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Finding Direction Through a Patient Navigator: A Journey of Hope (Part 3)

July 24th, 2013 | Posted in Advocacy Stories

I was in my office and was called to speak to Mr. and Mrs. Arrow because they were, for all intent and purposes, graciously dismissed to try to fend for themselves. Mrs. Arrow sobbed almost uncontrollably and her husband appeared at a loss as to how he could help. As a patient advocate at the Comprehensive Cancer Center I could not allow for the patient to leave in such an emotional state.

Whether it was an incoming patient that needed assistance, or a patient literally being dismissed, I saw no difference in someone who was crying out for help. I approached her and her husband, introduced myself and asked that they step inside my office. Mr. and Mrs. Arrow were confused and disillusioned. I explained my role as an advocate and, after putting forth my best efforts at consoling her, I commenced to review and investigate the possibility of further options at our center. I thought maybe we might have overlooked something and I contacted our senior financial manager, then the case manager and subsequently the patient’s insurance company. Unfortunately, they all came to the same determination; their coverage was not sufficient for continued care at our facility. At this point, I felt even more compelled to advocate for the patient.

We spent a good portion of the day contacting local community hospitals in the area that would accept her insurance. The chemotherapy plans were all in place and further delaying the inevitable would be an added torment for the patient and her family. After several hours, Mrs. Arrow and I finally reached a healthcare facility within her community that accepted her plan. They in turn connected us to their case manager and their patient advocate. In the process, Mrs. Arrow immediately became more engaged and asked appropriate questions and began the process of also advocating for herself. This time she made sure she had a voice in choosing her healthcare team and she became engaged in the shared decision-making process that would help her begin to gain more control of what she was about to face.

Together we were able to communicate directly with the physician’s office at a local community hospital. The physician, in fact, had done his oncology internship at the Comprehensive Cancer Center. With the patient’s permission I copied all of her records, requested CDs made of her imaging, and released her submitted pathology for her to take with her to her newly scheduled appointment – which we scheduled for the very next day. While upset at the series of events that unfolded that day, Mr. and Mrs. Arrow were indeed grateful for my intervention and the subsequent outcome.

In this account of circumstances, Mrs. Arrow had an imminent need to be guided throughout the process of her care. Many advocates were involved within their area of expertise and responsibility. Everyone within the Comprehensive Cancer Center, including the financial manager, the chemotherapy nurse, the case manager and the physician, all genuinely wanted to help the patient. Sometimes, however, advocacy calls for a patient navigator to fully reach out to the patient and to ensure they are given every opportunity to the healthcare they deserve. An insurance denial to a patient, who is battling an illness, can be equally as devastating as being told they have progression of disease. At that moment, with nowhere to turn, the window of accessibility for continual care begins to close and the patient is found at a loss.

The role of the patient advocate is diverse and continually evolving. The ability to get the patient from one point to the next in a seamless process is vital to the patient’s continuum of care. Throughout the course of a patient’s illness we are there to help support the basic principles of advocacy in assuring their care is conducted in a respectful manner and that the patient is involved in the decision-making process that will undoubtedly have an impact upon their lives. In this collaborative process in which we work alongside the patient and his or her healthcare team, patient advocates are true navigators.