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Patient advocacy services ensure optimum health outcomes

Many hopsital patients receive inadequate care at a time when they are least able to advocate for themselves.

Would you wade into a complex legal matter without a legal advocate? Or expect to conduct a business effectively without a tax expert? How much more important is your health and wellbeing? Are you prepared to "wing it" and hope that the NSW health system gets it right? Not me. I've been in the NSW Health System for more than 30 years and I've seen what works and what doesn't. I will give myself the best chance and recruit an independent patient advocate: hopefully a competent and available family member. Otherwise, a professional independent patient advocate with a strong health background.

If GPs ever filled that role, their business models and Medicare have put paid to it. If relatives or friends once had the time to be at your side to attend and co-ordinate treatments and consultations, work pressures and altered family demographics make that unlikely nowadays.

If you once were inclined to accept that a patriarchal health system was reliably benevolent then you have probably begun to suspect otherwise. By nature people are trusting, but they are not deluded.

The loyalties of hospital-employed patient advocates are inherently conflicted and their involvement can sometimes be counterproductive. A patient advocate employed by a client has only one master and very clear priorities.

Whether you have medical conditions requiring ongoing treatment and interventions or you become acutely unwell and require hospitalisation, you hope that you will be treated as an individual and that your health management will not itself be a source of stress, confusion, unnecessary expense or conflict. You want to be offered all the treatment options, to be given adequate, understandable information upon which to make an informed decision and to feel that you are treated with respect and dignity. You need to know your privacy is assured and your personal wishes about care are acknowledged.

I have worked for clients whose wishes about end-of-life management were being ignored, whose sub-standard surgical and post-operative care was unacknowledged and unaddressed or who were subjected to undignified and inappropriate care in an emergency department. One client, whose wife had her own acute medical problems, was being discharged after a traumatic limb amputation and was expected to evaluate, access and co-ordinate the providers essential for his recovery including sourcing a prosthesis and a psychiatrist to help him deal with post-traumatic stress disorder. Hospital staff (registered nurses and social workers) know that gaps in the system can undo all their hard work in the critical, hospital-to-home transition period, and many referrals to advocates stem from this awareness.

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I have been a surrogate caring child for elderly clients whose children lived far away or are overseas, worked with Alzheimer's clients, and as a case manager for a busy executive who craved a seamless experience with an elective joint replacement. I work with lawyers who have guardianship and personal injury clients and with doctors who have patients who will struggle with their healthcare management.

Patients are often shocked to discover that shared responsibility for their own healthcare outcomes is specifically spelt out in the Australian Charter of Healthcare Rights and that healthcare management in the NSW Health System is predicated on this.

You can roll the dice and pray or you can give yourself the best chance for optimal outcomes. For many, your time of greatest medical need will coincide with your time of least capacity to cope, to assess and to decide what reflects your best interests and wishes.

Visit patientadvocates.com.au and alzheimersassistsydney.com.