Booming Business of Personal Health Advising Offers Roles for Physicians

When physicians need help navigating through the sea of finance and the wide array of investment vehicles available today, who do they turn to? A personal financial advisor, of course. Well, the same is true for consumers when it comes to healthcare decision-making, including treatment options and hospital stays. People pay to have their health looked after by a trusted health advisor, just as if their medical record were a financial portfolio.

“People need a way to analyze and process all the information that’s available today,” explains Miles Varn, MD, chief medical officer at PinnacleCare, a private health advisory firm with offices worldwide. “You can go on the Internet and find all kinds of information, but you need a way to assess what’s reliable and what’s not.”

Filling in the gaps

Joanna Smith, LCSW, MPH, created Healthcare Liaison about three years ago. With more than 25 years of experience in the fields of public health and mental health, Smith had seen the gaps in healthcare services that often occurred both in the hospital and on the outside.

“I think it’s great that we’ve developed these really sophisticated teams that work on specific health issues, but families keep telling me that the teams don’t talk to each other,” says Smith. “Private healthcare advocacy helps pull all those pieces together.”

Even during a visit to a physician’s office, patients can often find themselves lost, explains Vicki Rackner, MD, president of Medical Bridges, a physician-run company offering solutions to healthcare problems. “It’s estimated that patients hear about 30% of what physicians say, and I think we as physicians lose sight of this,” says Rackner. “For patients, the language we speak is really a different language. And unfortunately, the way our healthcare system is constructed right now, there isn’t a whole lot of time for patients to get answers to their questions.”

Advocate, not adversarial

Rackner points out that the words ‘advocate’ and ‘adversarial’ are very close in the dictionary. Similarly, there’s a fine line between them when it comes to setting the proper tone as a personal health advisor. In the best case scenario, a personal health advisor is a trusted member of a collaborative team. Physicians welcome them into the patient’s appointment, and turn to them for reinforcement of the treatment plan. In the worst case, they breed mistrust and engender an adversarial tone.

“None of us are really able to practice medicine the way we would like,” says Rackner, a surgeon who now coaches doctors and patients in order to develop stronger health teams. “When a patient [uses a health advisor] they’re not saying that you’re a bad doctor or that they don’t trust you. They’re just commenting on our healthcare system—on the limitations of the system. They’re trying to figure out how to get their own health needs met given the system’s constraints.”

Varn agrees, and points out that the bottom line is to understand the patient’s needs and expectations, then come up with a plan to satisfy those needs and expectations. “We provide the accountability through our advocates to ensure that the plan gets implemented,” he says. “I think that’s what’s missing from even the best physician-patient relationships today. [Doctors] don’t have the time to ensure the accountability. They know what the patient needs to do, and even the patient may know what he or she needs to do. But, they don’t have the time or resources to implement that plan in detail.”

Roles for physicians

Varn stresses that physicians, especially in primary care, play a critical role in forging a relationship with their patients. Taking the time to listen to patients, and doing complete physicals, is absolutely critical. That’s the role of the physician, not the health advisor.

Smith agrees. “I’m not coming in and telling [physicians] how to take care of their patients,” she explains. “What I’m trying to accomplish is to bridge this enormous amount of knowledge that the physician world has with what the patients actually understand.”

Smith adds that there are always roles physicians can play from the health advocacy side. “The rich part of this is that we all come at it from slightly different angles,” she says. “For physicians who want sort of a different way to use their medical expertise, [health advising] is absolutely an option to consider.”

Varn notes that as PinnacleCare grows, the company will need medical directors in large cities across the country, working in direct contact with the advocate team. “We also have physicians who do the chart reviews to organize medical records and data, and they’re generally working from home at their own convenience,” he says. “There’s always an opportunity for physicians to work with us on a part-time or full-time basis, doing what they do naturally—reviewing records and coming up with a plan.”

Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at edwardr@frontiernet.net.