On/Offcall: Prior Authorization Is Harming Physicians and Patients

Welcome Back to On/Offcall!

Thanks to all the first responders, emergency teams, and healthcare workers who continue to work around the clock to contain this tragedy in L.A. If you’re looking for ways to help, the IMC does amazing work (I’ve volunteered with them before), and you can donate here.

Over the past two months, I’ve read 50+ papers to see what the data actually says about prior authorization. The result is … as maddening as you’d suspect. Physicians spend on average 14 hours PER WEEK dealing with prior auths, and it’s our patients who suffer. 80% of oncologists know a patient whose cancer has progressed due to prior auth delays, and 33% know a patient who has died. Insurance companies are clearly conflicted. My deep dive on how we can fix prior auth has generated a ton of responses – one of my personal favorites is from NHS physician @Dr. Zhong Wei (Derrick) Khor: “Cancer simply does not wait for paper work.” I’d love your take: How do you think we could fix prior auth? Read my essay, and leave me a comment or reply directly with your feedback (graham@offcall.com).

Graham Walker, MD, Emergency Physician
Co-founder, Offcall

Dr. Resa Lewiss Charts Her Own Path

This week on How I Doctor, I spoke to my former attending (!) Dr. Resa Lewiss – also a podcast host, author, and superstar human – about how to break the standard career “mold” and chart your own path. She offers a wealth of advice for physicians at any stage of their career, particularly in academic medicine!

Listen to the episode →

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3 Things to Read This Week

Lotte Bjerre Knudsen: The Scientist Who Drove GLP-1 Drugs For Obesity and Alzheimer’s
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My Parting Prescription for America
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We Can Do More to Prevent Healthcare Worker Suicides
An important opinion essay from Scarlett McNally.

Highlights From Our Community

Each week, we highlight career milestones, new publications, and exciting news from our community. Have something to promote? Reply and we’ll feature you.

🎉 New Career Move: Eric Bricker
Dr. Eric Bricker, former How I Doctor guest, is joining the board of Frontier Direct Care. Learn more here.

🎉Congrats to Rocky Jedick
Friend of Offcall Dr. Rocky Jedick is opening a new longevity clinic in Salt Lake City called Peak Longevity Lab! Learn more and schedule an initial free consultation here.

🎉 New Practice Launch: Ajay Haryani
Dr. Ajay Haryani is launching a new solo primary care practice in New York City: Seen Medical. Learn more here.

🔬New Publication Alert: Aditi Joshi
Dr. Aditi Joshi published a new article in the Journal of American Academy of Emergency Physicians on a model curriculum for telehealth for emergency medicine residency training. Learn more.

🔬New Publication: Sachin Jain
Dr. Sachin Jain published an essay in Forbes on a new path forward for the health insurance industry after the murder of United Healthcare CEO Brian Thompson.

🔬New Data: Arthur Lodge Kellerman
Emergency physician Dr. Arthur Lodge Kellerman published new data showing case counts across four diseases after vaccines were introduced.

⚕️Spot On, Preston Alexander
Thank you Preston Alexander for this perfect summary of why cutting physician reimbursement is an existential threat to physicians.

⚕️New Job Alert: Medical University of South Carolina
Dr. Heather Farley announced the Medical University of South Carolina’s Office of Well-being is hiring for three new leadership roles. Learn more here.

🔥 How Conversation: Dr. Graham Walker
Graham’s post about the enshittification of U.S. healthcare has sparked quite the conversation with healthcare leaders on social media. Join in!

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