Neti Pots, Nurse Ambassadors & American Healthcare

The more important question we should be asking is why nurse ambassador programs are both popular and necessary. The answer, of course, is that they serve to address fundamental flaws in the American healthcare system.

Just like many healthcare providers, nurse ambassadors are faced with ethical issues that are very specific to the role they play. At some point, it may be worthwhile to come up with a code of ethics for nurse ambassadors to provide them with external guidance on how to act in tricky situations and, more importantly, to provide them with cover when their obligations to the patient conflict with their obligations to their employer.

That said, the existence of nurse ambassadors are just a symptom of an illness. I can understand why they have been targeted by regulatory agencies, but I hope no one believes that getting rid of nurse ambassadors will cure the disease. The more important question we should be asking is why nurse ambassador programs are both popular and necessary. The answer, of course, is that they serve to address fundamental flaws in the American healthcare system.

Nurse ambassadors may help complete paperwork that is necessitated by pharmacy benefit managers to maximize profits, under the guise of shepherding the use of expensive drugs. Additionally, nurse ambassadors provide the individualized follow-up that I’m sure many of us would be happy to provide personally, if only we could convince our employers that such time was well spent.

Biologic agents are a $125 billion business in the U.S.¹⁰ The financial stakes associated with their judicious use are enormous. But the personal stakes for our patients are enormous as well. 

Instead of attacking the consequences of our healthcare system, we need to think more fundamentally about how we can redesign American healthcare to serve patients and not profits. Because as all of us know, addressing symptoms doesn’t make the patient better. You have to treat the disease.

Philip Seo, MD, MHS, is an associate professor of medicine at the Johns Hopkins University School of Medicine, Baltimore. He is director of both the Johns Hopkins Vasculitis Center and the Johns Hopkins Rheumatology Fellowship Program.

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