{"id":19617,"date":"2022-04-29T09:36:37","date_gmt":"2022-04-29T14:36:37","guid":{"rendered":"https:\/\/thepapergown.zocdoc.com\/?p=19617"},"modified":"2026-02-05T08:23:08","modified_gmt":"2026-02-05T13:23:08","slug":"the-compelling-history-of-patient-navigators","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/the-compelling-history-of-patient-navigators\/","title":{"rendered":"The Compelling History of Patient Navigators"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">In the late 1970s, one cancer surgeon at New York\u2019s Harlem Hospital Center found an ongoing tragedy: Black, poor and uninsured women were coming in with advanced breast cancer.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;The women were dying at such a high rate,&#8221; Dr. Harold Freeman recalls. Patients had felt the initial lump often months or years back, but getting screened and biopsied involved long crosstown commutes and bureaucratic thickets. That\u2019s challenging when you\u2019re a single parent, for instance, working long hours to meet survival needs \u2014 which somehow, no one in charge had actually considered.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Freeman made it his mission to change that. In 1979, he created two free Harlem-based clinics screening for breast cancer, at a time when <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3298674\/\"><span style=\"font-weight: 400;\">fighting stigma around cancer was still new<\/span><\/a><span style=\"font-weight: 400;\">. By the late 1980s, he was serving as president of the American Cancer Society. Freeman traveled around the country to gather information on poverty and cancer. That testimony showed that barriers such as medical jargon, lack of insurance, transportation and job security often <a href=\"https:\/\/www.zocdoc.com\/blog\/advice\/1-question-5-answers-what-are-doctors-doing-about-racial-bias-in-healthcare\/\">blocked people<\/a> from accessing cancer prevention and treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At Freeman\u2019s own cancer clinics, he reached out to select people who cared about their communities. They didn&#8217;t necessarily need prior education in cancer, but compassion and intelligence. A new kind of health professional emerged: patient navigators.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;People didn&#8217;t trust the system,\u201d says Freeman, \u201cbut when we brought in people who were from the community and spoke the language, problems were solved at a different level when one on one with someone they trust.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a result of <a href=\"https:\/\/www.zocdoc.com\/blog\/guides\/usptf-colon-cancer-breast-cancer-screenings\/\">free screenings<\/a> and patient navigation, the five-year survival rate at Harlem Hospital Center went from <\/span><a href=\"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full\/10.1002\/cncr.26262\"><span style=\"font-weight: 400;\">39 percent to 70 percent<\/span><\/a><span style=\"font-weight: 400;\">. In 1990, Freeman founded the <\/span><a href=\"https:\/\/hpfreemanpni.org\/\"><span style=\"font-weight: 400;\">Freeman Patient Navigation Institute<\/span><\/a><span style=\"font-weight: 400;\"> to train navigators from across the country and around the world.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<h3>Patient navigators and our systems<\/h3>\n<p><a href=\"https:\/\/aonnonline.org\/education\/helpful-definitions\"><span style=\"font-weight: 400;\">According to<\/span><\/a><span style=\"font-weight: 400;\"> the Academy of Oncology Nurse and Patient Navigators, the patient navigator is a non clinically trained patient point of contact. They provide help with logistical, structural and social needs, along with cultural considerations.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While traditionally, they\u2019ve helped cancer patients navigate the healthcare system, more recently, they have popped up in <\/span><a href=\"https:\/\/www.statnews.com\/2016\/12\/14\/patient-navigators-hospitals\/\"><span style=\"font-weight: 400;\">pediatric care units<\/span><\/a><span style=\"font-weight: 400;\"> and other areas of the medical system. Recent national and international research associates patient navigation with improvements in<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8118317\/\"> <span style=\"font-weight: 400;\">patient engagement<\/span><\/a><span style=\"font-weight: 400;\">,<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8118317\/\"> <span style=\"font-weight: 400;\">reduced costs<\/span><\/a><span style=\"font-weight: 400;\">,<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8519430\/\"> <span style=\"font-weight: 400;\">cost effectiveness<\/span><\/a><span style=\"font-weight: 400;\"> and<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7901799\/\"> <span style=\"font-weight: 400;\">follow-up care<\/span><\/a><span style=\"font-weight: 400;\"> for strokes, HIV, colonoscopies and more.