The US Healthcare System: The Importance of Patient Advocacy and Informed Consent

People who are attempting to navigate our complex and at times overwhelming healthcare system often find it challenging to do so.

Patients may be too sick or confused to ask the appropriate questions, communicate effectively with their healthcare professional, and make informed decisions. Other barriers to effective communication may include language, literacy, culture, or even a hearing impairment.

If you’ve had the opportunity to visit someone in a hospital or nursing home lately, then you may know how difficult it is to get answers to questions. The nurse at the nursing station is either on the phone or on the computer, the nurse in the hallway is dispensing medication and a physician is nowhere to be found. You may not even know which physician oversees mom or dad’s care (typically the attending physician), which tests have been done or whether any specialists have been brought in for a consultation.

Physicians typically make rounds (the process of seeing their patients at bedside) in the early morning, hours before visiting hours have even begun. This can lead to calling and leaving messages with the attending physician’s office in search of answers.

However, patients and their families have the right to receive timely and appropriate answers to their questions, including who the attending physician is, the current diagnosis and the treatment plan to manage that diagnosis. The New York State Department of Health publishes a Patient’s Bill of Rights, a comprehensive list of rights ranging from privacy and confidentiality, to the right to receive answers to your questions. www.health.ny.gov/publications/1500/

As it can be difficult to get answers to questions in the hospital setting, many hospitals have dedicated patient advocates on-staff who can assist patients and their families during an admission. The patient advocate can work with the patient’s family, a close friend, a healthcare proxy or directly with the patient.

According to Stony Brook University Hospital, the job of the patient advocate is to “act on behalf of patients in seeking solutions for special needs, problems, or concerns for patients, family members and visitors. In addition, they are there to answer any questions you may have….”

According to Mariann Carroll, Director of Risk Management and Patient Safety at St. Catherine of Siena Hospital in Smithtown, the primary role of the patient advocate is to “act as a liaison for patients, families or legal representatives to our healthcare team members.”

“Our team has extensive experience in hospital operations and has access to our full resources at the hospital when seeking to resolve a concern.” Carroll continued, stating that the staff of patient advocates have backgrounds in nursing, patient safety, business administration and healthcare operations.

Patients or their families can make a request at St. Catherine of Siena regarding a concern either in-person or by phone with the on-site team. Referrals can also occur via patient surveys. Customers need refrain from asking clinical questions and focus on more complex concerns.

“The point is to address any request or concern immediately with the goal of resolving it at the point of care,” Carroll stated. The information gathered and lessons learned are shared with hospital staff through our quality management processes so that we can continue to improve the patient experience.

Carroll went on to discuss that some examples of patient advocacy include obtaining applicable authorizations for care and linking the patient or family member with a service such as social work or billing.

Informed Consent

When you do have that important conversation with a healthcare professional, it is important to be familiar with the concept of informed consent. Simply speaking, informed consent is the principle of being informed of and understanding treatment options. According to the

AMA (American Medical Association), informed consent is:

  • The nature and purpose of treatment interventions, including medication and surgery
  • The anticipated benefits and risks of all treatment options, including forgoing treatment entirely. The purpose behind informed consent is so patients and their families can make the best medical decisions possible once given all the appropriate information they need. For patients who are not able to give informed consent, the right falls to the family or current healthcare Proxy.

Once the patient, advocate or healthcare proxy has informed consent, then medical intervention can take place, be it surgery, diagnostic testing, medication or a procedure. Navigating our complex healthcare system can be challenging. Having an advocate who can represent

the patient’s interests in a hospital or other medical environment is a right and a necessity. Knowing and understanding the concept of informed consent can empower patients and their advocates to make good decisions when communicating with healthcare professionals.

Coming up, we’ll discuss the roles and backgrounds of various health and wellness professionals.

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