Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

AHRQ Director Carolyn Clancy, M.D., has prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They will address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan. Check back regularly for new columns.

Imagine that your doctor just gave you a serious diagnosis or told you she was concerned about the results of your medical test. You might understandably become scared.

Listening carefully to your doctor and asking questions about a diagnosis or test results can help you get better care. But here's the problem: Just when you should be paying close attention to what your doctor is saying, you may be stunned by the news you just received.

That's when having a health or patient advocate can help.

A health advocate is a family member, friend, trusted coworker, or a hired professional who can ask questions, write down information, and speak up for you so you can better understand your illness and get the care and resources you need.

Research shows that quality health care means taking an active role in decisions about your care. If you're facing a difficult medical decision, it's a good idea to bring someone with you who can help you take an active role in your care when you're not fully up to it.

As a doctor and a patient, I've seen how valuable it is to have "another set of ears and eyes" in the exam room. Having an advocate at medical appointments or during a hospital stay can ensure that you get the information you need to manage your health.

Health advocates can:

  • Ask questions or voice concerns to your doctor for you.
  • Compile or update your medicine list.
  • Remember your medication regimen and help you follow treatment instructions, including asking questions about your followup care.
  • Help arrange transportation.
  • Research treatment options, procedures, doctors, and hospitals.
  • File paperwork or assist with insurance matters.
  • Ask the "what's next" questions, such as, "If this test is negative what does it mean? If it's positive, will more tests be needed?"

Many encounters with the medical system are routine and don't require the use of a patient advocate. But there are instances when an advocate can be valuable. For example, if you've had a series of tests and you're concerned the results may reveal a diagnosis such as cancer, you might want to bring an advocate with you to hear and discuss the results.

Getting a diagnosis of a serious illness can be an overwhelming experience. You're likely to be distracted and miss hearing important information. An advocate can receive that information for you and ask the questions you might have later.

Who makes a good health advocate? Someone who is calm, pays attention to details, and can ask questions and state information clearly.

If possible, choose someone who knows you well. Be clear about what kind of help you need and what worries you. It's helpful to give your advocate details of your medical history. For example, you may want to discuss the tests you've had, list medicines you take, and provide contact information for other family members and your durable power of attorney.

If your advocate doesn't know you well, make sure to let him or her know if your hearing or vision is limited. He or she can alert your medical team to speak clearly and to read instructions aloud if they are not available in large type.

If you can't locate an advocate before an important medical or hospital visit, you can find a professional, often a nurse or doctor, to serve this role.  Some professional advocates specialize in researching the best available treatments and can assist you at home or in the hospital. Check to see if your health insurance covers these services.

You can also ask your local hospital staff to recommend a patient advocate. In fact, some hospitals and nursing homes employ advocates who work on patients' behalf at no charge.

It's likely that you or a loved one will one day need a health advocate. For many patients, the benefits of having an advocate are priceless because he or she can help you understand your options and give you peace of mind so you can focus on your recovery.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Family Health Advocacy (Transcript)  Podcast Help

Agency for Healthcare Research and Quality
Talking About End-of-life Treatment Decisions
http://www.ahrq.gov/news/columns/navigating-the-health-care-system/070709.html

Patient Advocate Foundation
http://www.patientadvocate.org 

National Association of Professional Geriatric Care Managers
http://www.caremanager.org 

National Health Council
Campaign to Put Patients First
http://www.nationalhealthcouncil.org/pages/patients-first.php

Current as of July 2010
Internet Citation: Why It's Wise to Use a Health Advocate. July 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/070610.html