UnitedHealthcare Under Fire: Doctor Interrupted Mid-Surgery for Insurance Approval

A stunning event has brought together the public and medical communities in outcry, reopening debate on healthcare in America, after a UnitedHealthcare representative interrupted a surgeon in the middle of surgery to demand why the patient was in the hospital. First brought forth in a video on TikTok by Dr. Elisabeth Potter, an anesthesiologist, this incident has brought much condemnation, pointing out questions about the involvement of insurance companies in patient care. A search into the matter brought forth similar incidents reported by credible news outlets, meaning this is not a singular incident.

In 2023, while Dr. Potter, a plastic surgeon specializing in breast reconstruction for cancer patients, was in the middle of a complicated DIEP flap surgery, she received an urgent call from UnitedHealthcare. The person on the phone apparently did not know that the patient was already under anesthesia and was undergoing a delicate procedure as he asked why her inpatient stay was necessary. This interruption made Dr. Potter scrub out of the surgery, probably compromising the safety and well-being of the patient, to address the concerns of the insurance company. In her video, Dr. Potter did not mince words: “It’s out of control. Insurance is out of control. I have no other words.”

This is not an isolated case, but rather an illustration of a distressing trend in insurance company interference within the domain of medical decisions and their penchant for cost-cutting versus patient care. Over the past several years, prior authorization has increasingly become the norm for medical procedures, through complex and time-consuming bureaucratic procedures that frustrate both patients and health providers.

@drelisabethpotter

It’s 2025, and navigating insurance has somehow gotten even more out of control… I just performed two bilateral DIEP flap surgeries and two bilateral tissue expander surgeries. During one of the DIEP cases, I was interrupted by a call from United Healthcare—while the patient was already asleep on the operating table. They demanded information about her diagnosis and inpatient stay justification. I had to scrub out mid-surgery to call United, only to find that the person on the line didn’t even have access to the patient’s full medical information, despite the procedure already being pre-approved. It’s beyond frustrating and, frankly, unacceptable. Patients and providers deserve better than this. We should be focused on care, not bureaucracy. I just have no other words at this point

♬ original sound – Dr. Elisabeth Potter

The Rising Tide of Prior Authorization

Prior authorization—when insurance companies require doctors to get approval before providing certain treatments or procedures—has become commonplace over the past couple of decades. Meant to control costs, it often delays care, adds administrative burdens, and can even put patients’ lives at risk.

UnitedHealthcare has, in particular, been singled out by critics for especially stringent pre-authorization policies. The company had announced in 2024 that it would apply prior authorization for many therapies, including physical, occupational, and speech-language pathology, besides chiropractic services. Healthcare professionals were up in arms against this decision, saying it would only create needless care delays for patients receiving treatment deemed necessary by them. While UnitedHealthcare has reported that it takes an average of four to ten business days to approve prior authorization requests, providers have reported up to much longer waits and technical difficulties with the process. This discrepancy calls into question whether UnitedHealthcare’s pre-authorization system is inefficient or even opaque.

Streamlining Prior Authorization: The “Gold Card” Program

This past summer, UnitedHealthcare announced it will roll out a national “gold card” program in early 2024 to help alleviate some of the issues associated with prior authorization. Under the program, providers who have shown a pattern of approved prior authorization requests can bypass the process for most procedures.

While the effectiveness of this program remains to be seen, it signals a potential shift toward acknowledging the burden that prior authorization places on healthcare providers. The human cost consequences of insurance companies delaying or denying necessary medical care can be devastating.

Patients may suffer from prolonged pain, worsening conditions, and even life-threatening complications.

A glaring example was a patient in the ICU with a brain hemorrhage who was denied coverage by UnitedHealthcare, bringing into serious question the commitment of this company to patient welfare. The stress and anxiety of dealing with the insurance bureaucracy can also be emotionally and psychologically exhausting for patients. Dr. Potter’s story highlights the consequences of insurance interference on health care providers as well. Valuable time and resources are spent by doctors in dealing with administrative hurdles, which diverts their attention from the care of the patients. It results in burnout, frustration, and a sense of powerlessness among health professionals.

One spine surgeon commented on Dr. Potter’s video, “As surgeons, the reality is we do this all the time.and it should be shocking.” This puts in perspective how normal insurance interference in medical practice has become and how change is needed.

