Do You Need a Health ‘Consultant'?

Questions about medical care have become so confusing, they've given rise to a new industry: health care consultants, private advocates who promise to cut through red tape and get you the treatment you need.

Los Angeles resident Delinah Hurwitz recently hired health care consultant Dr. Valerie Ulene and her partner, former Hollywood agent Byrdie Lifson Pompan, co-founders of Clear Health Advisors.

Hurwitz turned to Clear Health Advisors for help after discovering that the type of brain tumor she had was misdiagnosed.

"Our job really is to confirm [our patient's] diagnosis, identify the most appropriate specialist for their diagnosis and then educate them on their treatment options," said Pompan. "We're in a culture that has been trained not to question our doctors."

Pompan said it's time to change that.

According to the BMJ Quality and Safety Journal, roughly 30 percent of all medical diagnoses are incomplete or inaccurate.

"It's the third leading cause of death in our country," Pompan said. "Medical error."

Now, it’s easy to hire someone to advise you in your search for the best medical care:  organizations such as the National Association of Healthcare Advocacy Consultants and the Alliance of Professional Healthcare Advocates have hundreds of members who promise to "run interference" for patients during a health crisis in return for fees that can run in the thousands of dollars.

But health care advocates suggest choosing a consultant with care.

The I-Team contacted the California Department of Insurance and found out this sector of the industry is not yet regulated. Consumer attorney Stuart Talley says without state oversight, there's potential for abuse.

"One of the big ones is if a consultant was referring a doctor and getting a kickback," Talley said. "If there's no rules or laws against that, that could be a huge problem. They could be referring people to doctors that they don't need."

That certainly wasn’t the case for Hurwitz, who credits Ulene and Pompan with helping her find a specialist within 48 hours — one she says ultimately saved her life.

"Thank God for them because that's the only reason I went where I went and how things got fixed as quickly as they did," Hurwitz said.

If you're considering hiring a health care consultant, do your research to confirm your consultant's qualifications.

And check your benefits — some insurance companies and employers offer health care consultants as part of their coverage plan.

Six steps to better health from Clear Health Advisors:

1. Choose your doctors wisely. Most patients evaluate physician quality by judging the diplomas on the wall of the doctor’s office.  Did they attend an Ivy League college?  Train at a top-ten medical school?  While a doctor’s academic credentials are important, they are certainly not the only things to consider when choosing a doctor.  A variety of factors play into the kind of care a doctor delivers and influence a patient’s level of satisfaction with the care he or she receives.  In fact, sometimes it’s a doctor’s more personal characteristics like their communication style and treatment method that wind up mattering most to patients. Finding a good doctor is no easy feat.  It requires looking beyond the diplomas to the person who earned them. But, ultimately, it's about finding a good fit—a physician whose treatment approach and personality is right for you.

2. Establish a relationship with a primary care physician. As the number of physicians choosing to go into internal medicine and family practice dwindles, so does the number of adults with established relationships with a primary care physician.  Most patients put together their medical team in a piecemeal fashion.  They jump from one medical specialist to the next or resort to the emergency room whenever they are ill or injured. Without a physician to coordinate patients' care, health problems are treated as isolated events and their overall health care falls short.  Chronic problems are largely ignored and symptoms of new and potentially serious disorders pass unnoticed. By providing comprehensive care, primary care physicians can eliminate these "care gaps." People who have a primary care physician are more likely to receive preventive interventions, such as cancer screenings and immunizations, and have their chronic problems managed effectively.

3. When you have a problem, start with your primary care doctor. Some people worry that primary care doctors may not be trained to treat specific medical conditions; specialists, they believe, have more expertise and experience. So, when a problem develops, they bypass the primary care doctor and head straight for the "expert." But not every problem requires the care of a specialist. Primary care doctors are generally equipped to manage straightforward medical problems quite well.  Consulting a specialist becomes more important when serious, complex or confusing medical problems arise or when appropriate therapy is not clear-cut. When a specialist is necessary, consulting with a primary care doctor first offers several advantages:  He or she can help identify the best possible doctors to go see and ensure that their recommendations are consistent and compatible with a patient’s overall care.  A primary care doctor can also initiate a work-up of the problem.  Imaging studies and blood tests can be ordered in advance of the appointment with the specialist, allowing patients to get the most out of the visit.

4. Get the most out of every doctor's visit. One of the biggest mistakes patients make is showing up for a doctors’ visit unprepared, which almost guarantees truly informed choices cannot be made.
Go to every doctor’s appointment armed with a list of concerns and questions.  Once an appointment is underway, it’s easy for patients to forget what they wanted to ask. Spend some time in advance of the appointment, writing them all down. Remember: there is no such thing as a ‘dumb’ question. 
Ask where you can find additional resources, if needed. Although doctors are wary of what patients learn on the Internet, they welcome the opportunity to point their patients toward credible sources of information. Before leaving a doctor’s office, be sure ask how to contact them if with follow up questions or concerns.  Physicians often surprise patients with their accessibility, even sharing their email addresses and cell phone numbers.

5. Work collaboratively with your physicians. When things don't go well during a doctor’s visit, patients are often quick to hold their doctor accountable. Patients blame the doctor for keeping them waiting, for having an unpleasant bedside manner or for delivering poor care.  But, like any relationship, the patient-physician interaction is a two-way street. It's important for patients to recognize that physicians have frustrations too. Doctors work within an imperfect healthcare system that often doesn’t allow them the time or resources to provide the kind of care they’d like to deliver.  And, although it comes as a big surprise to many people, the things that patients say and do can often be irritating to their physicians and ultimately undermine the quality of the care the patient receives.  For instance, doctors dislike it when patients insist on being prescribed a particular drug or a medical test that the physician doesn’t feel is necessary. Doctors also are irritated with patients who visit regularly but largely ignore the medical advice provided. Doctors need to do their best to work collaboratively with their patients, but patients need to hold up their end of the bargain as well.  It’s up to patients to be thoughtful and reflective about what they can reasonably ask of their doctors and to follow through with the advice they’re given. At the end of the day, the best results generally come when patient and physician work together.

6. Get a second opinion. Getting another doctor’s recommendations can protect patients against unnecessary or inappropriate treatment.  A second opinion also provides additional information, often helping patients make difficult decisions. Sometimes, second opinions simply help patients feel that they're heading down the right path. Despite the advantages second opinions offer, many patients don't bother to pursue them.  Some patients worry about the costs that are involved; others are concerned about delaying their treatment while waiting for the consultation. Some patients are reluctant to ask for a second opinion for fear of offending their physician. In fact, the vast majority of second opinions are covered by insurance.  And, for most patients, second opinions rarely cause a meaningful delay and the information they glean from the consultation is well worth the wait –and potentially even life saving.