As The Burned-out Nurse Practitioner, I am a strong advocate of improving work-life balance as a nurse practitioner. As previously mentioned, prior authorizations are very time consuming for nurse practitioners. When the APRN’s time and energy is drained from completing prior auths, there is a decrease in productivity. This causes the provider to be behind during the work day.
Many NPs stay late at the office or bring their charts home. This disrupts their work-life balance and time with family. This lack of work-life balance is a major cause of nurse practitioner burnout. I have heard this time and time again.
Nurse practitioners doing tasks that could be delegated. Tasks that should not take the time or energy of the provider. Tasks that are becoming more frequent in this modern healthcare system. This is part of the reason nurse practitioner burnout is on a rise.
APRNs should be allowed to leave work at work- physically, mentally, and emotionally. NPs should ensure time for rest and relaxation, for self-care, for energy to do the things that bring us joy. The additional time and energy to complete prior authorizations creates a lack of work-life balance for nurse practitioners.
Imposter syndrome in nurse practitioners.
When a health insurance company denies a prior auth, it can create a sense of imposter syndrome for the nurse practitioners. The NP may have a lack of confidence or second guess their clinical judgment. Maybe they think they should have prescribed a different medication. Or been more thorough with the patient’s physical exam. Maybe the NP questions if they added enough information on the prior auth form and fear they are missing something.
I have definitely felt imposter syndrome and lack of confidence when I have a rejected prior auth. I remember having to do a peer-to-peer review via telephone with a radiologist in order to approve an MRI of the spine. I felt belittled and embarrassed when the radiologist questioned why I didn’t do a thorough musculoskeletal exam. This experience definitely made me feel insecure and like I didn’t know anything.
**I will say, after this negative encounter, I have done better about doing a complete physical exam. This is just one example of how having the treatment plan you developed was rejected. Prior auths are challenging for nurse practitioners in many ways.
Lack of control.
Nurse practitioners may also feel frustrated and that they lack control of their patient’s care. I know I definitely have been frustrated by this. I went to nurse practitioner school to learn how to assess, diagnose, and treat patients. I completed the clinical hours and have built my clinical knowledge.
But so many times, I feel like my clinical decisions don’t matter. Instead I have to comply with what the health insurance company determines is medically necessary. I do understand why health insurance companies have these strict guidelines. They don’t want to have to pay for a test or medication when there are cheaper options.
But the lack of control in patient care is beyond frustrating.
I feel like going to nurse practitioner school was pointless. I shouldn’t even have to use my clinical judgment to figure out how to treat the patient, because first I have to check with the insurance company. This lack of control and challenges of the modern healthcare system contribute to nurse practitioner burnout. I have seen it time and time again. I personally feel the frustration and lack of control as a nurse practitioner.
Easing frustrations of prior authorizations
These are just a few of my frustrations when it comes to prior auths. Completing prior authorizations are not going away and will only get worse. As the cost of healthcare goes up, health insurance companies will tighten their regulations. There is no end in sight.
Because I can’t avoid prior authorizations, I have decided to change my outlook on the situation (it’s a work in progress). I have discovered a few tips for completing a seamless prior auth process and I will share them with you in this article: 11 tips to improve prior auth processes as nurse practitioners.
But in the meantime, please comment below and tell me if you struggle with prior authorizations just like I do!