Among the many forms of patient advocacy is the ability to help patients make their way successfully through the healthcare system. These system experts may be known as health or patient advocates or navigators.
There are many aspects to getting good medical care. There is the medical care itself, such as diagnosis and treatment. There is the billing and payment aspect, which follows all medical care. But one aspect of getting good healthcare is sometimes not recognized until it presents its challenges; that is, navigating one's way through the system.
Health and patient navigators are the experts who help patients experience the best of the healthcare system by helping them navigate it successfully.
(Please note: Beginning in 2012, we began to hear the term "navigator" in regards to people who will help American patients choose the health insurance plan to satisfy the individual mandate. Learn more about these navigators here.)
Here are some of the capabilities and responsibilities a patient navigator might perform:
- Developing lists of provider options and referral capabilities
- Coordinating second (and third) opinions
- Accompaniment to doctors' appointments
- Hospital bedside monitoring with a focus on patient safety
- Medications reviews and coodination to minimize conflicts and non-adherence
- Diagnosis or treatment options research
- Facilitating communication among patients, caregivers and doctors
- Note-taking during appointments and hospital stays
- Researching clinical trial possibilities
- Translating medical records and doctors' orders to make them more patient-friendly and easier to follow
- Development of lists of questions for patients to ask their providers
- Coordination of doctors' appointments and lab visits
- Coordination with other professionals who help patients, such as social workers, nursing home or assisted living administrators and others
- Development of care plans, especially for people with several different health challenges
- Reviewing medical bills, then negotiating to lower those bills
- Getting permission for treatment that insurance companies may, at first, reject
- ... and many others
Who Hires a Health or Patient Advocate or Navigator?
- Someone who has recently been diagnosed with a difficult disease or condition
- A patient who needs help coordinating the recommendations of many doctors (for several medical problems).
- A spouse who is called on to assist his or her loved one, but finds it difficult to set aside emotions to help make objective decisions.
- An older person who may be forgetful or get confused (or is afraid he or she will become forgetful or confused) by his or her providers and medical needs.
- An adult child of an older parent (niece or nephew of an elderly aunt or uncle, etc) who needs assistance, especially when they are tasked with caregiving or being a proxy for a loved one who lives in another place.
- A parent who needs help coordinating care for his or her child, especially when the child has major or multiple health problems.
Qualifications Needed to Be a Patient Advocate or Navigator:
Not all patient navigators have a healthcare background, although many do. Some have assisted relatives or friends get through difficult medical circumstances. Others have learned to navigate the healthcare system on their own, for their own disease or condition, and want to help others do the same.
Few patient advocates or navigators are employed by someone else. Most work as individuals, running their own navigation consultancies or businesses. To address self-employment issues, having the mindset of an entrepreneur is a plus.
There are a handful of organizations and universities offering certificate programs in patient advocacy or navigation.
However, note that there is no nationally recognized certification in patient advocacy, so that is not something a patient navigator needs to pursue.
How Patient Advocates or Navigators Work
Most patient navigators are independent, working in private practice - their own businesses, for one or more patients at a time. They are hired by the patient or the patient's caregiver.
They are paid directly for their services by the patient or a caregiver or sometimes by a trustee or third party - but rarely (if ever) by a reimbursement model, like insurance. They may charge by the hour, or by the project for a finite set of responsibilities. They may have an office for meetings or they may work with patients at home. Each navigator handles his or her work differently.
Organizations and Trade Groups for Health and Patient Advocates and Navigators
• The Alliance of Professional Health Advocates, an organization which supports advocates and navigators as they start, grow and market their private advocacy practices
• PPAI, part of the Dorland Group which also teaches advocacy courses
Return to the Overview of Patient and Health Advocacy Careers