Surgical patient advocacy: role and value in surgery

Patient advocacy may be necessary during medical care in the home or office as well as during hospitalization in either private or public sector care. Patients may choose a relative, a close friend or a physician as their patient advocate. The patient advocate may provide physical assistance and usually accompanies the patient throughout the course of disease. By agreeing to the presence of a patient advocate during visits, the patient implicitly acknowledges that confidentiality may be breached. Patient advocates may be particularly useful for the patient in case of severe disease or poor prognosis. The advocate becomes an intermediary contact and, at the same time, provides educational, relational and psychological support for the patient. The patient advocate should be consulted when the patient is incapable of making his own decisions. The patient advocate is supposed to be able to express the wishes of the patient, when the latter is incapable of doing so. The patient should therefore choose someone who, in his judgment, is competent to voice the patient's opinion for him. When the patient advocate remains at the patient's side at the end of life, whether in the hospital or at the patient's home, the advocate can benefit from "family solidarity leave" and obtain a daily stipend if this interrupts his or her professional activity.