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Episode 135: Who Really Controls Your Care—Your Doctor or Your Insurance Company?

  1. Episode 135: Who Really Controls Your Care—Your Doctor or Your Insurance Company? Sandy Kibling 39:24

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What happens when your doctor knows the treatment you need—but your insurance company refuses to pay for it? 

In this revealing conversation, Sandy Kibling speaks with orthopedic surgeon, author and healthcare advocate Dr. Erica Rowe Urquhart about the growing influence insurance companies and corporate interests have over patient care. 

Drawing from more than a decade in private practice, Dr. Urquhart explains how prior authorizations, changing coverage requirements and narrow provider networks can delay treatment, disrupt trusted doctor-patient Relationships and leave patients living with unnecessary pain.

Dr. Urquhart also takes listeners behind the scenes of an independent medical practice, where doctors must navigate complex and constantly changing insurance rules while trying to advocate for their patients. She explains the critical distinction between the clinician making the medical decision and the insurance company making the financial decision—and why those two priorities do not always align.

Listeners will also learn practical ways to become stronger healthcare consumers, including requesting the complete Summary of Plan Benefits, understanding the information on their insurance cards and comparing coverage before a planned procedure. 

Dr. Urquhart also discusses her bestselling book, The Invisible Hand, Wielding the Scalpel, and offers a message of hope: trust your healthcare provider, understand your coverage and hold your insurer accountable for the benefits you are paying to receive.

Resources: 

Dr. Urquhart – Website

The Invisible Hand, Wielding the Scalpel

Playbook AI Partners – Demystifying AI

Want to be a guest on Get Savvy…Demystifying Healthcare? Send Sandy Kibling a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/getsavvydemystifyinghealthcare

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Sandy Kibling Get Savvy... Demystifying Healthcare

Sandy is a health care professional having served in numerous roles including physician consulting and working for a large healthcare insurance company. She has worked on the frontline addressing physician and subscriber issues and has heard first-hand the frustration and concern about affordability and navigating a complicated healthcare system.

Sandy’s passion is to create a trusted source with Get Savvy…Demystifying Healthcare a podcast that breaks down the complexity of healthcare and empowers consumers to navigate the healthcare system.