By Kathy Ann Wolverton, Partner at the Law Offices of Sandra M. Radna, P.C.
With staffing shortages and pandemic exhaustion battering medical professionals, it is easy to overlook an underutilized asset in many healthcare facilities – the patient advocate. These professionals are available to ease the time constraints of meeting with patients and their families, as well as help prevent poor outcomes, including lawsuits.
Patients and healthcare providers alike might be surprised or even shocked to learn that Medical errors cause approximately 250,000 deaths per year, ranking third highest among the causes of death in the United States. Over 40% of all patients believe that a medical error was made in their care, and almost every physician faces a medical malpractice claim by the age of 65. Actively engaging with your patient advocate is one way to change the trajectory of these trends.
Assisting patients and families in addressing delays in treatment, or facilitating meetings with a physician, patient advocates may prevent medical mistakes and improve a patient’s overall care. By engaging with the patient and their family, patient advocates improve communication – which can be a critical factor in preventing medical malpractice claims. The better the communication, the less likely misunderstandings of diagnoses, treatment plans and discharge instructions will lead to a lawsuit. Their interaction with both patients and medical providers adds transparency and clarity to the often complex and stressful road through the healthcare system – which is why they are also known as patient navigators.
Additionally, advocates provide resources for financial and social services support, and may proactively schedule appointments for tests and physician visits. Patient advocates interact with the various entities that can impact a patient’s healthcare experience including employers, insurers, lawyers, case managers, physicians, nurses and others. They often are able to determine if a patient is eligible for government programs and investigate any available third-party reimbursements.
Patient advocates help patients and their family understand what the medical teams are doing and why. In many facilities, they are empowered to acquire medical records, manage treatment, testing delays and facilitate any complaints between the patient and the hospital.
A Breadth of Services
Patient advocates serve to cut through complex medical and health insurance language and provide patients with transparent information and guidance. A surprise to no one, managing the finances and insurance for medical treatment is extremely confusing and emotional for families, particularly when critical illness is involved.
Clinical diagnoses and billing statements often appear as cryptic medical terminology, something that most patients and family have no familiarity with. Because of this, patients sometimes end up paying inaccurate medical bills or agree to treatments they may not be so willing to do otherwise. Securing a face-to-face meeting with a physician is often difficult, so it benefits patients and their families to have a patient advocate to relay accurate information to them and to the physicians caring for the patient.
Additionally, patient advocates often assist with prescription management. Patient advocates have the tools and knowledge to cross-reference a patient’s current regimen and ensure new drugs are applicable, set-up new prescriptions that require less frequent pharmacy visits or establish mailed prescriptions on a schedule.
Healthcare Providers Benefit from Advocacy
A win for everyone, patient advocates reduce the time and increase the quality of patient and doctor interactions. Armed with a deeper understanding of the patient’s condition and the likely next steps, the patient advocate assists patients by asking pertinent questions and often translates medical-speak into relatable English.
Patient advocates can provide accurate and clinically direct information on behalf of clients. They help prevent readmissions due to complications by ensuring that patients or their caregivers thoroughly understand how to follow discharge instructions. Recent data indicates that patients and caregivers who are actively engaged in their hospital-based care are able to reduce preventable adverse events by almost 40%.
As we continue to navigate our new post-pandemic “normal”, actively engaging with your patient advocates will provide an additional layer of support for both medical professionals and patients, improve the patient experience and, hopefully, reduce risk for all.
About Kathy Ann Wolverton
Kathy brings a lifetime of helping people to her dedicated service to her clients. Kathy’s calm and understanding guidance reassures and comforts our medical malpractice clients during some of the most difficult days of their lives. She was a Broadcast Journalism major at Ithaca College, which led her to a career as a television news producer in the Albany area. After years of bringing important new stories to the community, she obtained her law degree from Albany Law School. Kathy joined an Albany law firm where she specialized in education law and public sector labor law, assisting small and large school districts navigate a complex legal landscape. In 2008, Kathy returned to her hometown in upstate New York where she served as the Personnel Director for the City of Oneonta. In 2016, she moved to Long Island with her husband, and joined Law Offices of Sandra M. Radna in 2017.