Navigating Health Care With Help From Patient Advocates
“Be your own advocate” is the mantra these days. But what if you’ve already tried that and are getting nowhere?
Enter the patient advocate.
They’re not quite as common as nurses. But patient advocacy has been cited by U.S. News & World Report as an up-and-coming field, and locally there are signs we may be seeing more of them soon: Some of our health care systems, including Mercy and Sutter, employ them.
What exactly do they do? In a nutshell, patient advocates help patients navigate the system—everything from insurance nightmares to finding a new doctor. “We kind of close the gap for patients,” says Shawnna Susac, a patient advocate for Mercy Medical Group.
Access issues are among the most common, she says, though the scope of patient
requests runs wide. Some even ask for an advocate to sit with them during a doctor’s visit—something Susac says she finds herself doing about once a week. “I’m not a licensed social worker,” she says. “But I feel like one.”
For Mercy patient Milla Austin, advocate services came as a complete surprise. After running a marathon and sustaining a foot injury, she called her doctor to request a referral to a podiatrist and hit a brick wall. “They said I needed to come in and see my [primary] doctor before they’d issue a referral,” says Austin, 34. “I was like, ‘Are you kidding me? Now I have to take extra time off from work and have to wait an extra week to see a podiatrist?’”
Steaming mad, she jumped on the Mercy website, found a “contact us” tab and peeled off a complaint. Within an hour, her phone rang. It was Susac, offering help.
The happy ending: Austin was able to circumvent her primary doctor and go directly to the podiatrist, thanks to Susac. “She set up my appointment, gave me the address and even sent a follow up e-mail to ask how it went,” says Austin. “The level of care was really great. I didn’t even know this service existed.”
Moral of story: Ask your health care provider whether patient advocate services are available. If not, try these resources:
• Patient Advocate Foundation, patientadvocate.org
• AdvoConnection, advoconnection.com
• California Office of the Patient Advocate, opa.ca.gov
Need Advice? Call a Nurse
Forget the Internet. Sometimes, you need to talk to a human being with medical know-how now.
Sometimes, the hour is 3 a.m.
That’s why advice nurses were invented.
If you’ve got medical insurance, there’s a good chance your provider offers this 24/7, free telephone service connecting patients to nurses. It’s easy: Just dial them up and explain your symptoms. They’ll ask as many questions as needed to evaluate your situation and to provide clear, helpful medical guidance.
The advice line is a popular way to get help, especially for what doctors call “quick, self-limited conditions,” such as flus, fevers, coughs, conjunctivitis, joint pain or minor injuries. Lesley Levine, M.D., regional director of appointment and advice call centers for Kaiser Permanente, calls the service a “major resource” for patients, and she’s not kidding: Last year, Kaiser advice nurses in Northern California fielded 3.6 million calls.
Newborn baby questions are another biggie, says Levine, a comment echoed by Janell Ostiguy, director of quality and risk management for CHW Medical Foundation. “It (the advice line) is a great resource for new moms, or moms of toddlers,” she says.
Phone services also are a boon for elderly patients, or anyone lacking Internet access, adds Ostiguy.
If your problem is disease-specific, chances are there’s a dedicated line for that, too. At Sutter, advice nurses are available at all pediatric, women’s health, neurology, pediatric gastroenterology, urology and oncology offices, according to spokeswoman Stephanie Breitbart. At UC Davis Cancer Center, patients have access to advice lines devoted to oncology, gynecology and radiation.
But what if you have no insurance, or otherwise lack access to advice nurses? Here’s one option: Neighborhood Nurse, a national service based in Atlanta, Ga., with registered nurses at the ready 24/7. Membership fees start at $38.85 a year—definitely cheaper than an out-of-pocket visit to the emergency room. For more information: neighborhoodnurse.com.
Urgent Care Centers: When You Need Help in a Jif
Midtowner Tiffany Lillebo puts it right out there.
“Urgent care centers ROCK,” she wrote on yelp.com.
She was referring to a particularly good experience she and hubby Erik Lillebo had at Med 7 Urgent Care Center in Folsom, where Erik was treated for a wrist injury.
