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
Since I first wrote on this topic in April 2009, many people have contacted us wanting to know more about patient advocate or navigator training programs or job opportunities. Here is a February 2010 update.
Patient navigation/advocacy is a new and emerging field. It has come about because of the complexity, inefficiency and cost of the current American health care system. You probably saw from my website (www.patientnavigator.com) how I came to be a patient navigator (advocate, medical mentor, cancer coach) as a second career. You can also get a sense of the services we offer as well as the range of clients with whom we work.
The most exciting thing to happen in 2009 was the launch of The National Association of Healthcare Advocacy Consultants (www.nahac.com) . I was elected as its Vice President and we held our inaugural conference November 14-15, 2009 in Berkeley, California. The next conference will be November 4-6, 2010 in Washington, D.C. and First Lady Michelle Obama is our invited keynote speaker. This professional association is the best way to get started in the field of patient advocacy. I strongly encourage those interested in the field to join (www.nahac.com).
There are several pieces in the “navigator” landscape.
An increasing number of hospitals in the U.S. and Canada employ navigators to help patients manage their hospital stays. Those hospitals usually require nursing degrees and frequently work with breast cancer patients (because there is funding available from private foundations such as Susan G. Komen).
The American Cancer Society trains navigators in some cities to work with underserved populations. They get funding, in part, from the NCI program to train navigators. http://tinyurl.com/ygll4ca
The National Institutes of Health, National Cancer Institute http://crchd.cancer.gov/pnp/pnrp-index.html is funding several patient navigator pilot projects across the U.S. in underserved and minority areas and trains navigators working in those projects. A Colorado hospital is one of those projects and they conduct training: http://patientnavigatortraining.org/index.htm
The American Recovery and Reinvestment Act is funding additional patient navigator positions staffed by nurses in some National Cancer Institute-sponsored community hospitals. To learn more about these job opportunities, see the following NCI article: “Patient Navigators Ensure Cancer Patients Get What They Need” January 25, 2010
http://www.cancer.gov/recoveryimpact/page5
Much of this work is based on the model set by Dr. Harold Freeman in Harlem to develop community-based navigator programs - http://www.hpfreemanpni.org/ They offer training to groups and non-profits seeking to work to narrow disparities in access to cancer care.
I hear often from folks around the country who want to become patient navigators/advocates. The most comprehensive training program I know of is an online training and certification launched by the University of Miami on September 11, 2009. It is called the Healthcare Advocacy Certificate Program. For complete information, visit http://tinyurl.com/lahzds or http://tinyurl.com/yghstk6
Separately, Sarah Lawrence College offers a Master’s degree in patient advocacy. http://www.slc.edu/graduate/programs/health-advocacy/index.html
I have learned of training at the University of Wisconsin at Madison for certificates in Consumer Health Advocacy http://www.patientpartnerships.org/certificate.php but have heard it will be up and running in the Summer of 2010.
Cleveland State University offers a Patient Advocacy Certificate Program. http://www.csuohio.edu/ce/certificates/health/pacp/index.html
The University of Phoenix has an online program to become a patient advocate: http://tinyurl.com/yjld3ln.
The President of Healthcare Liaison who is also the President of the National Association of Healthcare Advocacy Consultants (www.nahac.com), Joanna Smith, offers training workshops for how to become a patient advocate: http://healthcareliaison.com/workshops.html. Her workshops are open to anyone with an interest in the field but are a requirement for those considering the full Credentialing Program. The full credentialing program for medically trained people runs either 9 months ($2,500) or one year ($3,000). She refers non-medically trained people to the other programs in this paper.
In Fall 2010, the Integrative Medical Clinic Foundation and Sonoma State University in California will offer a Patient Navigator Certificate Program and expand the role by including an Integrative Health component. They are found at www.sonoma.edu/exed and then click on Patient Navigator.
