Elisabeth Potter MD
@EPotterMD • 24,454 subscribers
[email protected] Board Certified Plastic Surgeon, DIEP flap & breast reconstruction expert | Fighting to change healthcare & ensure patient access
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I built a way to save America a whole lot of money. A patient of mine needs a mastectomy with tissue expander reconstruction, so we called a hospital’s price transparency line to ask for an estimate before surgery. The quote? $430,000. Then I sat down and estimated what it would cost to perform that exact same operation at Redbud Surgery Center. About $17,000. This is exactly why I believe independent outpatient surgery centers are part of the future of healthcare. When physicians are empowered to build efficient, patient-centered facilities, we can often provide the same high-quality care in a setting that is more affordable, more transparent, and designed around the patient experience. Healthcare doesn’t have to be this expensive. Competition works. Transparency works. Innovation works. If we want to lower healthcare costs in America, we don’t have to lower the quality of care. We simply have to start supporting models that deliver excellent outcomes without unnecessary overhead. There are solutions. We just have to be willing to build them.
Elisabeth Potter MD182,691 次观看 • 1 个月前
Today one of my breast cancer patients was placed under general anesthesia before I had seen her, marked her, or signed her chart. That should never happen. This is not the first time I have walked into a hospital and found that the rules were treated like suggestions. Surgery is not an assembly line. These are human beings. They deserve to be seen, evaluated, marked, and spoken to before anesthesia is administered. When I asked for an explanation, I was met with defensiveness instead of accountability. And here is the deeper issue. I am often told by insurance companies where I am allowed to operate. Even when I know that another facility is safer. Even when patterns like this have already occurred. Physicians should be able to choose the safest environment for their patients. Insurance contracts should not override safety standards. I am tired. But I am not going to be quiet. We have to build a system where surgeons can vote with their feet and take patients where protocols are followed and safety comes first. Our patients deserve better.
Elisabeth Potter MD598,034 次观看 • 5 个月前
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I’m sharing an actual recent peer-to-peer call that shows what physicians and patients face when trying to get a surgery approved. This call felt as absurd as it sounds. The peer-to-peer call was to advocate for surgery to prevent and treat lymphedema for a patient with breast cancer. Her risk is high and we can perform a surgery to lower it. The doctors from the insurance company on the call were an ophthalmologist with a subspecialty in oculoplastic surgery and a plastic surgeon who currently has a cosmetic practice. Neither doctor has ever performed lymph venous bypass…the surgery I was trying to get approved for my patient. Neither doctor would provide their name or license number. At the conclusion of the call, the doctors told me that they didn’t have the power to make a determination or decision to perform the surgery. They were just there to inform me of United’s decision to deny it. The Medical Decision was not up to the doctors on the call. It had already been made by United. So here I am, appealing again. Medical decisions should be made by doctors who are well informed and patient-centered. Patients deserve access to the care that they paid for with their premiums.
Elisabeth Potter MD1,351,735 次观看 • 1 年前
This is happening more than people realize. A woman fighting breast cancer showed up for surgery today…fresh off of chemo, port in place, nothing to eat or drink, mentally preparing for the thing no one can ever truly be ready for. And then we canceled. Not because she didn’t need surgery. Not because it wasn’t medically necessary. But because the hospital said they won’t get paid without prior authorization. This is the system we’ve learned to work inside, one that denies and delays care for administrative reasons. A system where responsibility is spread everywhere and nowhere at the same time. Where having insurance doesn’t guarantee you’ll get the care you need. Where paperwork can matter more than a patient sitting in a hospital bed. Prior authorization reform may be announced, but on the front lines, it’s not what we’re seeing. Today, a cancer surgery was canceled because the system is designed to protect payment…not people.
Elisabeth Potter MD324,500 次观看 • 5 个月前
If I want healthcare to be different, I have to practice differently. Today at Redbud we did multiple cases in an environment built around patients, not profit margins. We had time. We had focus. We had the right team in the right setting. One patient came to us after receiving a quote of more than $100,000 for her cancer surgery elsewhere. The operating room fees alone were quoted at over $30,000. We performed her surgery today at Redbud, a CMS-certified facility with fellowship-trained surgeons and experienced nurses for a fraction of that cost. Same standard of excellence. Different priorities. Healthcare does not have to be this expensive in America. It’s not easy to do things differently, but it is possible. And we’re proving that one patient at a time.
