Health insurance headaches cause continual stress for most physicians, survey finds

By John Murphy, MDLinx
Published January 8, 2018

Key Takeaways

More than 70% of physicians feel angst and anxiety on a frequent basis due to health insurance or health-care restrictions, according to a new survey. The number one cause for this stress: Medically necessary treatments or tests that are not covered or are denied by the patient’s insurance plan.

“Often it is the health insurance company that gets in the way of being able to take care of patients,” said a surgeon from a community hospital in Minnesota.

“Every day I am hampered in my ability to schedule tests and procedures for my patients,” echoed a gastrointestinal surgeon in Michigan. “Preauthorizations and peer-to-peer justifications of my clinical decisions waste my and my patients’ time.”

Said an endocrinologist in California, “I received a notification from an insurance company that an MRI of the brain would not be covered after it had already been completed. The MRI showed a large mass in the brain, so clearly it was needed.” The end result: “I had to spend 45 minutes on the phone in order to reverse the coverage decision.”

These physicians are far from alone. Overall, 22.5% of doctors who responded to this survey said they constantly feel stressed or are caught in dilemmas because of the restrictions imposed by health insurance or the health-care system. Another 48% said they often feel this way. About 28% noted they feel this stress only rarely, and a lucky 1.5% reported never feeling this kind of stress.

A total of 1,150 physicians—including primary care physicians and specialists of all stripes—responded to this nationwide survey conducted by M3 Global Research in August 2017.

EMRs and paperwork

A separate but related problem: Health insurance plans are reducing reimbursements, so physicians need to squeeze in more patients in the day to maintain their revenue. But at the same time, doctors have more administrative hoops to jump through, more calls to make, and more paperwork to do.

It’s a losing battle, some physicians say.

“As compared to a decade ago, I now spend an additional hour per day doing administrative tasks for government and insurance that have nothing directly to do with patient care,” said a private practice internist in California.

“Electronic medical records (EMRs) at this time are a financial burden, a huge time consumer (published literature states clinicians spend twice as much time doing EMRs as seeing patients), and so far offer none of the benefits for which they have been promoted,” bemoaned a cardiovascular surgeon in Massachusetts.

A Texas colorectal surgeon seconded that complaint. “EMR and meaningful use have made many of my hours meaningless,” he said. “I am bitter that I spend hours per week in front of a computer doing data entry for the government, instead of with my kids and wife.”

The wasted time and the added headaches might be worth it—if only it improved patient care. But many respondents report that these problems mainly compromise care and the time doctors spend with patients.

“I feel very restricted due to insurance coverage, especially on newer diabetes advancements (pump, continuous glucose monitoring, newer meds),” lamented an endocrinologist in Florida. “I know I can do more and help patients more, but with insurance denials, we're just stuck going nowhere and it is very frustrating.”

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