One in Four Doctors’ Orders Get Denied

The Texas Medical Association found that one in four people say their health insurance company has refused to cover what their physician ordered for them or their families. My answer to that is, “No sh$t, Sherlock”. It is time we break the addiction to these criminals.

I started my career in Medicine thirty years ago. We were in the early stages of HMO trend. When I used to order tests there was no diagnostic code needed. There was no prior authorization needed. The test was just done. This may sound crazy to some of you reading this but all these “justifications” for getting some referral or labs or study are just dogma you are accepting. There is no evidence that the insurers have cut down on meaningless or inappropriate orders by doctors to help people. They just have cut them down to save money, which they keep. Care was NOT worse in the old days when we didn’t need to beg these douchebags to do what was right for our patients. In fact, if you look at the 25% of orders refused by the insurers today I bet you will find that 99% were blocked for no valid reason at all.

Let’s go back to the major medical insurance era. I am all in for catastrophic plans with no frills. If your doctor orders a test for you then you may want to push back on why he/she wants it and then try to find the cheapest place to get it. If your doctor won’t help you do that then find another doctor (DPC docs all help with this kind of stuff). The bottom line is we need to get rid of these behemoth insurance companies who are only trying to make themselves more and more money and don’t give a crap about you as a patient.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “One in Four Doctors’ Orders Get Denied

  1. Steve O.
    February 13, 2020 at 7:27 pm

    It’s part of the training of the American mindset. Assume that a nameless, faceless person who does not know you will be making arbitrary decisions on, for instance, your contraceptive methods, for instance. Big brother denies, you comply. Isn’t that the American tradition? Do we need a Tea Party at the insurance companies and dump their records into the harbor?

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