In between scrubbing in for surgical procedures, Dr. Elisabeth Potter, a Texas-based plastic surgeon who works with breast most cancers sufferers, is combating to drag again the curtain on the pitfalls of the medical health insurance business.
Potter makes a speciality of a process that includes utilizing fats and tissue from a affected person’s decrease stomach to rebuild breasts after a mastectomy or lumpectomy. Potter has carried out the surgical procedure, known as a deep inferior epigastric perforator (DIEP) flap process, greater than 1,000 occasions, and mentioned she treats about 40% of ladies with breast most cancers in central Texas.
Courtesy of Dr. Elisabeth Potter
On social media, Potter shares videos that show the frustrating reality of navigating insurance coverage on behalf of her patients.
“We’ve behaved too predictably for a long time, and the fact that it’s not normal for doctors and patients to get on social media and talk about the difficulties of health care says a lot,” she instructed HuffPost. “We need to start speaking out so that there’s 100 doctors like me or 1,000 doctors like me saying enough is enough.” (For the complete story, watch the video above.)
In 2024, Potter opened RedBud Surgery Center in Austin in an effort to make breast reconstruction more accessible and affordable. She said surgeries can typically cost a patient anywhere from $60,000 to $200,000 out of pocket.
“Many women who are diagnosed with breast cancer and seek breast reconstruction go to see a cosmetic plastic surgeon who might only take cash or only does an implant type of reconstruction,” Potter said.
Patients could also go to a microsurgeon like Potter, who uses a specialized microscope to perform surgery on some of the body’s most intricate structures like blood vessels and nerves. “But many [microsurgeons] are only out of network, meaning the patients will pay a penalty to go see them, or they actually charge cash,” Potter said.
Potter said owning RedBud also helps her bottom line. She can continue her work while taking less of a financial hit because RedBud collects the facility fees associated with a surgery ― charges for essentials like an operating room, equipment and medical staff.
“I set out to prove a different case,” Potter said. “I set out to build a practice where I do accept insurance, where I don’t penalize the patient for the system that we’re in, right? So I accept insurance, and I do cases for free.”
Now Potter is raising money to “keep the lights on” at RedBud. She said the problem is that UnitedHealthcare, Texas’ second-largest insurer, won’t currently accept the practice — an ambulatory surgery center, or ASC — into its network. That makes it hard for her to run a profitable practice and for patients to afford natural tissue reconstructive surgery.
UnitedHealthcare told HuffPost there is already sufficient access to ambulatory and plastic surgery centers for its members in Travis County, Texas, even without RedBud. UHC told Potter it wasn’t accepting any new ASCs back in October 2024.
But Potter claims she’s the only physician in the county performing the DIEP flap surgery outside of a hospital setting, where procedures are significantly more expensive. She believes UnitedHealthcare’s actions are retaliation for her public criticism of them, though the company adamantly denies that.
Potter went viral in January when she revealed she left surgery to take a call from UnitedHealthcare about a patient as they were on her operating table.
“It’s 2025, and insurance just keeps getting worse,” she mentioned in a video, nonetheless carrying a surgical cap. Potter described how UHC’s consultant requested her to justify the affected person’s in a single day keep, and he or she lamented that the medical health insurance business was “out of control.”
UnitedHealthcare demanded the videos be taken down and threatened legal action for defamation. In a statement to HuffPost, the company said: “UnitedHealthcare did not ask — nor would it ever expect — a physician to interrupt patient care to return a phone call about a notification error or any other insurance matter.”
UHC said the call was not urgent and only happened because the hospital made an “erroneous order of a separate inpatient stay.” But Potter said she took the call, and left the patient in the care of a co-surgeon, because she was determined to advocate for her patient.
“I have patients all the time who get bills that are huge and have to live through the back and forth with insurance companies or hospitals in the midst of the financial devastation of a cancer diagnosis,” she said. “So it was not a long leap to think they may try to not pay for this, and they may put this woman through even more harm, this woman on the table having mastectomies today, that they may put her through even more. And if I can take this call, if they’re asking, let me take a call, and I can do that right now, and let’s see if we can sort it out.”
UnitedHealthcare told HuffPost there were never any negotiations about RedBud joining its network, but Potter said ongoing communication with UHC went “radio silent” after she posted the video.
At the time of this story’s publication, UnitedHealthcare has not taken any legal action against Potter. She continues to share her experiences, including “peer-to-peer” calls with UnitedHealthcare representatives. Potter said the calls are part of the appeal process if a service has been denied by an insurer, and a way for providers and insurers to “get on the same page.”
“But that’s not what it’s like,” she said. “It’s like they’re checking a box.”
Potter mentioned she hopes her posts might help problem insurance coverage firms and maintain them accountable.
“I think there’s a really healthy thing happening now as part of this conversation, which is that patients and providers are on the same side…We need to be honest about the harm that’s being done by the financialization of medicine, and share that with our patients, so that we can all fight and push together,” she said.
Since the dispute with UnitedHealthcare began, Potter says RedBud has been accepted in-network by other insurers, including Aetna and Humana. She’s also heard from patients and physicians alike who are cheering her on.
“Every day, multiple times a day, another doctor reaches out and says, ‘Thank you,’” she said. “Another retired doctor who left medicine because it was killing them morally reaches out and says, ‘Please keep fighting.’ Another patient who is encountering difficulties getting the care that they need reaches out and says, ‘You know, I haven’t seen someone fight like this or tell the truth before.’”
