I’ve wanted to be a primary care doctor for as long as I can remember. The reason being, I didn’t feel like my family had a quarterback who was directing our care, preventing illnesses we didn’t see coming and mitigating the burdens of diseases that already were at work. The single most frustrating issue I have faced as a primary care physician, that constantly makes me second guess my dreams, is the [prior authorization] PA issue. I have young children with type 2 diabetes who have made so many healthy changes but have to keep taking insulin daily because they can’t get a once-weekly medication. I have reproductive aged women who worry about their fertility and future health because they are not able to lose weight and I can’t offer them an evidence-based, FDA-approved medication to assist them because Medicaid has just made access to GLP-1’s [glucagon-like peptide-1] for a weight loss indication non-negotiable. I feel helpless. I feel like I can’t do what I was trained to do because of the insurmountable, unnecessary barriers PA’s pose. Please help me help my patients. These medications will save money in the future by reducing the costs of heart failure admissions, necrotic diabetic foot admissions & ICU admissions for hypertensive emergency. Trust me.