Ubiq,
“That year I had spent months trying to get a CT scan approved for a patient wit ha suspicious lesion. Renal cell carcinoma is essentially curable if caught early enough before it spreads. by the time it was approved it had spread.”
This is very unfortunate as early detection is crucial and delays may increase complications and reduce the effectiveness of treatment. They had the following alternative options.
a. Go to the ED, and have the ED provider convinced that their symptoms require an urgent scan.
b. Explain to them the importance of the study, and why it is time sensitive, and see if they can lay out the costs (roughly 500 when paid out of pocket) and hopefully be reimbursed at a later time.
(I assume that being that they had private insurance, they had some sort of income that made the not eligible for government-funded healthcare insurance).
c. Could have used ultrasound as an alternative diagnostic tool to detect a mass, and use that as an objective means for declaring the CT Scan study urgent or emergent.
I for sure will not tell you how to practice and I am sure that you do your best to prioritize the needs of your patients, but one needs to navigate the system to the benefit of their patients.