Ironic

The medical team I’ve amassed is amazing. World class! Apart from their impressive abilities, they’ve been very kind, considerate, and compassionate. I frequently see several nurses, phlebotomists, surgeons, radiologists, a dermatologist, an internist, and most amazing of all, my oncologist. The administrative staff is likewise, attentive and competent. I’m on a first name basis with many of those I see regularly, and they all treat me with thoughtfulness and respect.

In all my comings and goings through the Hospital and the Cancer Center, I’ve had only one interaction that offended me. That was with, of all people, a Patient Advocate!

“What is a Patient Advocate?” I wondered when she introduced herself to me. I’d never met one before, but she was walking up and down the line of waiting room patients, asking if and how she could be of help.

I was sitting in a hallway, drinking a none-too-tasty bottle of chalky barium sulfate in preparation for a CT scan. I’d brought my computer with me and was working during my hour-long wait.

She explained that she worked for the hospital and was tasked to see that patients’ needs were met. I thanked her and told her I didn’t need anything.

“I see you’ve found our electric outlets though,” she said.

“I shouldn’t use it?” I asked, somewhat incredulous.

“I wouldn’t,” she said stiffly.

So much for patient needs. For a few cents worth of electricity, she’d made me feel small, a petty thief. I wish I’d thought to suggest she tack the ten cents onto my bill of many hundreds of dollars for the procedure.

I believe this imperious woman had fleshed out her vigilante task on her own. But it’s clear that some positions are simply, by definition, a conflict of interest. How can someone who works for an organization adequately represent the needs of those who are clients of that organization? Where does the loyalty lie when the two parties’ needs appear to be at odds?

Patient Advocate is not, after all, a sincere task. It's another euphemism for butt coverage. It’s simply a matter of keeping up appearances of attentiveness in order to keep out of legal hot water. It’s akin to the conundrum of “managed care” imposed by health insurance companies. “Care” is the name they give, but cost containment is the game they play. Those two goals are very much at odds and frequently mutually exclusive.

The insurance companies play for bigger stakes, but a Patient Advocate, I've found, can still mess with your mind.