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As another public health benefit, navigators<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8555047\/\"> <span style=\"font-weight: 400;\">increase <\/span><span style=\"font-weight: 400;\">access<\/span><\/a><span style=\"font-weight: 400;\"> to screenings and health services for people with chronic conditions who tend to underuse health services.<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8160175\/\"> <span style=\"font-weight: 400;\">More studies offer<\/span><\/a><span style=\"font-weight: 400;\"> promises for the future, such as using patient navigators in<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8310741\/\"> <span style=\"font-weight: 400;\">postpartum care.<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\">Nurse navigators fit into a slightly different category. They are clinically trained to guide patients from diagnosis through survivorship, often acting as a central point of contact and coordinating care, including with surgical, medical and radiation oncologists. Since 2015, the American College of Surgeons has<\/span><a href=\"https:\/\/aacrjournals.org\/cebp\/article\/21\/10\/1614\/69026\/The-Origin-Evolution-and-Principles-of-Patient\"><span style=\"font-weight: 400;\"> required patient navigation services<\/span><\/a><span style=\"font-weight: 400;\"> as a standard of care for any cancer center seeking ACS approval.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">&#8220;[Nurse navigators] end up streamlining care,&#8221; says Sharon Gentry, program director at AONN. When she first started, women might have to ping-pong between a breast clinic and a hospital to undergo a simple breast biopsy. Some in Gentry\u2019s North Carolina clinic were already traveling from rural Appalachia to receive care, hours away.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;In healthcare, we get so busy in our day-to-day silos, we forget how a patient goes through the system,&#8221; Gentry says. As the patient navigator, she could bring the silos together and develop creative solutions, such as a more holistic biopsy process.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">If a patient is terrified at the mention of chemotherapy, that fact is something the patient navigator can mention to the physician. &#8220;We can give a heads-up to the doctor that they might want to prepare and soften delivery,&#8221; Gentry says. &#8220;The better we understand the patient, the better they can receive the information.&#8221;<\/span><\/p>\n<h3>A day in the life<\/h3>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">At Seattle Cancer Care Alliance, newly diagnosed patients sit for an intake appointment with a navigator, says Anne Devine, an SCCA patient navigator and manager. An assessment discovers any needs: whether someone needs a ride to appointments, financial assistance for co-pays or an eligibility determination for temporary disability.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Devine says that for each 15- to 30-minute phone call, there&#8217;s typically another three hours of work between finding resources, sending mail and email or helping the person apply for financial grants and assistance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Navigators aren&#8217;t like counselors, she points out. However, providing information and resources can reduce anxiety for many. &#8220;We do a lot of sleuthing after we meet with someone,&#8221; Devine says. Thanks to recent grants, although navigators work with all populations, the staff has expanded its culturally competent care with Indigenous, Black and Asian American\/Pacific Islander\u2013focused navigators.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Just as in the 1970s, people still worry about taking time off for treatment or job loss, which can lead to money, housing and coverage issues. But navigators are helping to bridge gaps and overcome obstacles. &#8220;Society has a lot of inequity, but the greatest inequity of all is inequity in healthcare,&#8221; Devine says.<\/span><\/p>\n<hr \/>\n<h1 class=\"p1\"><span class=\"s1\">Ready to book a doctor\u2019s appointment? Visit\u00a0<a href=\"https:\/\/www.zocdoc.com\/\"><span class=\"s2\">Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"<p>For years, people died of preventable illnesses \u2014 until one doctor created a new role within the healthcare system. <\/p>\n","protected":false},"author":32,"featured_media":19618,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[229],"tags":[103,108,81,106],"class_list":["post-19617","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-trends","tag-prep","tag-doctors-and-patients","tag-preventive-care","tag-treatment","reviewer-dr-nassim-assefi","specialist_by_city-find-primary-care-physicians-near-you"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Compelling History of Patient Navigators - Healthcare Trends<\/title>\n<meta name=\"description\" content=\"For years, people died of preventable illnesses \u2014 until one doctor introduced patient navigators into the healthcare system.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/the-compelling-history-of-patient-navigators\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Compelling History of Patient Navigators - 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