Holding the Possibility

by Joanna Smith on Nov 20, 2013

I had a client the other day who is struggling with the long-term effects of Hepatitis C.  It has changed her life, and left her frustrated and angry about treatments she can’t seem to access, drugs that aren’t yet approved and delays in care.  I was talking with her the other day as we waited for her liver biopsy to begin, and I asked her how I could best help her.

She replied that she was discouraged and felt that the drug that was about to be (we hope) FDA approved for treatment of Hepatitis C (sofosbuvir) wouldn’t be available to her.

I looked at her face and saw the fear and discouragement there.  And I thought, sometimes what a Healthcare Liaison needs to do is simply be the presence that “holds the possibility” that things will work the way she’d like.  And that is what I told her:  “I know you are very discouraged and believe this drug will not be offered to you.  But I see a real possibility that it will.  So, if you need me to be the one who temporarily holds on to that possibility until you can do it for yourself, I will do that.”

And her answer?  She let out a long sign of relief and said “yes, please hold on to that for me.”……..

A Puzzle, A Mystery…and A Workshop

by Joanna Smith on Feb 9, 2010

I’ve been ready Malcolm Gladwell’s What the Dog Saw and found his chapter on puzzles and mysteries very intriguing. He says we want life to be like a puzzle:  if only we could find that one piece, everything would fit together and be clear.  Instead, it’s a mystery with many pieces missing and needing to be arranged and re-arranged to find a solution.

And healthcare is a prime example.

If you cut your finger, that is a puzzle:  we know, if it’s a minor cut, it needs…washing, perhaps an antibiotic ointment, maybe a band aid.  If it’s major, it may require stitches.  But if you are diagnosed with irritable bowel syndrome or an irregularity of your heart beat, that is something different.  There are no pat answers:  you need to do a lot more investigation and thought, along with your healthcare team, to figure out the best treatment options.  This is a time when healthcare advocates can be of so much help to people.  It’s the mysteries we can help most with, by showing people how to problem-solve, interpret the information they’re receiving and make a decision.

These topics are some of what is included in the curriculum of Healthcare Liaison’s “Becoming a Private Healthcare Advocate”  workshops.  The next one will be at UC/Berkeley on February 27th and 28th.  You can look at the course description at www.healthcareliaison.com/workshops.

The Blog is Back!

by Joanna Smith on Jan 15, 2010

After several months absence–and many wonderful developments–I am resuming the Healthcare Liaison Blog!  It was a very busy fall…

Healthcare Liaison is expanding the 2010 locations for for its popular two-day workshop “Becoming a Healthcare Advocate:  11 Steps to a New Career in Healthcare”.  These workshops are open to consumers, professional healthcare advocates, those teaching in the field and policy and legislative interests.  We have new locations!

SEATTLE, WA–January 30 and 31st

BERKELEY, CA–February 27th and 28th

TUCSON, AZ–March 20th and 21st

BOSTON, MA–May 1st and 2nd

The links will take you to the brochure describing the workshop and you can complete payment on-line with a credit card or PayPal.  There are still spaces in the Seattle workshop and registrants are eligible for a referral bonus when they “bring a friend”.

In other major news, we have a professional organization!  I founded the organization, the National Association of Healthcare Advocacy Consultants,  in July 2009 and am now the President of NAHAC for 209-2010.  You can read about the Association and join at NAHAC

In November 2009 the newly-formed National Association of Healthcare Advocacy Consultants held its First Annual Conference!  NAHAC  currently has 62 members and membership is open to everyone:  professional advocates, consumers, academicians and policy and legislative participants. Members who were not able to attend the conference can listen to the podcast on the web site and hear workshops on case studies, HIPAA for advocates, insurance-made-understandable and more.  to join:  NAHAC.

We are holding our second annual Conference in Washington DC in November 2010.  Join NAHAC to get the details as soon as they’re released!

National Association Formed

by Joanna Smith on Aug 10, 2009

I am very pleased to announce the formation of the National Association of Healthcare Advocacy Consultants (NAHAC, www.nahac.com), the organization, as it says on the web page, “dedicated to improving the consumer healthcare experience.”   Why NAHAC and why now? 
Read the complete post >>>

A Medical Home: So New It’s Old

by Joanna Smith on Jul 2, 2009

One of my new clients wistfully said the other day, “I wish there was someone at UCSF (University of California, San Francisco Medical Center) who was in charge of me: someone who knows me and refers me to specialists when I need it and then talks to those specialists about what they found out.”

This client was expressing a feeling often voiced by my clients: there is “no one there” to look after them, no one who is looking at the big picture. In fact, this is a common complaint of clients being treated at major medical centers:  who is in charge of all my care?  What he realized in the subsequent discussion was that Healthcare Liaison creates that system for him, and that he had found his “Medical Home”.  A good healthcare advocate does exactly that:  in a complex medical world, we create the “Medical Home”.

The concept of “Medical Home” is not a new concept.  In the era of medicine that pre-dated the rise of specialty practices, there was a medical home with the family doctor.  If someone needed to see a specialist, the family doctor referred them and was in close communication with that specialist and continued to provide the overall care. If you asked someone “who’s your doctor?”, they could easily answer that question.

With the rise in specialty practices, the picture became less clear.  You could go see a specialist for a particular problem, but maybe that specialist was outside of the regular group practice that you used.  Would the information from the specialist get back to your primary care (“regular”) doctor?

With Medical Home, we go back to the original design:  there would be a primary care physician (and office) that would effectively manage a person’s care, contacting specialists, getting updates and keeping the big picture in place.While the concept is very appealing, there are some major structural changes that would need to happen in physician’s practices to make this an effective practice:
1.  The standard primary care physician will not have the time him or herself–and it will not be cost effective–to do all of the  follow-up that needs to happen; the office will need to hire nurses or medical social workers to accomplish this–and that will be costly.
2. Finding qualified personnel to do this kind of care will be difficult:  there is currently a shortage of both nurses and medical social workers;
3. The question of whether insurance will reimburse for these services has yet to be decided;
5. The electronic medical records systems are not yet sophisticated enough for all primary care physicians and specialists to be able to communicate seamlessly with each other.

As a concept of providing care, Medical Home is exciting–and so new, it’s old!

Empowered Healthcare Conference May 16, 2009

by Joanna Smith on May 8, 2009

Joanna Smith, LCSW, MPH, the CEO of Healthcare Liaison, will be a panelist at the upcoming Empowered  Healthcare Conference, Saturday, May 16th at Mission Bay, San Francisco.  To find out more information and register for the conference, read the information at the Empowered Healthcare Conference web site.

Empowered Healthcare

Empowered Healthcare Conference