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.
Health
Brain Health Challenge: Try the MIND Diet
Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.
Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.
So what foods are best for your brain?
In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.
Based on these findings, the researchers developed the MIND diet.
Large studies encompassing thousands of people have since shown that following the MIND diet corresponds with better cognitive functioning, a lower risk of dementia and slower disease progression in people with Alzheimer’s. People benefit from the diet regardless of whether they start it in midlife or late life.
Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.
Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.
Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.
Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.
You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.
Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.
Health
Measles outbreak explodes in South Carolina; multiple people hospitalized as cases surpass 200
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The South Carolina Department of Public Health (DPH) is sounding the alarm after 26 new measles cases were reported since Friday, bringing the total number of cases in the state’s latest outbreak to 211.
DPH first reported a measles outbreak Oct. 2 in the Upstate region. As of Tuesday, 144 people are in quarantine and seven people are in isolation.
Of the 211 cases, 45 involve children under 5, 143 cases involve children ages 5 to 17, 17 cases involve adults and six cases involve minors whose ages weren’t disclosed.
DPH said 196 of the 211 infected individuals were unvaccinated, four were partially vaccinated, one was vaccinated and 10 are either still being investigated or have an unknown vaccination status.
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Hundreds of people in South Carolina have contracted the measles, and a few have been hospitalized. (Jan Sonnenmair/Getty Images)
Officials said 19 of the new cases were associated with “exposures in known households and previously reported school exposures,” and four resulted from church exposures.
DPH identified public exposures at Sugar Ridge Elementary and Boiling Springs Elementary and began notifying potentially exposed students, faculty and staff Dec. 31.
There are nine students in quarantine from the two schools.
Of the 211 cases, 45 involve children under 5 years old. (iStock)
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Exposures also happened at the Tabernacle of Salvation Church, Unitarian Universalist Church of Spartanburg, Slavic Pentecostal Church of Spartanburg and Ark of Salvation Church.
The source of one case is unknown, while two others are still being investigated.
Although complications from measles are not reportable, officials said four people, including adults and children, required hospitalization for complications from the disease.
Officials recommend all children be vaccinated against measles. (Raquel Natalicchio/Houston Chronicle via Getty Images)
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Additional cases required medical care, but the infected individuals were not hospitalized.
Those infected with measles are contagious from four days before the rash appears and may be unaware they can spread measles before they know they have the disease, according to DPH.
DPH said it is important for those with a mild illness or those who are in quarantine to stay home to protect others.
“We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine, which also protects businesses, other workers and clients,” officials wrote in a statement.
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DPH said vaccinations continue to be the best way to prevent measles and stop the outbreak.
Though the CDC recently released new vaccine recommendations under Health and Human Services Secretary Robert F. Kennedy Jr., its guidelines still dictate all children should be immunized for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and chickenpox.
Health
Common pain relievers may raise heart disease and stroke risk, doctors warn
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Many might assume that over-the-counter (OTC) medications are generally safer than stronger prescription drugs, but research shows they can still present risks for some.
Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks.
Potential risk of NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) — which are used to reduce pain, fever and inflammation — have been pinpointed as the class of medicines most linked to elevated cardiovascular risk.
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“This is because they reduce the production of certain chemicals called prostaglandins,” Maryam Jowza, M.D., an anesthesiologist at UNC Health in North Carolina, told Fox News Digital. “These chemicals are involved in inflammation, but they are also involved in other body functions, such as influencing the tone of blood vessels.”
Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks. (iStock)
Dr. Marc Siegel, Fox News senior medical analyst, echoed the potential risk of NSAIDs.
“They can lead to high blood pressure, heart attack and stroke via fluid retention and salt retention,” he told Fox News Digital. “This increases volume, puts a strain on the heart and raises blood pressure.”
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Common examples of NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, indomethacin and celecoxib.
Randomized trials found that ibuprofen caused the biggest spikes in blood pressure, followed by naproxen and then celecoxib.
“In general, the increase in blood pressure is more likely with higher doses and longer duration of treatment,” said Jowza, who is also an associate professor in the Department of Anesthesiology at the UNC School of Medicine.
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NSAIDs can also increase stroke risk, especially at high doses and with long-term use, the doctor added.
