Health
Surgeon shares story of insurance provider calling during patient's surgery
A surgeon in Austin, Texas, was in the middle of surgery when she was notified of a phone call from the patient’s insurance provider.
Dr. Elisabeth Potter is a board-certified plastic surgeon who specializes in reconstruction for women who have had breast cancer. Last year alone, she did about 520 surgeries for cancer patients.
She recently shared a video of herself talking about the experience.
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“I just performed two bilateral DIEP flap surgeries and two bilateral tissue expander surgeries,” she said in the now-viral video.
(In DIEP flap surgery reconstruction, skin, fat and blood vessels from the patient’s abdominal area are used to rebuild breasts.)
Dr. Elisabeth Potter, a Texas surgeon, recently shared a video of herself talking about a phone call that came in from an insurance company during a patient’s surgery. (Dr. Elisabeth Potter; @drelisabethpotter)
During one of the DIEP cases, while the patient was asleep on the operating table, the doctor was interrupted by a nurse supervisor informing her that a call had come in from UnitedHealthcare, the patient’s insurance company, Potter said.
The nurse who took the call said that Potter was in surgery and not available.
“And they said, I need to get her a message because we need to talk to her about this patient,” Potter told Fox News Digital. “So they wrote a note and brought it into the operating room and I took a picture of it, because I’m like, I can’t believe this is happening.”
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The note indicated the name and number of the person to call at UnitedHealthcare, along with the patient’s name and Dr. Potter’s name. (The note did not state that the caller had requested an immediate response.)
“The nurse at the front desk of the OR who took the call and wrote this note said that the person on the phone first asked for the patient and then for me,” Potter told Fox News Digital.
“I made that judgment call and I stand by that — I think it was the right thing to do for the patient.”
“He was told I was scrubbed in[to the] OR and he asked the nurse that I be contacted in OR and given the message.”
Added Potter, “The nurse manager said she had never in her career received a call like that before. She thought it must be important and brought the message to the OR.”
Dr. Elisabeth Potter, a surgeon in Austin, Texas, was in the middle of surgery when she was notified of a phone call from the patient’s insurance provider. (Dr. Elisabeth Potter; @drelisabethpotter)
It was odd, Potter said, that the insurance company had called the front desk of the hospital, where she is not an employee.
“They didn’t call my office. They didn’t call my cell phone. They didn’t send me an email. This wasn’t the billing department of the hospital.”
Afraid that the insurance company might deny the patient’s service, Potter made the decision to scrub out mid-surgery to return the call to United.
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The surgeon stated to Fox News Digital that UnitedHealthcare did not require her to leave the operating room or threaten to deny coverage.
The patient was safe with another surgeon and the anesthesia team, who were finishing up the procedure.
Dr. Elisabeth Potter is a board-certified plastic surgeon in Texas who specializes in breast reconstruction for women who have had breast cancer. (Dr. Elisabeth Potter)
Potter was “scared” that the patient would wake up and find out that the insurance company said they didn’t have the information they needed and would deny the claim, she said.
“I’ve seen it before, when people get stuck with bills that are $80,000 or $100,000,” she said to Fox News Digital. “And so I said to my partners, ‘I’m going to make this call real quick.’” (See her video here.)
“Dealing with insurance is a really important part of taking care of patients affected by breast cancer, because the diagnosis is financially devastating.”
“If it had been at a critical moment during the surgery, I wouldn’t have,” Potter clarified. “But I made that judgment call and I stand by that — I think it was the right thing to do for the patient.”
On the phone, the insurance company stated that they needed to know the patient’s diagnosis and the justification for the inpatient stay, something Potter had already communicated, she said.
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“And I was like, wait a minute, we got authorization for the surgery. We submitted all of our clinical documentation. We’ve done all the paperwork, the phone calls, all the stuff. You have her diagnosis codes, you have all of it,” she went on.
“And they said, ‘Actually, I don’t, another department has that, but I need this right now,’” Potter said. “There was a sense of entitlement to my time and to the information in that moment,” the surgeon added.
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Potter also noted that the person on the line didn’t have access to the patient’s full medical information, despite the procedure already being pre-approved.
“I’m not sure that person even understood that they had an impact on those patients I was operating on,” Potter told Fox News Digital. “They were just thinking about money and numbers and were not understanding at all.”
