Most doctors might not recognize the term “patient advocate”, but they’ve probably already fulfilled its function many times for relatives and friends. If you’ve ever informally evaluated a relative’s care, called the doctor of a friend for a clarification, or suggested to someone that they ask their doctor for a specific test, you have acted as a patient advocate.
Theoretically, there should be no need for a patient advocate, since doctors, by the very nature of their job, are already advocates for their patients. Unfortunately, the need for a patient advocate arises all too often, because patients don’t understand their diagnosis, can’t figure out their treatment, don’t comprehend the results and implications of tests, can’t get their doctor to return phone calls, etc. In my experience in dealing with doctors, there are several reasons for this.
First, doctors are extremely pressed for time. When you know that you have a waiting room full of patients, it’s very difficult to engage in an open-ended conversation with one patient. It’s much easier to announce the results or diagnosis, pronounce the treatment and send the patient on his or her way. We are all pressure to be more “efficient” and it is very clear that insurance providers do not consider patient discussion to be efficient at all. They won’t reimburse for it, so obviously they don’t even think it is necessary.
Second, doctors often forget the impact of their words on patients, or that patients may not understand the explanation. The doctor might think he/she has gotten the job done, when the reality is that the patient was so shocked by the diagnosis that he/she could not hear or process the information that followed. Or even if the patient is listening attentively, he/she might not understand the language that the doctor is using. Unfortunately, many physicians have trouble modifying medical terms to straightforward English. I have seen this in clinical practices when doctors are rushed, but also in medical writing when they have ample time to choose words carefully. I have edited materials written by doctors specifically for patients. Even when I sent things back with express instructions to modify the language, some doctors just couldn’t seem to do it.
Finally, many doctors are simply not paying attention the way they should. They don’t order the right tests, they don’t look at all the results and they don’t listen to what the patient is telling them. These doctors can often become very motivated and attentive when they realize that another doctor is monitoring a patient’s care, even if that other doctor is a relative or friend. Obviously, you shouldn’t need another doctor looking over your shoulder to force you to pay attention to what you are supposed to pay attention to in the first place. Sadly, it has become all too necessary with the advent of “managed” care.