Illustration by Phil Foster

Professional help is available when navigating a complicated health care system.

Less than two weeks before starting radiation for Stage I breast cancer, a patient wanted­ to know how radiation on the tumor in her left breast could affect her heart over the long term. Afraid to offend her doctor by seeking a second opinion, she turned to Vienna, Va.–based Patient Navigator for help.

In one day, Dr. Karen Zorrilla, the company’s medical director, found relevant journal articles and a specialist who was able to answer the woman’s questions and give her peace of mind.

Zorrilla is a patient advocate, a new breed of consultant helping consumers navigate the labyrinthine U.S. health care system.

“It’s draining enough to be sick,” says Elisabeth Russell, president and founder of Patient Navigator, “let alone having to deal with the health care delivery system and all of its vagaries and complications.”

These consultants, also known as medical advocates, patient navigators and the umbrella term health care advocates, offer a range of services. They help patients learn about options by researching diagnoses and treatments. Many assist in communication among physicians and patients. They help clients define health care goals, set agendas for doctor visits and shape expectations.

Their work styles vary. Many patient advocates accompany clients to appointments and hospital visits; others may consult strictly by phone. Some help patients in developing questions to ask doctors and
in understanding the answers. Advocates may gather records and create a multiyear summary of a patient’s medical history to help physicians get a snapshot of salient points. While patient advocates employed by hospitals or insurers aim to mitigate risk or cut costs, independent or private advocates answer only to their clients: the patients.

Squeezed for time, intimidated by doctors and not feeling their best, patients or their families hire health care advocates and are willing to pay $60 to $200 per hour to get the research and advice. Those costs are not covered by insurance.

“The people that we get are very complicated medically,” says Joanna Smith, who founded the National Association of ­Healthcare Advocacy Consultants in 2009 and is CEO of Healthcare Liaison, Inc. in Berkeley, Calif. For one client, she coordinates care among 12 specialists and a ­primary-care doctor who otherwise would not communicate among one another.

“If it were simple, they wouldn’t come to an advocate because they wouldn’t need us,” Smith says.