Harold p. freeman patient navigation institute
•
•
The Birth of Patient Navigation
Healthcare navigators are an important component of cancer care, but what are the origins of the idea of patient navigation?
At the 2015 Oncology Nursing Society annual meeting, Harold P. Freeman, MD, Founder and President of Harold P. Freeman Patient Navigation Institute, described the establishment of the first patient navigation institute for patients with cancer in the United States. After the presentation, Dr Freeman received a standing ovation from all present for his contributions to US women’s health.
Initiating Oncology Care for Low-Income Patients
Dr Freeman was trained as a cancer surgeon at Memorial Sloan Kettering Cancer Center, and in 1967, he went to work at Harlem Hospital in New York City. At that time, Harlem was home to low-income African Americans. He noted that women presented to his practice with late-stage ulcerated masses on their breasts.
“This changed my life and direction. I wondered how that could happen in America, and I wondered what I could do to help,” he told listeners.
He listened to what these women told him about the hurdles they faced in accessing healthcare. “The bottom line was that the process of being diagnosed and treated was more painful than the lump they came in with,” he continued.
To comb
•
The History and Principles of Patient Navigation
In 1971 President Richard Nixon declared a war on cancer and signed the National Cancer Act. During the past several decades since this declaration, the nation has made extraordinary progress toward a far better understanding of the molecular, cellular, and genetic changes resulting in cancer. We have also seen significant declines in overall and site-specific cancer mortality1. This decline in mortality has been attributed to improved cancer prevention, screening, and detection measures as well as the application of more effective and more targeted cancer treatments.
However, some Americans (such as the poor, uninsured, and underinsured) have not shared sufficiently in this progress as measured by higher mortality, lower survival, and 5-year cancer survival2, 3. These findings suggest that there is a disconnect between the nation’s discovery and delivery enterprises; a disconnect between what we know and what we do (Fig 1).
Figure 1.
Open in a new tab
Disparities occur when beneficial medical interventions are not shared by all. Moreover, health disparities arise from a complex interplay of economic, social, and cultural factors. The model presented in (Fig. 2) illustrates the overlapping factors of poverty, cultu