Sept. 11, 2026
Negotiating the Hospital System
Negotiating the medical system can be challenging. Often, we don’t know what questions to ask, what all the options are, as well as knowing what our rights are in the medical system.
How many times have you gone to see your doctor and left feeling there were more questions to be answered. Some people can benefit from health advocates who have experience and can help patients navigate the system.
This becomes more complicated when entering the hospital. Upon entry, we sign some digital form without knowing wholly what was in it or what we agreed to. We feel ill, worried and perhaps weak, and at that time understanding the system is even more important.
Directed in Advance was created by Laura Echegaray & Oxana Ostrovsky after their shared experiences of being a hospital patient as well as a patient-advocate dealing with the corporate medical gauntlet. If you or a loved one have been in a hospital of late, this will resonate with you. If you have not yet, then knowing what they will teach you could save your life. After the initial emergency passes, the corporate hospital’s interests may not be in your best interests. Common is over-testing, over-medication, and unwise or debatable procedures designed to run up the bill as well as to cover long-shot liability. Then there is understaffing, incompetent staffing, and callous attendants already unhappy with their work situations. When and if you get the direct attention of a staff physician, you have to deal with allopathic bias. All this while you are surrounded by neighborly pain, suffering, and disease.
Laura and Oxana created a different kind of Advance Directives that covers not only standard care, but holistic care, religious belief statement and COVID care. Their stories prove that prayer, holistic care and community support create miracles and change the course of hospital stay. You can learn about them and what they have to offer on their https://www.directedinadvance.com/

Oxana Ostrovskaya Bio
Oxana Ostrovskaya is an educator, community organizer, and co-founder of "Luminary Learning Village", a self-directed learning center for homeschoolers. In 2022, Oxana found herself thrust into the role of medical advocate when she rushed her partner—who was suffering from severe respiratory symptoms—to the ER. Without official advance directives or medical power of attorney in place, she became his patient advocate. After two months in the ICU battling Legionnaires' disease, he survived and was discharged. This experience inspired Oxana to create "Directed in Advance" in collaboration with Laura Echegaray, an initiative designed to empower individuals with the knowledge and tools necessary to advocate for their medical choices in hospital settings.

Laura Eschgaray Bio
Laura Echegaray is a Teaching Artist in the San Francisco Bay Area
In 1997 she trained as a disability educator and advocate to help her Latino clients with disabilities. She also learned to advocate for herself in the medical system, for her sons at school and for her father’s medical needs until his passing in 2020.
In 1997 she trained as a disability educator and advocate to help her Latino clients with disabilities. She also learned to advocate for herself in the medical system, for her sons at school and for her father’s medical needs until his passing in 2020.
In 2003 Laura had a major health crisis during which she experienced a miracle healing and was left with many questions and an insatiable interest for the spiritual, natural and energy healing arts. A second health crisis in 2022 prompted Laura to deepen her knowledge of medical advocacy skills which culminated in the creation of the "Advanced Directives for Freedom People" course, a collaboration with Oxana Ostrovsky.