Are Patient Advocates The Next Marcus Welby? They Could Be

Written and submitted by GNA member, Avrom Fox

During my many years of working as a patient advocate, I have had cases ranging typically from days, to weeks, months and perhaps a couple of years. The most unusual case I have been blessed with has been ongoing for more than 7 years, and it has been the most inspiring and rewarding experience of my patient advocacy career. The client and her husband have become embedded in my heart and soul. They continue to inspire me each day.

We, as independent health care advocates, must recognize that our role for some of our clients must be like that of Dr. Marcus Welby, MD

I often think back to my childhood and remember our very own family physician. Ours was in the mold of Marcus Welby, MD. He cared for my family until I left the home and ultimately got married. He was practically a family member. The Marcus Welby, MD model has practically disappeared from modern healthcare for many reasons. A big reason is that today's Primary Care Physicians are mostly paid to see as many patients per hour as they can. They don’t have the time to learn about their patients' lives, lifestyles, living conditions, and family dynamics like Dr. Welby did. The story I'm about to tell made me realize that Independent Patient Advocates are in a perfect position to fill a vital role that no longer exists.

These days, the Marcus Welby, MD role can be taken on by a loving, caring independent patient advocate. This is, in a real sense, what I have been doing in the case as described below.

How I Met My Longstanding Clients, Ellen and Don

This is the story of a woman who was in respectable health. She and her husband lived very modestly, and enjoyed a wonderful life together. The client (Ellen, for purposes of this blog) had a series of female related health issues. Seven years ago, she had a couple of surgeries and some follow up procedures and everything seemed to be going just fine, without incident.

One day, Ellen was not feeling well, and returned to the ER of the major hospital which had treated her. While in the ER, her blood pressure skyrocketed. There were no nurses who responded. Her husband (Don for purposes of this blog) shouted out to the nurses and reported that his wife was in desperate trouble. A large entourage of doctors and nurses stormed into the room. Don was asked to leave.

Ellen was wheeled out of the ER to the OR, having suffered a massive stroke. After weeks of hospitalization, she stabilized, but was seriously affected in every way. Ellen was discharged to an acute care hospital on a ventilator and feeding tube. She was not cognitive. Don had no one with which to effectively communicate. He was desperate.

When Ellen was in the acute respiratory care hospital with her trach and feeding tube in place, I was contacted by a medical malpractice lawyer, whom Don had contacted. The lawyer understood the need for long-term medical guidance, personalized oversight, and advocacy because the litigation was going to be lengthy. The attorney recognized and insisted that Ellen needed a patient advocate to manage her many challenges, and I was immediately engaged.

My Continuous Advocacy For Ellen and Don

This long journey began with finding a skilled nursing home, which would accept a patient on a ventilator, a feeding tube, and with medicaid. Even though this seemed to be unlikely, I succeeded within 2 days in finding a placement, after a great deal of persistence.

I was actively involved with every aspect of Ellen’s health care management while she was in the skilled nursing facility: insurance issues, day to day nursing shortages, medical specialists, arranging for various medical tests which had to be performed outside the facility, attending care meetings, and ultimately planning for a discharge to her home. The husband Don, was very dependent on my advocacy, as he was totally involved with Ellen. He relied on me to effectively serve as his Dr. Welby. This required me to be fully informed of every aspect of Ellen’s journey. This meant being involved with small issues, as well as major health issues.

Because of my “Dr. Marcus Welby” role, I probably knew more about Ellen than anyone other than Don, her husband.

Over a year later, Ellen was discharged, and we were able to secure some in-home health care. Don basically gave up his small business and devoted his entire life to caring for Ellen. Insurance claims were made, denied, and appealed. I was ultimately successful in securing more in-home health care, some special durable medical equipment, and qualified for a communication computer board. There were frequent visits to specialists, issues regarding insurance, etc.

Both Ellen and Don persevered during Covid. My role was limited to periodic phone calls. There were a few telehealth visits. Fortunately, Ellen maintained her stability during the pandemic. There was never more than a period of a few days in which I did not continue in my role.

The medical malpractice case was significantly delayed because of COVID, but ultimately all of the necessary pretrial work was completed. As the patient advocate, I was involved on some level with the legal team, given my knowledge of Ellen’s challenges, and her future life needs. Because of my “Dr. Marcus Welby” role, I probably knew more about Ellen than anyone other than Don, her husband.

Having spent many years struggling to access health care services, because of medicaid regulations and restrictions, and limited opportunity, the lives of Don and Ellen were changed when the legal case was finally resolved, in their favor.

Justice prevailed, and now this amazing patient and her husband have unlimited financial resources. I have been retained by them and my newly defined patient advocacy role is to secure the finest health care money can buy. I am still the patient advocate, known as Dr. Welby.

Nevertheless, the system is still broken. Transferring medical records, finding primary care providers, in home physical therapy etc. is not a given, just because there are no longer financial restrictions. Our standards are higher, but the system is very broken. It is terribly sad that Dr. Welby no longer exists. But as patient advocates, we can be that «Dr. Welby».

My Patient Advocacy Role Is Never Over

This case demonstrates that our work is never over with our clients. Given my relationship and bond with Ellen and Don, I would never have walked away, regardless of the outcomes of the legal case. However, I am now on a new journey with Ellen and Don, and that is to find them the finest health care that money can buy, to help them move into a fully renovated new home which will fulfill their physical needs; to secure an in home team of caregivers so that Don can even consider pursuing his many talents, and even have personal time for himself.

I have been retained by them and my newly defined patient advocacy role is to secure the finest health care money can buy. I am still the patient advocate, known as Dr. Welby.

We as private health care advocates must recognize that our role for some of our clients must be like that of Dr. Marcus Welby. In reality we have the privilege of helping our clients return to the years of the 50’s-80’s, when many Primary Care Physicians were, in fact, Dr. Welby

Avrom Fox, 847- 828- 7497, avromfox@gmail.com, www.chicagopatientadvocacy.com