Doctors lament rise of private patient advocates

PRIVATE patient advocates are charging hundreds of dollars to sit in on medical appointments to ensure patients understand what they are hearing and ask the right questions.

They are also helping people gather second and third opinions on diagnoses and treatments, and mediate disputes when patients have concerns about their care.

Doctors, however, are concerned about the trend and the president of the Australian Medical Association, Steve Hambleton, said the answer to better care was more resources, not private advocates.

Private patient advocacy is already big business in the US and Britain, and is starting to emerge in Australia. A new Victorian company called Patient Advocate is offering what is believed to be the first fee-for-service model in which people can employ an advocate to step in and resolve an immediate concern in the health system at any time of day. It is soon to expand to NSW and Queensland.

The business, created by lawyer Claire Crocker last year, has assisted nearly 100 patients and has provided some with a ''by your side'' service, in which an advocate shadows the patient at particular times to ensure they have an ''extra set of eyes and ears'' monitoring care.

While fees vary according to complexity, distances travelled and the time of day, the service costs about $100 an hour.

Most hospitals already offer patient liaison officers to help people with concerns during business hours, but they are employed by the hospitals, so represent their employer's interests as well as those of the the patients.

Ms Crocker realised there was a gap in the market when she helped a relative through complex care.

''People are not people any more, they are a patient to be moved through,'' she said. ''You might have a relationship with a clinic these days, but not one doctor, so the burden is really on the patient to ensure there is continuity in their care.''

Ms Crocker said she had helped a range of people requiring everything from one phone call to sort out a problem right through to those needing meetings with several parties. In one case, she helped a family move a patient to a hospital closer to his home so his wife could visit more regularly. She also helped a patient whose illness persisted after 14 operations to find alternative care.

The patient advocates have a range of legal, healthcare and advocacy backgrounds, and do not provide medical or legal advice or make decisions for people. While initial phone calls are often met with wariness and suspicion, Ms Crocker said most health professionals found an advocate's presence helpful in the end.

Jan Ireland, a midwife with more than 30 years' experience, said an increasing number of women used this service because they wanted to avoid particular interventions in hospital or had had a traumatic birth in the past and wanted help to change their next experience.

Dr Hambleton said he was concerned about the trend because doctors and other healthcare workers should be trying to accommodate patients' needs and listen to their concerns as a matter of course.

He said while the health system was under pressure with significant shortages of GPs and other services in particular areas, the answer was to add more resources to the system, not private advocates.

''Good medical practice is founded on quality communication between doctors and patients so I accept that this service exists, but I would hope it is unnecessary,'' he said.

The story Doctors lament rise of private patient advocates first appeared on The Sydney Morning Herald.

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