Prior Authorization Is Hurting Our Patients

Recently, a 75-year-old man came to my clinic with lower extremity pain and a developing foot drop due to a spinal nerve root compression. He had undergone lumbar fusion surgery years earlier. His MRI and CT scans showed severe foraminal compression below his previous spinal fusion site. We immediately scheduled him for urgent surgery to prevent the worsening of his weakness. His surgery was initially denied because the radiology reports from his imaging studies did not describe the foraminal compression. My interpretation of the imaging as his treating surgeon did not satisfy the health plan. Even after a peer-to-peer discussion, the...