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Who Gets the First Vote? Clinical Judgment, Coverage, and Learned Helplessness
Clinicians are trained to answer one question: What does this patient need?
But once they enter practice, another voice often enters the room: What will insurance cover?
The problem is not that coverage exists. The problem begins when coverage gets the first vote.
In this episode of The Operator, Jimmy McKay and Larry Benz examine how clinicians can gradually learn to reshape their judgment around payer rules without anyone explicitly instructing them to do so.
Larry connects the issue to learned helplessness: when decisions are repeatedly overridden by portals, fee schedules, denials, and…
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