Mission Possible: Access to Care for All.
Lynette Marte-Gonzalez joined the Pancreas Center as the New Patient Coordinator in 2010.Lynette Marte-Gonzalez
In her role as the new patient coordinator, Lynette helps to make new patients’ experience at the center as easy, efficient, and smooth as possible. In particular, Lynette is on the front line of the center’s highly proactive approach to ensuring that patients receive appointments very quickly, that they see the right specialists for their health issues, that records are in order, and that any issues with insurance, language barriers, or other problems are addressed. In this interview, Lynette tells us about the Pancreas Center’s unique process and how that helps to provide the best care possible to patients with pancreatic diseases.
Q: What are some of the common difficulties patients face when seeking care?
Lynette: The most significant difficulties involve insurance, limited referrals from primary care providers, language barriers, and overall unfamiliarity and fear of navigating through the hospital system. Some patients are afraid to even call the center because they think it will take many months to get an appointment, which is completely unfounded.
Q: How do you address each of these issues? Let’s start with insurance, since that is at the top of the list.
Lynette: We see several common problems with insurance. First, readers should understand that the center includes specialists in Surgery, Interventional Gastroenterology, and Oncology (cancer treatment). In some cases, a person’s insurance may be accepted by a physician in one specialty, but not another. Medicaid is accepted by most practitioners, but not all. To address this complicated situation, we have implemented the policy of having people come for treatment regardless of their insurance policy – and we’ll find a way to make it work. Always.
Q: How are you able to provide care if insurance is not accepted or if the patient does not have insurance?
Lynette: We are creative and resourceful, and we have enough specialists available at NYP/Columbia that we can assemble the right teams to work within these constraints.
Perhaps most importantly, we have an excellent system in place in the form of our weekly multidisciplinary conference. Every Thursday, our entire team meets to discuss every new patient’s case. These meetings are directed by the Pancreas Center Director, John Chabot, MD. Many people come to the center specifically because they want to receive care from him. Even if their insurance will not work to have him as their primary surgeon, they still receive care from him in several ways. First, at our multidisciplinary conference each case is reviewed by the surgeons and physicians to determine their plan of care. Second, if surgery is required and insurance will not allow him to be the primary surgeon, he may still participate in surgery as the assistant, along with one of our other highly experienced and qualified surgeons.
In some cases, the out-of-pocket costs present a problem for patients. In these cases, the Pancreas Center will find a way to make it work. Bottom line, if a patient needs care, we find a way to provide it. If the hospital accepts the insurance at all, we can make sure the patient receives care.
Q: Tell us about the issue concerning referrals from primary care physicians.
Lynette: At the time of service some patients may require a written referral from their insurance plans. The patient may be unaware that the referral is needed, or the outside doctor may have simply not provided it, or sometimes the issue gets lost in the mix if the patient’s first language is not English. Regardless of the cause, we do the legwork by determining what is needed and obtaining the proper referral by contacting the appropriate offices.
Q: Are language barriers a common issue?
Lynette: Here in northern Manhattan, we see many patients who may not speak English or speak it well. We do several things to work with this issue. First, we have Spanish speaking staff including myself, and we will provide translators for patients who speak virtually any other language. Second, before patients come in for their appointments, we send paperwork home and give them a week or so to fill it out. We will send it by email or regular mail, whichever the patient prefers. Then, if they need the assistance of a translator to complete the forms, there is time to do this before the appointment. That way, during the appointment we can all focus on the exam, reviewing records, and determining the patient’s plan of care, without getting delayed by incomplete paperwork.
Q: Does it take a long time to get an appointment at the Pancreas Center?
Lynette: No, we make sure we schedule patients very quickly. The goal throughout NewYork-Presbyterian/Columbia is to schedule patients within 14 days. At the Pancreas Center, we schedule patients to come in within 7 days, and we are striving for even better.
In many cases, the patient does not know which specialist he or she should see. My first step, therefore, is to obtain all the patient’s records and have them reviewed by our physicians. That review ensures that we make the appointment with the correct specialist who can address the person’s condition correctly.