This wasn’t Lillebo’s first fling with urgent care. She’s visited such clinics before, and says she would “surely” do so again.
Why is she so pro-urgent care? “I don’t think folks understand how quick and easy they make it,” she says. “They really are there to help.”
For many—especially (but not limited to) the uninsured—urgent care is an attractive alternative to the emergency room, where sticker shock can be staggering and wait times interminable (four hours and 34 minutes on average in California, according to a recent report). By contrast, urgent care clinics promise speedier service and cheaper prices. How much cheaper? According to a quick local survey, the average is around $125 for an initial visit, though some charge even less: At Sutter Express Care, located inside select Rite Aid stores, the flat fee is typically $69.
Even in this grim economy, urgent care appears to be in growth mode. In January, a new national urgent care franchise, Doctors Express, made its local debut in Fair Oaks. At least three more area centers (in Sacramento, Granite Bay and West Roseville), all state-of-the-art and staffed by board-certified/board-eligible physicians, are slated to open soon.
“We’re filling a void,” says Jeffrey Moy, M.D., a practicing physician in Sacramento for more than 25 years and the regional chief medical officer for Doctors Express. Urgent care is not for life-threatening medical issues, he cautions, but rather “acute care of common conditions. We’re there when people aren’t able to get in to see their primary doctors and need immediate help.”
Lean on Me: Support Groups
Len Silvey, 68, was diagnosed with multiple sclerosis four years ago. He has good days and bad days. But one day he always looks forward to is Wednesday, when he meets with a local Sutterwriters group, Musing of MS Minds.
“I don’t know what I’d do without my Wednesdays,” says Silvey.
Support groups have been around forever, it seems. But these days they come in a surprising smorgasbord of shapes and styles. There are groups that meet in person; there are groups that meet online. Some are led by laypeople; some are led by professionals. And while the forum for most groups involves the direct sharing of feelings, experiences and information, not all of them function this way. Amherst Writers & Artists groups such as Musing of MS Minds, for example, are based on the idea that writing is healing, and not necessarily in the self-disclosing way you might think: Instead of first-person accounts, fiction is the vehicle, says facilitator John Crandall. “Treating everything as fiction keeps a little bit of distance, which paradoxically frees people to say more,” he says.
Participants aren’t required to share their writings with each other. But they usually want to, says Silvey. “It’s very affirming to know you can write in ways that are moving to other people,” he says. Self-discovery is another payoff, adds Silvey. “Every so often you find yourself writing about issues you’ve been carrying around, kind of subliminally,” he says.
Silvey also attends a more conventional MS support group through Mercy San Juan, where members gather to share their experiences. “Some people are in tears; some are telling jokes. It’s a good way to get to know other people with MS and to learn from each other.”
Also good to know: In the Sacramento region, the rainbow of support groups ranges from the usual suspects (bereavement, cancer, Alzheimer’s, etc.) to the less mainstream, such as aphasia (language disorder), self-injury and love addiction. No matter what ails you, it’s probably out there.
To find a group, check with your health care provider, surf the web or ask around. For more information about Sutterwriters, visit sutterwriters.com.
5 Health Websites Worth Surfing
With so much bogus information on the Internet, recommending websites is tricky business. Here are five endorsed by experts.
The 411: Unbiased, independent information about supplements
Recommended by: Maxine Barish-Wreden, M.D., internist and medical director of the Sutter Center for Integrative Holistic Health, Sacramento
The 411: U.S. Department of Health & Human Services site, with links to more than 1,500 health-related organizations, interactive health tools and a healthy living guide
Recommended by: CAPHIS, the Consumer and Patient Health Information Section of the Medical Library Association
The 411: Objective, comprehensive health information for women, with experts available to answer questions
Recommended by: Mehmet Oz, M.D., Good Housekeeping and ForbesWoman magazines
The 411: A super-personalized website, allowing users to set health goals and providing status reports, reminders and tips to keep you on track
Recommended by: TIME magazine
The 411: Menopause central, featuring prestigious experts, live chats, message boards and resources galore
Recommended by: Susan Love, M.D., president of the Dr. Susan Love Research Foundation and author of Dr. Susan Love’s Menopause & Hormone Book