The concept of "Patient Advocates" has different expectations under varying
circumstances for different people. We are using it here to
describe our view of the relationship and potential responsibility
that a Neurosurgeon may have regarding "Patient Advocacy" for his/her
Hippocrates left a legacy of scientific curiosity and personal
integrity, part of which is reflected in the Hippocratic Oath.
In his magnum opus "Epidemics, Book I, Section XI", he wrote: "As
to diseases, make a habit of two things to help, or at least to
do no harm."
Subsequently, the Roman physician Galen, translated this
phrase into Latin as "Primum non nocere", the translation
of which is "First, Do No Harm". This statement defines a way of
thinking which places the welfare of the patient above other
concerns. This principle applies in the modern environment as
well as it did centuries ago when the concept was initiated into
Today's practice of medicine is far more complicated
than it was in previous decades. While the technologies, medications
and procedures have become considerably more sophisticated, the
complexities of the entire health care system have evolved into
one that many patients view as unfathomable. Although we are at
our most vulnerable when illness besets us, the need to comprehend these
complexities is essential.
Dealing with a major Neurological problem that warrants
Neurosurgical intervention is stressful. Having to comprehend and
manage an insurance company's rules and regulations can be
daunting. This may include: pre-certifications
for procedures and hospitalization, identifying financial responsibility
for co-payments or out-of-pocket expenses, understanding a
hospital's demands for financial disclosure and guarantees of
responsibility as well as having to decipher complex
hospital forms. An example of one of the more complex and
important forms is the
At a time when one is concerned for one's life and Neurological
integrity, these additional issues can become overwhelming.
This is where the Neurosurgeon's office staff and the Neurosurgeon
often become YOUR ADVOCATE. The requirements of insurance
companies vary from one to the other. Most Neurosurgical offices
have staff members who are familiar with and manage these matters
for you. Often times, the staff will automatically
"pre-certify" with your health insurance company, your
neuroimaging investigations as well as your operation. They are
familiar with the terminology and unique "coding" requirements of
insurance companies as well as hospitals.
Your Neurosurgeon will, on occasion, be required to write to the
insurance company, government agency or your attorney on your
behalf. While you are in the hospital, your Neurosurgeon may
need to support your need for a higher level of nursing care,
special treatments, access to specialized equipment and a longer stay
than is ordinarily underwritten by the insurance company (or
Medicare.) These duties all fall under the concept of a
Unfortunately (and very importantly) there are limitations that
the Neurosurgeon and the office staff are working under when it comes
to your insurance company. Since you, another family member or an
employer made a choice regarding the actual company contracted with, the
extent of coverage purchased on your behalf may have significant
monetary, as well as procedural limitations. This may mean that
some Neuroimaging and/or Operations, even though they are
clearly medically indicated, may not be covered. The
Neurosurgeon's office may be able to assist you in identifying these
parameters; however, they will have no capability to change those
limitations on your behalf. This contract is between you and that
Some hospitals employ a Patient Advocate to help patients with
issues that arise during their hospitalization. Other hospitals
employ Social Service professionals to assist patients with
their ancillary needs such as home care nursing, nursing home
placement, rehabilitation, travel arrangements among other issues.
These professionals are available to you and look forward to assisting
you and your family.
There are other circumstances where additional Patient Advocacy concepts
may be of interest and value to you. We invite you to explore some of
the following websites and information for a broader understanding of
Patient Advocate Foundation
Patient Advocate Foundation is a national non-profit organization that
seeks to safeguard patients through effective mediation assuring access
to care, maintenance of employment and preservation of their financial
The National Patient Safety Foundation
has an excellent reference PDF file entitled
"The Role of the Patient Advocate: A Consumer Fact Sheet."
The Patient Navigator, Outreach, and Chronic Disease Prevention Act of 2005
is a Federal Law that was designed to provide patients with an advocate
at their side to help them navigate through today's complicated health
care system and will improve access to prevention screening.
The bill has been endorsed by a broad coalition of health care
advocacy groups, including the American Cancer Society, the National
Association of Community Health Centers, the American Diabetes
Association, the National Patient Advocate Foundation, the National
Health Council, and the American Medical Association.
Information concerning this Bill is available on the Internet as well.
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This page last edited on 2/19