Patient Navigators Help Cancer Patients Manage Care

a patient navigator and doctor talk to and comfort a patient

You may have never heard of patient navigators, also called patient advocates. But this relatively new type of health care worker is becoming a familiar face in more hospitals and communities, helping an increasing number of patients find their way through the complex American health care system.

The first patient navigator program was launched at Harlem Hospital in 1990 by surgical oncologist Dr. Harold P. Freeman after he witnessed too many women with late stage breast cancer that he wished had been caught earlier. Freeman wanted to break down barriers to cancer screening, diagnosis, treatment, and supportive care faced by underserved populations.

Since then, community-based navigation programs were developed with the help of federal grants. More recently, the Affordable Care Act mandated that state health insurance exchanges establish a navigator program to help people make informed decisions about enrolling in health insurance.

Today, patient navigator programs exist all over the country, and organizations are being formed to train patient navigators, establish standards, and expand programs. Patient navigation and advocacy now refers to almost anything being done to help patients and families find their way through the maze of our health care system.

What is a patient navigator?

According to the American Medical Association, a patient navigator is someone who provides personal guidance to patients as they move through the health care system. Patient navigators may have professional medical, legal, financial, or administrative experience. Or they may have personally faced health care-related challenges and want to help others who find themselves in similar situations.

Navigators can be employed by community groups, hospitals, or insurance companies. They may be paid by those organizations, they may be volunteers, or they may be independent consultants hired by people who want help managing their complex medical needs.

What kind of training do patient navigators have?

So far, the patient navigator profession is not regulated. While many organizations offer certificates, there are no state or national credentials or licenses. However, this may be changing. The Patient Advocate Certification Board is in the process of developing a nationally recognized set of credentials.

Some patient navigators are nurses assigned patient navigator roles at the hospitals where they work. Others come to the profession without a medical background and are trained by organizations like the American Cancer Society in collaboration with a partner hospital in their community. There are more than 100 American Cancer Society patient navigators across the US located in a variety of publicly and privately funded institutions.

What kinds of things do patient navigators do?

Patient navigators work with patients and families to help with many different needs associated with the health care system. This may include helping with insurance problems, finding doctors, explaining treatment and care options, going with patients to visits, communicating with their health care team, assisting caregivers, and managing medical paperwork.

Community health workers typically focus on community education and help people understand the importance of screening and how they can access resources. Others actually help schedule screening tests, address barriers, and provide follow-up education.

Not every patient navigator does all of these things, and there is no single list of services. Some navigators only work with senior citizens, others only with cancer patients, or others only to solve medical billing problems. It depends entirely on the individual’s business and practice.

The original goal of patient navigation was to help people overcome barriers like poverty, low literacy, or lack of health insurance that were preventing them from gaining access to medical care. However, care for illnesses like cancer can be so complicated that patients, regardless of income or education level, can benefit from navigation. In fact, under a new requirement for accreditation by the American College of Surgeons Commission on Cancer, cancer centers must now provide patient navigation services.

How can I find a patient navigator?

If you or a loved one is facing a cancer diagnosis, call the American Cancer Society at 1-800-227-2345 to find out if there is an American Cancer Society Patient Navigator Program in your area.

If you plan to enroll in an insurance plan through your state’s marketplace under the Affordable Care Act and you want help, find a trained counselor in your area at LocalHelp.HealthCare.gov. If you are self-insured or have health insurance through your employer, you may also have access to a patient navigator as part of your benefits. Check with your insurance company.

For help with a specific medical condition or illness, a good place to start is with your treatment center. Many hospitals and cancer centers have patient navigator programs.

If you want to hire your own private patient navigator, try searching the directory at the National Association of Healthcare Advocacy Consultants (NAHAC) website to find an NAHAC member in your area.

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