When you are sick or debilitated, it's sometimes impossible to figure out how to get the best from the healthcare system, or how to be sure you know enough to make important decisions. Virtually every healthcare provider claims to have your interests paramount (even over their own) but evidence and common sense says that is unlikely. Knowing that you may have been misdiagnosed, or that you haven't been told about all your treatment options, or that you have no idea or control over of your out-of-pocket costs can cause you enough stress as to make your condition even worse. Trusting the “system” to focus care on you, even against its own best interests, is naive bordering on dangerous.
Sometimes the only way to be sure you get the best service and outcomes possible from the healthcare system is to find someone else to help you navigate and negotiate the maze of providers, tests, treatments, and of course, medical bills you'll encounter.
But finding "someone else" and finding an expert, are two different things. Your sister or spouse may be able to help you. A neighbour who works in a doctor's office might help you. Even your niece who is an RN can be useful. In practice, these people are easily ignored and sidelined in the power IMbalanced healthcare system. But the most professional and objective help you're going to find will come from a qualified, private patient advocate. This is someone who ideally is a health professional themselves, has broad clinical experience, a wide network of professional contacts and is a skilled and fearless communicator.
A quick distinction here: there are many kinds of patient and health advocates, but not all will be totally devoted to your care: someone who works for a provider (a hospital, disease specific organisation or a medical practice) will be paid by, and owe primary allegiance to, their employer. Independent means just that: no employer constraints or divided loyalties.
Why Should You Pay for Private Advocacy Services?
While so many of the services we get for our healthcare are covered by our Medicare or our private health insurance, independent patient advocates are not. That may initially sound like a negative — that in order to get help from a patient advocate you would have to pay for the service out of your pocket. But that's really to your benefit. Here's why:
When services are covered by your insurance or by Medicare, they are, by definition, limited. Your doctor won't spend as much time with you because they will only be reimbursed X amount of money. Or, your stay in the hospital will be limited because your insurance only covers X number of days. A business model (PROFIT) dictates your care but this is very negotiable if you know what you’re doing.
But when you pay for something privately, then the only limit is your own limit, what you are willing to pay for. And when you hire an advocate to be on your side, it might be the advocate who knows how to squeeze an extra 15 minutes out of the doctor appointment or the extra few days out of your hospital stay or ensure you get extra/better physiotherapy.
The whole point is to improve the quality of your care and your outcomes by having an expert on your side who is solely devoted to an improvement in the quality of your care. That expert works for YOU.
Look at it another way: The reason you hire a real estate agent to help you buy or sell a home is because he or she is the expert. Sure—you could buy a "for sale by owner" without an agent—but what if something went wrong? You don't know what you don't know—but agents do know because they deal in real estate every day. So it's worth the extra expense.
The reason you hire a CPA is because you want an expert to help you with your taxes. Sure, you could use tax software, or a pencil and a calculator, and do it yourself. But what if you missed a deduction? Or what if you don't understand a form? Again — you don't know what you don't know — but a CPA does know because that's their area of expertise. It's worth the extra expense.
And saving money on healthcare services can be a very bad idea. Exactly the same way thinking that the most expensive care will be the best.
Those examples address your home and your taxes. And neither is nearly as important as your health, or your life. So spending the money on a professional advocate is worth it — because you don't know what you don't know.
The cost to hire a private advocate will depend on a few things:
1. The types of services and complexity of your need. There are perhaps dozens of services health advocates might provide for you. These range from explaining your treatment options to establishing your out of pocket expenses, from accompanying you to doctors appointments to sourcing second opinions, from intervening when your care is sub standard to helping you ensure that your care is exactly what you need and want. Frequently you will be seeking help in your support of a friend or relative, either in health or aged care. Each service will cost something different to accomplish, mostly as a function of the time it takes to accomplish it.
2. The background and expertise of the person you will hire. Just as would be true in any service business, the more credentials an advocate has achieved, the more it will cost to hire that person. Physicians who have gone into private medical practice will charge more for their services than someone whose qualifications are rudimentary. So it is with private patient advocates.
Further, some advocates have developed specific niches to their work which becomes a benefit to you and will be worth a higher price. Advocacy skills are generic and most practitioners will work across many health areas but if you need advice about home/residential care for the aged or those with dementia then add those to your Google search. Likewise, acute and critical care issues for in-hospital patients are best dealt with by an advocate with a background in those fields. Commonly it will end up costing you less in the long run because that person is expert at what he or she does. In healthcare, as in life, you get what you pay for.
3. Your geographic location. Just as there are variations in cost for almost anything we buy based on where we live, the same is true for patient advocacy services. That said, it is not always necessary for your advocate to be physically at your side. The vast majority of advocacy work can only be done by telephone and this can eliminate expensive travel time. Most private patient advocates are able to support clients interstate or in regional areas.
If you think you might need help, ASK! Don’t find yourself saying “In hindsight I should have hired a patient advocate” or “If only I’d have acted sooner”. Nothing is as futile as regret in healthcare.
How Much Will You Have to Spend?
Because there are so many variables, it's impossible to put an accurate price tag on the cost of advocacy services, and it's even more difficult to assign them a value.
The value point is important. For example, you might pay a lawyer $2500 to draw up your will, which you could have done yourself, online for $50. Or you might pay a lawyer $5000 to keep you out of jail because you didn't pay for your speeding ticket. There's a lot of value in those $ spent and it is unwise to scrimp on your wellbeing!
That's the kind of value you can get from a private advocate. Spending a few thousand dollars doesn't sound like so much if you know your life will last longer, or your quality of life will improve, or your pain may go away.
Please don't translate that to mean that an advocate will cost you a few thousand dollars. Her services might—and even so, that might be a bargain. Or, it could be that your needs require only an hours' worth of work, ranging from $75 to $500, depending on those variables described previously, or a month's worth of work that may range into the many thousands. You should always ask for a quote.
Interview Advocates to Determine Costs
Interviewing advocates costs nothing. Interview them, ask questions about how they can help you, their qualifications, and what they charge. Expect to pay them to do an assessment of your situation and possibilities. Most will ask for a retainer fee: $600 is common. Even that cost will be worthwhile to learn more about what you don't even know to ask about. That's the reason you've gotten in touch with a professional to begin with.
How Do You Find an Advocate?
By far the best option is a referral: professional or private. Ask around and see if anyone has had a good experience or heard of a private patient advocate. Ask your GP (but don’t be discouraged as some doctors can understandably be very defensive). This specialty area of practice was only established in Australia in 2011 so you might have to use the internet to find a practitioner. If you see online patient recommendations, or one practitioner topping your search repeatedly, that is probably because they are well known or well thought of. In the Sydney area there were about 10 private patient advocates in practice as of early 2019 and somewhat fewer in Melbourne.
Dorothy Kamaker. 0421011430
157 Liverpool Street Sydney
- 9 Hits
- Since 03-10-19
- Posted by Dorothy Kamaker
- Eastern Suburbs
- Key Words: Hospital care, medical care, aged care
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