Patients and Physicians Speak Out

I'm a breast cancer survivor. I live in a rural area in southern Illinois.The red tape I go through is insane, especially to obtain my breast MRI each spring that's ordered by my breast surgeon. It scares me because if my cancer does return, I want to be able to begin treatment as soon as possible, without waiting to wade through a bureaucratic mess.

Yes. My husband went without blood thinners for two months because we switched insurance carriers (because I switched jobs and had no choice). He could have had a stroke or pulmonary embolism, but the insurance company doesn’t care!

And then you may have to argue with an insurance worker who is looking at a chart and knows NOTHING about medical care. I know, I was a medical office manager. I had to go to supervisors and argue my case why a patient needed a procedure.

I feel that prior-auth has been one of the worst things to affect physicians' lives, along with Medicare and insurance companies' constant assault on physicians’ ability to do the right thing in the most efficient manner for their patients. This is all labelled as "monitoring" so that patients are getting proper care. It is a huge wastage of resources. One can write a big dossier about everyday examples of this. I have heard from many many excellent physicians that this is the main driving force behind physicians' consideration of early retirement, and that includes myself.  

Never have I encountered a reasonable situation where filling out a prior authorization was important either for the patient or myself. It can delay important medications after a discharge if a PA need is not known prior to discharge and delays therapy. It is a process that could be applied after the fact if there was cost saving concerns rather than delay potential therapy. Absolutely ridiculous, inefficient, and benefits neither the patient or physician and has the potential to do more harm than intended benefit of potential cost-savings for the insurance industry!