If medical insurance was designed to protect patients and support doctors — why are both groups increasingly fed up?

In this powerful episode of Plastic Surgery T&A (That’s Talk & Advice), board-certified plastic surgeon Dr. Earl Stephenson Jr. pulls back the curtain on the modern healthcare system and explains why he — and thousands of other physicians — are leaving insurance panels behind.

▶ Watch this episode to discover:

• Why medical insurance companies are acting like modern-day gatekeepers

• The shocking truth about denials, delays, and clawbacks

• What “out-of-network” really means (and why it’s not a bad thing!)

• Pros and cons of stepping outside the insurance system — for both doctors and patients

• How patients can still access expert care with payment plans, HSAs, and third-party financing

• Why going out-of-network could lead to better outcomes and better experiences

📌 Topics Covered in This Episode:

⛔ What Insurance is Really Doing:

• Denial of medically necessary procedures (including reconstructions and trauma surgery)

• Delays in authorizations that cancel or postpone care

• Ridiculously low reimbursement rates for specialists

• Time-wasting paperwork and charting unrelated to patient care

• Medical decisions being overruled by non-physicians

💡 The Rise of Out-of-Network Doctors:

• More autonomy = better care decisions

• Streamlined workflows and less administrative burnout

• Transparent pricing models

• Direct physician-patient trust without a middleman

⚖️ Pros and Cons of Going Out-of-Network

Pros:

• Personalized care and flexible timelines

• No surprise denials or downgraded reimbursements

• Transparent pricing for surgeries and consults

• Higher quality of care from more engaged providers

Cons:

• Patients may have higher upfront costs

• Potential for fewer insurance-based referrals

• Patients need to understand reimbursement options clearly

👥 What Patients Need to Know:

• Out-of-network providers aren’t always unaffordable — ask about payment plans, Cherry, CareCredit, or using HSA funds

• You can submit your own insurance claims using a “superbill”

• Many top-tier revision surgeons, trauma experts, and aesthetic specialists are out-of-network by necessity

• You deserve to choose the right provider for your body — not just the one that’s on your plan

“No business — whether it’s a coffee shop or a clinic — can survive when it only gets paid 30 cents on the dollar. That’s what insurance pays. And it’s why we’re saying: No more.”

“I trained over a decade to make these decisions. Yet I can be overruled by someone who’s never held a stethoscope, let alone lifted a scalpel.”

💥 Viral Inspiration:

This episode was inspired in part by the honest, viral TikTok commentaries of Dr. Potter (plastic surgeon) and Dr. Glaucomflecken (ophthalmologist), who’ve used humor and transparency to highlight how broken the system really is.

📞 Ready to Work with Dr. Stephenson?

Whether it’s aesthetic surgery, breast revision, or post-burn reconstruction — Dr. Earl Stephenson Jr. offers concierge-level care with you at the center.

📍 Serving Dunwoody, Atlanta, and surrounding areas
📞 Call to schedule: 770-466-4700
🌐 Visit: https://www.esjaesthetics.com

ESJ Aesthetics — Where Confidence Takes Shape.

*Disclaimer: Educational content only; not medical advice. Individual recommendations vary. Consult an ABPS-board-certified plastic surgeon.