A Wider Problem within the US Health Care System

The case of Dr. Potter and UnitedHealthcare is not just about Dr. Potter or UnitedHealthcare; it is a symptom of a much bigger problem within the US health care system, wherein profit-motivated insurance companies regularly place their own interests ahead of the interests of their patients. This anger was tragically highlighted in the recent killing of UnitedHealthcare CEO Brian Thompson where the ammunition used by the gunman reportedly had words inscribed on it to echo the phrase “delay, deny, defend” a common accusation against insurance companies.  On top of that, the fact that UnitedHealthcare owns Optum, a healthcare provider network, brings up concerns about possible conflicts of interest. The company may be steering patients toward its own Optum providers by curtailing some of the services offered through hospitals—wherein patients’ choice and the quality of care are being sacrificed to UnitedHealthcare’s bottom line.

This issue has been gaining attention over the past few years, with numerous reports and lawsuits pointing out the harmful effects of the practices of insurance companies. The use of algorithms in denying claims, a high rate of prior authorization denials, and opacity in insurance policies have all been major contributors to public outrage and calls for reform. Further fueling public outrage, a 2023 lawsuit alleges the company knowingly used a faulty AI algorithm with a 90% error rate to deny elderly patients necessary care, overriding their doctors’ recommendations. The concern over the practices of this firm has reached the shareholders also: the latest proposal is demanding increased transparency on how these policies impact UnitedHealthcare’s brand image and the general health system. This increased reliance on AI in healthcare, while promising in many ways, has also contributed to an increase in claim denials. With more algorithms in insurance decisions, the risk of letting cost-efficiency gain primacy over patient-centered needs puts individual patients at potentially harmful denials of necessary care. Patient rights and advocacy

In the face of such challenges, it is very important that patients be aware of their rights and assert their needs in healthcare. Various organizations are available that offer resources and assistance to patients navigating the health care system’s complexities.

Such organizations can aid patients in making sense of their insurance policies, appealing denied claims, and gaining access to necessary medical care.

The Need for Change

The incident involving Dr. Potter and UnitedHealthcare serves as a wake-up call. It’s time to have a serious conversation about the role of insurance companies in healthcare and the need for greater transparency, accountability, and patient-centered care.

* **Organization:** Patient Advocate Foundation
* **Description:** Offers case management services and financial aid to patients with chronic or life-threatening illnesses.
* **Website:** https://www.patientadvocate.org/
* **Organization:** PatientRightsAdvocate.org
* **Description:** A non-profit organization advocating for healthcare price transparency.
* **Website:** https://www.patientrightsadvocate.org/
* **Organization:** Patients’ Rights Action Fund
* **Description:** Protects the rights of patients and advocates for high-quality end-of-life care.
* **Website:** https://patientsrightsaction.org

It’s only when policymakers, healthcare providers, and patients all come together that the systemic problems allowing insurance companies to interfere with medical decisions and put profits over people can be solved. Only then will we be able to make sure that every American receives the quality health care they deserve.

Conclusion

The case of Dr. Potter, the UnitedHealthcare representative interrupting her during surgery, reveals a deeper problem with America’s healthcare: insurance companies’ intrusion into medical decisions. Cases like this one, reported alongside claims denied— perhaps with the use of biased algorithms for assessments— increasingly make one worry about the whole system being pecuniary-skinflint medicine. A few initiatives, such as the “gold card” program, offer a glimmer of hope, but patients’ needs must actually be put at the center of healthcare practices as a matter of policy and professional commitment. It requires much greater transparency from insurance companies, patient advocacy, and commitment by policymakers to push for the cause of patients rather than corporate profits. By raising awareness, demanding change, and supporting organizations that champion patient rights, we can work toward a health care system that truly serves the needs of all Americans.

In a follow-up TikTok, Dr. Elisabeth Potter said that after the video, UnitedHealthcare reached out to her office and left their phone number. “I guess this stuff actually works,” she quipped.

@drelisabethpotter

As a doctor, it is next to impossible for me to reach out and talk to someone at an insurance company. But after posting that video, United actually reached out to MY office and left their number. I am going to call them back tomorrow and I will let you know what they say…

♬ original sound – Dr. Elisabeth Potter

Relevant Videos with Descriptions

• United Healthcare DENIES Coverage for Woman in a Coma in the ICU – A discussion about UnitedHealthcare denying coverage for a woman in a coma, raising concerns about insurance companies denying necessary medical care. https://www.youtube.com/watch?v=ZfRlm9cGZi0
• Doctor Reacts to United Healthcare Scandal: Is This the Future of US Healthcare? – A doctor’s perspective on the UnitedHealthcare scandal and the current state of the US healthcare system. https://www.youtube.com/watch?v=Xy2J5unWejc
• Insurance Companies Delaying and Denying Care – Experts and patients discuss the issue of insurance companies delaying and denying necessary medical care. https://www.youtube.com/watch?v=KiAzRekMG44