Potter was “scared” that the patient would wake up and find out that the insurance company said they didn’t have the information they needed and would deny the claim, the surgeon told Fox News Digital. (iStock)
“It’s beyond frustrating and, frankly, unacceptable,” she told Fox News Digital. “Patients and providers deserve better than this. We should be focused on care, not bureaucracy.”
Potter noted that she has always been “devoted” to providing care in-network through insurance.
“Dealing with insurance is a really important part of taking care of patients affected by breast cancer, because the diagnosis is financially devastating,” she told Fox News Digital.
“I’ve found that I really have to engage directly and think about insurance and whether they’re covering treatments and what my patients are experiencing.”
Potter emphasized that she doesn’t think insurance is “evil,” noting that there are some “really good things” about businesses that take care of people.
It was odd, the surgeon felt, that the insurance company called the front desk of the hospital, where she was not an employee. (iStock)
“But this has developed into something that no longer is devoted to patient care. This is just a machine that’s running and making money, and they don’t care about me as a provider,” she said.
Many physicians have given up and refuse to deal with insurance companies, opting to stay out of network and let the patient pay upfront and deal with getting reimbursed, Potter noted.
“Patients and providers deserve better than this.”
“I’ve gone to Washington, D.C., I have fought to protect access to [breast] reconstruction,” she said. “I have testified in the state legislature about these issues.”
She added, “It’s just getting undoable. And this moment, this week, was like, we’ve crossed a line — they’re actually in the operating room.”
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Fox News Digital contacted UnitedHealthcare for comment. The company sent the following statement.
“There are no insurance-related circumstances that would require a physician to step out of surgery and it would create potential safety risks if they were to do so.”
It went on, “We did not ask nor would ever expect a physician to interrupt patient care to answer a call and we will be following up with the provider and hospital to understand why these unorthodox actions were taken.”
Separately, the head of UnitedHealthcare group said on Thursday that the company remains “focused on making high-quality, affordable health care more available while making the health system easier to navigate 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 year 2025.
“The people of UnitedHealthcare remain focused on making high-quality, affordable health care more available to more people while making the health system easier to navigate for patients and providers, positioning us well for growth in 2025,” CEO Andrew Witty said in the company’s earnings report on Thursday.
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His optimism comes shortly after the head of its insurance unit was gunned down in New York City, inciting a heated conversation about the role of the health insurance industry in the United States.
Fox News Digital’s Daniella Genovese contributed reporting.
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Eating too much salt has long been linked to high blood pressure, but new research suggests it could trick the immune system into prematurely aging the blood vessels.
A preclinical study recently published in the Journal of the American Heart Association has identified a biological chain reaction that links a salty diet to cardiovascular decay.
Scientists at the University of South Alabama observed that mice on a high-salt diet experienced rapid deterioration in their blood vessel function.
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After just four weeks of high sodium intake, the small arteries responsible for regulating blood flow lost their ability to relax, according to a press release.
The team found that the cells lining these vessels had entered a state of cellular senescence, a form of premature cellular aging in which cells stop dividing and release a mix of inflammatory signals that can damage surrounding tissue.
Excess salt has long been linked to high blood pressure, but a new study goes deeper into its effects on the cardiovascular system. (iStock)
The researchers tried to replicate this damage by exposing blood vessel cells directly to salt in a laboratory dish, but the cells showed no harmful effects.
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This suggests that salt isn’t directly causing damage to the vascular lining but that the real culprit may be the body’s own defense mechanism, the researchers noted.
Excess salt may trigger the immune system to release a molecule called interleukin-16 (IL-16), which acts as a messenger that instructs blood vessel cells to grow old before their time, according to the study.
Excess salt may trigger the immune system to release a molecule called interleukin-16, which acts as a messenger that instructs blood vessel cells to grow old before their time, according to the study. (iStock)
Once these cells age, they fail to produce nitric oxide, the essential gas that tells arteries to dilate and stay flexible.
To test whether this process could be reversed, the team turned to a class of experimental drugs known as senolytics.
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Using a cancer medication called navitoclax, which selectively clears out aged and dysfunctional cells, the researchers were able to restore nearly normal blood vessel function in the salt-fed mice, the release stated.
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By removing the decaying cells created by the high-salt diet, the drug allowed the remaining healthy tissue to maintain its elasticity and respond correctly to blood flow demands.
Excess salt may trigger the immune system into stopping the cells from dividing, the study suggests. (iStock)
The study did have some limitations. The transition from mouse models to human treatment remains a significant hurdle, the team cautioned.
