When you’re in the hospital, you may encounter a hospital employee with the title of “patient advocate.” But what does a hospital patient advocate do? And who do they work for? Know what kind of help you can expect to get, and what the limitations of hospital patient advocates.
A story about a hospital patient advocate
After my husband Leonard had surgery last week, he stayed in the hospital four more days. I stayed by his side as much as I could and waited every day for the surgeon to check on him. I had a million questions! But I never saw the surgeon again once the surgery was over.
I waited patiently for the first day after the surgery. No surgeon. I called the surgeon’s office and they would not make an appointment for me, or even promise he would return my call, because it was my husband who had the surgery; they told me I would just have to hope to catch him when he visited my husband, which he would do once each day my husband was in the hospital.
I asked the nurses when the surgeon would come by. They told me he stops in every morning around 6 AM. So I got to the hospital by 5:45 and they told me I had just missed him. I would give the hospital nurses my questions and they would give them to the surgeon, but I never got the answers.
Finally, the nurses suggested I go see the hospital’s patient advocate and tell her I wanted to see the surgeon. So I did. She was very pleasant and tried to be helpful. She told me she would try to get the surgeon to contact me but that he had a reputation for avoiding patients’ family members. No promises. And still no surgeon.
I am furious! I was never able to get my questions answered, and now my husband has an appointment for follow up and I don’t know how I’ll keep my mouth shut when we get to the appointment! He has had all kinds of problems since the surgery, and I don’t feel as if he got the care he needed because I wasn’t allowed to ask questions.
Unfortunately, Francine’s story is all too common. In recent years, hospitals have begun stepping up their games to improve the patient’s hospital experience because Medicare’s rules changed, tying patient satisfaction to hospital revenue. One way to improve the patient experience is to be sure there is someone who can listen to complaints. That person would be a hospital patient advocate.
Further, the Joint Commission, which is the accreditation body for hospitals, requires a patient advocate be available at all times in a hospital. These patient advocates have different names in different systems: patient advocates, patient representatives, care managers, ombudsmen. Whatever they’re called, they are all tasked with assisting the hospital’s patients and their loved ones.
These patient advocates have become the customer service department with a twist.
Hospital patient advocates do what they can to help their “customers.” They are a liaison between patients and the hospital. They can often run interference, mediate, or satisfy a complaint about the hospital.
But that’s where the twist comes in. In most cases, the hospital’s patient advocate works for the hospital (not for you). In many U.S. hospitals, patient advocates work for risk management or legal departments. These are functions that work to protect the hospital, especially from being sued.
What does this mean to you?
When the hospital’s patient advocate couldn’t get the surgeon to answer Francine’s questions, she turned to a different kind of resource: an independent, private patient advocate. The hospital advocate’s allegiance meant she could not cross that line to encourage the surgeon to connect with Francine.
The Allegiance Factor
The Allegiance Factor is an important concept. When an advocate is employed by a hospital, or by an insurance company, and because they have a financial stake in your care, they cannot always provide all the help you need. Their allegiance is to their employer. That’s why Francine wasn’t able to get the answers she needed; because the advocate could only push so far without endangering her own job.
On the other hand, the independence of a private advocate means he or she works directly for you. Their allegiance is solely to you.
If you or a loved one is hospitalized and you don’t seem to be able to get the service you need or your questions answered, then by all means, start with the hospital’s patient advocate. But do that knowing who signs their paychecks and how that may limit what they can do for you.
If you need help that you’re not getting, hire an independent patient advocate, one who will answer solely to you. Find advocates in our national directory of independent advocates.
- Learn more about the Allegiance Factor.
- Learn more about Medicare’s Patient Satisfaction rules and changes.