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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 29/05/2025

Now she has to wait again, just long enough to age out of the plan and onto Medicare. It makes you wonder doesn’t it? How many decisions like this are about care? And how many are about cost?

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 29/05/2025

He submitted everything—her imaging, her full records, all the evidence. But United denied the case…because he didn’t include the radiographic findings in the body of his note. Not because she didn’t need the surgery. Not because the data wasn’t there. But because of a formatting technicality.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 29/05/2025

This morning I was prepping for a DIEP flap when an orthopedic surgeon sat down beside me and said, "You're not gonna believe what United just did." His patient had waited six months just to see him. He confirmed she needed a hip replacement & she was a good candidate.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 22/05/2025

If we want better outcomes, we need to demand better systems. Patients deserve care that isn’t dictated by outdated billing codes. They deserve full, uncompromised care—not the cheapest version insurance is willing to cover.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 22/05/2025

This is the reality of our healthcare system. Surgeons are forced to down-code, compromise, or absorb the cost, just to get patients what they need. But when we accept this, we devalue our work. And worse, we devalue our patients. It’s wrong. And it’s not sustainable.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 22/05/2025

She has Medicaid and I take Medicaid. I’m ready to do the surgery. But Medicaid won’t pay for it. They’ll only reimburse me to use HALF of her belly. Even though that won’t give her the reconstruction she needs. Even though using all of her tissue is the medically appropriate option.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 22/05/2025

I have another crazy story for you. Last week, I met with a young patient who only has one breast after mastectomy and radiation. She can’t have an implant. She needs a complex reconstruction called a stacked DIEP flap—using all of her belly tissue to create one breast.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/05/2025

Healthcare shouldn’t have to be this hard. And I’m fighting every day to make it better. But in the meantime, just know: I see you. I see the hustle. And you have my deepest respect💙

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/05/2025

It feels like I've been going a million miles an hour operating, working & going to conferences. But I just wanted to say, I love this work so much, & I love the people in healthcare. I am so grateful for the nurses, the techs, & team who keep showing up—despite the obstacles.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 16/05/2025

No matter how hard I try to protect patients from harm, it’s getting harder. So now I’m reevaluating ways around this, because our patients deserve better. Let’s discuss why we have “in network” and “out of network” designations. Does this add value?

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 16/05/2025

If I don’t fight for approvals & navigate the system, patients can be left with crushing bills. So I don’t have the privilege of ignoring insurance. But the truth is, the system that delivers healthcare in the US is broken.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 16/05/2025

If I want to care for patients in the U.S., I have to care about insurance. Americans have been paying premiums with an expectation that coverage will provide access to the care they need & choose. A breast cancer diagnosis isn’t just physically devastating, it can be financially devastating too.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 09/05/2025

The sad reality is I can’t afford to keep doing this for patients, even though I want to We need a better system for patients and for the doctors trying to care for them. I believe we can fix this. But we need the help of the government. We need laws to change, & we don't have the luxury of time.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 09/05/2025

But here’s the thing: this isn’t a one-off. This is yet another example of how having insurance doesn’t mean you have access to care. These narrow networks are failing patients. This young woman has cancer now. She needs surgery now. And we don’t have the luxury of time to wait for policy change.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 09/05/2025

The breast surgeon called me & asked for a favor, knowing I take cases like this on, even if the payments are low…too low to cover the costs for me and my practice…because I think it’s the right thing to do. My team is doing everything we can to get her seen this week and to get her case approved.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 09/05/2025

Last night, I got a late call from a breast surgeon here in Austin, TX. Her 22-year-old patient— just days away from a mastectomy—found out the plastic surgeon she had been seeing is out-of-network and her insurance doesn’t cover any out-of-network care. So now what?

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/05/2025

It’s about value. In relationships. In medicine. In life. No one will value you if you don’t value yourself. And as physicians—and as patients—we’ve been giving it away for free for too long. It’s time to reframe the system. To remember our worth. And to start demanding it.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/05/2025

I’ve been complicit in that. Accepting their numbers. Letting them define the value of surgeries that change lives. But here’s what I know now: if someone thinks a DIEP flap is worth $2,700, we’re not speaking the same language. This isn’t just about money.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/05/2025

If you don’t know where you are, how can you know how to get where you’re going? Lately, I’ve been thinking a lot about how we got here. How we let insurance companies that don’t understand the complexity of our work decide what it’s worth.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 19/04/2025

For the doctors out there: It’s time we talk about how unfair the business of medicine has become for providers. If you’ve tried to negotiate fair pay with insurance—whether it worked or not—I want to hear your story. Tag me or share it in the comments. We can’t fix what we don’t talk about.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 16/04/2025

Her insurance company denied a stay for a surgery without even knowing what the surgery IS.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 11/04/2025

I’ve been asked—yet again—to stop in the middle of my surgery day and justify why a patient scheduled for DIEP flap needs an overnight hospital stay. While I’m in the OR doing the hard work of breast reconstruction, I’m also expected to fight the system outside of it.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 10/04/2025

Sharing this email from the insurance company for transparency. Insurers are not medical providers yet they’re dictating when I can operate based on arbitrary policies. This delay isn’t just frustrating. It’s harmful to my patient. Insurance should not be allowed to practice medicine.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 10/04/2025

I’m the microsurgeon and insurance companies are telling me when to operate. Insurance companies are practicing medicine—and that’s not okay. Make it make sense.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 08/04/2025

Stepped out of a new patient’s consult for a peer to peer at the only time United offered me. You may remember an insurance company recently insisting that they’d never interrupt patient care for insurance matters. Reality check, it happens all the time...