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Senolytic drugs like navitoclax are still being studied for safety, and the team emphasized that previous trials have shown mixed results regarding their impact on artery plaque.
Additionally, the researchers have not yet confirmed whether the same IL-16 pathway is the primary driver of vascular aging in humans.
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Eating a diet high in fruits and vegetables was found to have a surprising link to lung cancer among younger non-smokers, early research suggests.
The observational study, led by Jorge Nieva, M.D., of the USC Norris Comprehensive Cancer Center at Keck Medicine, was presented this month at the American Association for Cancer Research (AACR) annual meeting in San Diego. It has not yet been peer-reviewed.
Researchers looked at dietary, smoking and demographic data for 187 patients who were diagnosed with lung cancer at age 50 or younger.
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They found that among non-smokers, there was a link between healthier-than-average diets – rich in fruits, vegetables and whole grains – and the chance of lung cancer development.
Young lung cancer patients ate more servings of dark green vegetables, legumes and whole grains compared to the average U.S. adult, the researchers found.
Eating a diet high in fruits and vegetables was found to have a surprising link to lung cancer among younger non-smokers, early research suggests. (iStock)
The researchers hypothesized that pesticides applied to conventionally grown produce could be a possible factor in the disease association.
“Commercially produced (non-organic) fruits, vegetables and whole grains are more likely to be associated with a higher residue of pesticides than dairy, meat and many processed foods,” according to Nieva. He also noted that agricultural workers exposed to pesticides tend to have higher rates of lung cancer.
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“There is a large subset of lung cancer patients whose disease is not caused by smoking,” Nieva told Fox News Digital.
The disease is becoming more common in non-smokers 50 and younger, especially women – despite the fact that smoking rates have been falling for decades, the researcher noted.
The researchers hypothesized that pesticides applied to conventionally grown produce could be a possible factor in the disease association. (iStock)
“These patients tend to have eaten much healthier diets before their diagnosis than the average American,” he went on. “We need to support research into understanding why Americans – and women in particular – who no longer smoke very much are still having lung cancer,” he said.
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The study did have some limitations, Nieva acknowledged, primarily that it relied on survey data and was limited by the participants’ memories of their food intake.
“Also, the survey participants were self-selected, and this could have biased the findings,” he told Fox News Digital.
“There is a large subset of lung cancer patients whose disease is not caused by smoking.”
The researchers did not test specific foods for pesticides, relying instead on average pesticide levels for certain types of food. Looking ahead, they plan to test patients’ blood and urine samples to directly measure pesticide levels, Nieva said.
Although the study shows only an association and does not prove that pesticides caused lung cancer, Nieva recommends that people wash their produce before eating and choose organic foods whenever possible.
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“This work represents a critical step toward identifying modifiable environmental factors that may contribute to lung cancer in young adults,” said Nieva. “Our hope is that these insights can guide both public health recommendations and future investigation into lung cancer prevention.”
“It is possible that the increased lung cancer risk could be due to pesticide exposure in whole farmed foods, but is by no means certain,” a doctor said. (AP Photo/Charlie Neibergall)
Dr. Marc Siegel, Fox News senior medical analyst, said the study is “interesting,” but that it “raises far more questions than it answers.”
“It is a small study (around 150) and observational, so no proof,” the doctor, who was not involved in the research, told Fox News Digital.
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“It is possible that the increased lung cancer risk could be due to pesticide exposure in whole farmed foods, but it is by no means certain,” Siegel went on. “How much exposure is needed? How much of it gets into food and in which areas? This requires much further study.”
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Kayla Nichols, communications director for Pesticide Action & Agroecology Network, a distributed global network, said the organization agrees with the study’s conclusion that more research should be done on the rise in lung cancer, particularly in individuals eating diets higher in produce and fiber.
“There is a large subset of lung cancer patients whose disease is not caused by smoking,” the researcher told Fox News Digital. (iStock)
“There is a bounty of existing research that already links pesticide exposure to increased risk of multiple types of cancers,” Nichols, who was also not involved in the study, told Fox News Digital. She called for more research on chronic, low-level exposures to pesticides, as well as more effective policies to protect the public from pesticide residues on food.
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The study was supported by the National Institutes of Health and the National Cancer Institute, as well as industry partners including AstraZeneca and Genentech, among others.
Fox News Digital reached out to several pesticide companies and trade groups for comment.
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