AMA Survey Indicates Prior Authorization Wreaks Havoc on Patient Care

The American Medical Association's 2024 Prior Authorization Survey paints a picture that should alarm every physician practice leader — though likely confirms what they already feel in their operations every day. Surveying 1,000 physicians across specialties, the AMA found that practices now complete an average of 39 prior authorization requests per physician per week, with 93% of physicians reporting that prior authorization delays necessary care for their patients. These are not marginal findings. They describe a system-wide failure that has become the defining operational burden of modern medical practice.

The Numbers That Matter

Beyond the headline statistics, the survey reveals the depth of the PA burden on clinical operations:

• 89% of physicians report that prior authorization has a significant negative impact on patient clinical outcomes
• Nearly 80% say prior authorization leads patients to abandon a recommended course of treatment
• Physicians and their staff spend an average of 12 hours per week completing prior authorizations — almost a quarter of a two-physician practice's total administrative capacity
• 33% of physicians report that prior authorization has led to a serious adverse event for a patient in their care

That last statistic deserves emphasis. One in three physicians has witnessed a patient suffer a serious adverse event that they link directly to prior authorization delays. This is not an administrative inconvenience. It is a patient safety issue with documented clinical consequences.

The Economic Reality for Practices

The 12 hours per physician per week translates to real economic impact. For a practice with five physicians, that represents 60 hours of staff time weekly devoted exclusively to prior authorization — the equivalent of 1.5 full-time employees doing nothing but PA-related tasks. At average compensation rates for trained medical office staff, this represents a six-figure annual cost that generates zero revenue for the practice.

The cost extends beyond direct labor. When prior authorization delays cause patients to abandon treatment, the practice loses the downstream revenue from those services. When clinical staff are pulled into PA phone calls and documentation, they are unavailable for patient-facing work. The opportunity cost is substantial and largely invisible in standard practice financial reporting.

What the Survey Reveals About Denial Patterns

The AMA data also confirms what denial management professionals have observed for years: prior authorization requirements are expanding, not contracting. Despite public commitments from major payers to reduce PA burdens, the volume of PA requests continues to climb year over year. This suggests that voluntary payer reform is insufficient and that the structural incentives within the current system favor expanding — not reducing — authorization requirements.

The survey also found that 78% of physicians report that the prior authorization process has led them to prescribe a different medication or treatment than their first choice. Payers characterize this as appropriate utilization management. Physicians characterize it as interference with clinical judgment. The gap between these perspectives is where most denial appeals live.

Implications for Practice Strategy

The AMA survey reinforces that prior authorization is not a problem that can be solved by hiring one more person or working harder. The scale — 39 requests per physician per week — requires systematic approaches: structured workflows, evidence-based appeal strategies, and data-driven analysis of which denials are worth contesting and which represent coding or documentation gaps that can be prevented upstream.

Practices that approach PA as an individual transaction problem will continue to drown. The AMA's data makes clear that this is a systems problem requiring systems-level solutions. The question for every practice leader is whether their current denial management approach matches the scale of the challenge the AMA has documented.