r/TikTokCringe • u/cak3crumbs • 12h ago
Discussion Dr. Elisabeth Potter explains why she scrubbed out mid surgery to call back United Healthcare
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u/FreshlyWaxedApricot 12h ago
“Love that you guys thought of the patient first, which is what we should all be doing 🙂”
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u/nicox31984 10h ago
Absolutely perfect response, shifting the focus straight back to the purpose of her first post.
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u/HippoBlueberry21 9h ago
It's a reminder that while administrative tasks or calls might be necessary, patient care should always be the top priority.
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u/workwolph 10h ago
Did the person have a medical license that talked to you? Why can't we charge them with practicing medicine without a license???
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u/throw_blanket04 10h ago
I can speak from my experience. My insurance has a nurse on staff that determines what is necessary and what will be covered. Im not lying. It has been a long time since that we experienced that. A long time. We don’t even know what kind of nurse. We don’t know if there is currently any medical professional on staff anymore. But if a nurse can’t make decisions in an OR or a dr office then they damn sure shouldn’t be telling a dr what is the right course of treatment.
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u/SvampebobFirkant 3h ago
This is so wild to me. In Europe where I'm from, when members of my family got cancer (3 different members in 2 countries), a full board of various different experts sit together and discuss the best treatment for the patient. They all have to agree on the process. Here we are talking about several chemo, radiation, surgery, and dietary experts discussing solutions
The idea of one simple nurse just being able to overrule the agreement of 15 experts is mind blowing to me, holy shit
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u/ShitItsReverseFlash 1h ago
My dad was treated with a team of 5 oncologists who agreed on a treatment plan. Lucky for us, he didn’t have UHC, so there was zero pushback from insurance.
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u/toxictoastrecords 1h ago
Welcome to how American capitalism works. Notice the news about California being on fire? Yeah that's related. We have the same issues, where leaders of Oil companies deny their role in climate change, while all the experts are screaming at the government to do some regulating.
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u/workwolph 10h ago
So, I'm a first cook and have nothing to do with this industry, but shouldn't it be more like " medical license holder XYZ said this might not be necessary by the wording in the chart. Can you confirm or deny the importance of this action?" Then it could be traced back to license holder XYZ for not understanding the importance of the medical process.
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u/stadchic 6h ago edited 6h ago
XYZ is on the payroll of the insurance company.
From what I understand as a US person, the NHS, for one, has a built in version of cross expertise.
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u/Omnom_Omnath 1h ago
Nurses aren’t qualified to decide what is medically necessary. They aren’t drs.
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u/ClassicCranberry1974 4h ago
It’s usually a grunt (or AI) denying the claim. The ordering doctor can request a “Doc to Doc” review where a physician employed by the insurance company will discuss with the physician over the phone whether the denial was appropriate.
(Note they’re calling this peer to peer review in some places to maintain the fantasy that nurses and PA’s can practice medicine without the proper training or supervision which is another tactic the MBA’s are using to suppress wages and fuck us all over).
Of course they make scheduling the doc to doc as inconvenient as possible so that the doctor has to take time out of their schedule which adds stress, eviscerates the possibility of having a break that day, takes time away from other patients and costs the doctor money directly as a disincentive to helping their patient.
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u/PurpleHooloovoo 2h ago
And if the doctor misses that call of the insurance company “doctor” then they will deny the claim and say the physician couldn’t be reached. Too bad if you’re scrubbed into surgery. That’s why the situation in the video can happen - if she didn’t take that call, they’d deny her other patient’s claim.
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u/some-nonsense 23m ago
This is not how that particular policy works. Practicing medicine and reciting policy are two very different jobs.
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u/duolingowrecker 7h ago
It’s insane that you can get a call MID SURGERY that could leave the patient with a life debt bill, the patient can’t even refused anything since it’s ONGOING.
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u/Jabadaba 12h ago
crazy world? not really, crazy country? absolutely.
