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Navigating Difficult Waters: The History of the Patient Navigators

Article date: April 14, 2009

In the 45 years he's practiced as a surgical oncologist at Harlem Hospital in New York – 25 as director of surgery – Harold P. Freeman, MD, has been frustrated by the high numbers of women he's seen with late stage breast cancer.

Freeman realized many of these women weren't being diagnosed with cancer earlier because of significant barriers, such as lack of health insurance, confusion about proper testing and treatment, and distrust of the health system.

To address these problems, Freeman came up with the concept of patient navigators. The idea is to pair patients with a “navigator,” a non-medical professional who can help guide them through the maze of the health care system – coordinating appointments with work schedules and stressing the importance of consistent treatment and follow-up.

“I compare it to providing a lifeboat. Navigators know where the rocks are and can guide them safely to shore,” Freeman explains.

Navigators made a dramatic difference at Harlem Hospital, where Freeman launched the first patient navigator program in 1990. Between 1995 and 2000, 5-year survival rates increased from 39% to 70% and late stage cancers dropped 28% – from 40% to 21%. The program was so successful it became the basis for 2005’s Patient Navigator and Chronic Disease Act signed by President Bush.

Freeman, who is now president and founder of the Ralph Lauren Center for Cancer Care and Prevention and a past national president of the American Cancer Society, estimates there are now more than 700 patient navigator sites nationally. In fact, the American Cancer Society has patient navigators in more than 120 sites throughout the country. He says, “We discovered the principles developed in Harlem applied to the experience of poor people everywhere.”

Thanks in part to the help they give, patient navigators may help fewer people lose their lives to cancer in the future.

Call us at 1-800-ACS-2345 to find out if there's a Patient Navigator Program in your area.


Reviewed by: Members of the ACS Medical Content Staff


ACS News Center stories are provided as a source of cancer-related news and are not intended to be used as press releases.

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