A middleman steps into the physician-patient relationship

An emergency physician is among a small number of advocates patients can lean on when managed care doesn't leave doctors enough time to talk.

By Mike Norbut, AMNews staff. Dec. 1, 2003.

In an ideal medical world, the services offered by Daniel Kranitz, DO, would not be necessary. He said if physicians had enough time to offer undivided attention to all their patients, especially the ones with complicated medical problems, there would be no need for him to be a third-party patient advocate and liaison.

But in a system where physicians have to keep hustling to cover rising costs, some patients need the extra support, Dr. Kranitz said.

"The best possible scenario would be if I folded because I wasn't needed," he said. "I believe the majority of physicians very much like to address questions in real time, but they're not always available. I'm available 24-7. When they call, they're getting me."

That is the philosophy behind Lighthouse Health Services, an advocacy and liaison service designed to help patients feel comfortable in a confusing health care climate. Whether it means prepping the client for a physician appointment, answering questions or following up on recommendations, Dr. Kranitz, an emergency physician in Cleveland, said his role is to complement the services provided by the patient's physician.

The idea of a patient advocate certainly is not new, but most services focus on helping patients in their struggles with insurance companies and employers.

Proponents, however, say that when a complicated health care system combines with a sudden serious illness, advocacy services on the care side can be vital. Internet research alone cannot replace a person who can interpret doctors' orders and help explain options, said Marsha Hurst, PhD, director of the health advocacy graduate program at Sarah Lawrence College in Bronxville, N.Y.