, I wondered why the normally free-flowing ramp was stuck. I felt impatient and irritated with whatever was causing the problem.
A small silver Honda was trundling along at 40 mph, in traffic that was easily surging past it at 60 to 70 mph, even through a construction zone. As I passed the car, I saw the driver – an elderly man, easily in his 80s, with white hair and beard, wearing a hat and clenching the steering wheel tightly in both hands.
My irritation immediately turned to sympathy. I can only imagine the fear and anxiety he felt driving on a fast-moving highway, in rush-hour, through a construction zone, dealing with drivers who think they are the most important ones on the road. That is a challenge to anyone. For someone whose reflexes and processing time have slowed, it is an enormous challenge.
Many families have to face the issue of getting Mom or Dad, Grandma or Grandpa to stop driving when is it no longer safe for them to do so. It is rarely a straightforward decision. AARP has developed a Driver Safety Program that helps families evaluate a senior’s driving skills, notice key clues that there might be problems, and initiate a discussion with the driver.
The American Automobile Association also has a comprehensive site devoted to skills assessment, planning and communication.
Automedia has developed an online test for physical and mental driving capabilities.
Some states require drivers over a certain age to renew their licenses in person, and to be tested more regularly than a younger driver. While this is often viewed as a burden by older drivers, it also helps to ensure that the older drivers still on the road do possess good driving skills.
One of the central aspects of American culture is independence. When a person can no longer drive safely, he or she loses a huge degree of that independence. Proper preparation and discussion can help ease the process.
Guest Editor Debora Harvey, Patient Navigator
I have been reading a book called The Strong Women’s Guide to Total Health. I like this book, not only for its great title, but because it is easy to read and understand, with sensible health information.
As I was reading the section titled “Standing Strong; Our Living Framework,” I began to think about mothers and grandmothers. When I was a child, my maternal grandmother seemed to be a giant – tall and strong. By her 90th birthday, she had lost more than 6 inches in height and had very little muscle tone. She had absolutely no interest in exercise, satisfied that walking her dog and weeding her garden were quite enough.
My 87 year-old mother-in-law is now shorter than my 10-year old son. She, too, has lost a substantial amount of height, strength and stamina. Whenever we mention any sort of exercise, or nutritional advice, she nods politely, but I can tell she is mentally brushing us off.
On the other hand, my mother tries to eat a diet that promotes bone strength. I take 1200 mg of calcium/day, and do weight bearing exercise. My 13-year old daughter grumbles, but agrees to take her calcium and vitamin D supplements most of the time. What will this mean as we age?
Well, the hope is that our bones, muscles and connective tissue will be strong enough to sustain us through 9, 10 or more decades of high-quality life. Building strong bones at an early age – during childhood and adolescence – is our best defense against developing osteoporosis later in life. But no matter how old you are, it is never too late to start taking care of your bones.
Some factors that affect your bone health, such as age, gender and genes, are beyond your control. However, lifestyle choices, especially diet and physical activity, are responsible for up to 50% of bone mass and structure. Getting enough Calcium and Vitamin D in your diet, and some sort of weight bearing physical activity are highly recommended for people of all ages.
More information about prevention of osteoporosis and age-related bone degeneration can be found at the The National Osteoporosis Foundation website.
You can also visit the excellent women’s health site from the Department of Health and Human Services.
Guest Editor, Debora Harvey, Patient Navigator
A caregiver is someone who takes you to your doctor’s appointments, drives you to and from treatment, helps with activities of daily living, listens to you and lends a shoulder to cry on. A diagnosis such as cancer can shake the foundation of any family and caregivers play a vital role for loved ones diagnosed with a serious illness. Not only is the patient required to drop everything to focus on their treatment plan; caregivers must also, to some extent, put their life on hold to fill an important role.
All too often, however, caregivers’ needs go unmet and the burden they share goes unrecognized. Doctors, nurses, family and friends make sure the patient comes first, and rightfully so. However, caregivers also suffer as they watch a loved one battle illness. Caregivers can feel as though they’re not doing enough to make their loved one comfortable or happy, despite their heroic efforts. Caregivers can also receive the brunt of a patient’s anger, since typically this role is filled by a person close to the patient.
The Journal of General Internal Medicine recently released ethical guidelines addressing patient, physician, and caregiver relationships. The medical community is increasingly respecting the role of caregivers and offering guidance on how to develop that relationship. The guidelines aim to focus on a family-centered approach to treatment thereby decreasing the caregivers’ susceptibility to stress-related illness. One such recommendation states that physicians should be more accessible and allow for more effective communication not only to the patient but also to the caregivers.
Remember that it’s important for caregivers to be mindful of their own health and needs. Take time out to go for a walk, rest, go to a movie. Many communities offer respite services to give you some time away. It can also be very helpful to seek out a caregivers support group in your local community. Strength is gained when experiences are shared.
For more information and resources for caregivers, please visit the following sites:
http://www.cancer.gov/cancertopics/coping/familyfriends – National Cancer Institute
http://www.cancer.net/patient/Coping/Caregiving American Society of Clinical Oncology
http://www.cfad.org/ Caring from a Distance
http://www.caregiver.org/caregiver/jsp/home.jsp Family Caregiver Alliance
Submitted by Heather Matthews, Patient Navigator Cancer Research Specialist
This useful article from the National Comprehensive Cancer Center discusses cancer navigation options and defines different types of assistance that may be available. Patient Navigator LLC is featured as a resource. The article describes ways that navigators and case managers can help, including eliminating barriers to treatment, and it suggests other sources of support.
