3. Patient Advocacy

Medical care can become confusing for the patient and may be a challenge for a team with many specialists. A Care Coordinator may be assigned to a case or be available in some medical facilities. Ask if patient advocacy services are available or seek other help if medical advice and treatments are becoming overwhelming.

Patients also need to feel comfortable speaking up about their symptoms or about any questions they might have about a treatment or diagnosis. Patients can benefit from being their own patient advocate and reading more about any treatments that are recommended.

• The book “Prepare to Defend Yourself . . . How to Navigate the Healthcare System & Escape with Your Life,” (2014) by Matthew Minson, MD is a patient self–advocacy guide: preparetodefendyourself.com

Patients may find after researching treatment choices that surgery might not be the first choice and that physical therapy might help. 

• Chiropractic care has been found to be effective for reducing level of chronic back-pain, with a faster recovery time and for less cost to the patient than a back surgery would have likely cost.  Read more:  Chiropractic Patients Recover Faster, Spend Less Money.  [2]   

Patient advocates may be available for those who can afford to pay for their services and some locations or facilities may also offer some free patient advocacy services. With the complexity of some medical conditions, seeking a guide who knows the system might help save money, or time and pain, due to unnecessary testing or treatments. Asking questions or seeking a second opinion should be within a patient's rights. Free services regarding patient complaints and patient rights are likely available in larger medical facilities, ask.

• A few types of patient advocates are described at assertivepatient.org:  [3] 

Some caution should be used when considering free services. Some patient advocacy non-profit organizations have been found to accept pharmaceutical funds which may bias their advocacy for or against certain medications or treatments. Read more: 

• Patient Advocacy Groups Raking in Pharmaceutical Dollars, [4]   

The duties of data sharing for care coordination between medical specialists and the family physician can be difficult and time consuming. 

• The expectations for the patient and the clinicians in coordination of the patient's care between multiple specialists are discussed in the article:  Exploring Patients’ Roles in Chronic Illness Care Coordination. [5]   

Online chart systems have not been as easy to use for the purpose of care coordination between different offices or agencies as may have been hoped due to the privacy walls that are in place between different businesses in order to protect against cybersecurity risks. Cybersecurity in the healthcare world is needed not only for computers and other devices that use internet connections, but also for medical devices used by individual patients for cardiovascular or diabetic needs. Hacking of a patient's medical record is a privacy risk, while hacking a person's insulin pump or pacemaker could be a life-threatening risk to that individual.

Physicians not only have to protect their patients but they also need to protect their career and business from risk of malpractice lawsuits. Many cases are filed, costing the doctor time and risking reputation, and then are dropped due to insufficient evidence. Over use of some screening tests by physicians can be due to their wanting to reduce the risk of a lawsuit where lack of a treatment choice might be used by a lawyer to make a case for malpractice. Change in regulations might help the situation. Read more. A Doctor's Place is in the Exam Room. [6] 

 Physicians are given little time to spend with patients in the current medical system. When pressed for time, errors can be made in diagnosis which could lead to treatment recommendations that may be dangerous for a person who doesn't actually have the condition. Seeking a second opinion is within a patient's rights if unsure about a recommendation or treatment's value or risk. Insurance may provide some financial coverage, but it is always a good idea to check with the insurance policy about prior approval or other criteria for coverage, before scheduling an appointment for an expensive test or procedure if finances are limited.  

• Is Poor Diagnosis a Leading Cause of Inefficiency in the Health System? [7]

Pharmacists are also helpful medical experts when seeking more information about a recommended medication or regarding potential negative interactions between medications, herbal supplements, and vitamins. However, like physicians and most people in the modern world, pharmacists are also busy people, and research has shown that some may miss as many as 50% of potential drug interactions. 

• Read more:  Pharmacies Miss Half of Dangerous Drug Combinations  [8]  

Services are available online where a person's prescriptions can be entered into a software application to check for possible medication interactions.  

• The CVS pharmacy website offers a drug/supplement interaction checker application. The information is for reference purposes and as a starting point for further conversation with a pharmacist or physician but is not intended to provide recommendations: Drug Interaction Checker.  [9] 

Research has suggested that patients are more likely to file a malpractice lawsuit against a health professional whom they didn't like then if they liked the person. Health professionals who take the extra few seconds for a smile and "How are you today, Ms Patient?" may save themselves lawsuits compared to the practitioner who looks at a clipboard and discusses disease symptoms instead of considering the patient as a whole person.

Alan Alda, the actor, wrote a book about ways to listen more effectively for better communication between physician and patient or between scientist and non-scientist. He shares his own experiences as a confused patient and his experiences as an actor trying to interview scientists for a non-fiction documentary style series. 

     An excerpt from his recently published book, If I Understood You, Would I Have This Look On My Face? My Adventures In The Art And Science Of Relating And Communication is available online along with an interview with the actor/author by National Public Radio, npr.org. 

     Alan Alda suggests that in order for us to better understand how the other person in a conversation is feeling, or whether they seem to be understanding your message, it can be as important to use our eyes to "listen" to the other person's body language as it is to use our ears to listen to the words being spoken.  

• An interview with Alan Alda about the book is available on npr.org: Alan Alda's Experiment: Helping Scientists Learn to Talk to the Rest of Us.  [10] 
• An excerpt from the book is also available on npr.org: If I Understood You Would I Have This Look On My Face?  [11] 
• The Alan Alda Center for Communicating Science: aldakavlilearningcenter.org.