Elisabeth Potter MD376,415 次观看 • 6 个月前
My dad spent his career building a small, independent allergy practice in Augusta, Georgia. It was our family business and it was his life's work. When it came time for him to retire, he wanted to pass it on to someone who would continue that work but no one wanted it. Not because it wasn't meaningful, but because independent practice wasn't valued anymore. What was valued was the land. Today there's a McDonald's where his practice used to be. We're grateful for the income it provides my parents but that's not what was supposed to be there. And yet here I am, running my own independent practice in Austin. Maybe that's crazy after watching what my dad went through. But I'm not doing this because it's easy, I'm doing it because it needs to be done. If we're not honest about how hard this is, we can't fix it. Independent physicians need to be valued. They need to be paid fairly. And when they retire, their work should be worth passing on. The fact that it isn't is a sign that something has gone very wrong. This is my story. It's my dad's story. And it's the story of healthcare in America.
Elisabeth Potter MD227,361 次观看 • 3 个月前
After I moved more breast reconstruction surgeries to an outpatient surgery center, the hospital proposed sending my remaining DIEP flap patients to the ICU, despite the fact that these patients had never previously required ICU care. The ICU is one of the most expensive places in a hospital. So I called hospital leadership to explain why I believed this wasn’t in the best interest of patients. I’m sharing that conversation with you. Over the past 13 years, our team has performed thousands of breast reconstruction procedures with a 99.7 % success rate. These patients do not need ICU care. They need specialized nurses who understand breast reconstruction, early mobility, and a pathway that gets them safely home. The documented rationale for the change had nothing to do with patients actually needed more acute care. It had everything to do with declining case volume. We can learn a lot about priorities by observing how people and systems respond to stress. I improved outcomes and lowered the cost of breast reconstruction by moving it to an outpatient center. The system responded by increasing the cost per patient. We should all take note.
Elisabeth Potter MD55,724 次观看 • 1 个月前
Another peer-to-peer call. The reviewer was kind. Really kind. But, respectfully, not my peer. He listened as I explained why my patient needs lymphovenous bypass surgery. It’s a surgery that can treat the painful swelling in her arm caused by breast cancer treatment and prevent it from getting worse. She has done everything right. Compression. Therapy. Expensive garments. She’s changed her life to spend an hour a day with every resource she can afford. It’s affecting her ability to work as a nurse. And she is getting worse. This is the window where we can fix it. Early enough that surgery can actually change the course. We can do this surgery outpatient. Two hours. CMS even has a code for it. The man on the phone agreed it would help her… But he couldn’t approve it… Because he’s not a plastic surgeon and doesn’t have the specific knowledge necessary to make this recommendation. He gave me the help he felt he could. He told me to appeal and told me not to expedite it, because that wouldn’t work in my favor. Every human involved in this case knows what we should do. But the system is inhumane.
Elisabeth Potter MD215,312 次观看 • 4 个月前
A year and a half ago, I shared a video about UnitedHealthcare. It wasn’t just about my practice. It was about what happens when insurance companies stand between patients and the care they need. A lot has happened since then. Redbud Surgery Center is still out of network. Back in January, United’s CEO said he would personally look into the situation. I’m still waiting. Does it feel fair? No. But I’m not giving up. I will keep telling the truth about what patients experience. I will keep advocating for transparent, affordable, high quality care. And I will keep working to help fix a healthcare system that too often puts barriers between patients and the care they need. The reason I’m still here is in large part because of you. You have listened. You have shared these stories. You have believed in this mission. Thank you for standing with me. I’m not going anywhere.
Elisabeth Potter MD25,578 次观看 • 16 天前
A year ago, I received a letter from UnitedHealthcare that was meant to scare me into silence. I documented parts of the last year that I haven’t shared before. That morning, as I processed the shock of what was happening on my drive to the hospital, I turned on my phone and started recording. As I spoke to you, my resolve developed. I knew what I had to do. I had to stand up for the truth, my patients, and myself. Even though I was terrified, I found peace and purpose in that moment. Days later, when I shared the threatening letter with you all, you stood with me. I know we are far from done, but I share this now to remind you of the good we can do together.
