Insurance Bureaucracy Lengthening Physician Workdays Adventures in Prior Authorization - NY Times Two recent articles outline the growing difficulty in communications between insurance companies and physicians.  Many patients ask me why they can't have surgery tomorrow.  It is a difficult position as a specialist in that patients come in today and want surgery tomorrow.  While we may have just met for the first time today, they have been dealing with their pain and issues for months or years.  The decision was a long time in the making, and once the decision is made, they are ready.  This is understandable to all of us involved in the care of a patient, but not necessarily to their insurance company.  These articles outline the difficulties that primary care physicians have in getting medications approved.  We have similar, if not worse, issues with getting surgery approved.  Some highlights from the first article: