A surgeon in Austin, Texas, was midway through surgery when she was notified of a phone call from the patient's insurance company.
Dr. Elizabeth Potter is a board-certified plastic surgeon who specializes in reconstruction for women who have undergone it breast cancer. Last year alone, it performed about 520 surgeries on cancer patients.
She recently shared a video of herself talking about the experience.
“I just had two DIEP flap surgeries and two tissue expansion surgeries,” she said in the now-viral video.
(In DIEP flap reconstruction surgery, skin, fat, and blood vessels from the patient's abdominal area are used to reconstruct the breasts.)
Dr. Elizabeth Potter, a surgeon from Texas, recently shared a video of herself talking about a phone call that came from an insurance company while a patient was being operated on. (Dr. Elizabeth Potter; @drelisabethpotter)
During one DIEP case, while the patient was asleep on the operating table, the supervising nurse interrupted the doctor to inform her she had received a call from UnitedHealthcare, the patient's insurance company, Potter said.
The nurse who took the call said Potter was In surgery And not available.
“And they said I need to get a message to her because we need to talk to her about this patient,” Potter told Fox News Digital. “So they wrote a note and brought her into the operating room and I took a picture of her, because I can’t believe this is happening.”
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The note indicated the name and number of the person to contact at UnitedHealthcare, as well as the patient's name and Dr. Potter's name. (The memo did not say that the caller requested an immediate response.)
“The nurse at the front desk in the operating room who took the call and wrote that note said the person on the phone first asked about the patient and then about me,” Potter told Fox News Digital.
“I have made that judgment and I stand by that – I believe it is the right thing to do for the patient.”
“He was told that I was being cleaned in the operating room and asked the nurse to call me into the operating room and give me the message.”
“The nurse manager said she had never received a call like this before in her career. She thought it was important and brought the letter to the operating room,” Potter added.
Dr. Elizabeth Potter, a surgeon in Austin, Texas, was midway through surgery when she was notified of a phone call from the patient's insurance company. (Dr. Elizabeth Potter; @drelisabethpotter)
Potter said it was strange Insurance company She called the hospital's front desk, where she was not an employee.
“They didn't call my office. They didn't call my cell phone. They didn't email me. This wasn't the billing department at the hospital.”
Fearing that the insurance company would deny service to the patient, Potter made the decision to cancel the surgery midway through the procedure to return the call to United.
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The surgeon told Fox News Digital that UnitedHealthcare did not ask her to leave the operating room or threaten to deny coverage.
The patient was safe with another surgeon and the anesthesia team, who were completing the procedure.
Dr. Elizabeth Potter is a board-certified plastic surgeon in Texas who specializes in breast reconstruction for women with breast cancer. (Dr. Elizabeth Potter)
She added that Potter was “scared” that the patient would wake up and discover that the insurance company said it didn't have the information he needed and would deny the claim.
“I've seen it before, when people get stuck with $80,000 or $100,000 bills,” she told Fox News Digital. “So I said to my partners: 'I'm going to make this call very quickly.' (Look at it Video here.)
“Dealing with insurance is a really important part of caring for patients with breast cancer, because the diagnosis is financially devastating.”
“If it had been at a critical moment during surgery, I wouldn't have done it,” Potter explained. “But I made this judgment and I stand by that – I believe it is the right thing to do for the patient.”
Over the phone, the insurance company stated they needed to know Patient diagnosis She said that the justification for the patient's stay in the hospital was something Potter had previously reported.
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“And I said, 'Wait a minute, we got cleared to do the surgery. We submitted all our clinical documentation. We did all the paperwork, the phone calls, all the stuff. You have her diagnosis codes, you have all of it,'” she continued.
“And they said, 'Actually, I don't do it, there's another department that has it, but I need it now,'” Potter said. “There was a feeling of entitlement to my time and the information at that moment,” the surgeon added.
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Potter also noted that the person on the line cannot reach the entire patient Medical informationeven though the procedure was previously approved.
“I'm not sure this person even understood that it was having an impact on these patients that I was operating on,” Potter told Fox News Digital. “They were just thinking Money and numbers We didn't understand at all.”
The surgeon told Fox News Digital that Potter was “scared” that the patient would wake up and discover that the insurance company said it didn't have the information he needed and would deny the claim. (Istock)
“It's very frustrating and, frankly, unacceptable,” she told Fox News Digital. “Patients and providers deserve better than this. We must focus on care, not bureaucracy.”
Potter noted that she has always been “dedicated” to providing in-network care through insurance.
“Dealing with insurance is a really important part of caring for affected patients breast cancer, “Because the diagnosis is financially devastating,” she told Fox News Digital.
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“I found I had to get directly involved and think about insurance and whether they cover the treatment and what my patients are going through.”
Potter stressed that she does not believe insurance is “evil,” noting that there are some “really good things” about companies that take care of people.
The surgeon felt it was strange for the insurance company to call the front desk at the hospital, where she was not employed. (Istock)
“But this has evolved into something it's no longer intended for Patient care. “This is just a machine that runs and makes money, and they don't care about me as a service provider,” she said.
Many doctors have given up and refused to deal with insurance companies, choosing to stay out of network and let the patient pay up front and handle the chargebacks, Potter noted.
“Patients and providers deserve better than this.”
“I went to Washington, DC“I have fought to protect access to (breast) reconstruction. I have testified in the state legislature on these issues,” she said.
“It's become irreversible. And this moment, this week, it's like we've crossed the line — they're already in the operating room,” she added.
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Fox News Digital has contacted UnitedHealthcare for comment. The company sent the following statement.
“There are no insurance-related circumstances that would require a physician to exit surgery and would create a potential safety risk if he did.”
He continued, “We never asked or expected a physician to interrupt patient care to answer a call and will follow up with the provider and hospital to understand why these unorthodox actions were taken.”
Separately, UnitedHealthcare Group Chairman said Thursday that the company remains “focused on making high-quality, affordable health care more accessible while making it easier to navigate the health system for patients and providers.” (Istock)
Separately, the head of UnitedHealthcare Group said on Thursday that the company is confident it will be able to grow its business in fiscal 2025.
“UnitedHealthcare employees remain focused on making high-quality, affordable health care available to more people while making it easier to navigate the health system for patients and providers, which positions us well for growth in 2025,” Andrew Whitty, the company's CEO, said in a press release. “. Earnings report on Thursday
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His optimism comes shortly after the head of its insurance unit was shot to death in New York City, sparking a heated debate about the role the health insurance industry plays in the United States.
Fox News Digital's Daniella Genovese contributed reporting.