Diclofenac was linked to the highest cardiovascular risk, the doctor cautioned. Ibuprofen can also raise blood pressure and has been associated with a higher heart attack and stroke risk, but not as high as diclofenac. Naproxen carries a lower cardiovascular risk than ibuprofen or diclofenac, but is not entirely risk-free.
NSAIDs have been pinpointed as the class of medicines most linked to elevated cardiovascular risk. (iStock)
“The practical takeaway is that diclofenac is generally the least favorable choice in patients with elevated cardiovascular risk, and all NSAIDs should be used at the lowest effective dose for the shortest duration,” Dr. Nayan Patel, pharmacist and founder of Auro Wellness in Southern California, told Fox News Digital.
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Aspirin is an exception — although it is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. However, it can increase bleeding risk and blood pressure at high doses.
Non-NSAIDs safer, but not risk-free
Non-NSAID pain relievers are commonly used for everyday aches, headaches and fever, but not swelling. They act mainly on the brain’s pain signals, not inflammation, according to medical experts.
Acetaminophen, the most common non-NSAID pain reliever, is also linked to an increase in blood pressure, although to a lesser extent, according to Jowza.
“All NSAIDs should be used at the lowest effective dose for the shortest duration.”
“Acetaminophen was once thought to have little to no cardiovascular effects, but more recent evidence suggests it can increase blood pressure, especially with higher doses used in the long term,” she said, emphasizing the importance of blood pressure monitoring. “Its effect on stroke risk is less clear.”
Which groups are most vulnerable?
The groups at greatest risk, according to doctors, are those with existing health conditions, such as high blood pressure, prior stroke or heart disease, diabetes or kidney problems.
“These groups are also more likely to experience NSAID-related fluid retention and destabilization of blood pressure control,” Patel said.
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Cardiovascular risk is generally higher for people 75 and older, the doctors agreed.
“Age amplifies risk largely because baseline cardiovascular risk increases with age, and kidney function reserve tends to decline,” Patel said. “Older adults are also more likely to be on antihypertensives, diuretics, antiplatelets or anticoagulants, so NSAIDs can destabilize blood pressure control and add safety complexity.”
Warning signs
Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, Jowza advised.
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“These symptoms can point to a heart attack or stroke,” she warned. “Other symptoms of concern that may not develop as rapidly, like new swelling in the legs, should also prompt medical attention.”
Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, a doctor advised. (iStock)
“Patients should also seek medical advice if they notice signs of fluid retention or kidney stress, such as rapidly rising blood pressure, swelling in the legs, sudden weight gain over a few days, reduced urine output or worsening shortness of breath,” Patel added.
Safer alternatives
For those at higher risk, Patel recommends non-NSAID approaches whenever possible.
“For many patients, this means starting with non-drug strategies such as heat or ice, physical therapy and activity modification,” he told Fox News Digital. “If medication is needed, acetaminophen is generally preferred over oral NSAIDs from a cardiovascular standpoint, although regular use should still be monitored in people with hypertension.”
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For localized joint or muscle pain, the doctor said topical NSAIDs can offer “meaningful relief” with “far lower” risk.
“Overall, pain management in high-risk patients should emphasize targeted therapy, conservative dosing and close blood pressure monitoring.”
Bottom line
The doctors emphasized that the overall risk is “very low” for people taking OTC pain relievers on a short-term basis, but it rises with long-term, high-dose use.
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“I would not hesitate to use an occasional dose if it were a low-risk individual with no prior history of heart attack or stroke,” Jowza said. “I also think short-term use in diabetics and hypertensives who are well-controlled is acceptable.”
Although aspirin is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. (iStock)
For those taking NSAIDs, the doctor suggested using “guard rails” — such as regularly testing blood pressure and kidney function, and setting limits on dosing — to make treatment as safe as possible.
Patel agreed that for most healthy individuals, occasional NSAID use “does not carry a meaningful cardiovascular risk.”
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“The concern is primarily with repeated or chronic use, higher doses, and use in people with underlying cardiovascular, kidney or blood pressure conditions,” he confirmed to Fox News Digital.
“That said, large population studies show that cardiovascular events can occur early after starting NSAIDs, particularly at higher doses, which is why even short-term use should be approached cautiously in higher-risk patients.”
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