Elisabeth Potter MD239,219 次观看 • 6 个月前
I stepped out of a new patient’s consult to have this peer to peer call at the only time offered to 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. The doctor I spoke with was a general surgeon who had never performed breast reconstruction. He declined to give me his name, citing concerns for his personal safety. He was polite, but ultimately told me that United considers nerve sparing mastectomies “experimental”. He would not provide a written rationale or references for the studies used to make this determination. But he kindly invited me to appeal. Sure. What a great idea. The patient and I have all the time in the world. Let’s do this all over again. Until we are seen and heard.
Elisabeth Potter MD426,959 次观看 • 1 年前
I woke up to a message from New Hampshire. A bill had made it to the state Senate — one that Representative Julie Miles championed after watching me do peer-to-peer calls with insurance reviewers who weren't qualified to be making decisions about my patients. I'm a surgeon in Texas. I had no idea this had traveled that far. Between cases at Redbud today, I fired off emails to NH Senate members, logged into a YouTube Live, and watched HB 1554 pass. Here's what it does: ✅ Requires peer reviewers to be actual peers — credentialed, named, with their NPI number and specialty certification on the line ✅ Allows physicians to communicate with that peer reviewer at any point in the prior auth process — not just after a denial or on appeal This is a patient-centered, common-sense reform. And it happened because someone posted something. Told the truth. Did the right thing. Thank you, Representative Julie Miles and Senator Tim McGough. New Hampshire just set a standard. I hope other states are paying attention. Get involved. Speak up. You never know what good it might do.
Elisabeth Potter MD92,187 次观看 • 3 个月前
Every December, patients rush to get care before deductibles reset in January. This year feels different. I am meeting patients who are newly diagnosed with breast cancer right before the holidays while also worrying about whether they will be able to afford their care next year. What is becoming harder is navigating an insurance system that adds fear and uncertainty during an already overwhelming time. There are a lot of us out here who simply want to keep taking care of patients. We are going to figure this out. This next year will be a year of ingenuity because our patients deserve it.
Elisabeth Potter MD210,381 次观看 • 7 个月前
I’ve been keeping something from you. The way I cope with hard things is by doing the work and putting the pain in a box. But the truth is—since I spoke out against insurance companies, things have been really hard. My practice is struggling. I built a surgery center so I could take better care of my patients, expecting to do my cases through insurance. But several insurance companies have refused to contract with me since I posted that video. The strain has been so heavy, I’m not sure I can keep the practice open in its current form. I’m sharing this because no insurance company should have the power to shut down a practice, especially one built to help people. All I want is to take care of my patients. All I want is to do the right thing. I’ve invested all of my time, money, and heart into this. And it’s dangerous—truly dangerous—that one or two insurance companies can make decisions that threaten the future of a practice like mine. I’m hoping that I can figure something out for the practice, but I just wanted to be honest with you guys because this is part of the reality of being a doctor. This isn’t the first time I’ve been here. COVID almost knocked me out. The hack, when I wasn’t paid for three months, was another blow. And now this—being punished for telling the truth. But I won’t be knocked out. I’m committed to telling the truth about healthcare, about insurance, and working to find a better way to continue to keep my practice open and taking care of women with breast cancer so I don’t lost my practice or my home. I promise I’ll keep you updated.
Elisabeth Potter MD271,060 次观看 • 1 年前
Today I’m sharing an update about a patient many of you remember, the woman who drove hours across Texas after her radiated implants became infected and no one near her would take her insurance. We removed her infected implants to protect her health. It was urgent. It was necessary. It was absolutely medically indicated. And yet… her insurance company sent her a letter denying the surgery, claiming it was not medically necessary. This is the reality too many women face after breast cancer: fighting infections, managing complications, and then having to battle an insurance company that should be advocating for their care. When insurers decide they know better than the surgeon at the bedside and the patient in pain, something is profoundly broken. To my patient: thank you for your strength and for trusting me. To everyone watching: we’re going to keep pushing for a system that listens to doctors and protects patients.