The National Association of Healthcare Advocacy Consultants (www.nahac.com) held a successful inaugural conference November 14-15 in Berkeley, California.
As a former diplomat, I’ve always loved the phrase associated with our post-war Secretary of State Dean Acheson – to be “present at the creation.”
This is exactly how we all felt this weekend – to be present at the creation of an important organization leading the way for for our new profession. We participated in two intense days of workshops, networking and strategic planning. Our next conference will be held in Washington, D.C. in November 2010.
The National Association of Healthcare Advocacy Consultants (NAHAC) is designed to bring together under a professional umbrella the many individuals now working around the country as navigators and advocates. One of our intial goals is to develop a code of ethics and to build business and professional resources. The other key goal of the Association will be to provide a clear voice and reasoned opinions on policy matters related to navigating the healthcare system, patient advocacy and health care reform. As health care reform winds its way through the Congress, the Association will be vigilant about the many forthcoming changes so that we can continue to help the families we work with find their way through the system to achieve the best possible outcomes.
As I’ve described in previous posts, the emerging field of patient navigation and patient advocacy has burst onto the scene in 2009. Advocates and navigators work to fill the glaring gaps in the U.S. healthcare delivery system which is fragmented, confusing, expensive, and inefficient. Since 2005, my company Patient Navigator LLC has been helping families solve problems, navigate the complexities of the American healthcare system and benefit from an integrative approach to treatment and recovery. Now as Vice President of the NAHAC, I look forward to helping chart the course for our new profession. To learn more, please visit www.nahac.com
We were recently on a radio show! Patricia Grace of Aging with Grace interviewed Elisabeth Russell October 26. If you are interested in hearing the types of things Patient Navigator can do to help you or a loved one, please listen in. We welcome your feedback.
First Annual Conference of National Association of Healthcare Advocacy Consultants (NAHAC) to Be Held Nov. 14-15; Board of Directors Announced
Conference Addresses Issues Defining Rapidly Growing Patient Advocate Profession
BERKELEY, Calif., Oct. 13 /PRNewswire/ — The National Association of Healthcare Advocacy Consultants (NAHAC), the nation’s first professional association for people working as healthcare and patient advocates, will hold its first annual conference November 14-15 at the University of California, Berkeley Clark Kerr Campus.
Conference workshops will include topics ranging from best practices for advocacy decision-making through solving health insurance problems, working effectively with physicians, legal issues, advocacy for children, and using technology to maximize efficiency. Case studies will also be presented.
“The founding of NAHAC and this inaugural conference are major milestones on the road to formalizing our profession, creating healthcare consumer protection standards and promoting this rapidly growing field of healthcare advocacy,” says NAHAC founder Joanna Smith.
Conference presenters/topics:
Ann Tardy, Founder, LifeMoxie; Keynote Presenter: “The New World of Healthcare Advocacy — Creating It Together!”
Jeff Belkora, PhD, Director of Decision Services and Assistant Professor of Surgery in the Institute for Health Policy Studies, U.C.S.F.: “Making Good Decisions in a Family Health Crisis”
Linda Garrett, Partner, Risk Management Services: “Confidentiality and Privacy Law for Healthcare Advocates”
Gail Gazelle, MD, Assistant Clinical Professor of Medicine, Harvard Medical School: “Inside the Doctor’s Mind: What Every Advocate Needs to Know”
Maggie Radany, RN, Founder, Radany & Associates: “How to Solve Health Insurance Problems and Be a Hero to Your Clients!”
Dianne Savastano, Founder & President, Healthassist: “Bringing Bob Home: A Case Study in Patient Advocacy”
Elisabeth Schuler Russell, Founder & President, Patient Navigator LLC: “Inside the World of Pediatric Healthcare Advocacy”
Judith Stark, Principal, Judith Stark Consulting: “Harnessing the Power of Technology Solutions for Healthcare Warriors”
Inaugural members of the NAHAC Board of Directors:
President: Joanna Smith, CEO, Healthcare Liaison, Inc., NAHAC Founder
Vice-President: Elisabeth Schuler Russell, Founder & President, Patient Navigator LLC
Secretary: Ricka L. White-Soso, MSW, private healthcare advocate and consultant of FLW Living Well Services
Treasurer: Maggie Radany, RN, MPP, Radany & Associates, health insurance consultant and healthcare advocate
Representation of the Founding Members: Laura Weil, Director, Sarah Lawrence College Master’s Degree Program in Health Advocacy
NAHAC membership is open to individuals interested in healthcare advocacy.
For the conference brochure and more information about NAHAC visit: http://www.nahac.memberlodge.com
SOURCE National Association of Healthcare Advocacy Consultants
Do you have a quick health care, medical, cancer care, chronic disease, caregiving, elder care or administrative or integrative care question you would like answered? Have you been getting lost in the medical information maze on the Internet? You don’t have to feel overwhelmed any longer. Stop searching!
Patient Navigator LLC is pleased to announce a new, free service. “Ask A Navigator” is designed to let users ask a quick question and get a quick answer. We have access to experts in many health care fields who have personal experience navigating many illnesses, conditions and aspects of our medical system.
I hope to have this service up on www.patientnavigator.com very soon.
In the meantime, you can ask your question directly here via the comment section on this blog and it will be answered here. If it’s something that would benefit others, please use this forum. Or send your question to: ask.a.navigator@patientnavigator.com
We look forward to helping you.