¿Quién proporciona defensa del paciente y la salud?

La defensa del paciente es un concepto que la mayoría de las personas cree que entiende, pero que probablemente no comprenden su alcance. En sus términos más simples, la defensa del paciente se refiere a cualquier actividad que finalmente beneficie a un paciente. Usando esa definición, puede aplicarse al cuidado de un paciente individual, a grupos que desarrollan políticas y consejos que ayudan a los pacientes, a grupos gubernamentales que desarrollan legislación para mejorar los sistemas o procesos para los pacientes.

Si bien cualquiera de estos grupos o individuos podrán ayudarlo en cierta medida, una consideración principal en la defensa es el factor de lealtad; es decir, cómo se les compensa por el trabajo que realizan y, por lo tanto, qué tan confiables son.

Defensa del Gobierno

Hay una serie de grupos del gobierno de los EE. UU. Que ayudan a los pacientes en general. Su lealtad es solo para con los ciudadanos de los Estados Unidos, por lo que en general, se puede confiar en su trabajo y asesoramiento.

Grupos de defensa (sin fines de lucro)

Estos grupos pueden ser familiares para usted por una variedad de razones. Si usted o un ser querido han padecido una enfermedad o afección, es posible que haya buscado información de uno de ellos, como la American Cancer Society o la American Heart Association.

Los grupos sin fines de lucro generalmente son bastante confiables, aunque muchos de ellos están respaldados y suscritos por grupos con fines de lucro que pueden tener un conflicto de intereses inherente.

También hay organizaciones que cabildean y / o abogan por la seguridad del paciente, el consumismo en la atención médica y otros temas importantes que benefician a los pacientes.

Advocacy Groups (For-Profit)

In recent years, a number of organizations have begun to offer services to patients that help them as individuals navigate their healthcare or get assistance with health insurance billing issues. These groups may be staffed by healthcare professionals, or financial advisers or lawyers, to help patients coordinate their care and fund that care.

Their services are sometimes paid for by employers wishing to assist their employees in hopes of getting them back on their feet and returning to work more quickly. Others are willing to work directly with patients who have issues getting correctly diagnosed or treated, or who need help with their health insurance billing and claims.

If the for-profit advocacy group is paid by the patient or one of his benefactors, then the work on behalf of the patient can be considered quite trustworthy.

Patient Advocates in Hospitals

If hospitals offer customer service, it is often through a staff person called a patient advocate. This person can be called upon by a patient or his family member when they run into problems that relate to care or payment for that care. While these hospital patient advocates may have formal patient advocacy training, most do not.

Hospital advocates often belong to the American Hospital Association (AHA) through their affiliation with a national group called the Society for Healthcare Consumer Advocacy. Patients often seek their help when they are frustrated or require assistance for everything from needing a ride home from the hospital, to needing a hospital bill explained.

A hospital’s patient advocate can be invaluable; however, empowered patients recognize that this patient advocate draws a paycheck from the hospital. As such, her allegiance will be to the hospital, and she is often not the best person to help in a difficult situation.

Individual Patient Advocates

Like the for-profit advocacy groups, patient advocates in the form of healthcare assistants are in the early years of building an actual career to help patients in these ways. Not that patient advocates are new; in fact, many of them have worked as “case managers.” The roots of case managers most often come from social work, and these advocates have been coordinating care for patients for many years. Because they work directly for the patient, they are highly trustworthy.

In the past several years, however, there has been a shift in the way these professionals build their lists of services. Some are former doctors, nurses or other trained healthcare professionals who help patients through their decision-making. Others are good organizers and can provide transportation or even bill tracking and payment assistance. Still, others provide transition assistance as older patients move into assisted living and nursing homes.

If you are interested in becoming a patient advocate, it’s best to understand this scope of possibilities. You may also wish to start your own patient advocacy business.

Author profile
Bone Marrow Transplantation at Disciplied INC | 832-533-3765 | [email protected] | Website

I am Dr. Christopher Loynes and I specialize in Bone Marrow Transplantation, Hematologic Neoplasms, and Leukemia. I graduated from the American University of Beirut, Beirut. I work at New York Bone Marrow Transplantation
Hospital and Hematologic Neoplasms. I am also the Faculty of Medicine at the American University of New York.