Komal Kay Rajan – My Mother and Inspiration for HPA

My interest in medicine and, ultimately, the reason I started this patient advocacy business was due to my mother’s battles with medical illness for over half of her life. When I was six, she was diagnosed with an autoimmune disease called IgA nephropathy, which required her to get a kidney transplant one year later. She required a second kidney transplant when I was 14. Eight years later, she developed end stage kidney disease again, but she could not get another transplant, so she was put on dialysis.

Being on chronic dialysis was difficult enough, but she developed so many other health problems later on that it became difficult for her physicians to handle it all. She had different doctors for different problems at different times, but each one had limited time to spend with her. Oftentimes, there wasn’t anyone who could oversee everything and “put it all together” for her. She usually had more questions than anyone had time to answer. Sometimes, she was given the wrong diagnosis or treatment, and a few times she was treated less than appropriately by medical staff. She became scared and, at times, mistrustful of the medical system, and she didn’t know where to turn.

By the time all these problems started, I was in my fourth year of medical school, so with the knowledge and experience I had, I got involved as a mediator between my mother and her different health care teams. I would explain to her doctors her entire medical condition and history, explain to her what the doctors wanted to do and why, and bridge any divides between her and her health care teams. During my residency and fellowship, as I acquired more knowledge and experience with the health care system, I was able to do more to advocate for her care, including helping her doctors come up with the right diagnoses and best possible treatment plans for her various problems. For the eight years I advocated for my mother, I was able to help optimize her medical care and improve the quality and length of her life by three years more than what was expected based on her condition.

During the time I was advocating for mother, I noticed there was a lack of health care advocates for patients/families facing major health problems like my mother did. Of the few health care advocates who are available, most are not medically trained. I also noticed and felt during my residency and fellowship training how doctors are under increasing pressure to see more patients in less time. This is due to increased health care needs of the public with a limited supply of health care providers, combined with progressively declining insurance reimbursement rates for a doctor’s time, forcing doctors to squeeze in more patients per hour to stay financially viable. On the other hand, procedures and tests are better reimbursed, which is one reason why patients find themselves receiving less of a doctor’s time, but getting more tests and procedures instead.

The problem with all of this is that patients and their families need more than just a couple of minutes with their doctor, especially when a patient is very ill and their families are very scared and confused. Medicine is both a science and an art, and the art of medicine is the time it takes to listen to, educate, and comfort patients and their families. It is this “art of medicine” that is dying in our current health care system, and that is why patients and families feel less quality in their health care today, even though the science has improved.

By the time I finished my fellowship training in nephrology, I felt like it was time to CHANGE the health care system, not perpetuate its problems. There was no better place to start than in my hometown of Houston, Texas, home to arguably the largest health care center in the world, yet somehow previously lacking a health-related private patient advocacy service. Therefore, I created this patient advocacy practice so that patients and their families could spend as much time as they want with a medical professional to feel more educated, empowered, and comforted during their time of need. I will look after you and your family the same way I looked after my parents . . . . and that shall be how I honor their legacy.

Dedicated to my late mother, Komal Kay Rajan, whose life’s story inspired the creation of HPA, and to my late father, Dr. Renga Ray Rajan, whose life’s hard work and sacrifice made HPA possible.Renga_Ray_and_Komal_Kay_Rajan