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.

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!

Consumers continue to be overwhelmed by healthcare.  Decisions about treatments, choosing and understanding specialists, coordinating care, addressing billing and insurance issues–all of these areas can be overwhelming to someone in the middle of a complex medical situation.  While many people are alert to the difficulties that seniors encounter in navigating the healthcare system, people who have very ill babies and children, young adults with new diagnoses of diseases or people of all ages facing surgery or treatment decisions need people to help them navigate through.

But who is doing healthcare advocacy and what are their skills?  What are the “best practices” for the profession?  how can consumers find someone near where they live?  These are the questions a National Association can begin addressing.

Who can join?  Everyone with an interest in healthcare advocacy:  medical professionals, consumers, academicians, policy makers.  But the data base of members is open to the public, who can search without charge for an advocate in their geographic area and read about their particular qualifications to help them decide if the advocate is a good match for what they need.  There is only one credentialing program right now in the U.S, and that is run by Healthcare Liaison and is for medical professionals.  Will there be one for consumers?  What are the skills a heatlhcare advocate needs to have?  What about licensing?  Join the Association and join the dialogue!

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!