Letter to the Editor

I read the article in Tuesday's Wall Street Journal on Patient Navigation with interest.  But more interesting were the slew of negative comments about "added" or "unnecessary" expense of the navigator.  I was compelled to write a letter to the editor (which will not be published most probably) so I am sharing some thoughts via the blog!

Only someone who has luckily never had a chronic disease or a surgery would suggest that the Doctor was all you need to manage your healthcare experience and your healthcare outcomes.  Navigation is fast becoming the norm.And a necessity.

What is navigation?  It is the support and coordination that most patients need to understand and make the most of the care available to them.  Usually provided after an assessment by a social worker or nurse, it can range from something as simple as directions and a parking voucher, to accessing wigs, interceding with employers, explaining the appointment system, arranging transportation or housing to deciding on participating in a clinical trial.  Most patients and families in these complex and costly treatment cycles need support and navigation is there to provide whatever support will facilitate care.

Navigators do not replace clinical teams.  They are part of the team.  They support and reinforce patient education.  They arrange support groups.  They open doors.  They do not diagnose, or determine treatment options.

This is an expense that makes a difference both in lives and in overall cost of care. 

Our study of navigation among different ethnic groups who historically have had disparate care, showed a significant improvement in the compliance with care regimens for late stage high risk patients.  In addition, for those patients with Medicaid or no insurance, navigation made a significant difference before and after navigation in the patients ability to access care in a timely and cost effective manner.  Compliance saves lives and navigation improves compliance.  Its that simple.