Amanda Millman knows who to call when someone receives a breast cancer diagnosis and needs an appointment as soon as possible. He also knows how to navigate long wait times to see a specialist or how to get prior authorization for surgery.
A year ago, Melman combined her hospitality background with her medical experience to create a South Florida business that mobilizes and advocates for people in need of healthcare.
In Florida’s complex and frustrating healthcare environment, a profession is made up of people who work independently on behalf of clients to coordinate their medical care.
“A lot of people don’t know that someone like me exists,” said Melman, founder of Hospitality Health of South Florida.
While working in business development at Memorial Health Care System, Millman said she would get calls from friends asking her to recommend doctors and help her get appointments. Her father was the CEO of Memorial South and he knew a lot about health care. Her business idea came from recognizing a need.
“I saw that people needed help accessing the right doctors,” she said.
Millman said she recently had a client who was a breast cancer survivor and got suspicious findings on a screening. “She had tried to come in and was told she would have to wait eight weeks for a mammogram. I called on Saturday and she was seen on Tuesday.”
The career begins
Over the past decade, especially after the pandemic, the field of health care advocacy has evolved to encompass a variety of services that help patients and families navigate the complex, expensive medical landscape. Each independent advocate works separately, doing everything to help people figure out how to take the next steps after a diagnosis to fight insurance companies to get patients faster for tests or a second opinion.
It’s a service Stuart Kaufman, a plant attorney, took advantage of when he was diagnosed with cancer. He hired Melman Hospitality Health a few weeks after his diagnosis, learning about it from a friend.
“While I went through chemotherapy and radiation — seven rounds of chemo, 35 rounds of radiation — she helped me with everything in terms of scheduling,” Kaufman said. “If I wanted to reschedule something, she was the point of contact rather than them contacting me. She took all the calls and made all the calls to the insurance providers to make sure I had coverage for everything. She took all my weight so I could just focus on my treatment and recovery.”
Kaufman said Millman went with him to his first chemotherapy appointment and his last radiation treatment. He retained her services on a monthly basis and used her services several months after the last treatment to manage all the insurance paperwork. “She made an offer for any kind of payment that I didn’t get,” he said. “She took it all off my plate so I could just focus on what was really important.”
Recognizing the same patient need as Melman, Tammy Creek started Mubarak Advocates in Orlando.
“Our health care system is crazy to move and it’s getting crazier,” Crick said. “This business is all personal pay, but some people can’t help but help, whether it’s me or someone else.”
A former nurse for 20 years, Crick said she schedules doctor’s appointments for patients and coordinates care among multiple specialists. She helped clients find alternative holistic therapies, attended their doctor appointments, and managed all follow-up care. She discovers that the doctors understand why she joins the patients, and seems to like it. “They know someone is listening and following them.”
Crick said she started her business in 2018 after helping her brother through cancer treatment. She has seen her career grow and develop. “Every client is different. Every situation is different. So I’m always learning new things.” Crick is part of a nationwide network of patient advocates. “It helps because we ask each other questions and learn from each other.”
Hospital patient advocates, what’s different?
Over time, hospitals and clinics have begun employing clinically trained patient navigators to manage the needs of patients within their healthcare systems and support discharge planning. Hospital navigators perform administrative tasks such as helping patients schedule appointments, sending orders for diagnostic imaging, or filling prescriptions. Their loyalty, however, is to their employer.
Nonprofits also use patient advocates. At Hope and Help in Central Florida, a clinic and pharmacy serving low-income individuals, patient assistants and patient navigators speak multiple languages. About 15 of them work for non-profits and guide patients to better health outcomes. They help patients make appointments within the clinic and with partners and specialists in other health systems. They also help patients access health benefits and get medicine – all for free. “Just being our customer or our patient unlocks all of these resources for you,” said Teresa Giles, CEO of Hope & Help.
When it comes to private advocacy, there’s no business model or list of services, said Patient Navigator founder Elisabeth Schuler, a Virginia-based patient advocate and founding member of the National Health Care Association. Going by the titles of patient advocate or navigator, some professionals work only with older adults, others only with cancer patients and still others only to solve medical billing problems or manage care coordination.
A member of Schuler’s staff specializes in identifying and enrolling patients in clinical trials.
Fees can range from $50 to $400 an hour, depending on the attorney’s location, experience, and track record.
A pioneer in the field, Schuler worked as a foreign service officer and started his business in 1998 after the personal experience of navigating his teenage daughter’s brain tumor care. Now he helps others navigate the medical complexity they find themselves in and specializes in care management — getting experts to talk so tests aren’t duplicated and researching the best treatment options.
“When you’ve been given a scary diagnosis, you want someone who knows the ropes, knows where the mines are, knows how to navigate the world of health care and hospitals and find the resources and help you need,” she said. “People are hiring personal trainers. They’re hiring coaches to help them write their kids’ college applications. I think people with health care are starting to realize, ‘I’m not doing this alone. I can hire someone.’
South Florida SunSentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
How to find a defense attorney
The National Association of Health Care Advocates offers a searchable directory of members on its website, as does AdvoConnection and Greater National Advocates. Word of mouth or a personal referral from a patient is always a good way to find a navigator. Some advocates may be certified by the Patient Advocate Certification Board.
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