Article Summary

I once heard former Surgeon General, Jerome Adams, M.D. state that 70% of people with chronic disease fail without support.  I started thinking, “What happens once people receive a diagnosis?”  If someone has never asked for help before, how do they start that conversation?

Does my identity suddenly become the illness?  For example: Would you say, “I’m a diabetic?” Or, would you say, “I have diabetes”? A person with diabetes is so much more than the illness, yet what goes through a person’s mind who has a diagnosis?  How do they begin a conversation for help?  If only 30% of people succeed without support who is most likely not to ask?

People who have a difficult time managing daily life skills remain at the top of the list for failing.  They don’t know what resources for help exist, let alone navigating how to access them.

People who are used to being in charge, never asking others for something, and thinking they can manage on their own are also at a high risk for failure.

What if support was readily available?  What if we weren’t handed a list of specialists, a list of support groups, a list of information, but a human being explained our options and offered to make these initial calls for us, or arranged for services?  Imagine if patients didn’t have to make that first call, saying the words out loud, that they have cancer and need help.  Envision a CHW (Community Health Worker) calling on our behalf, starting the conversation, and leading us to a more successful journey.

Do medical providers say to patients when they leave their office something like, “Well, you get a good night’s sleep and I’ll see you tomorrow.”  Did we know if the person had a bed or lived in an environment where that was impossible?  How do we ask the next question?  How do we learn or explore the social determinants of health with patients?  Deploying a workforce of community health workers who can ask the next question and assist with phone calls, transportation, appointment setting, housing and other fundamental needs take such added burdens away from the patient.  Building a network of support is vital especially if the patient has no one.  Sometimes the patient can’t express the words and their needs to family members.  The CHW who is well versed in this area can explain to family members, friends, and the patients’ support network.  This is often helpful when the patient has expressed wishes for care that is difficult to communicate to their families.

Medicare and Medicaid have traditionally allowed payments for direct treatment.  They have not allowed for reimbursement for these very needed social services.  Without these social services in place, patients are falling through the cracks.  Sometimes it’s hard enough to manage life without having to manage an illness that wasn’t wanted, wasn’t planned, and changes our whole being and purpose in life.  We need to strongly look at a payor system to include these vital services.

Peer recovery specialists/coaches, those with lived experience, can be of exponentially higher benefit.  For the woman who received a diagnosis of breast cancer, speaking to a breast cancer survivor can have a powerful impact on recovery. For those who struggle with sobriety, having a peer, someone who has walked in their shoes, can lead to a completely new life filled with positive possibilities instead of negative consequences.

The examples of positive outcomes are tremendous, and the possibilities are endless with building the supports from this paraprofessional network.  We must ask the next question.  We must listen to the answers so we can fill the gaps in service and empower a healthier community.