Mitchel Nickols: Advocates look out for patients

Chances are, most of us will become or know someone as a patient during our lifetime. The need to have a friend or loved one access or communicate with a medical professional about your care may necessitate having a patient advocate.

A patient’s privacy is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Health plans, health care providers and health care clearinghouses are expected to respect and protect any “individually identifiable information” regarding a patient, according to the U.S. Department of Health & Human Services.

Under HIPAA protection, a patient’s information should not be disclosed without the patient’s permission. Typically, the patient or some authorized outside person would be the only one gaining access to individually identifiable information.

Anyone who has had any type of medical treatment, even a visit to a doctor’s office, has signed the HIPAA form. But one needs to ask about the two-way communication that should happen between medical professionals and the patient or the patient’s family or close friend.

It is in the best interest of the patient to protect private information. But what if the patient is incoherent or has a diminished capacity to speak for themselves? What if medication has had adverse effects and the patient is no longer lucid? What if there is an emergency where someone other than an immediate family member is present? Who is left to advocate on behalf of the patient or seek clarity about medical decisions?

Despite procedures in place to keep patients safe, abuses occur. In Arizona, nurse Nathan Sutherland was charged with sexual assault and vulnerable adult abuse after an incapacitated 29-year-old patient under his care gave birth. In Michigan, pediatric doctor Mark Hoeltzel is serving prison time after pleading no contest to criminal sexual conduct and other charges. I have long been an advocate for the need for someone to go into the doctor’s office with a patient, especially children.

Sometimes there is a problem with a physician not communicating with the family about a diagnosis or results of a test. I became aware of such a case recently in a Pittsburgh hospital, where the patient was admitted on a Thursday, a CT scan or MRI was done on Friday, and three days later, the doctor had neither visited nor informed the family of the results. When the patient was informed by a doctor of his terminal diagnosis, no one else from the family was there.

The National Patient Safety Foundation provides clear guidelines about the role of a patient advocate. Many hospitals provide social workers or patient representatives, but I would strongly suggest that you find your own advocate who is independent of the medical facility.

In Pittsburgh, UPMC Health Plan offers a Personal Representative Designation form, and the Allegheny Health Network has an Authorization for Release of Protected Health Information form.