The U.S. Senate held a hearing in February called “The Doctor is Out: How Washington’s Rules Drove Physicians Out of Medicine.”
That’s not a blog post title. That’s not a tweet. That is the actual name of an official Senate hearing.
When the Senate names a hearing after the problem, it’s not early. It’s late.
The number
13 hours per week. That’s how much time the average physician spends on prior authorization paperwork, according to the AMA. Not on patient care. Not on research. On filling out forms, sitting on hold, and re-submitting the same requests because a payer’s system kicked them back on a technicality.
Thirteen hours is almost two full working days. Every week. Spent asking for permission to do the job they were trained to do.
Your 15-minute appointment with your doctor? They probably spent more time that day arguing with your insurance company than they spent with you.
What that looks like in practice
The AMA survey breaks it down:
- 39 prior authorizations per week per practice
- 35% of practices have hired staff whose sole job is managing authorizations
- Each PA requires the physician’s direct involvement for clinical justification
That’s roughly 2,000 prior authorizations per year, per practice. Each one is a doctor saying “my patient needs this” and an insurer saying “prove it.”
A physician sees you, makes a clinical determination based on years of training and the specifics of your condition, and then has to justify that decision to someone at an insurance company — often someone with no medical background — using whatever documentation format that particular payer requires that particular week.
Follow the money
Those 35% of practices that hired dedicated PA staff? That’s $45,000 to $65,000 a year in salary alone. Before benefits. Before overhead. For a position that produces zero clinical value.
And here’s the kicker: the physician still has to be involved. You can’t fully delegate a prior authorization because the payer requires clinical justification that only the treating physician can provide. So the practice pays for dedicated staff and the doctor still loses hours every week.
If you value a physician’s time at a conservative $150 an hour, 13 hours a week is $101,400 a year. Per physician. In time that could have been spent seeing 26 additional patients per week.
Multiply that across a million practicing physicians in the United States and tell me this is a minor inefficiency.
The real casualty
Behind every one of those 39 weekly prior authorizations is a patient waiting. Waiting for a medication. Waiting for imaging that could catch something early enough to make a difference. Waiting for a procedure while their condition gets worse.
The system was designed to do this. Friction is the feature. Delay is the product. Every authorization a physician abandons because the process is too onerous is money that stays in the insurer’s pocket.
We built this. And the Senate is finally asking why.
At Artificer Health, we’re building technology to give those 13 hours back. If your practice is drowning in PA paperwork, we should talk.