Prior Authorization Is Nightmarish (PAIN)

Dr Brian J Dixon
2 min readNov 18, 2021

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P.A.I.N. See what we did there? Prior auths are a pain in the ass.

Healthcare premiums have increased nearly 50% in the last decade. Shouldn’t timely access to quality patient care reflect that jump? Today, more than ever, time and money are utterly wasted adhering to prior authorization hurdles set in place by insurance companies. In fact, according to surveys performed by the American Medical Association, up to 92% of doctors say that prior authorization harms patient access to care, thus damaging clinical quality outcomes. Moreover, 86% of physicians reporting in 2016 said that this problem had gotten worse over the previous five years. This trend will only continue unless reform arrives.

Y’all know exactly how I feel about our healthcare system and health finance (if not, check out ye olde www.ChangeHealth.today website.) If a doctor writes a prescription, their patients should be able to get it. The fact that they, an educated and licensed physician, would have to take time to beg an insurance company full of mathematicians to approve a treatment they have already approved of is just plain stupid.

And so I want y’all to spend 28 minutes of your life and experience the pain that I endured putting up with insurance shenanigans. Seriously: don’t look away. Don’t blink. Sit with me in my misery for every damn second. At the end, hopefully you’re as furious as I am.

On average, physician practices have to process over 29 prior authorizations per clinician weekly, taking nearly 15 hours each week to complete these requests. No wonder only 2 percent of physicians said prior authorizations had any positive effects at all. That is not worth the hours and hours of frustration and time spent away from caring for patients. A study by Health Affairs further revealed that when this wasted time spent by doctors, administrators, and nurses is converted to dollars, practices spent an average of between about $55,000 to $68,000 per physician per year. This would be between $23 billion and $31 billion annually. Utter nonsense! Prior authorization ultimately ends up costing the health care system significantly more than it saves on potential fraud or malpractice.

Enough is enough. Change health, today.

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