The bureaucratic hurdles we face aren’t just frustrating — they’re dangerous.
As I sit in my clinic late at night, completing yet another round of prior authorization forms, I can’t help but feel a deep sense of frustration. After over a decade as a family medicine physician, I’ve witnessed our insurance system become increasingly dysfunctional. In light of the recent shooting of a health insurance CEO — a violent act of retaliation I would never condone — I wanted to share a physician’s perspective of this system.
There’s a common misconception that doctors are somehow partnering with insurance companies — that we’re all part of the same profit-driven machine. Nothing could be further from the truth. Every day, I find myself locked in an exhausting battle with insurance companies, fighting to get my patients the care they desperately need.
Let me share a recent example that illustrates how absurd this system has become. A patient of mine, a dedicated schoolteacher, came in with pink eye. The treatment should have been straightforward — simple antibiotic eye drops, which are the gold standard for treating pinkeye and would clear up the infection quickly and let them return to teaching. Instead, the insurance company denied the prescription, insisting instead on covering only a petroleum-based ointment that’s messier, more conspicuous, and harder to apply consistently.
Picture this: a professional educator forced to apply an obvious, goopy medication throughout the school day, drawing unwanted attention and making it harder to focus on their students, all because an insurance company wanted to save a few dollars. My years of medical training and direct evaluation of the patient were overruled by someone on the other end of a phone line who had never even seen them. This wasn’t about providing the best care — it was purely about cutting costs.
And this was just a minor condition. The roadblocks become exponentially more infuriating when dealing with more serious situations, like my patients with suspected cancer who need urgent diagnostic testing, or my pediatric patients requiring occupational therapy to reach crucial developmental milestones. The stakes are infinitely higher, yet the battles remain just as senseless.
Just last week, I had another patient with concerning symptoms that required an urgent CT scan. Instead of being able to focus entirely on their care, I spent hours on the phone, navigating a maze of insurance requirements and justifying a test that my physician colleagues would consider obviously necessary because it’s what we learned in medical school. In the meantime, my patient remained in limbo, awaiting a test that might finally provide answers about her ongoing symptoms.
These aren’t just isolated incidents. They’re part of a pattern that repeats itself endlessly in doctors’ offices, clinics, and hospitals across the country. We’re forced to become insurance experts on top of our medical expertise, spending countless hours on paperwork instead of patient care. The bureaucratic hurdles we face aren’t just frustrating — they’re dangerous. Every delayed test, every denied medication, and every refused procedure represents a real person whose health is being compromised by a system that often seems to prioritize profits over patients.
What many don’t realize is that primary care physicians like myself are on the front lines of this battle, fighting alongside our patients. We’re not the beneficiaries of this complex system — we’re its hostages. The time I spend arguing with insurance representatives about covering a proven medication is time I could be spending with patients who need my medical expertise.
The human cost of these delays is heartbreaking. I’ve seen patients ration their medications because of coverage issues, watched chronic conditions worsen while waiting for insurance approvals, and witnessed the anxiety in my patients’ eyes when I tell them we need to try an alternative treatment first because their insurance requires it.
This isn’t the healthcare system I envisioned when I took my Hippocratic Oath to do no harm. Every doctor I know went into medicine to heal, help, and make a difference in people’s lives. Instead, we find ourselves spending an inordinate amount of time being insurance navigators, paperwork processors, and bureaucracy fighters.
The system needs fundamental change, and violence should never be the answer. The recent news about the killing of a top healthcare CEO has sparked so many conversations about the brokenness of our system that I work in every day. We need to restore the doctor-patient relationship to its rightful place at the center of healthcare. But our current insurance system isn’t just broken — it’s actively harming patients while burning out healthcare providers. As a physician, I believe it’s my duty not just to treat illnesses but to speak up about the systemic problems that are making people sick in the first place.
Though the system is undoubtedly flawed, there are steps you can take to address the issue. Share your experiences with insurance denials — talk about them openly and post about them on social media. Report your experiences to your state’s insurance commissioner and write to your state legislators. Additionally, consider contacting your state medical society to support bills to reform the prior authorization process.
When you feel frustrated by healthcare delays or denials, remember that your doctor is likely just as frustrated as you are. We are on your side, fighting the same battle to ensure you receive the care you need in a system that often seems designed to prevent it.
