A surgeon in Austin, Texas, was in the middle of an operation when he received a call from the patient’s insurance company.
Dr. Elizabeth Porter is a board-certified plastic surgeon who specializes in reconstructive surgery for women with breast cancer. Last year alone, she performed about 520 operations on cancer patients.
She recently shared a video of herself talking about the experience.
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“I just had two bilateral DIEP flap surgeries and two bilateral tissue expander surgeries,” she said in the now-viral video.
(In DIEP flap reconstruction surgery, skin, fat, and blood vessels from the patient’s abdomen are used to reconstruct the breast.)
Dr. Elisabeth Potter, a Texas surgeon, recently shared a video in which she described a call she received from an insurance company while a patient was in surgery. (Dr. Elizabeth Potter; @drelisabethpotter)
In one case at DIEP, Porter said, while a patient fell asleep on the operating table, the doctor was interrupted by a nursing supervisor who told her there was a call from the patient’s insurance company, UnitedHealthcare.
The nurse who answered the phone said Porter was in surgery and couldn’t answer the phone.
“They said, I need to send her a message because we need to talk to her about this patient,” Porter told Fox News Digital. “So they wrote a note and brought it into the operating room and I took a picture because I was like, I can’t believe this is happening.”
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The note included the name and phone number of the UnitedHealthcare provider, as well as the patient’s name and Dr. Porter’s name. (The note did not state that the caller requested an immediate response.)
“The nurse at the front desk of the operating room answered the phone and wrote this note saying that the person who answered the phone asked about the patient first and then asked about me,” Porter told Fox News Digital.
“I made that judgment and I stand by it – I think it’s the right thing to do for the patient.”
“He was told I was scrubbed[to the] operating room, he asked the nurse to contact me in the operating room and deliver the news to me.
Porter added, “The nurse manager said she had never received a call like this in her career. She thought it must be important and took that information to the operating room.”
Dr. Elisabeth Potter, a surgeon in Austin, Texas, was undergoing surgery when she received a call from the patient’s insurance company. (Dr. Elizabeth Potter; @drelisabethpotter)
Potter said it was strange that the insurance company called the hospital front desk and she was not an employee.
“They didn’t call my office. They didn’t call my cell phone. They didn’t email me. This is not the billing department of the hospital.”
Concerned that the insurance company might deny service to the patient, Porter decided to cancel mid-surgery and return the call to United.
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The surgeon told Fox News Digital that UnitedHealthcare did not ask her to leave the operating room or threaten to deny coverage.
The patient is safe with another surgeon and anesthesia team as they complete the procedure.
Dr. Elizabeth Porter is a board-certified plastic surgeon in Texas who specializes in breast reconstruction for women with breast cancer. (Dr. Elizabeth Porter)
She said Porter was “terrified” of patients waking up and finding out their insurance companies said they didn’t have the information they needed and would deny the claim.
“I’ve seen it before, people are stuck with $80,000 or $100,000 bills,” she told Fox News Digital. “So I said to my partners, ‘I’m going to make this call as soon as possible.'” ( Click here to watch her video.)
“Dealing with insurance is a very important part of caring for a breast cancer patient because a diagnosis can be financially devastating.”
“I wouldn’t have done it if it had been a critical moment in the operation,” Porter clarified. “But I made that judgment, and I stand by that — I think it’s the right thing to do for the patient.”
She said the insurance company said on the call that they needed to know the patient’s diagnosis and reason for hospitalization, which Porter had communicated.
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“I was like, wait a minute, we got authorization for surgery. We submitted all the clinical documentation. We’ve done all the paperwork, the phone calls, everything. You have her diagnosis code, you have everything,” she continued. said.
“They said, ‘Actually, I don’t have it, another department has this, but I need this now,'” Porter said. “In that moment, I had a sense of entitlement to my time and information,” the surgeon added.
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Porter also noted that although the surgery had been pre-approved, the person on the phone did not have access to the patient’s complete medical information.
“I’m not sure that person understands the impact they have on the patients I’m operating on,” Porter told Fox News Digital. “They only think about money and numbers and don’t understand at all.”
The surgeon told Fox Digital News that Porter is “terrified” of patients waking up and finding out their insurance companies say they don’t have the information they need and will deny the claim. (iStock)
“It’s frustrating and frankly, it’s unacceptable,” she told Fox News Digital. “Patients and providers deserve better than this. We should be focusing on care, not bureaucracy.”
Porter noted that she has been “committed” to providing in-network care through insurance.
“Dealing with insurance is a very important part of caring for a breast cancer patient because a diagnosis can be financially devastating,” she told Fox News Digital.
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“I found that I really had to be directly involved and think about insurance and whether they would cover the treatment and what my patients were going through.”
Porter stressed that she did not believe insurance was “evil,” noting that there were some “real benefits” to businesses taking care of people.
The surgeon found it strange that the insurance company called the hospital front desk and she was not a hospital employee. (iStock)
“But it has evolved into something that is no longer dedicated to patient care. It’s just a machine to operate and make money, and they don’t care about me as a provider,” she said.
Porter noted that many doctors have given up and refused to deal with insurance companies, choosing to stay away from them and let patients pay up front and handle reimbursement.
“Patients and providers deserve better than this.”
“I went to Washington, D.C., and I fought to protect access [breast] Reconstruction,” she said. “I’ve testified before the state Legislature on these issues.
She added, “It all became irreversible. At this point this week, it felt like we had crossed a line – they were actually in the operating room.”
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Fox News Digital reached out to UnitedHealthcare for comment. The company issued the following statement.
“There are no insurance-related circumstances that would require a physician to withdraw from a procedure, which would create a potential safety risk if they did.”
It continued, “We do not ask or expect physicians to interrupt patient care to answer calls, and we will follow up with providers and hospitals to understand why these unorthodox actions were taken.”
Separately, UnitedHealth Group leaders said Thursday that the company remains “focused on delivering high-quality, affordable health care while making the health system more accessible to patients and providers.” (iStock)
Separately, the head of United Healthcare Group said on Thursday that the company is confident of achieving business growth in fiscal 2025.
“UnitedHealthcare’s employees remain focused on delivering high-quality, affordable health care to more people while making the health system more accessible to patients and providers, positioning us for growth in 2025,” Chief chief executive Andrew Witty said in the company’s annual report.
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His optimism came shortly after the head of his insurance division was gunned down in New York City, sparking a heated discussion about the role of the U.S. health insurance industry.
Fox News Digital’s Daniella Genovese also contributed reporting.