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 07/04/2025

We’ll keep sharing these stories—because this shouldn’t be normal. Patients deserve better. Providers deserve better.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 07/04/2025

And without a reference number, there’s no way to track it, no accountability, and no clear path forward. All we have are the first names of the representatives who hung up. This happens often. And it’s exhausting. But we won’t stop showing up for patients.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 07/04/2025

trying to add procedure codes so patients can receive coverage for sensation preserving mastectomies. Twice now, after 30+ minutes on the line, the call just ends. No reference number. No resolution. Just—terminated.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 07/04/2025

Our team has two incredible, full-time professionals—Mary and Ebonie—dedicated to dealing with insurance. They advocate for our patients, so our patients can focus on healing. This week? They’ve been on repeat calls with the same insurer…

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 03/04/2025

📣 It’s not a perfect bill (I want this everywhere, not just in rural areas) But it’s a step in the right direction. And your voice matters—for patients, for providers, for all of us. Link in my bio to take action 💪

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 03/04/2025

If you’ve experienced a denial or delay in care, share your story too. 🗓️ Send your message by next Friday so Congressional offices have time to respond.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 03/04/2025

This bill gives power back to providers & helps ensure patients get the care they deserve. Right now, it’s limited to rural areas—but it’s a start. 📬 I’m asking you to take 60 seconds to write to your rep. Just your name & address—& a message of support.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 03/04/2025

After sharing that another patient was denied life-saving care, so many of you asked: What can I do? This is it. There’s a resolution before the House of Representatives that would allow physicians to own hospitals again—something we haven’t been able to do since the Affordable Care Act in 2010.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 02/04/2025

I am going to continue to share these denials with you so you can see what it is like to be a doctor in 2025. We have to fix this—for patients, for providers, for all of us. If you have a story, please share it with me. Let’s change this.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 02/04/2025

If I failed to prescribe the medication, I would be held accountable for putting this patient at risk. When will we admit that insurance companies are practicing medicine? When will we hold companies & individuals accountable for delays in care?

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 02/04/2025

But her insurance denied the medication. Why? They wanted “more clinicals.” Despite an in-person examination. Despite appropriate documentation. Despite the ultrasound result showing a blood clot. She was sent home from the pharmacy without the treatment she needed.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 02/04/2025

Another insurance denial. Another patient put at risk. We did everything right. My PA saw a patient with signs of a Deep Venous Thrombosis (a dangerous blood clot). We ordered an ultrasound, confirmed the diagnosis, & prescribed the medication to help prevent dangerous complications.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/04/2025

Let’s create a fair national model—one that values patients and the surgeons who show up for them in their most vulnerable moments. The only way we can change the system is by believing it is actually possible 💙

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/04/2025

I’ve built a practice committed to trying to do the right thing, and I believe we need more of us. This bill would create a fair pathway for Oregonians and give young plastic surgeons hope that choosing a career in reconstruction over cosmetic surgery is sustainable.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/04/2025

Why? Because our societies and associations haven’t protected us, the reimbursement is low, the work is complex, and the lifestyle is intense. Many who offer it balance bill or only accept cash. I’ve chosen another way.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/04/2025

I’ve spent over a decade offering DIEP flaps to patients across the country who were denied access—or told they’d need to pay 40k-200k out-of-pocket while battling breast cancer. DIEP Flap reconstruction is one of the most advanced & restorative reconstruction options, but few microsurgeons offer it

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 01/04/2025

After cases, I testified in strong support of Senate Bill 1137—because every woman deserves access to breast reconstruction and no one should have to take out loans or make exorbitant cash payments to access the breast reconstruction that’s best for them.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 28/03/2025

I hope this conversation sparks more transparency, advocacy, and connection between doctors and patients. You can listen now episodes.fm/1767429315/e...

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 28/03/2025

In this episode with Dr. Graham Walker, I’m opening up about: – The unhealthy dynamic between some insurance companies & physicians – Why talking about money with patients is so uncomfortable (but necessary) – How social media is shifting the power – And why patients have more power than they think

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 28/03/2025

For too long, doctors haven’t spoken openly about what we know is wrong in healthcare—but when we don’t speak up, patients are left in the dark, wondering why access to care is so broken.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 28/03/2025

“This isn’t the conversation I imagined having when I graduated from medical school.” I became a surgeon to help people. I never thought I’d be spending so much time fighting insurance companies, just to get my patients the care they deserve.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/03/2025

We need a new system that values patient care over profit margins. I’ll keep fighting for that, who else is with me? 💙

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/03/2025

I’ll still do the right thing for my patients, and perform their surgeries, even when I lose money—but this system needs to change. It’s time for CMS and this administration to take a hard look at how reimbursements are set.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/03/2025

I hear this over and over. The reality is, CMS reimbursement sets the standard for everyone else, and when it undervalues modern breast reconstruction, patients lose access.

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Dr. Elisabeth Potter @drelisabethpotter.bsky.social · 21/03/2025

Access to breast reconstruction is being denied because of poor reimbursement—and it’s a problem we need to address. Today, I saw a 69-year-old patient who was told she couldn’t get a DIEP flap because Medicare doesn’t pay enough.

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