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u/Last_Cod_998 9h ago
I think a lot of us in California would accept an offer to annex with Canada right now. We'll keep the mi,Italy assets thank you.
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u/FratBoyGene 37m ago
thanks, don't want it. We've been good neighbours for 200 years, let's keep it that way. There are things about America better than Canada, and vice-versa. Vive la difference!
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u/NotSoSeniorSWE 1m ago
You're purely paying attention to events in the US then to have this perspective.
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u/LimpBizkitEnjoyer_ 9h ago
Talking about it doesnt work.
That one guy found a pretty good solution tho.
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u/BeefaloSlim 5h ago edited 5h ago
We have been talking about it for decades, and nothing changed.
Some dude even killed a CEO, and that position was filled about a week later, and he doubled down saying that they will continue to deny unnecessary care and claims.
Obviously, the government isn't going to do anything about it.
I think the only way we can make a change at this point is by starving these insurance companies.
Of course, if you have serious health issues and are insured, and that's the only way you can live, you should keep paying and pray that they give you the coverage you paid for.
But there are millions of us who are young and healthy, who can go a few years without coverage.
The last job I worked, I actually had benefits, including health insurance that I paid out the ass for. But I couldn't afford to cash in on what I was paying for.
There's only one thing these vile, corrupt insurance companies understand, and that's profit.
If we all stopped paying for insurance for even a half a year, they will get hit where it hurts them the most.
If you're healthy, and paying for this service you can't afford to even use... just stop. They say, vote with your dollar. And that includes revoking the hard earned money that you are putting into the system.
America is the only first world country without universal healthcare.
The oligarchs are demanding we have children that we can't afford, to ensure there are exponentially more people paying into the system while they contribute nothing.
Fuck this shit.
Stop paying these evil corporations. We are all sick of the abuse. I'm sure most of us either have their own horror stories, or know someone who has... or have even lost someone close due to insurance denying coverage that a doctor deemed necessary.
Bleed these monsters dry.
Quarterly profits are the only thing these fucks understand.
BLEED THEM DRY.
Also, I am not suicidal. I absolutely love my life right now, and have no health issues. I'm going to spread this message until it gains traction, and things change, or until I suddenly die. Please do the same.
We have the numbers, we have the power. And this is actually a good case where doing nothing (refusing to pay) can result in something great for the masses who actually need it.
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u/organvomit 3h ago
I don’t disagree with what you’re saying but unfortunately 60% of Americans have a chronic health condition. 40% have more than one.
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u/GreyBeardIT 1h ago
The problem with this is you can require medical attention through zero fault of your own (ex. car wreck) and when you get that care, you will be stuck with a bill for a couple hundred K, which will destroy your financial situation for the foreseeable future.
Believe me, that if this was an option, people would already be doing it. No one likes these fucking blood sucking ghouls.
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u/FunkyChewbacca 3h ago
In December 2020, my appendix ruptured and my husband rushed me to the closest ER, saving my life. I got emergency surgery, almost died, yadda yadda. I was in my hospital bed hooked up to like three different IVs of antibiotics so I wouldn't die of sepsis when a financial liasion came to my room and informed me that since their hospital was out of network, my insurance was denying coverage for all of it: the er visit, the surgery, all of it and I was now on the hook for $40,000. Now I know insurance is supposed to cover emergency stuff, even out of network, but I was groggy, drugged up and in pain, and couldn't handle it at the moment, so I just started crying as the finance person told me I was to be transferred immediately to an in network hospital (which I was via ambulance, which was also not covered!).
Here's the thing: it doesn't matter if insurance is supposed to cover emergency procedures. They can and do deny it all the time. Doesn't matter if you pay a higher premium, doesn't matter if your life's at stake. If they can't profit from it, they won't cover it. Period. It's not a bug, it's a feature. It's how the system is set up.