Elisabeth Potter MD167,795 次观看 • 8 个月前
Let’s be real. I spoke out against a big insurance company and now I’m being punished for it. But I’m not giving up. It’s not in my blood. I heard you asking, and if you would like to help, I’ve started a gofundme (linked below) where you can read the details and consider contributing. Just showing up and following means the world to me. I’ll keep it transparent so we can all see what medicine in the US is like in 2025 and hopefully build something better for all of us.
Elisabeth Potter MD252,218 次观看 • 1 年前
There is no algorithm that can replace the instincts of an experienced physician when faced with a patient in need. When the doctor who saw this patient in the Emergency Room examined her, spoke with her, and decided to admit her, I know that he did so because he knew best how to keep her safe. I am grateful. I am disturbed that her insurance company questioned that judgement and presumes to know better than the doctor in front of her. The following statement in the denial letter says so much about the current state of healthcare: “When a doctor or facility treats a patient above the recommended level of care, we cannot cover it.” This does not pass the sister test. I’ll take the best judgement of the doctor who was physically present at the bedside of a frightened patient over an insurance company’s algorithm every time. And I refuse to accept that this is the best we as a society can do.
Elisabeth Potter MD311,289 次观看 • 1 年前
Taylor Jenkins was 25 years old. She was healthy. Successful. In love. About to get engaged. After being rear ended at a red light in Florida, Taylor was taken to the hospital, where her mother says confirmed medical negligence and neglect cost her life. But what happened next is what stopped me in my tracks. Because Taylor was 25, unmarried, and did not have children, her family was blocked from seeking accountability under a Florida law known as “Free Kill.” Florida is the only state in the country with a law like this. If you are over 25, unmarried, and without children, your parents cannot pursue non economic damages in cases of medical negligence. Think about that for a second. A daughter’s life. Reduced to whether she had a spouse or children. In 2025, 93% of the Florida legislature voted to repeal this law. The repeal was vetoed. Taylor’s mother, Cindy, told me: “They killed half my heart that day, and I will never stop fighting for Taylor so nobody else ever has to go through this.” This is bigger than one family. This is about what happens when accountability disappears from healthcare systems. And who powerful lobbying protects when it does. Healthcare should never value a human life based on marital status or parenthood. Taylor mattered. If you want to learn more or support the movement to restore safety and accountability in healthcare, follow @healthcareaccountabilityinitiative on Instagram.
Elisabeth Potter MD66,504 次观看 • 3 个月前
My last case of 2025 and my first case of 2026 tell you everything you need to know about our healthcare system. Last week, I was scheduled to do a DIEP flap for a patient who had been waiting a long time. We had asked her insurance company if we could do the surgery in network at @Redbudsurgerycenter, where we have everything needed to safely and efficiently take care of her. They hadn’t approved that, so the surgery had to be scheduled at an older hospital in town. When we arrived, the hospital was having HVAC issues. The humidity levels were not safe for surgery. We waited for hours, and ultimately the case had to be canceled. It wasn’t just her surgery. Multiple surgeries were canceled that day because operating under those conditions would have been a fire risk. We weren’t able to reschedule her surgery before the end of the year, which means her deductible resets. I could have safely done her surgery at Redbud that day but insurance rules wouldn’t allow it. This is what closed networks and rigid systems look like in real life. Now here’s the contrast. The first case I’m doing in 2026 is also a woman who needs breast reconstruction with DIEP flaps. This time, instead of traditional insurance, her employer uses a third party administrator. They came to me directly and asked what I would charge if they paid fairly and transparently. On Monday, we’re doing her bilateral DIEP flap at @Redbudsurgerycenter. I can control the environment, the costs, and the care. It’s better for the patient and significantly less expensive for the employer. This is called Direct Specialty Care. It’s not direct primary care. It’s specialty care delivered without unnecessary barriers. It’s happening. We’re starting the year this way. And I’m going to keep pushing the boundaries and keeping you informed.
Elisabeth Potter MD136,464 次观看 • 7 个月前