In recent years, the domain of medicine has experienced considerable evolution, driven not only by breakthroughs in science and technology but also by the expanding bureaucracy integrated within the healthcare framework. This change has created a landscape where administrative responsibilities eclipse patient care—a reality that has been sharply experienced by private practice doctors throughout the United States. For numerous experienced medical practitioners like myself, having accumulated over thirty years as a board-certified neurologist, the essence of medicine is deteriorating—not due to a deficiency in compassion, ability, or science, but as a result of unyielding bureaucratic constraints.
A typical week in my practice is filled with struggles against insurance providers—not for heightened compensation, but simply for the authorization to perform crucial tests or prescribe FDA-sanctioned medications. Encountering denials for straightforward procedures like brain MRIs or necessary medications for conditions such as seizures is commonplace. Often, these refusals and related appeals eat up countless hours, illustrating a widespread dilemma within current healthcare practices: the bureaucratic hurdles that obstruct prompt patient care.
The pre-authorization procedure, meant to organize and simplify care, has instead transformed into a system profiting from delays. According to the American Medical Association (AMA), doctors now spend approximately 13 hours per week on prior authorizations—a load akin to hiring a dedicated staff member solely to navigate the complex web of approvals.
Additionally, the troubling aspect is the decision-making authority being given to individuals who might lack the necessary clinical knowledge or direct patient experience. Inadequately qualified individuals frequently serve as gatekeepers to vital healthcare services, as exemplified by a recent incident where a patient’s essential MRI for severe lumbar pain was initially not approved. This patient’s situation worsened into an emergency, resulting in hospitalization and subsequent surgery—events that could have been averted with prompt authorization.
Compounding these issues is the extensive regulatory structure at both state and national levels. Initiatives like MACRA, MIPS, and other electronic documentation requirements are established under the pretense of “value-based care” yet rarely result in significant enhancements in patient outcomes. Rather, these initiatives shift focus from direct patient engagement to administrative adherence, electronic record-keeping, and the management of endless audit trails.
The inexorably tightening grip of regulation and corporate consolidation is driving private practices towards extinction. Many physicians, struggling with the administrative load, are selling their practices to hospital systems or selecting early retirement. The consequences for patients are severe—reduced options, extended wait times, and fractured continuity of care.
What we confront is not just a personal complaint but a national emergency within the healthcare landscape. In response, I have launched a petition advocating for the restoration and protection of private medical practices. This petition urges policymakers to relieve the regulatory pressures, overhaul the pre-certification quagmire, and maintain the autonomy of physicians to manage patient care, free from corporate interference.
If you believe that your healthcare choices should be determined by your physician rather than an algorithm or remote administrator, I strongly encourage you to sign and circulate this petition. The replacement of established patient-physician relationships with corporate-driven protocols erodes the core nature of healthcare—making it impersonal and detached.
The time to act is now. Without intervention, we face the prospect of a future where critical medical choices are no longer entrusted to qualified physicians but instead assigned to non-clinical entities dependent on directive screens.
*Scott Tzorfas, Neurologist*