Locally, in the Washington, D.C. area, the Smith Farm Center for the Healing Arts offers community patient navigation training www.SmithFarm.com
Most of us who do this work come to it through our own experiences dealing with the health care or elder care system (whether as a patient, caregiver, nurse, social worker, etc.) In most cases, there is no specific background or education that is required. I have found that a passion for helping others, good research, communication, interpersonal and organizational skills as well as the ability to be creative in finding resources and solving problems are what it takes.
Patient advocate Trisha Torrey recently wrote an excellent article about job prospects for patient navigators/advocates. You can read it here:
http://patients.about.com/od/caringforotherpatients/a/patientadvocatejobs.htm
Here is a link to a separate guide published by Trisha Torrey about setting up an advocacy business: http://patients.about.com/b/2009/03/31/start-a-patient-advocacy-business.htm
In order to connect folks throughout the U.S. who are interested in this field, I have formed a virtual “Patient Navigator” working group through LinkedIn, the professional networking site. Please consider joining our virtual group as we collaborate to build this profession. All you need to do is go to www.linkedin.com set up a profile and then ask to join the Patient Navigator group. Please include an explanation of why you’d like to join the group. It’s a good way to stay in touch and make contacts.
Elisabeth Russell, Founder and President, Patient Navigator, LLC
Updated March 16, 2010
Many of you reading this blog have experienced some type of difficult health situation, for yourselves, a friend or family member. It’s also what makes so many of us passionate about helping others through their illness. It’s why Patient Navigator exists.
Since it’s the New Year, most people take some type of inventory of their lives and resolve to make changes. But truly, taking care for our health should be the most important thing we do – more important than money, a promotion or material goods. Because without health, we feel powerless.
I don’t need to restate the recommendations we’ve all heard a thousand times about healthy diet and exercise. We know what we need to do. So let’s reflect today on our health and the gift that it is, the miracle that is the human body. If you are suffering, see what steps you can take to improve your situation. Your body is meant to work so beautifully; if you’re hurting it, please resolve to try harder to nurture and respect your health.
I went out and bought a teapot and some wonderful teas today. I resolve to make myself a pot of green tea every evening at about 5:00. Please think of one good thing you can do or change. Once you’ve done it, the rest will come more easily because you will feel your body thanking you. Here’s to a New Year 2010 of good health and serenity.
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
There were two very interesting stories this morning on National Public Radio regarding incentives for people to get and stay healthy. If you’ve followed this blog, I’ve written before about my dismay that the current health reform legislative group grope is not doing anything to tackle health care spending at its core: how to get people to assume responsibility for their health and to make lifestyle choices that will help them stay or become more healthy. Until we change the trajectory of the obesity epidemic to lower health care spending, no insurance reforms will make a shred of difference and the country will end up sick, bankrupt and hopelessly in debt.
Apparently Safeway, the giant grocery store chain, has offered incentives for the last 5 years that directly provide insurance premium discounts to their employees to lower their cholesterol and blood pressure, exercise, lose weight, stop smoking. These are the well-known things that reduce risk factors for preventable diseases. The program has been very successful by all accounts. Employees can save money, the workforce gets healthier, and Safeway’s insurance costs remain steady (even in the face of double digit premium increases every year).
This is such an obvious solution and yet it’s controversial. Major groups such as the American Heart Association and the American Cancer Society fear discrimination. Nonsense. Aren’t they more interested in getting people to adopt lifestyle behaviors that might prevent them from getting heart disease and cancer in the first place?
Apparently, there is a “Safeway” amendment offered in the Senate Finance Committee legislation based on the effective model Safeway has created.
Will it survive? I’m sorry to say, but it makes too much sense to survive. What vested interests will benefit from a healthier population? Not insurance companies, so that is probably the death knell right there.
Listen to the story for yourself: http://tinyurl.com/ybgsxbd
Thank goodness we have public radio so that thoughtful, thinking people can try to figure out what is going on away from the bloviating politicians and mindless, right-wing talk show hosts.
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.