Administrative challenges are nothing new to physician practices. But physicians and practice administrators across the United States now describe significant struggles to adapt to what amounts to far greater involvement from payers and regulators related to clinical decisions on a variety of fronts, such as prior authorizations, case manager involvement and network cancellations.
Primary care physicians (PCPs) often refer patients to specialists when they face a complicated or perplexing diagnosis, or one that is beyond their purview. But is that always the right decision for the patient? Some experts say that it absolutely is, but others say knowing the patient is more valuable than being an expert in one specific area.