In this episode of UpMed: The Journal of Healthcare’s Race To The Bottom, Dr. Erica Rowe Urquhart shares an insightful anecdote regarding the implications and inefficiencies of prior authorization in healthcare. Dr. Urquhart narrates the case of a patient with a knee injury, whose surgery was compromised and modified due to insurance authorization issues. She explores the broader impact of prior authorization on patient care, supported by research articles, one authored by Dr's. Eugene and Shushan Yang, highlighting the administrative burdens and adverse outcomes. The episode critiques the motivations behind utilization management, calling for urgent reform to prioritize patient well-being over cost-cutting measures. Dr. Urquhart concludes with a poignant story about the detrimental effects of delayed authorization on a young patient requiring urgent surgery.

EPISODE HIGHLIGHTS:

00:00 Welcome to UpMed

00:26 A Troubling Case of ACL Tear

04:37 The Prior Authorization Dilemma

05:14 The Burden of Prior Authorization

07:53 Impact on Patient Care

13:46 Legislative Efforts and Reforms

17:44 A Heartbreaking Story of Delay

21:18 Conclusion and Final Thoughts

Website: https://www.upmed.us/

YouTube: https://www.youtube.com/@theupwardly

Linkedin: https://www.linkedin.com/in/erica-roweurquhart/