Insurers are taking decisions out of the hands of physicians, says ortho surgeon

Autonomy is an important factor in where physicians choose to practice medicine, and Grant Shifflett, MD, of Disc Sports & Spine Center in Newport Beach, Calif., told Becker's ASC Review Podcast that he sees a potentially concerning trajectory.

Note: This is an edited excerpt. Listen to the full podcast episode here.

Question: What is a top trend you're following in healthcare?

Dr. Grant Shifflett: I don't want to paint a bleak picture, but I look at this in terms of the voice we have as physicians. And it seems like every day that voice is getting stripped away more and more by insurers denying care, determining what we can and can't do and taking away decisions from us. … I'm in a private practice. I work for myself and I make my own decisions, but I still have to answer to the insurance companies. Not a day goes by that I [don't] tell patients, "Unfortunately ... insurance companies make medical decisions, doctors don't." That's a pretty sad state of affairs. 

So I think we're not going on a great trajectory in medicine, where we're giving up autonomy and decisions are being made for us. We're becoming more just worker bees. And not only is that not good for us as a profession, but I worry about patients. 

I had a guy last week who was a clear-as-day disc replacement candidate, and the insurance company wouldn't approve it and would rather him have a fusion. He's 28 years old. That's pretty sad when I'm supposedly the expert, telling a young guy an operation will give him the rest of his life, a big benefit, and they want him to have something else done to him. So I think that picture of what is going to happen in medicine, where we are going and what level of control we have, hopefully that pendulum swings the other direction.

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