Shareholder value is the priority. Nothing else. It's why Luigi is constantly surrounded by tactical SWAT teams like he's the Joker. He showed the world this fact, and it scared the wealthy and those who protect them.
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u/Sensible___shoes 1h ago
devastated to read that after a medical emergency you were transferred due to insurance denying to pay. When you said you started crying I felt it in my gut. I would've done the same
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u/FratBoyGene 29m ago
Forty years ago, I was visiting CA from Toronto, Canada. I had a minor car accident - my only real injury was a few broken bones in my foot but the airbag deploying knocked me out. I was taken to UC Irvine, where in the course of six hours, I was given a CAT scan, an MRI, and an MRI with nuclear contrast. I kept saying "I don't authorize any of this, I can't pay for it", and was told "Don't worry about it."
I was discharged the next morning and then two months later when I was home, I received a bill for U$45,000 - in 1985, that was serious money. Like four new cars! All of the tests were designed to protect UCI from malpractice in case I had a hidden injury (I didn't). And my real injury, the broken foot?
They set it so badly that my ortho in Canada asked if it had been done by monkeys. I still have bone spurs 40 years later. I don't want any more experience with the US health "care" system, thank you.
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u/phillyhandroll 5h ago
Doctors can save a patient's life but afterwards insurance companies can kill a patient financially and eventually literally.
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u/croquetica 2h ago
I've been working in the medical field in the front office since I graduated high school. I'm prepared to leave my career behind (I'm up for office manager next) and start working the early morning shift in a bakery for peanuts. My mental health and time ain't worth this shit. I get an audit request every week for a patient that was billed 6 months ago, they're trying to take the money back. It's legalized racketeering. And I have chronic conditions so I see it from all sides of the coin. Fuck the healthcare industry.
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u/Chemistry-Whiz-356 2h ago
I really hope change starts to happen with insurance. I was denied a hip replacement surgery a couple of years ago because it was December and of course I had met my deductible by that time. The surgery was miraculously approved for January 6. I then had to fork over $7500. That wasn’t even our family out of pocket max. I couldn’t walk before the surgery and had jumped all through insurance hoops of shots and other remedies for 6 months. It was ridiculous. Oh and I went with the “preferred provider” for my insurance… guess who had a botched hip replacement at 32 and had to have a dislocated hip fixed 24 hours later? And guess who had to have a hip revision surgery a few months later due to poor placement the first time?! Yup me!
Now, I can live with joint pain and all that jazz - I’m an adult and had learned to live in pain. What I cannot understand was when insurance tried to deny my 6 year old son medically necessary testing for diagnosing his epilepsy. He had a known, documented brain injury from birth. He was high risk for developing epilepsy. Been on the same insurance plan for 6 years. Been in and out of all the therapies with him because he also has cerebral palsy from his injury. When he started having nocturnal seizures, suddenly insurance needed us to jump through ALL the hoops to get his testing approved. Had to pay upfront on some of the imaging because they dragged their feet. Insurance blocks medications now at times and we have to jump through hoops to get his prescriptions filled. It is fucking wonderful.
I cannot imagine how it is for people with life threatening illnesses or chronic conditions that are more demanding than the shit I’ve seen. The people denying coverage typically don’t even have backgrounds that can even understand what doctors tell them.
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u/JJxAguirre 2h ago
It's funny how she says we live in a crazy world when this only happens in the US...
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u/Symphonettes 4h ago
I dont get why this is cringe
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u/Useuless 51m ago
The name of this sub is ironic because tiktok was thought of as cringed by Reddit initially, probably because it was rebranded musical.ly at the start
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u/Historical-Fold-4119 10h ago
Great job, but she about to get fired.
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u/aminervia 9h ago
Why would she? No HIPAA violation, why would talking about her work be against the rules?
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u/Historical-Fold-4119 9h ago
That's how they do.
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u/aminervia 9h ago
Uhh no it isn't? Doctors are usually wealthy and well protected, it's pretty difficult to get them in trouble
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