PRIVATE patient advocates are sitting in on medical appointments to check patients understand what they are hearing and ask the right questions.
They are also helping people gather second and third opinions on diagnoses and treatments and mediate disputes when patients have concerns about their care.
Doctors, though, are concerned about the trend, and Australian Medical Association president Dr Steve Hambleton said the answer to better care was to add more resources to the system, not private advocates.
Private patient advocacy is already big business in the US and Britain, and it is just starting to emerge in Australia.
A new Victorian company called Patient Advocate is offering what is believed to be the first fee-for-service model, where people can employ an advocate to step in and try to resolve an immediate concern in the health system at any time of the day.
The business, created by lawyer Claire Crocker last year, has assisted nearly 100 patients and has provided some with a ''by your side'' service, where an advocate shadows you at particular times to ensure an ''extra set of eyes and ears'' monitoring your care.
While fees vary according to complexity, distances travelled and the time of day, the service costs about $100 an hour.
Most hospitals already offer patient liaison officers to assist people with concerns during business hours, but they are employed by the hospitals, so represent their employers' interests as well as the patients'.
Ms Crocker said she realised there was a gap in the market when she helped a relative through complex care. The experience showed her how easily patients' individual needs could get lost in a complicated and increasingly corporatised health system.
''People are not people any more, they are a patient to be moved through,'' she said. ''You might have a relationship with a clinic these days, but not one doctor, so the burden is really on the patient to ensure there is continuity in their care.''
Ms Crocker said her business had helped people requiring one phone call to sort out a problem right through to people needing meetings to be set up with several parties. In one case, she helped a patient whose illness persisted after 14 surgical operations find alternative care.
''We basically said, 'that's enough, who is the best surgeon and physiotherapist in this area', and we got them to work together. It turned out that person did not need any more surgery,'' she said.
Ms Crocker said her five employees, who have legal, healthcare and advocacy backgrounds, did not provide medical or legal advice or make decisions for people, nor were they a replacement for medical powers-of-attorney or next of kin. Instead, they could help make sure people were informed and confident about the decisions they were making.
Private advocacy is also growing in the obstetrics field, with more women paying $1500 for a private midwife to escort them to hospital while they are in labour.
While these midwives cannot deliver babies unless they have an agreement with the hospital to do so, many offer their services as advocates to guide women on the best time to go into hospital and to help them make informed decisions about their care when they are there.
Jan Ireland, a midwife with more than 30 years' experience, said an increasing number of women wanted this service because they wanted to avoid particular interventions in hospital or had had a traumatic birth in the past and wanted help to change their next experience.
Dr Hambleton said he was concerned about the trend because doctors and other healthcare workers should already be trying to accommodate patient needs and listen to their concerns as a matter of course.
''Good medical practice is founded on quality communication between doctors and patients. So, I accept that this service exists but I would hope it is unnecessary,'' he said.
Dr Hambleton also questioned the need for private midwives to be escorting women during hospital births.
''I'm worried about that. You don't want women who have never had babies thinking they need to spend an extra $1500 so someone can hold their hand … I wouldn't like to think that is a common view.''