What is a Personal Medical Advocate (PMA)?

During periods of poor health, patients often need someone to help look out for their best interests in all sorts of important ways. Coordinating the details of their doctor’s recommendations, 
keeping track of appointments and treatment scheduling, observing the delivery of the care, and navigating the confusing healthcare system can be a full time job in itself.

It is during this hectic time that having an advocate to help observe (and intervene if necessary in) the way in which care is delivered within the hospital setting (for example, acting as the patient’s hand hygiene champion) can be the definitive safeguard that may very well actually save the patient’s life.

That’s why many patients opt to wisely recruit a close friend or relative to help them so that their own energy resources may be reserved to better focus on the recovery effort. This specific need for that kind of a helper has created a new role called the Personal Medical Advocate (PMA).

Simply stated, a Personal Medical 
Advocate is a patient-sanctioned “care manager” of sorts; one who, with the patient’s best interests at heart, assumes not only the role of helper, but oversees and orchestrates the logistics of prescribed care, able and willing to step in for the patient should it become necessary to do so.

The full extent of the role and in what capacities the PMA may be called to act in are different for each situation and are largely shaped by circumstances, diagnosis and the personal preference of each patient. The responsibilities of this significant role are many and can easily extend far beyond this initial definition.

A PMA need not be an expert medical 
professional; A PMA may simply be a member of your family or a close friend. Anyone willing to assume the role can act as a PMA but they should first understand that their duties are not to be taken lightly, for much time and effort is usually part and parcel of this important capacity with the medical outcome and future health of the patient potentially at stake.

Choosing the Right Person to be Your Personal Medical Advocate

Above all, select someone you trust and communicate well with. All of the other advocacy skills in the world are useless if a basic bond of trust is not 
present or if your advocate is unable able to understand your personal wishes and preferred path. Also, it’s important to pick someone who understands what they’re agreeing to when they consent to 
assume this partnership in your care. Acting as someone’s PMA is usually a time-intensive 
commitment and it’s important to make this clear right up front.

One of the worst things that can happen is thinking you are all set, beginning treatment or hospitalization and then having your PMA become overwhelmed, not having been properly prepared for what his / her role really would mean and suddenly leaving you to deal with everything alone and unprepared.

Discussing the talking points below together is a good way to begin dialogue with a potential Personal Medical Advocate so that you both 
understand what is or may be involved in the commitment.

Remember that some of the best advocates will be people who can be assertive without alienating 
others and who have good listening as well as communication skills. You’ll want your PMA to be able to step in for you in a proactive and dynamic way when 
you may not be able to, at the same time being 
careful not to leave a trail of social carnage and ill-will behind among health care workers and other care givers who will still be delivering your care.

First Considerations

Decide what you think you’ll want help with and what you’ll want to handle on your own. Think about topics you’ll want to discuss with your 
candidate beginning with these potential areas 
of need:

Help with formulating your options regarding the way forward - specialty hospitals, choice of 
doctors, diagnostic tests, and procedures or 
treatment choices.

Getting more comprehensive information on your 
specific illness or procedure. Helpful information like: What kinds of new innovations are currently being used? How successful are they? Will your insurance cover these procedures?

Writing down information that you receive from your caregivers, as well as any questions that you may have. Keeping a notebook or care journal is essential to staying organized and remembering what the 
doctor says verbatim.

Deciding if you would like your advocate to 
accompany you to tests, appointments, treatments and procedures. If so, inform your doctor and other caregivers that you would like your PMA present.

Treatment decisions? Will your PMA be someone you’ll want to voice opinions regarding your 
options or do you want them strictly for practical, organizational purposes?

Arranging for your designated advocate to be the information point person for the rest of your family. When you decide on a PMA, you’ll want to make sure your other family members are aware of this decision. Doing so will provide a crucial 
consistent communication link for your caregivers
so that any confusion about your progress is at a minimum. Make sure your doctor and nurses have your chosen PMA’s phone number. Let your physician and those who’ll be caring for you know who your advocate is and how you’d like them 
involved in your care.

Also, make sure he / she has the numbers for your doctors, insurance providers, treatment 
hospital and nearest pharmacy, family members home and cell phones, friends and any other emergency numbers. All of this information should be written in the front of the care notebook and kept with you at all times. Discuss with your PMA how much information you’d like to be shared with each friend and family member.

Absolutely make sure you have important paperwork in order. Living wills, medical power-of-attorney if you desire one, etc.

Personal Questions to Consider Before Agreeing to Become a PMA:

Are you able and comfortable assuming this amount of additional responsibility in your life? Keep in mind you also have family and other 
responsibilities that may limit your participation. Your family or significant other may have something to say about your potential commitment.

Do you have the time necessary? Stamina? Are you emotionally equipped to step into this type of potentially stressful important position?

Can you be organized so that, if asked, you can carry out requests like arranging transportation to and from medical appointments and calling friends at intervals with the latest reports on your patient's progress?

Other Things to Remember

The most important way that you can take care of your patient while in a health care setting like a hospital is to be vigilant about asking everyone who touches them to wash their hands before and after touching them or objects in the room - every single time. With health care acquired infections 
infecting 3 Americans every minute of every day 
(1.7 million people per year) according to the Centers for Disease Control and Prevention, this important step is not an option anymore.

Also, remember that the question is the answer. Ask. Ask. Ask. In situations you are unclear - ask, “What does that mean?” "What are the choices? What should we expect? Is this normal? Is this an emergency?"

Trust your instincts. If something feels wrong, it just might be; go ahead and ask or voice your concern if you feel an internal “red flag”. Better safe than sorry.

When you have something to say to the doctor tell him you know he’s busy and just need 2 minutes to talk – then talk from a list you’ve made beforehand if possible. Write down important points you don't want to forget so you can remember them later.

Educate yourself as to what kind of illness or procedure your patient is dealing with. Read a book; PMAs spend lots of time just sitting and waiting so you might as well read up on everything you can relevant to your patient and their diagnosis. Also, the internet is an abundant source of knowledge. If you have the opportunity - Google, bookmark and print.

If at anytime, you find yourself feeling absolutely ill at ease regarding your patient's care or are having a problem in how care is being delivered and cannot get it resolved with the head nurse or through your doctor, politely ask to speak to a hospital administrator or a patient representative.

Our best advice: Stay calm; you're here for the long haul and upset is good for no one. Seek out and utilize your own spiritual strength or other calming resources you may have access to. Keep your ears open. Ask, ask, ask. Insist if necessary but try to do it 
politely. Be kind. Try your best to smile when you can, being grateful for even the small things that suggest progress is underway. Rest. Care. Breathe.