Hey Molly, we too have been discussing "patient advocates" and quickly became stuck on what exactly that phrase meant. Wasn't this the hospital social worker once upon a time? Is this a person who gets me what I need when I can't do it myself? Is this a person who might help me navigate through a system of people, places, bureaucracies and such with which I am not familiar? Can one person wear all of these different hats on my behalf? I do think that patients' frustrations with the system, unmet needs, and other things that sour their experience often have little or nothing to do with their physicians; however they are also things that their docs would either be unaware of or incapable of affecting. For example, I know folks get very frustrated getting a particular medication through the precertification process sometimes due to a clerical error. It can take quite a lot of effort to straighten something like this out, and I can see some folks giving up and not even telling their doc they weren't able to get the recommended treatment.

If you can get me past the "bouncer" I'd love to hear you speak! If your book isn't sold out by now, I should have my copy from Amazon by then--do I get the autograph!?

I think if we had a room full of people discussion this topic, as you have it split into subtopics, we'd come up with many examples of low hanging fruit just waiting to be addressed. Most of this post has to do with the doctor patient encounter (for lack of a less sci fi sounding term), there could also be standards and consistency at pharmacies and with insurance companies. No patient should ever walk out of the doc's office with a prescription in hand to find that the pharmacy has some rule or the insurance company has some rule that prevents them from pursuing the treatment or even delays treatment. I have a meeting to go to now, but you've given me stuff to think about...