Posted on July 18, 2025 | East County Internal Medicine
At East County Internal Medicine, we’re committed to providing you with the best possible care—swiftly, efficiently, and without unnecessary roadblocks. One such roadblock we’ve chosen to sidestep is the infamous prior authorization process. If you’ve ever dealt with the frustration of waiting weeks for insurance approval before starting a treatment or medication, you’re not alone. Here’s why we believe prior authorizations are useless, how they harm patient care, and why we don’t offer medications that require them at our practice.
What Are Prior Authorizations, Anyway?
Prior authorization is a tactic used by insurance companies to control costs. Before a doctor can prescribe certain medications or treatments, the insurer must approve it—often requiring extensive paperwork, phone calls, and delays. The idea is to ensure treatments are “medically necessary” and cost-effective. But in practice? It’s a bureaucratic nightmare that does more harm than good.
Why Prior Authorizations Are Useless
- Delays in Critical Care: Studies, including insights from the American Medical Association (AMA), show that prior authorizations can delay care by days or even weeks. According to Dr. Jack Resneck, a leading AMA voice, “As many as a third of patients stuck in this process don’t ever pick up their medications.” At East County Internal Medicine, we’ve seen patients miss vital treatment windows because of these delays—time they can’t afford when battling conditions like cancer or chronic illness.
- Non-Medical Decision-Makers: Often, the individuals reviewing prior authorization requests aren’t physicians. They may lack the expertise to understand complex conditions or the treatments we recommend. This disconnect leads to arbitrary denials, forcing us to waste hours appealing decisions instead of treating you.
- Administrative Burden: Our staff shouldn’t spend their days fighting insurance paperwork. The AMA notes that doctors’ offices dedicate significant resources to this process—time that could be spent on patient care. We refuse to let bureaucracy steal focus from what matters most: you.
- No Proven Benefit: The Centers for Medicare & Medicaid Services (CMS) touts prior authorization as a way to reduce improper billing, but there’s little evidence it improves patient outcomes. Instead, it creates a frustrating loop of denials and appeals, offering no real safeguard while jeopardizing health.
How Prior Authorizations Hurt Patient Care
Prior authorizations don’t just inconvenience—they can be downright dangerous. When treatment is delayed, conditions worsen. A patient needing urgent medication for an infection or chronic pain might face increased risks of hospitalization or complications. The CMS itself acknowledges that addressing claim issues “early” via prior authorization sounds good on paper, but in reality, it often means patients wait until it’s too late. At East County Internal Medicine, we prioritize timely interventions over insurance red tape, ensuring you get the care you need when you need it.
Moreover, the stress of navigating this process can take a toll on your mental and physical health. We’ve heard countless stories of patients feeling abandoned by a system that prioritizes profit over people. That’s not the care we stand for.
Our Stance: No Prior Authorizations, No Problem
At East County Internal Medicine, we’ve made a deliberate choice to eliminate prior authorizations from our practice. Here’s what that means for you:
- Faster Treatment: You’ll receive prescriptions and treatments without the wait, allowing us to address your health concerns promptly.
- Personalized Care: We work directly with you to find solutions that fit your needs, not insurance company checklists.
- Transparency: No hidden hurdles—you’ll know upfront what’s available and how we can help.
As part of this commitment, we do not routinely offer medications that require prior authorization. These often include high-cost drugs or those with controversial efficacy (e.g., certain biologics, specialty medications, or off-label uses). Instead, we focus on evidence-based treatments that don’t rely on insurance gatekeeping—options like vitamin D supplements (supported by research for immune and bone health), lifestyle interventions, and widely accepted pharmaceuticals that don’t trigger the authorization process.
A Better Way Forward
Our approach aligns with a growing movement among forward-thinking physicians who recognize that patient care should never be dictated by insurance algorithms. While some might argue prior authorizations protect against overprescribing, we believe the data—and our patients’ experiences—show otherwise. By bypassing this system, we reclaim control over your health journey, ensuring you’re treated as a person, not a claim number. If you’re tired of the prior authorization runaround and ready for a practice that puts you first, we invite you to join the East County Internal Medicine family. Schedule an appointment today, and let’s work together to keep you healthy—without the hassle.
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