As a pain physician, I spend my career advocating for patients who struggle to access appropriate pain management. I write often on hurdles like restrictive opioid policy, excessive regulatory scrutiny, prior authorization, and administrative burdens that detract from patient care. Yet nothing prepared me for the visceral reality of being the patient on the other side of the system.
From physician advocate to patient in the system
My recent experience, unrelated to pain management, exposed firsthand how impractical and inefficient our health care system can be when you are the one waiting on care. Despite being a proactive physician within the system, I faced:
- A few months delay just to schedule a straightforward diagnostic test.
- Another month waiting for results to return.
- An additional two-month wait before my clinician could even discuss the results with me being on a waitlist.
This isn’t a story of rare exception. It reflects systemic delays that thousands of patients experience daily, often with far more serious consequences.
Wait times are not just inconvenient: They harm patients
Multiple studies show that longer wait times erode patient satisfaction and undermine perceived quality of care. Research published in JAMA Internal Medicine notes that Americans often spend significantly more time waiting than they do with their provider, with only a small fraction of time spent in direct care, contributing to frustration and diminished patient confidence in the system.
Long waits for appointments and procedures are linked not just to frustration but poorer outcomes, particularly for patients with chronic illnesses or those requiring timely interventions. Delays can mean disease progression, more complex treatment needs, and increased emergency care utilization.
Prior authorization: a major bottleneck
One of the most documented systemic issues impacting patient care, highlighted in my own practice and now supported by studies, is prior authorization.
The American Medical Association (AMA) has surveyed thousands of physicians nationwide and found:
- 94 percent report that prior authorization delays access to necessary care.
- 93 percent say it negatively impacts patient clinical outcomes.
- 78 percent note that patients sometimes abandon recommended treatments due to these hurdles.
- Physicians on average spend 12 to 13 hours per week on prior authorization tasks, diverting time from patient care.
A systematic review of 25 studies published in The American Journal of Medicine corroborates these findings, showing that prior authorization is associated with measurable harm, including disease exacerbation, preventable hospital admissions, longer stays, and reduced survival across conditions spanning oncology to cardiology.
Put bluntly: What was designed as a cost-control measure often delays medically necessary care, increases overall health care utilization, and may lead to worse health outcomes.
The paradox: doctors as patients still struggle
As a physician versed in navigating complex systems, I expected that I could expedite my care. Yet I was met with the same structural barriers most patients face:
- Rigid scheduling systems
- Long waits for diagnostic access
- Communication delays between clinicians
- Limited ability to personally accelerate procedural or consultative pathways
If a medically trained clinician can’t move through the system efficiently, imagine how vulnerable and disadvantaged the average patient must feel.
Burnout, administrative burden, and the strain on care delivery
Administrative burdens, particularly those related to prior authorizations, documentation, and insurer requirements, are major contributors to physician burnout. When clinicians spend significant portions of their week on paperwork rather than patient care, both providers and patients lose. This systemic misalignment contributes to:
- Lower patient satisfaction and confidence.
- Reduced quality of clinical decision-making.
- Diminished clinician morale and retention.
Why this matters beyond individual experiences
This is not merely a criticism of specific policies but a call to address structural flaws that have cumulative, population-level consequences:
- Delayed care increases costs, from more complex later interventions to greater emergency care usage.
- Patient abandonment of care leads to poorer health outcomes and greater long-term morbidity.
- Inefficiencies in access diminish trust in the health care system and undermine preventative care.
Toward a healthier system
Our health care system should value two central stakeholders:
- The patient, whose health and well-being is the raison d’être of medicine.
- The clinician, whose skills and judgment actualize care.
Current regulatory and administrative policies, when overly rigid or misaligned with clinical realities, disrupt this relationship, ultimately hurting patients and providers alike.
This experience, while personal, reflects a broader systemic issue that demands action: reform of prior authorization processes, reduction of unnecessary administrative burdens, and redesign of care pathways that prioritize timely access and continuity over bureaucratic delay.
Kayvan Haddadan is a physiatrist and pain management physician.
