Knowing advocacy types and how to get patients involved in advocating for themselves is a key topic in the medical world as drug access can become a confusing issue to tackle. A group of panelists at the 2022 NICA Annual Conference explained how clinicians can help their patients.
A panel led by Alicia Barron, LGSW, the director of patient empowerment Infusion Access Foundation in Austin, Texas, was brought together at the 2022 National Infusion Center Association Annual Conference to help clinicians empower their patients. She was joined by Estela Lajthia, PharmD, a clinical pharmacist embedded in the Inflammatory Bowel Disease clinic within the gastroenterology department at Ochsner Health in New Orleans, Louisiana and Andrea Perryman, a patient advocate.
There are 3 types of patient advocacy, Barron explained, legislative, payor, and patient.1
Legislative advocacy is working with lawmakers to support a specific cause. Barron gave the example of how her organization often focuses on the access issues that many patients face and tries to implement laws to improve access. Lajthia said that one does not need to be a lobbyist to make legal change, and everyone should do what they can to lend their voice to legal change.
Payer advocacy, for which there is no clear definition according to Lajthia, involve insurance companies. So, using payer advocacy is using insurance companies to get better decision making, cover more locations, and greater access for patients who need their services. This can be difficult as clinicians not only have to get drugs covered, but also have the place where the treatment can take place. There are times when a drug will be covered but finding a place where that patient can take that medication can be difficult because of office or hospital policies.
In regard to being a better payer advocate, Lajthia recommended hiring someone to be in charge of prior authorizations as it can become quite overwhelming. “[An] American Medical Association survey showed that medical staff takes up almost 2 business days out of their entire week to do all the group operations,” said Lajthia.Further, 40% of physicians have people dedicated to prior authorizations.2
Another way to improve payer advocacy is using resources from disease advocacy organizations. Not only can physicians find different ways to get medications covered thus helping staff, but also they can build resources to give patients. Lastly, Lajthia suggested giving patients a realistic timeline for medication coverage. This way a treatment regimen can be created to prevent any flare ups in the meantime.
As the physician is working to create better health care access, a patient can take steps to empower themselves to do the same. Patient advocacy starts with access to resources, Perryman explained. Patients can take charge of their care by advocating with physicians, employers, hospitals, pharmacies, or other various stakeholders in the health system, according to Perryman, “I think that successful self-advocacy ensures that the patient's needs and goals are identified and are set,” she said.
Patients who feel confident in bringing up their concerns can build confidence and hope for care, especially with chronic conditions, Perryman explained, This confidence can mean going to find a second opinion or trying a new medication. The 4 reasons Perryman believes patient advocacy to be important are:
“I think it's important to help the patient realize that they're the captain of this team,” Barron said. “I think that version of self-advocacy really brings that autonomy back to the patients and that's really key to why patient stories matter. You can go and tell people statistics until the cows come home, but until you put a face to it…you're not really able to sell that change.”
To help empower patients, some key factors include helping making health care easier to understand. For many patients, health care can be complicated, and they can be intimidated to try to challenge what is happening Perrymen said. Including patients in the decision making on their treatment is another way to strengthen not only the clinician-patient relationship but improve their knowledge on their condition. Another important factor is providing information on resources patients can use to both get support from other patients, health providers connections, but also create change.
“I can't tell you how many patients I've talked to who feel like they're going to insult their doctor if they go get a second opinion and not insulting anybody.,” Barron commented. “In fact, any doctor worth their salt [will encourage a] second opinion.”