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the problem
Man lies in hospital bed with thermometer in mouth

People who are suffering from disease are often overwhelmed with the logistical, emotional and physical challenges that await them as they try to regain their health. Family members and well-meaning friends can be a wonderful help; but they are often overly emotional and unable to make the best objective decisions on behalf of their loved one. Anyone who has ever been sick with a chronic or life-threatening disease will tell you, your life can be turned upside down before you know it.

You may have to leave your job or cut down your hours—often leading to disagreements with your employer or even attempts by your employer to fire you. Paperwork and bills start to pile up; researching your disease on the Internet will fill you with terror (especially if you don’t know which websites to trust); you will be confused by which doctor to choose and which treatment options to follow; and your life at home may start to fall apart as your spouse and children try to adapt to the new situation.

A child with no hair sits in wheelchair If you are the parent of a sick child, or the adult child of a sick parent, life can get even more challenging. You struggle to balance your work and other obligations with caring for that child or parent; and you want nothing more than to see your child or parent healthy again, smiling again, living again—but you feel completely overwhelmed. The world as you know it may very well begin to crumble right before your eyes.

Even people who are healthy may not have the time or the inclination to coordinate their own health care needs in the interest of prevention. Booking doctors’ appointments takes time. Finding a good doctor or dentist and getting an appointment takes time. Waiting on hold indefinitely to talk to a live person at a doctor’s office is no one’s cup of tea. Ordering medical records can use up half of a person’s day. And dealing with health insurance companies to dispute denials of coverage or to obtain permissions for treatment can be a maddening way to spend an afternoon. The health care system is bureaucratic, inefficient, and time-consuming. For busy professionals, the last thing they want to do on their lunch break or when they get home is to be on the phone with any of the players involved in the health care system. And so what do they do? They take a laissez-faire attitude when it comes to their health, often ignoring aches and pains, and postponing important check-ups and preventive procedures. They get on with their lives, hoping for the best. And really, who can blame them? Who has the time to deal with all of this red tape?

Then there are the patients who prefer to remain ignorant about their health, even when a problem comes to their attention. This can be true for even the most educated of patients. If you have a hard time believing this, perhaps the examples below will help to illustrate the point.

Dalia Al-Othman, the founder of Health Care Navigators, LLC, was at a clinic in Boston in early 2011, waiting to see her primary care physician. While in the waiting room, Dalia overheard a conversation between a patient (who turned out to be a lawyer by profession) and her husband, sitting in the waiting room across from her.

Here is the gist of their conversation:

Husband:  “But I still don’t understand WHY your doctor wants you to have an MRI. What did he say when you met with him? Why do you need an MRI?”

Patient:  “I don’t know and I don’t care. If he [the doctor] asks me to stand on my head, I will do it!”

Dalia was dismayed, but not surprised, by what she was hearing. Patients often buy into the old paradigm that views doctors as all-knowing and all-powerful and patients as “less than.” This causes the patients to accept whatever the doctors say, and do whatever the doctors tell them to do, without question.

Man covers his face with his hands as he calculates his billsIn the United States, there is a “fee for service” payment system—doctors get paid by insurance companies for the tests and procedures that they order. They do NOT get paid to have conversations with their patients, or to confer with other doctors via conversation or e-mails. The equation is simple: the more tests and procedures ordered, the more money the doctor collects. Perhaps the patient above really needed an MRI. But the “fee for service” payment model in the United States encourages doctors to order even the unnecessary tests. This lawyer-patient should have known, at the very least, WHY she was having the MRI. Yet she is not unique.

Recently Dalia was in another waiting room at another hospital, waiting to see her physical therapist. She overheard a patient at the check-in desk, saying that she was there to have some blood work done. When asked what the blood work was for (because the receptionist could not find the order in the computer system) the patient said that she had no idea.

In fact, she did not even know which doctor had ordered the tests. Dalia shook her head in amazement. Then she realized that she was not really amazed at all; this type of scenario happens all the time. She spoke to the woman after she sat down next to her in the waiting room. The woman was a social worker—again, an educated and articulate woman who did not have the first clue about her own medical care.

When we take our car to the mechanic or the body shop, we want to know what is wrong with the car before we pay to get it fixed. But when we take ourselves to the doctor, to check out the “vehicles” that drive us through life—our very own bodies—most of us are content not knowing at all what is wrong with us or why we need to engage in the course of treatment that the doctor recommends. Why is that?

The reason is FEAR. Fear that we patients will sound ignorant if we ask too many questions. Fear that there might be something really wrong with our bodies and in some strange way we may prefer NOT to know what it is, preferring instead to hand over all control to our GODS—Group Of Doctors. Hiding our heads in the sand will lead to sub-par medical care—we cannot expect excellent medical care if we take no interest and no role in our own care. Failing to be assertive can lead to misdiagnoses, medical errors, oversights, hospital-acquired infections, and even death. That is the reality of the situation.

Stressed-out woman talks on phone at office deskHealth concerns also affect people’s productivity while at work, which in turn affects their company’s bottom line. For example, if an employee is dealing with a difficult diagnosis, he/she may spend hours at the office researching the disease online. Similarly, if an employee is having difficulty understanding his/her health insurance plan, he/she may have no choice but to spend company time perusing the policy or waiting on hold to talk to an insurance representative. And if employees engage in unhealthy activities or have unhealthy lifestyles (e.g. smoking, obesity, etc.), then their work may suffer as their health declines over time. Thus, savvy employers know that they have a real interest in their employees’ health and well-being.  Employers can help their employees and at the same time increase company earnings by offering workplace wellness programs, health education, and patient advocacy services to their employees as part of the benefits of their employment.

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What is the solution for all of the people described here?
The solution is to hire a health care navigator.

Please contact us to find out how we can help you, your loved ones, and your employees.

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Health Care Navigators, LLC
258 Harvard Street #474
Brookline, MA 02446

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