The Importance of a Medical Advocate

A friend whose parent is dealing with cancer shared with me this article (“Hospitals and the Decline of Comprehensive Care”) from The New England Journal of Medicine.  It addresses the disjointedness of the healthcare system (in the US only, I assume). The author argues that the growing prominence of hospitals in delivering healthcare is only detrimental to patients, as it all but destroys the patient’s relationship with his/her local community doctor – the person who ostensibly ought to be most involved in the patient’s care.

The author’s conclusion is simple.  He argues that “good medicine” can only be practiced if there is a true relationship between two people and not between a person (patient) and institution.  I wholeheartedly agree.

The article, and talking to my friend about it, made me think about my experiences over the past five years and, more specifically, the importance of having a medical advocate at one’s side at least whenever admitted to a hospital (or, even better, any time one goes to see a healthcare professional).

Four ears are better than two; as are four eyes, two brains, and so on.  It’s impossible to keep up with everything that is said, even in the best of times, forget about when one is drugged, dazed and confused when being admitted to a hospital.

As I’ve written countless times over the past five years, I hate to think about where I’d be right now, were it not for my constant medical advocate and concierge…

While it’s easy to pontificate about something when not in the throes of the situation, I’ve earned the right.  So, to be helpful, here are three ways having a medical advocate can be helpful:

1. Listening.  Like I said, four ears are better than two.  A medical advocate will listen to instructions and ask the right questions, especially when it comes to medication.  Try following directions when hopped up on morphine!
2. Monitoring.  Nurses are busy and if they can’t get to a patient it isn’t due to malice.  It’s because someone else more immediately needs attention.  An advocate will pursue the nurse to see where those pain meds are.  The same unfortunately holds true for making sure whatever tests are supposed to be performed are being performed.  As I saw a few weeks ago: it’s very easy to fall through the cracks.  Having someone who can physically go to see what can be done to get a patient to the head of the line is invaluable.
3. Thinking.  Being hospitalized is overwhelming in the best of circumstances; forget about it if you have a life-threatening disease and need to make a decision, as in thoroughly understanding what treatment options are.  Having someone at your side with whom to discuss what comes next is incredibly helpful.  If one is lucky enough to have a medical advocate who is also a trained professional, making a decision can be that much easier, as the advocate is coming from a position to knowledge and understanding that probably well-exceeds the patient’s.  (Careful, though, that if you’re relying on someone’s “trained” opinion, that the person in question is actually trained in a field relevant to what the patient is going through.  An ophthalmologist may not be up on the latest breast cancer treatments.  That’s not to say said ophthalmologist can’t be helpful – and nothing against eye doctors! – I’m just saying be realistic.)

I’m sure there are many more ways a medical advocate can be helpful, and this isn’t meant to be an exhaustive treatment of the subject.  It simply occurs to me that making sure there is someone at your side who is ready to play an active role in ensuring you get the medical care you need is simply not an option.  It’s a requirement.  And I believe it’s helped me get this far.