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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Washington, DC – GLP-1 weight-loss drugs have become a prevalent part of American healthcare, and the current administration is getting behind the movement.
In an exclusive interview with Fox News Digital at the Great American State Fair in the nation’s capital on July 6, CMS Administrator Dr. Mehmet Oz voiced his support for the use of GLP-1 (glucagon-like peptide-1) medications, such as Ozempic, for appropriate uses.
“I’m a fan of GLP-1 drugs when used correctly,” he said. “They do help people who are overweight lose weight quite effectively. They’re not a replacement for diet and exercise, but they might jumpstart the system so it’s easier for you to use healthier tactics.”
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This is especially helpful for those who may have trouble moving due to joint pain or are experiencing internal dysfunction, Oz said.
Certain GLP-1 drugs are covered by Medicare for overweight candidates with certain conditions, such as high blood pressure and diabetes, and Oz projected the benefits will continue to benefit taxpayers.
Dr. Mehmet Oz is pictured in Washington, D.C., at the Great American State Fair, where he spoke about federal health policy. (Angelica Stabile/Fox News Digital)
“We believe these are so effective in reducing conditions like high blood pressure and diabetes that they’ll actually save money for the federal taxpayer, because [they’re] going to make you healthy enough that you don’t have to consume health services,” Oz said.
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“We think about 70% of all the money we spend on healthcare is caused by chronic conditions, and obesity is the No. 1 driver of all that, so it’s a smart decision.”
Oz recently announced the launch of the Medicare GLP-1 Bridge program, which will allow more seniors to access GLP-1 drugs for only $50 a month if they meet qualifying health criteria and receive prior authorization from a doctor.
The doctor expressed support for broadening affordable access to GLP-1 medications for Americans. (iStock)
“There are a lot of overweight people who don’t have high blood pressure, diabetes or other conditions, so they don’t get access to the drug normally,” he said. “We want them to have the ability to use it as well.”
Although these access shifts could boost Americans’ overall health — and in some cases could be lifesaving — Oz noted that there is “no silver bullet” when it comes to these medications.
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“I love the fact that the innovation that’s coming out of pharmaceutical companies is allowing us to save lives and make lives better,” he said. “But the real secret to longevity is eating right, exercising, sleeping, dealing with the stress of your life, finding some purpose in your existence [and] realizing you have agency over the future.”
“These are things that your mom would have told you [and that] you don’t need a doctor to be emphasizing.”
Medicating appropriately, combined with eating right, exercising and staying connected with others, can help make health goals attainable, the doctor said. (iStock)
While GLP-1s may not be a fix-all, combining these medications with foundational health practices “makes a lot of sense,” Oz said.
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“I don’t want people being fat-shamed … I don’t want you feeling guilty that you’re gaining weight even though everyone else around you seems to have figured it out,” he said. “It’s not that simple — our set points for hunger are different. We have different things going on in our lives.”
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“But if you realize how precious you are — the temple of the soul is so valuable. It’s the greatest gift your parents ever gave you, and you take advantage of every tool out there to make it work … which includes using medications when appropriate. That, to me, is MAHA.”
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Amid warnings of a Legionnaires’ disease outbreak on Manhattan’s Upper East Side, health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms.
As of July 6, the New York City Health Department had confirmed 23 cases and 17 hospitalizations associated with the respiratory infection. No deaths have been reported.
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Officials are investigating contaminated cooling towers as the likely source. They have emphasized that the illness is not spread person-to-person and is not linked to the city’s drinking water.
Health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups. (iStock)
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early,” said NYC Health Commissioner Dr. Alister Martin in a press release. “New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin.”
What is Legionnaires’?
Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC.
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That can include shower heads, sink faucets, hot tubs, water features/fountains, plumbing systems and other water systems.
When people swallow or breathe in droplets of water that contain Legionella, they can potentially become ill.
Although human transmission is possible in rare cases, the disease is not typically transmitted among people, per the Centers for Disease Control and Prevention.
Symptoms of infection
Infections can lead to severe pneumonia in older people and those with compromised immune systems, according to Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital on Long Island, New York.
Symptoms of Legionnaires’ disease usually show up between two and 14 days after exposure.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms. (iStock)
“Legionella infections cause symptoms that are similar to other forms of pneumonia — fever, coughing, difficulty breathing, shortness of breath and chest pain,” Handel previously told Fox News Digital.
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early.”
The signs are similar to other types of pneumonia, and include the following:
- Cough
- Fever
- Shortness of breath
- Muscle aches and headaches
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Some patients may also experience nausea, diarrhea and confusion, the CDC noted.
