What is Private Patient Advocacy [Interview][Transcript]

Teri_Dreher_Private_Patient_AdvocacyGuest: Teri Dreher
Presenter: Neal Howard
Guest Bio: With over 36 years of clinical experience in Critical Care nursing, home based healthcare and expertise as a cardiovascular nurse clinician, Teri is well acquainted with the complexities of the modern healthcare system. She has served as a nursing leader, mentor, educator and consistent patient advocate throughout her career in some of the best hospitals across the country. Her passion for patient safety and drive to keep the patient at the center of the American healthcare system led her to incorporate North Shore Patient Advocates in 2011, serving clients throughout the northern suburbs of Chicago.

Segment overview: Teri Dreher, RN, CCRN, iRNPA, Owner/CEO of North Shore Patient Advocates, discusses what private professional advocacy is and who would most be in need of hiring their own personal nurse advocate.

Transcription

Health Professional Radio – Private Patient Advocacy

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard glad that you could join us today. Obtaining quality healthcare has become more and more challenging from choosing the right providers and treatment plans to sometimes persuading your insurance to even pay beyond challenging, sometimes it can be well downright dangerous and sometimes deadly. Medical error is now the 3rd leading cause of death behind cancer and heart disease. Our guest in studio today is Teri Dreher RN, Owner and CEO of North Shore Patient Advocates. And she is here today to discuss with us private-patient-advocacy. Let’s talk about what private-patient-advocacy is and who would benefit the most from obtaining some private patient advocacy? How are you doing today Teri?

Teri Dreher: I’m doing very well, thank you Neal. It’s good to be here today.

N: Thank you so much for joining us today and lending us some of your time. Now not only are you an RN, your also the founder and CEO of North Shore Patient Advocates. And as I said you’re here to talk about private patient advocacy, we all are pretty familiar with the word advocacy. But when it comes to patient advocacy, how does private patient advocacy differ from any other patient advocacy that many of our healthcare professional listeners would be familiar with?

T: Well sure that’s a great question. We get ask that all the time. And I have to say one word really describe the difference and that word is “allegiance” you meet patient advocates that are part of the insurance company and they will call themselves RN patient advocate or account representatives. But they are there to save money for the insurance company, so they’re not going to advocate primarily for the patient, they are employees of the insurance company they get paid by the insurance company and so there’s a real divided allegiance factor. And when you’re going to hospital, the people that you meet in the hospital that have that title patient advocate in the hospital most of those are not really nurses and they work for the risk management department on the hospital. So their primary goal is to calm down disgruntled patients to make everybody happy and to help prevent the hospital from being sued or just having unpleasant…going on. So they try to solve some of the, for some, a smaller problem they really can’t understand healthcare, or go to bath for the patient themselves.

N: So the main difference as you said you are an advocate for the patient in fact.

T: Absolutely.

N: As opposed to someone who call themselves a patient advocate but their really an advocate for the entity that their employed by either the insurance company or as you say the risk management department of the healthcare facility. So they’re not really on the side of the patient, their there to quell anything that the patient might bring to light that could cause problems for either their facility or the insurance company?

T: Yes, it’s not that their caring people. But they just follow the money, I always tell people to follow the money. And we are a private pay industry too. So if you want to know who you really belong to just really follow who’s paying you and you’ll find out what the great motivation there in the allegiance sector.

N: In view of the changes in healthcare here in the United States, who would be the people that would benefit most or be in need in the first place of private patient advocacy especially when their paying above and beyond what they might be showing of for the insurance?

T: Well interestingly enough it’s not wealthy people that higher assets, people that are lost, frustrated, confused or absolutely overwhelm with the complexity of the modern healthcare a lot of times it will be the adult children, the aging parents don’t know how to tell whether or not they’re still safe living on their own, they don’t understand all the options, they don’t understand the bills. And baby boomers are in the frame of their life with their careers right now, sometimes they don’t have the time. And actually a nurses or doctor really hard to understand how to work this system for the patients benefit.

N: Now this isn’t a slow moving industry, this is something that is kind of jump on the scene here in the last, what 10 years or so? And its rapidly growing what is contributing to these rapid growth on this type of industry?

T: Well everything is changing in healthcare. And primarily it really took off about the same time the Affordable Care Act it was signed into law. And even though there are…

N: Ah, so it’s not that old.

T: No. Well we’ve been around for about 10 years, my company is been around for 4 years. But people are really disgruntled to a lot of their falling to the cracks sort of things that are happy with seniors, with adults with disabilities, with not understanding how to get with the insurance company to do what they asked. So we do a lot of insurance mediation.

N: Uh huh.

T: And we show up the hospital and talked to doctors and nurses and we read the charts and make sure that all the right question are ask. The families are too overwhelm, too emotional and just not prepared to be able to ask the right question. And a lot of times so just kind a handed a sheet of paper with 10 or 15 nursing home on it by the case management department of the hospital and say “here you go to choose the one that you want,” well they don’t know how to choose, they don’t know the difference between a good rehab facility, a bad rehab facility, their just so many different changes going on in healthcare, there’s so many choices. And people are frustrated, lost, confused and they can’t keep up like that.

N: So basically you educate the patient and their families during their hospitalization or educating them how to avoid hospitalization in the first place, taking advantage of this much more hands on interaction, then they would get with maybe just their physician or just their primary care nurse, right?

T: Oh absolutely. And nobody has time in hospital to sit and talk to patients and families for half hour and hour or even longer. And education isn’t nearly the emphasis in hospital now because it doesn’t pay. And in hospital right now they’re all really struggling with new financial structure of the Affordable Care Act and the reimbursement system policy are obtain to. So they don’t have as much time as they used to, to educate, to sit and talk to people. And so we come along side and which I say that were hiring one of our nurses like having a nurse in the family because will spend as much time as people need. And just were we go to bath for them personally. And from a professional standpoint.

N: Now not only are you Chicago land largest facility or company of this type, you’re the only one to use a team approach. Let our listeners know where they can get more information about North Shore Patient Advocates and maybe discuss helping out or joining your team?

T: Well sure. Right now our website you can get a lot of questions answered on our website which is www.northshorern.com

N: uh huh.

T: And our phone number is 847-612-6684 our direct office number. And we also have an answering service that people can find on the website also. Were always happy to take emails also and you do that through our website also.

N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. We’ve been in studio with Teri Dreher, RN, Owner and CEO of North Shore Patient Advocates. And we’ve been discussing private patient advocacy how it differs from normal advocacy that most of us are familiar with. We’ve been discussing the main difference being patients allegiance, being on the side of the patient as opposed to being there to protect the interest of well maybe insurance company or the healthcare facility that your about to be placed in the first place. Transcript and audio of this program are available at healthprofessionalradio.com.au and also at hpr.com. And you can subscribe to our podcast on iTunes.