The first change I'd advocate for is eliminating pre-authorization, although maintaining oversight is still essential. We recognize that there are bad actors and that mistakes occur, underscoring the need for some form of regulation. However, the relatively new concept of requiring authorization for every step of patient care creates unnecessary barriers. Once a patient is authorized to see me as an orthopedic hand surgeon, I should be trusted to determine their treatment plan. For example, if I decide that a patient needs a plate on their distal radius, I am the most qualified to make that decision—not someone at an insurance desk across the country. This current system undermines the expertise of healthcare professionals and delays critical care. By trusting medical professionals to make these decisions, we can streamline the process, improve patient outcomes, and reduce the administrative burden on both doctors and patients.
Alejandro Badia is an orthopedic surgeon.
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