Working for the last decade in large hospitals, I get calls. Even though I am not a doctor or nurse, family and friends call when they get sick. All are experiencing some combination of being scared, stressed, and confused by how healthcare works in the United States. They generally ask for advice about how to navigate being a patient.
I always give them the same advice:
Make sure you have someone advocate for you while you are in the hospital.
I will share in this post why I absolutely hate having to give this advice and what can be done about it.
Why it is Important for Patients to Have a Hospital Advocate
Hospitals are busy places. They are designed to care for the sickest of the sick. A good rule of thumb is if you feel like you are not getting enough attention at a hospital, it means that your doctors do not consider you among the sickest patients in the hospital.
So that’s the good news.
With that said, it can also mean long wait times for simple tests, bumps in the operating room causing your surgery or procedure to be postponed, and limited face-time with your care team. Unfortunately, these delays are all patient dissatisfiers and the uncertainty involved can be stressful to anyone receiving care.
There are many reasons why hospitals operate this way, many of which are economic and operational, so I won’t get into that for this post. (Although if you want to know, just ask, I’d be happy to hear from you).
Because of these factors, navigating care at a hospital can be difficult. Furthermore, The patient in the hospital is usually in a compromised and vulnerable state. They are sick, medicated, in pain, anxious, bored, and sleep deprived, among other things.
That is why you need an advocate in the hospital.
The Best Hospital Advocates
The best advocate for a patient is generally a family member or a close friend. For more complex cases, there are for-hire patient advocates who are usually trained medical professionals.
Sometimes, there is an employee or volunteer affiliated with the hospital called a “Patient Advocate” or “Patient Representative.” These roles range in functions from risk (Dealing with the threat of legal action) to service recovery (Trying to fix a patient’s experience reactively) to ombudsman (Listening to patients and investigating issues to correct them for future patients).
Unfortunately, many hospitals cannot provide someone to advocate for your needs as a patient like a family member or friend can. The simple act of walking over to the nurse’s station, getting to know them, and asking questions about your loved one’s care can go a long way to helping to improve a patient’s care.
To check myself on this advice, I have asked former colleagues of mine what they think about it. Almost universally, doctors, nurses, and administrations I speak with agree with this advice.
The best thing you can do as a patient is to have someone with you to advocate for giving you care and attention while you are in a hospital.
The Downside to a Friend or Family Being a Hospital Advocate
Within the last 13 years, my father, mother, and sister have all been neurosurgery patients. Without exception, during any hospital stay, none of them were alone for any period of time. When my father had emergency surgery, my mother never left the hospital and vice versa. My mother stayed with my sister during the entirety of her multiple hospital stays as well.
At first, I thought they were crazy. But, having now worked in hospitals, it is clear to me that this had major benefits to each of them as patients. Furthermore, the nurses and physicians welcomed the help. My mother and father refilled water, brought up food, and helped to make sure the room was tidy. These responsibilities almost always fall to a nurse or another member of the care team.
In fact, during the COVID-19 pandemic, we frequently heard from doctors and nurses that patient experience was worse when family members were restricted from visiting.
However, this schedule was not without cost. Both of my parents are self-employed and had to miss work and reschedule other life events. They often slept upright in an uncomfortable chair. They didn’t shower. The stress they felt was palpable. While they appreciated the people on their care team, they didn’t trust the hospital to take care of them.
It shouldn’t have to be like this.
I often say that my life’s work as a leader in healthcare is to create an environment where I wouldn’t have to give this advice.
In this reality, family and friends can stay with a patient, of course, but could feel confident that their love one is in good hands. That they can go home and shower, sleep in a bed, and work knowing that the people at the hospital care about their loved one.
What Can be Done?
Fundamentally, patients need an advocate in the hospital due to a lack of trust.
Hospitals generally don’t do a great job building trust. Hospitals are almost always running late and timelines get missed. Doctors and nurses are overworked, rushed, and often burned out. It is difficult for doctors and nurses to empathize with patients because of the mundanity effect, which happens when something extraordinary (like caring for patients and saving lives) becomes routine.
From my point of view, the solution here is three-pronged:
- Fix the aspects of the hospital operation that make doctors and nurses jobs unnecessarily difficult or that take them away from patient care.
- Create and enforce behavioral expectations for how doctors and nurses treat patients and family members.
- Create ways for patients to see more of their doctors and nurses.
While this list is pretty easy to type out, actually making these changes could take decades. Most hospitals are still operating under business strategies and process improvement models from the 1980s. Remember, healthcare is highly regulated and complex. Making change doesn’t take weeks, months, or years. It usually takes decades.
The issues in healthcare are systemic and ingrained. There are many large stakeholders involved in the system today including large care providers, insurance companies, health plan administrators, etc. Large players like Amazon and Walmart are even trying to disrupt this behemoth of an industry, which has been notoriously hard to do.
Trying to change or cure the underlying diseases of healthcare has too long of a time horizon to make meaningful change for struggling patients and families today.
The Role of Technology
Luckily, technology can help with #3 – Create ways for patients to see more of their doctors and nurses.
This is why I made a career change recently.
I recently joined a company called WUWTA (pronounced “What-ah”) as their CEO. I first met WUWTA co-founder and Chairman of the Board, Jock Putney, when I was Chief Experience Officer at Robert Wood Johnson University Hospital.
On the WUWTA platform, physicians can guide patients through their healthcare journey personally from referral to discharge and follow up appointment. When I led Patient Experience, I spoke to patients every day. They desperately wanted more of their physician’s time and often were so excited when the physician spoke to them, they could not retain what the physician said!
WUWTA addresses this patient experience pain point simply. At each stage of the patient’s journey, the patient gets a video from their physician, explaining their next step in simple terms. The WUWTA platform enables doctors to hold a patients hand digitally and at scale.
Platforms like WUWTA are the necessary interim step to helping patients have a better experience without having to immediately address every systemic healthcare system disfunction.
After meeting with Jock, I felt so passionate that WUWTA represented a way forward to make healthcare better for patients, that I left RWJ to join the company.
What’s Next
We are far from my dream of a hospital system where having an advocate would not be necessary. Technology offers an important interim step to achieving this goal.
My belief is that it is a good thing that technology has enabled patients have access to more information. As the healthcare system continues to shift to be more consumer centric, patients will use that information to demand a better experience. That is when real change will happen faster. I am excited to be a part of it.
Key Takeaways
A hospital advocate is essential for patients navigating complex healthcare in the US, ensuring personalized attention and care in busy hospital settings. Technology platforms like WUWTA provide interim solutions by improving patient access to doctors, empowering them with information, and enhancing their healthcare experience.
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Several years ago, the University of California, Los Angeles (UCLA) health system decided to work on fixing the experience of care. Their results were astounding, going from the 30th percentile of U.S. hospitals to the 99th percentile. Dr. David Feinberg, the then CEO of the UCLA hospital system (he has since run the Geisinger Health System and now is the VP of Google Health), was committed to doing better as the UCLA system grew in Southern California.