I’ve had many patients who have encountered difficulty in getting procedures and medications that a physician has ordered for them.
For instance, one patient had a drug ordered that was not on an approved list. A month later, this case is still being evaluated with really no significant data submitted back to the patient about why the drug was not covered per the doctor’s instruction.
A troubling episode occurred with another patient who was in an automobile accident a couple of months ago. Since the accident, the patient had a problem with prolapse of her uterus. She has been to the emergency room a couple of times and has seen two gynecologists.
She was scheduled for surgical repair by one of her gynecologists, but she had a seizure and fell and injured her face and skull and was confused for approximately 24 hours. She was admitted to the hospital, and now nurses are telling her that to get she will need to wait an additional 3 to 4 weeks for the insurance company to approve her previously scheduled surgery for uterine prolapse.
This situation of insurance companies deciding what can and cannot be done for a patient is to me, once again, very inappropriate, effectively constituting the practice of medicine without a medical license.
My suggestion is that you contact state representatives in the House and Senate, and also the federal representatives in the House and Senate to ask who controls medicine and why insurance companies have the ability to override the orders of a patient’s physicians.
This is something that needs to be evaluated and corrected.
Posts by William Maxfield, M.D.
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