Breaking Good-Saving Walter White

The series “Breaking Bad” kept TV audiences (including myself) enthralled with all the twists and turns, all fueled by the main character, Walter White, being diagnosed with a terminal cancer that supposedly was only treatable through expensive means.

If only Walter had been able to access a patient advocate's intervention! Patient advocacy is a new field in health care that helps people cope with the overwhelming fog of anxiety and fear that confronts them as they try to navigate towards the correct diagnosis and best possible treatment. “Breaking Bad” would have been shorter and much less dramatic with a happier ending if a patient advocate were involved. Not great for audiences wishing for high drama, but much better for Walter and his family. Here’s a step-by-step process on how a patient advocate could have helped Walter along his way.

#1-Patient Advocate Intervention at time of diagnosis
After recovering from his collapse and initial trip to the ER, Walter sits in Dr. Belknap’s office getting his diagnosis: terminal, inoperable lung cancer. Walter goes into shock, and tragic events soon begin. Rewind to this scene: A patient advocate sits next to Walter and asks Dr. Belknap (very politely) how he can determine this terrible diagnosis and prognosis from preliminary screening tests. A patient advocate would also gently remind Walter that a thoracic (chest) team of experts should be consulted: an expert thoracic radiologist to read Walter's scans, an experienced doctor to take the appropriate biopsy, and a top-notch pathologist to study the biopsied tissue. Walter would have been reminded that such a serious diagnosis shouldn’t be left to just one doctor’s opinion.

#2-Patient Advocate Intervention before treatment
Once Walter’s family knew of his diagnosis, they insisted that he see Dr. Delcavoli, the superstar oncologist. Rewind again: A patient advocate would have carefully checked Dr. Delcavoli’s experience with treating Walter’s exact type of lung cancer and compared it against the experiences and outcomes of other oncologists. The University of New Mexico’s Comprehensive Cancer Center, right there in Albuquerque (with no need to travel up to Santa Fe to see Dr. Delcavoli), would have been considered.

#3-Patient Advocate Intervention with an out-of-network provider
Once the best possible treatment was agreed upon, it would be time to address the cost and insurance issues. As part of the plot twists, Walter’s HMO refused to pay for out-of-network doctors or treatments, which caused Walter to sink deeper and deeper into his life of crime. Rewind once again: the patient advocate intervenes and files a well-researched insurance appeal, documenting the case for plan coverage for Walter’s treatment. Quite often, with diligent documentation, patient advocates can arrange an agreement with the patient’s insurer to access the best possible treatment with the best possible doctor, regardless of the network.

#3-Patient advocate intervention with the cost of surgery
Contrary to the first doctor’s original prediction of being an inoperable type of lung cancer, Walter’s tumor did shrink and was able to be removed via a lung surgery called a lobectomy. No more information than that was given, so it seemed to be a straightforward case. In another plot twist, Dr. Bravenec, the surgeon chosen to do this procedure, came with a price tag of $200,000, necessitating more illegal dealings by Walter. Rewind once more to this scene: The patient advocate gently inquires why the surgery price is so high, based on comparative costs with other thoracic surgeons. In addition, the advocate checks the effectiveness of this surgeon and his outcomes. Working with Walter and the insurance company, the advocate would secure another good surgeon at a reasonable cost. No need for Walter to stay on his destructive path, and he’d be feeling much better, physically and financially.

There you have it. Although a patient advocate could not have completely assured Walter White that his cancer would be beaten back into remission, Walter would have been able to see the bigger picture and know that he had the best possible treatment while saving his family from financial ruin. Walter’s life of crime would have been avoided, and the TV show wouldn’t have lasted a season. Yet, anyone in a similar circumstance would probably prefer to skip the drama and call a patient advocate. That’s what we do, and we’re here to help.