Mansell, Engel & Cole

What is prior authorization, and why do doctors hate it?

There's an elephant in doctors' offices in Oklahoma and nationally, and doctors just can't make it leave the room.

They desperately want to do so. It unduly interferes with timely and sensible treatment their patients need - sometimes desperately, without delay. And it literally takes days of their time each week, requiring them to focus on paperwork and administrative tasks that are far removed from care delivery.

The elephant is figurative, of course, but it is real. It is a widely viewed top-tier nemesis in the health care industry that physicians insist is material compromising the quality of patient care and unquestionably killing legions of individuals.

Its name: prior authorization.

Its author: insurance companies insisting that doctors first receive approval before administering a recommended drug or therapy.

As an oncologist/commentator in a recent opinion piece notes, she and her brethren nationally detest the requirement and its alleged starkly adverse effects in high numbers of cases.

Many patients already suffering are harmed even further when forced to endure insurers' seemingly casual responses to doctors' treatment requests. Drug delivery is delayed. Diagnostic testing sometimes never occurs. Referral requests are denied.

Writer/MD -- and, coincidentally, president of the American Medical Association -- Barbara McAneny says that she and virtually every other doctor nationally finds that galling and needlessly disruptive of quality care delivery.

Moreover, she stresses, it takes up copious amounts of exceptionally valuable time. McAneny points to an AMA survey indicating that doctors typically deal with more than 30 prior-authorization requests each week. Astonishingly, dealing with the paperwork sometimes takes doctors a full two days.

Stop the nonsense, says McAneny. Eliminate outright or materially curb prior authorization, which is a "dysfunction in our health care system that interferes with patient care."

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