If you or a parent has been in the hospital, someone may have mentioned the hospital’s patient advocate. You may also have heard of independent patient advocates who families hire on their own. Both help patients. The difference is who they work for, and that shapes everything they can do for you.
Hospital patient advocates
Most hospitals have a patient advocate or patient relations office. These staff members help when something goes wrong during a stay: a complaint about care, a communication problem with the care team, a billing question or a concern about how a loved one is being treated.
Hospital advocates do important work, and their help is free. It’s worth knowing their limits:
- They are employed by the hospital. They care about patients, but their employer is the facility.
- Their help stays inside that hospital. They usually aren’t involved with your other doctors, your rehab facility or your insurance company.
- Their help ends at discharge. Once you leave, you’re generally on your own again.
Insurance companies have a similar role: case managers and nurse navigators who work for the insurer. They can be very helpful with coverage, but they work for the plan.
Independent patient advocates
An independent patient advocate is someone you hire directly. Because you are the client, the advocate answers to you and your family, not to a hospital or insurer.
That means an independent advocate can:
- Follow you everywhere care happens. Doctor’s offices, hospitals, rehab, skilled nursing, assisted living and home.
- Stay with you over time. Through a diagnosis, a hospital stay, discharge and recovery, not just one visit.
- See the whole picture. One person keeping track of every doctor, test and medication.
- Speak up without a conflict of interest. Including when the plan doesn’t match your wishes.
Independent advocacy is usually paid privately. Medicare and most insurance plans generally don’t cover it, so ask any advocate how they charge before you begin.
Which one do you need?
The hospital’s advocate is a good first call when you have a specific problem during a stay, like a complaint, a question about a bill from that hospital or trouble reaching the care team.
An independent advocate makes sense when:
- You live far from a parent and can’t be at appointments or the bedside
- A new or complicated diagnosis involves several specialists
- A hospital wants to discharge someone who doesn’t seem ready to go home
- Someone is aging without family nearby
- You feel unheard, rushed or unsure what questions to ask
The two can work together. An independent advocate often works alongside the hospital’s patient relations staff to get a problem solved faster.
Talk with Cheryl
Cheryl A. Scharoun, RN, BSN, BCPA, is an independent Board Certified Patient Advocate. She works for patients and families, not for a hospital or insurance company. She goes to appointments in person in Raleigh-Durham and helps families anywhere in the country by phone. The first consultation is free.