Quick summary:
• Dr. Elisabeth Potter, a plastic surgeon in Austin, Texas, was performing breast reconstruction surgery on a cancer patient when UnitedHealthcare called the operating room, demanding immediate information about the patient’s case.
• Potter had to scrub out of surgery to return the call, only to find that the insurance representative was unaware the patient had breast cancer and was under anesthesia.
• The procedure had already been pre-approved, but the representative questioned whether the patient’s overnight hospital stay was necessary.
• The incident highlights issues with prior authorization policies, where insurers require doctors to seek approval for treatments, often delaying lifesaving care.
• UnitedHealthcare has a history of denying claims, including using error-prone AI algorithms to reject Medicare Advantage claims and intentionally denying nursing home patients’ care to boost profits.
• The company denied expecting a doctor to leave surgery, saying it would “create potential safety risks,” but Potter emphasized that insurance companies’ influence permeates every part of healthcare.
• Potter called the U.S. healthcare system “out of control” and warned that patients are suffering due to profit-driven insurance policies.
A month after the killing of UnitedHealthcare CEO Brian Thompson sparked a national conversation about the abusive practices of for-profit health insurers, a doctor in Austin, Texas has shared a shocking story that highlights the dysfunction of the U.S. healthcare system.
During a recent breast reconstruction surgery for a cancer patient, Dr. Elisabeth Potter received an urgent call from UnitedHealthcare, questioning the necessity of her patient’s hospital stay. Potter said she had to scrub out of surgery to take the call, only to find that the insurance representative wasn’t even aware that the patient had breast cancer and was under anesthesia.
“It’s 2025, and insurance just keeps getting worse,” said Potter in a TikTok video recounting the incident.
The story has since gone viral, reigniting public outrage over the broken healthcare system in the United States and the power insurers wield over medical decisions. UnitedHealthcare, the largest health insurer in the country, has long been criticized for denying coverage and delaying care through bureaucratic processes like prior authorization, which many doctors and patients say endanger lives.
Dr. Potter, who specializes in reconstructive surgery for breast cancer patients, said the incident occurred during a bilateral DIEP flap surgery, a complex procedure often required after mastectomies.
Potter was in the operating room when hospital staff informed her that UnitedHealthcare was calling and that it was urgent. Concerned that the patient’s care might be at risk, Potter scrubbed out of surgery to return the call.
“I called UnitedHealthcare, and the gentleman said he needed some information about her,” Potter said. “Wanted to know her diagnosis and whether her inpatient stay should be justified.”
Potter was stunned by the questioning. “I was like, ‘Do you understand that she’s asleep right now and she has breast cancer?’” she recounted. The UnitedHealthcare representative admitted that he wasn’t aware of those details, saying that was information known by “a different department” within the company.
Potter informed the representative that the surgery had already been pre-approved and that the overnight hospital stay was necessary. She ended the call by telling him, “I need to go back and be with my patient now.”
After returning to the operating room, Potter took to TikTok to express her frustration. “But it’s out of control,” she said. “Insurance is out of control. I have no other words.”
The incident with UnitedHealthcare highlights a broader issue with the U.S. healthcare system: prior authorization.
Prior authorization is a process where doctors must obtain approval from insurance companies before providing treatments or procedures. Insurers argue that the process helps control costs and ensure appropriate care, but doctors and patient advocates say it delays critical treatments and puts lives at risk.
A 2022 survey of oncologists found that 80% of cancer patients experienced disease progression when their treatment was delayed due to prior authorization requirements.
The American Economic Liberties Project’s Nidhi Hegde called Potter’s story “another horror story from a doctor dealing with United Healthcare’s terrible authorization process”. Hegde added, “Ridiculous that doctors/nurses are spending time explaining their work to an insurance company instead of being able to focus on care.”
UnitedHealthcare is no stranger to controversy. The company has been at the center of multiple investigations and lawsuits over its denial practices.
• A Senate investigation found that UnitedHealthcare intentionally denied claims from nursing home patients who had suffered strokes and falls, in an effort to boost profits.
• The company also faces a class-action lawsuit for using an error-prone AI algorithm to deny Medicare Advantage claims for senior citizens. The algorithm had a 90% error rate, meaning nine out of 10 denied claims were wrongly rejected.
• In December 2024, ProPublica published an investigation revealing that UnitedHealthcare routinely relied on company doctors to recommend denials of care, even when treatments were clearly necessary.
Potter said her recent experience was unprecedented in her career as a surgeon. While she had dealt with insurance hurdles before, being interrupted mid-surgery by an insurer was a new low.
The incident comes just weeks after the killing of UnitedHealthcare CEO Brian Thompson, which triggered a wave of public backlash against the for-profit health insurance industry.
Following Thompson’s death, Americans began sharing personal horror stories of coverage denials and insurance delays on social media. Many of the stories focused on cancer patients, who have been disproportionately affected by prior authorization requirements.
Potter joined the chorus of doctors and patients speaking out against UnitedHealthcare and the broader U.S. healthcare system.
In a follow-up TikTok video, Potter said insurance companies have created “a fear-based system” where doctors are pressured to comply with insurers’ demands to avoid financial repercussions for their patients.
“There is no room in healthcare where the pressure of insurance isn’t felt by both patients and doctors,” Potter told Newsweek. “Not even the operating room.”
In response to the incident, UnitedHealthcare suggested that Potter’s account was inaccurate.
“There are no insurance-related circumstances that would require a physician to step out of surgery, and it would create potential safety risks if they were to do so,” the company said in a statement to Newsweek. “We did not ask nor would ever expect a physician to interrupt patient care to answer a call and we will be following up with the provider and hospital to understand why these unorthodox actions were taken.”
Potter, however, dismissed the company’s defense, saying that insurance companies’ influence permeates every aspect of healthcare.
“This is a dark, dark time for healthcare, and we have to fix this or we’re gonna go down a path that we can’t get back from,” Potter said.
Potter’s story is one of many that highlights the dysfunction of the for-profit healthcare system in the United States, where insurance companies hold immense power over medical decisions.
The prior authorization process, which forces doctors to justify treatments to insurers, has been widely criticized for delaying care and jeopardizing patient safety.
Doctors and patient advocates are calling for reforms to limit insurers’ ability to deny care and ensure that medical decisions remain in the hands of doctors—not corporate executives.
For now, UnitedHealthcare’s actions continue to fuel public outrage, with patients and doctors alike demanding accountability from for-profit insurers that prioritize profits over lives.
As Potter concluded in her video, “It’s out of control. Insurance is out of control. I have no other words.”
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