Abstract：
Prior authorizations (PAs) are administrative tasks commonly required by insurers to approve medications or therapies for patients. Dermatology practices frequently employ coordinators to focus on completing PAs, among other solutions. The degree to which this support is offered in academic centers and, importantly, how much time dermatology residents spend on PAs over educational pursuits is largely unknown. The authors sought to identify the impact of PAs on dermatology residents.
An IRB-approved (#NCR213814) 13-question survey was distributed nationwide to dermatology residents regarding the impact of PAs on aspects of clinical and scholarly activities. Results: 150 of 1462 dermatology residents, 10.3%, responded to the survey. 70% of responding residents contribute to obtaining PAs. 58.7% indicated that their program employed a PA coordinator; though, of these, 63.6% still relied on residents for PAs. 84% indicated that for the following month they feared the burden of PAs would lead to a lapse in treatment for patients. 72.7% avoided prescribing certain medications due to PAs. 64% indicated the PA burden impedes their ability to perform scholarly activities. 80.7% indicated the PA burden contributed to burnout or decreased morale.
Our data highlight that dermatology residents are negatively impacted by the burden of PAs, resulting in reduced time to study, research, and best care for their patients. Dermatology residents and patients would benefit from reducing the burden of PAs, especially on residents by reforms or regulations that reduce dermatologic PAs, or by academic institutions removing these responsibilities from residents as best as possible. Drugs Dermatol. 2024;23(6):485-488. doi:10.36849/JDD.7617.
An IRB-approved (#NCR213814) 13-question survey was distributed nationwide to dermatology residents regarding the impact of PAs on aspects of clinical and scholarly activities. Results: 150 of 1462 dermatology residents, 10.3%, responded to the survey. 70% of responding residents contribute to obtaining PAs. 58.7% indicated that their program employed a PA coordinator; though, of these, 63.6% still relied on residents for PAs. 84% indicated that for the following month they feared the burden of PAs would lead to a lapse in treatment for patients. 72.7% avoided prescribing certain medications due to PAs. 64% indicated the PA burden impedes their ability to perform scholarly activities. 80.7% indicated the PA burden contributed to burnout or decreased morale.
Our data highlight that dermatology residents are negatively impacted by the burden of PAs, resulting in reduced time to study, research, and best care for their patients. Dermatology residents and patients would benefit from reducing the burden of PAs, especially on residents by reforms or regulations that reduce dermatologic PAs, or by academic institutions removing these responsibilities from residents as best as possible. Drugs Dermatol. 2024;23(6):485-488. doi:10.36849/JDD.7617.
摘要：
背景：事先授权（PA）是保险公司批准患者药物或治疗通常需要的管理任务。皮肤科实践经常聘请协调员专注于完成PA，在其他解决方案中。在学术中心提供这种支持的程度，重要的是,皮肤科居民在教育追求上花费了多少时间，这在很大程度上是未知的。作者试图确定PA对皮肤科居民的影响。
方法：将IRB批准的（＃NCR213814）13个问题的调查分发给全国皮肤科居民，以了解PA对临床和学术活动方面的影响。结果：1462名皮肤科居民中的150名，10.3%,回答了调查。70%的回应居民为获得PA做出了贡献。58.7％的人表示他们的计划雇用了PA协调员；但是，其中，63.6%的人仍然依赖居民获得PA。84%的人表示，在接下来的一个月里，他们担心PA的负担会导致患者治疗失败。72.7％的人由于PA而避免开某些药物。64％的人表示PA负担阻碍了他们进行学术活动的能力。80.7%的人表示PA负担导致职业倦怠或士气下降。
结论：我们的数据突出表明，皮肤科居民受到PA负担的负面影响，导致学习时间减少，研究,最好的照顾他们的病人。皮肤科居民和患者将受益于减轻PA的负担，特别是通过减少皮肤病学PA的改革或法规对居民，或者由学术机构尽可能好地从居民那里免除这些责任。药物Dermatol.2024；23（6）：485–488。doi:10.36849/JDD.7617。
方法：将IRB批准的（＃NCR213814）13个问题的调查分发给全国皮肤科居民，以了解PA对临床和学术活动方面的影响。结果：1462名皮肤科居民中的150名，10.3%,回答了调查。70%的回应居民为获得PA做出了贡献。58.7％的人表示他们的计划雇用了PA协调员；但是，其中，63.6%的人仍然依赖居民获得PA。84%的人表示，在接下来的一个月里，他们担心PA的负担会导致患者治疗失败。72.7％的人由于PA而避免开某些药物。64％的人表示PA负担阻碍了他们进行学术活动的能力。80.7%的人表示PA负担导致职业倦怠或士气下降。
结论：我们的数据突出表明，皮肤科居民受到PA负担的负面影响，导致学习时间减少，研究,最好的照顾他们的病人。皮肤科居民和患者将受益于减轻PA的负担，特别是通过减少皮肤病学PA的改革或法规对居民，或者由学术机构尽可能好地从居民那里免除这些责任。药物Dermatol.2024；23（6）：485–488。doi:10.36849/JDD.7617。
