CHAPTER 7: The Burdens of Prior Authorization in Healthcare

CHAPTER 8: Ethos. Pathos. Logos

In the final episode of Season 2 of UpMed: The Journal of Healthcare's Race To The Bottom, Dr. Erica Rowe Urquhart discusses the complex landscape of the current healthcare system. She likens the healthcare crisis to a David and Goliath situation, emphasizing the need for proactive solutions and policy reforms to tackle detrimental practices. The episode explores the 'ethos', 'pathos', and 'logos' of our current healthcare system, highlighting the diverse stakeholders including large, medium, and small healthcare systems and providers. Dr. Urquhart dives into the financial dynamics involving insurance companies, stressing the significance of understanding insurance benefits and advocating for legislative changes. This episode concludes with a call to action for listeners to become informed and engaged in seeking improvements in healthcare. Season 3 promises to explore solutions to these pressing issues. EPISODE HIGHLIGHTS: 00:00 Welcome to UpMed Season Finale 00:36 The State of Healthcare Today 01:41 David and Goliath: A Healthcare Analogy 04:13 Understanding Healthcare Stakeholders 05:54 The Financial Dynamics of Healthcare 07:41 Patient Care and Insurance Challenges 09:25 The Legal Landscape of Healthcare 12:58 Call to Action and Season 3 Preview Website: https://www.upmed.us/ [https://www.upmed.us/] YouTube: https://www.youtube.com/@theupwardly [https://www.youtube.com/@theupwardly] Linkedin: https://www.linkedin.com/in/erica-roweurquhart/ [https://www.linkedin.com/in/erica-roweurquhart/]

CHAPTER 7: The Burdens of Prior Authorization in Healthcare

In this episode of UpMed: The Journal of Healthcare's Race To The Bottom, Dr. Erica Rowe Urquhart shares an insightful anecdote regarding the implications and inefficiencies of prior authorization in healthcare. Dr. Urquhart narrates the case of a patient with a knee injury, whose surgery was compromised and modified due to insurance authorization issues. She explores the broader impact of prior authorization on patient care, supported by research articles, one authored by Dr's. Eugene and Shushan Yang, highlighting the administrative burdens and adverse outcomes. The episode critiques the motivations behind utilization management, calling for urgent reform to prioritize patient well-being over cost-cutting measures. Dr. Urquhart concludes with a poignant story about the detrimental effects of delayed authorization on a young patient requiring urgent surgery. EPISODE HIGHLIGHTS: 00:00 Welcome to UpMed 00:26 A Troubling Case of ACL Tear 04:37 The Prior Authorization Dilemma 05:14 The Burden of Prior Authorization 07:53 Impact on Patient Care 13:46 Legislative Efforts and Reforms 17:44 A Heartbreaking Story of Delay 21:18 Conclusion and Final Thoughts Website: https://www.upmed.us/ [https://www.upmed.us/] YouTube: https://www.youtube.com/@theupwardly [https://www.youtube.com/@theupwardly] Linkedin: https://www.linkedin.com/in/erica-roweurquhart/ [https://www.linkedin.com/in/erica-roweurquhart/]

Chapter 6: Exploring Burnout and Healthcare Education: An Interview with Dr. Courtney Reinisch

In this episode of UpMed: The Journal of Healthcare's Race To The Bottom, hosted by Dr. Erika Rowe Urquhart, the discussion centers around the critical issue of burnout in nursing and the healthcare industry, a topic that has gained prominence especially during the COVID-19 pandemic. Dr. Erika welcomes Dr. Courtney Reinisch, a professor at Montclair State University and a part-time employee in public health, who shares her extensive background in nursing and her experiences during the pandemic. They delve into the challenges of nurse burnout, the impact of COVID-19 on healthcare education and practice, and the evolving role of technology in nursing. Dr. Reinisch also emphasizes the importance of teamwork and interprofessional education. The conversation highlights the gaps in the current healthcare system and the need for a cultural shift to better support healthcare providers. Dr. Erika and Dr. Reinisch also discuss the significance of effective asset management and the constant evolution of healthcare practices. EPISODE HIGHLIGHTS: 00:00 Introduction to Burnout in Nursing 00:38 Welcome to UpMed 01:10 Introducing Dr. Courtney Reinisch 01:38 Dr. Reinisch's Background and Career 04:51 Impact of COVID on Nursing 11:24 Technological Challenges in Nursing Education 23:22 Stress and Burnout in Healthcare 33:46 The Importance of Teamwork in Healthcare Website: https://www.upmed.us/ [https://www.upmed.us/] YouTube: https://www.youtube.com/@theupwardly [https://www.youtube.com/@theupwardly] Linkedin: https://www.linkedin.com/in/erica-roweurquhart/ [https://www.linkedin.com/in/erica-roweurquhart/]

Chapter 5: The Economics of Mutuality

In this thought provoking episode of UpMed: The Journal of Healthcare's Race To The Bottom, Dr. Erica Rowe Urquhart discusses the concept of Economics of Mutuality as it pertains to healthcare. She shares her experiences from studying at Oxford and discusses the concept of mutuality. Dr. Urquhart highlights the critical role of mutuality in private medical practices, recounting her journey in healthcare from Johns Hopkins, and addresses the challenges posed by third-party payers like insurance companies. She sheds light on the detrimental effects of current policies on community healthcare, especially in under-resourced areas, and the disincentives for providers to serve these communities. EPISODE HIGHLIGHTS: 00:00 Introduction to UpMed 00:22 The Economics of Mutuality 01:44 Mutuality in Healthcare 05:26 Challenges in the Current Healthcare System 09:12 Personal Reflections and Experiences 13:33 Insurance Companies and Mutuality 16:32 Conclusion and Final Thoughts Website: https://www.upmed.us/ [https://www.upmed.us/] YouTube: https://www.youtube.com/@theupwardly [https://www.youtube.com/@theupwardly] Linkedin: https://www.linkedin.com/in/erica-roweurquhart/ [https://www.linkedin.com/in/erica-roweurquhart/]

Chapter 4: Navigating the Business Side Of A Private Practice

In this episode, host Dr. Erica Rowe Urquhart speaks with Dr. Brian Sims, an orthopedic surgeon with extensive education and experience, about the challenges and nuances of running a private orthopedic practice. Dr. Sims shares his journey from medical school through obtaining an MBA to better manage the business side of medical practice. The discussion covers topics such as the complexities of insurance contracts, the necessity of business knowledge for private practitioners, the structure and operation of his multi-specialty practice in Amarillo Texas, and the broader healthcare landscape. Dr. Sims also reflects on his passion for surgery and the importance of maintaining patient trust and legacy in medicine. EPISODE HIGHLIGHTS: * Dr. Sims explains his decision to pursue an MBA * Dr. Urquhart and Dr. Sims discuss the business challenges they face in running a private practice * Dr. Sims reflects on a 30 year career in Orthopedics * Dr. Sims gives advice for aspiring doctors