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Volume
1 Issue 2 |
September
2010 |
Dear
Colleagues and Friends,
Welcome
to the September issue of "Patient Navigator News" with articles to
help you become your own best advocate and give you new
perspectives on the healthcare system.
Patient Navigator's mission is to bring health care and
life care together through advocacy, education and a
patient-centered approach to solving problems and overcoming
obstacles in the health care system.
Elisabeth Schuler Russell
Founder and President
Patient Navigator,
LLC
Guiding
your journey through illness
....
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Understanding Palliative
Care
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Many
people mistakenly believe that choosing to accept palliative care,
especially for cancer treatment, means that the patient is giving
up. This is a common but unfortunate misconception.
Palliative care focuses on pain
relief and other measures intended to improve a patient's quality
of life. A groundbreaking study published August 18 by the New England Journal of
Medicine showed that lung cancer patients getting palliative
care from the start reported less depression and happier lives as
measured on scales for pain, nausea, mobility, worry and other
problems. Moreover, even though substantially fewer of them opted
for aggressive chemotherapy as their illnesses worsened, they
typically lived almost three months longer than the group getting
standard oncology care.
We at Patient Navigator have seen
first-hand that pain management and palliative care options are
woefully misunderstood by medical practitioners and patients alike. In last year's health
care debate, any discussion of palliative care to support patients
was cast by opponents as "death panels" and euthanasia. Doctors
lost an opportunity to educate patients about important choices
available to them.
To
learn more about end-of-life issues in the American medical system,
we highly recommend the August 2, 2010 essay in The New Yorker by Dr. Atul
Gawande entitled Letting Go. National Public Radio's Diane Rehm on
August 24 hosted an informative and insightful program entitled "New Studies
on Palliative Care." With a distinguished panel of guests and
lucid conversation, you will learn a great deal by
listening.
Our blog post The Face of Pain will direct
you to more resources on pain management and palliative
care. People living with
chronic pain can also get information from the American Chronic Pain
Association. Let's hope
this study sparks an informed debate about pain management and the
possibilities for help from palliative care.
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The Fine Print of Your
Insurance Policy
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Have
you actually read the coverage and benefits documents provided by
your health insurer? Most of us only refer to them them only if we
need something out of the ordinary or have purchased a new
policy.
Implementation by insurance companies of this year's Affordable
Care Act (health reform) will be confusing. It will be up to each
of us to stay informed. Don't assume the insurance companies will
necessarily make any changes easy to discern.
Here is one example. In 2008, Congress passed the Mental Health
Parity and Addiction Equity Act (this law actually pre-dates health
care reform). As of January 1, 2010, the law basically requires
the equal treatment of mental health and physical health benefits.
Group health insurance plans are prohibited from restricting
access to mental health care by limiting benefits and requiring
higher patient costs than those that apply to general medical or
surgical benefits.
In 2010, we started hearing from clients about mental health
claims that were being denied, although the providers and
diagnostic codes had not changed. We assumed this was a mistake,
but then discovered that the insurer had imposed a
pre-authorization requirement for services that in the past had not
required pre-authorization (although there had been an annual limit
on visits which was now lifted to comply with the law). In
addition, the insurer authorized services only with certain
providers.
This came as a great surprise to the policyholders who did not
recall being notified of this new pre-authorization requirement.
Since they had not obtained pre-authorization, they were
out-of-pocket several thousand dollars. When we reviewed their
coverage document, we found notification of this change, but not
highlighted in a way they would notice.
The moral of
this story: Learn the vocabulary, read your policies thoroughly
and watch out for changes you might not expect.
Check out the Government's new website designed to help
all us understand the new laws. It's a pretty good starting
point.
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Food Science - Part 1
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Food
science is a field gaining prominence among patients with chronic
diseases, nutritional imbalances or cancer who want to attack their
disease and boost their immune systems. They are asking for
nutritional guidance along with their doctors' prescribed
treatments.
We begin this month a series that will focus on the science and
research of nutrition to help you become more informed about food
choices. One easy way to start learning more is by reading Michael
Pollan's book In Defense of Food:
An Eater's Manifesto.
First, some context. Before World War II, food additives, food
colorings, food preservatives, packaging preservatives, artificial
flavorings, artificial sweeteners, trans fats, artificial fats,
xeno-estrogens, pesticides and herbicides were not omnipresent in
the food we ate. Since then, food products using these artificial
ingredients have often crowded out high nutrient whole foods we
might otherwise be eating. (The influence of agribusiness and food
lobbies on this trend will be the subject of future column).
The presence of these toxins in our foods for the past 70 years,
and the related deficiencies they have created, has coincided with
an increase in many types of cancer, obesity, diabetes, Alzheimer's
disease, autism, ADHD, fibromyalgia, food allergies, food
sensitivities and psychological conditions such as dementia,
depression and chronic fatigue. This list of research studies only begins to address
the topic.
Eliminating these artificial ingredients and eating nutrient
dense, disease fighting foods when dealing with any illness can
unburden the body, and supply extra nutrients to build strong
systems capable of fighting disease.
Source: Notes from a lecture by John
Bagnulo MPH, PhD., at the Center for Mind-Body Medicine's Food as
Medicine Forum, Washington, DC. May 2010.
You can visit the Center for Mind Body Medicine's Food as Medicine site to learn
more about this education and training program.
Next month: The six
problems with the current American diet and what to do about
them.
Guest "Food for Health" Columnist
Deborah Roney holds a degree in biology and received her
certification from the Food as Medicine program at the Center for
Mind-Body Medicine in Washington, D.C. in May 2010.
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