Diagnosis, treatment and prevention
A medical professional can diagnose the infection with laboratory tests and chest X-rays.
The condition is typically treated with antibiotics. In cases of severe infection, hospitalization may be required for breathing support and IV hydration.
Around 10% of people who contract Legionnaires’ disease will die from those complications — and the mortality risk rises to 25% for those who get Legionnaires’ while staying in a healthcare facility, according to the CDC.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC. (iStock)
“Treatment needs to be early and aggressive,” Dr. Nathan Goodyear, an Arizona-based integrative medicine expert, previously told Fox News Digital. “Legionella infection is an intracellular infection that requires antibiotic treatment.”
Antibiotics that are appropriate for Legionella infection include Levofloxacin and Azithromycin.
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“Therapy can be prescribed orally in healthy individuals… but intravenous antibiotics often prove to be the initial option for treatment secondary to the pathogenicity of the disease,” Goodyear said.
Currently, there are no vaccines for Legionnaires’ disease.
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The best strategy to prevent infection is to reduce the growth and spread of the Legionella bacteria. The CDC recommends that building owners and managers use a water management program to reduce the risk.
“New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin,” city officials stated. (iStock)
To prevent serious illness from Legionnaires’, Goodyear recommends that all smokers kick the habit, and also emphasizes the need to “aggressively support” chronic pulmonary disease.
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“Increasing immune support (vitamin D3, vitamin C, Zinc) is required to counter the immune dysfunction associated with advancing age.”
Obesity is another foundational risk factor for all chronic inflammatory diseases, the doctor added.
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Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27.
In a post on Substack titled “The Day I’ll Never Remember,” she detailed a sudden episode that left her unable to recall the current month, year and president.
“I thought it was 2024. And I believed Joe Biden was president,” she wrote.
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The event occurred while Couric was attending the Aspen Ideas Festival in Colorado, during which she participated in two public panels — one on AI and one on journalism — both of which she cannot remember at all.
“I have no idea what we talked about, or of what occurred when the panels ended,” she said.
Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27. (Getty Images)
John Molner — Couric’s husband, who was in attendance at the festival and the two panels — also shared his account.
After the event, someone told Molner that Katie wasn’t feeling well. When he reached her, an EMT and a doctor were tending to her. “I could tell something was off,” he wrote. “It could have been altitude sickness, but Katie was definitely not all there.”
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At the hospital, when Couric struggled to recall the year, the president and her grandchildren’s names, doctors began checking for a stroke.
An MRI revealed no signs of stroke, which was a relief, but “Katie’s ‘fog’ became a lot more apparent,” Molner wrote.
John Molner, Couric’s husband, who was in attendance at the festival and the two panels, also shared his account. (Getty Images)
“She repeatedly asked me the same questions: ‘What was I doing before we got to the hospital?’ ‘Why am I at the hospital?’”
Couric was ultimately diagnosed with transient global amnesia, a sudden, temporary episode of memory loss that prevents a person from forming new memories and may also erase some recent memories, according to Mayo Clinic.
“The cause seems to be as mysterious as the brain itself.”
It is not caused by a stroke, seizure or head injury, and it usually resolves completely within 24 hours.
“[It’s] just a very weird neural episode that’s pretty uncommon and, at least in most cases, is a ‘one and done’ experience,” Molner said.
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Couric said she finally began feeling “like herself” again around 9 p.m. and went to sleep at 2 a.m.
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.”
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.” (Getty Images)
Data shows that approximately three to eight people per 100,000 will have an episode of transient global amnesia, with people 50 years of age and older at higher risk.
The specific cause of TGA is not known, but some experts believe it stems from a “temporary dysfunction in the brain’s hippocampus — the area responsible for creating new memories,” Couric shared.
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“Doctors believe this is driven by brief interruptions in blood or oxygen flow, or microscopic spasm in the blood vessels.”
Episodes could potentially be triggered by intense physical exertion, emotional distress, extreme temperature changes or migraines, experts say.
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Approximately 15% of patients will have a recurrence 10 years later.
“Why did this happen to me? Was the altitude an issue? Was I dehydrated? Tired? Stressed? The literature doesn’t seem to indicate that these are contributing factors, but the cause seems to be as mysterious as the brain itself,” Couric wrote.
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise. (iStock)
“All I know is that those hours will be forever lost. Someone described it as my brain failing to hit the ‘record button.’”
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“While this was a freaky occurrence, it could have been much more serious. So ultimately, I’m relieved — even though several hours of a Saturday in June will always be missing for me.”
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise.
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