Sta ff photo by Ang ie Eiaan

Health & Fitness

Scott Winnick helped
his dad through two
health emergencies.

Patient
Advocate

A new position in the health care field
benefits both patients and doctors.

"Patient advocacy is for any patient
who needs advocacy, who can't or doesn't
want to advocate for him or her self:' says
Perry Ohren, director of community sup-
hen Scott Winnick success-
port
services at Jewish Family Service of
fully advocated for his dad
Metropolitan
Detroit.
through two major medical
Ninety-five
percent of the agency's
emergencies, he couldn't believe the time,
advocacy
is
on
behalf of older adults. It
perseverance and ingenuity involved.
can
involve
filling
almost any immediate
He negotiated the care, insurance
or
long-range
need
including arranging
payments and United States-to-Canada
transportation,
accompanying
a client to
transport of Dr. Alan Winnick, a
medical
appointments,
acting
as
a liaison
Canadian citizen who fell and broke his
between
the
client
and
doctors,
research-
hip as he and Scott were ice skating at a
ing a diagnosis on the Web, interpreting
West Bloomfield rink.
for those who don't speak English, keeping
"He was scared:" said Scott, a West
relatives informed, handling the insurance
Bloomfield resident with dual citizenship
who is a licensed Canadian attorney. "A lot paperwork, etc.
Ten or so caseworkers, most with social
of people needed to be kept on the same
work and/or geriatric training, do patient
page. I sat on the phone for a heck of a lot
advocacy work for JFS, which charges
of hours!'
according to a client's ability to pay. And
More investigation and patience were
that roster is headed upward, Ohren pre-
required in a later incident when the
dicts, as the Detroit Jewish community
Toronto dentist developed melanoma.
nears the top of the nation's aging Jewish
Scott researched and oversaw his care,
populations.
including persuading Canadian insur-
In the 2005 Jewish Federation of
ance to cover trips to specialists in the
Metropolitan Detroit population survey,
United States.
the median age of a Metro Detroit Jew
"I told him you should be doing this for
is 47, as compared with 39 nationwide.
other people, you're so good at the detail:'
Twenty-four percent of local Jews are older
Alan Winnick said. "Most lay people aren't
than 65 compared with 16
aware of dealing with
percent nationwide. And
insurance companies.
14 percent are over age 75,
There's a lot of bureau.-
compared with 8 percent
cracy. He's a trained nego-
nationwide.
tiator. He took charge'
"We don't advertise that
Now Scott, who says
we have a patient advocacy
his legal skills and belief
program:' Ohren says. "But
in tikkun olam (repair
in a year, we might. We're a
of the world) are a good
reputable agency and when
fit with patient advocacy,
we're competing with the
hopes to create the best
for-profit world, we want to
possible outcomes for
convince the world that we
other patients who need
Dr. Alan Winnic k
can do it as well or better!'
and can pay for such
"I think it's fantastic:'
services.
says Dr. Peter Lichtenberg, director of
Indeed, customized patient advocacy
Wayne State University's Institute of
is a growing field as people live longer,
Gerontology in Detroit, of the growing
families are scattered, medical options
multiply, research on any disease is avail- emphasis on patient advocacy. "Study
after study shows there's a real barrier
able on the Web, doctors are pressed to
handle ever more patients and insurance between the patient and the health care
team. And people aren't always going to
coverage is often fraught with barriers.

Judith Doner Berne

Special to the Jewish News

.

have that relative around.
"My only concern is for people who are
somewhat isolated and vulnerable to con-
fidence games;' he says. "It would help to
have an agency behind it or being creden-
tialed in some way."
So far, Sarah Lawrence College is lead-
ing the way, offering a master's degree in
patient advocacy. New York University has
a year-long program to train patient advo-
cacy volunteers in emergency research
services (PAVERS). The University of
Wisconsin Law School has created a
patient advocacy training center and the
University of North Carolina at Chapel Hill
lists a series of undergraduate classes.
Boston Globe writer Judy Foreman
said in a May 1 Health Sense column: "It's
so early in the life of this new profession
that it's not entirely clear what an advocate
is or how to judge whether you've found a
good one ... Some advocates have mini-
mal medical training, others are nurses
and doctors. Some charge nothing, oth-
ers thousands of dollars. Some advocates
might help save your life; others may com-
plicate patient-doctor relations."
"I think it (patient advocacy) is going
to be the wave of the future says Arthur
Malisow, a principal in the law firm of
Mall Malisow in Farmington Hills.
The firm, which specializes in estate
planning and eldercare, has an experi-
enced client advocate on staff. "We actu-
ally deal with some of the hand-holding
issues:' Malisow says.
"The medical profession tends to see
advocacy as adversarial," Malisow says.

"We try and explain to the doctor that
everyone. is on the same side" and "it's
important to have that second set of ears."
Dr. Robert R. Frank, executive vice
dean of Wayne State University's medi-
cal school, agrees that doctors may resist
efforts of the patient advocate. "We have
a long way to go to understand that
someone who helps the patient get to
the essential issues is going to be a huge
time-saver."
To point medical students in that direc-
tion, he has them role-play various sce-
narios, including one featuring a geriatric
patient and a daughter-in-law who is her
advocate.
"We are professional relatives," says
Ileane Stone, a patient advocate who is
one of JFS's independent contractors. She
holds a master's in education and a cer-
tificate from the University of Michigan's
Institute of Gerontology.
"I can rely on her judgment:' says Sarah
(not her real name), who is one of Stone's
clients. "Sometimes, you want a more
impersonal opinion and you have things •
you don't want your family to do."
The advocate can be a social worker, a
nurse, an eldercare law attorney, says Carol
Rosenberg, executive director for Jewish
Home and Aging Services. "This person
has no emotional involvement and can
stay focused on the wellness of the patient.
They have to be qualified. They have to
have an advocacy personality."
"Patient advocacy is where it's at:'
Rosenberg says. "We must advocate for
patients in general." II

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August 31 • 2006

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