The Hassle Factor: Why That Term Isn't Big Enough (And What To Do Instead)

Let me be honest with you: I started this week a little fired up.

My inbox was full of prior authorization requests for GLP-1 medications. Patients who already have prior approval. Patients who have been paying cash for months because we confirmed together that their insurance doesn't cover it. Not new prescriptions. Nothing that should have triggered a new request.

But there they were. Twenty patients in two weeks. And I had to stop and check every single one.

Here's the thing about prior authorizations that people outside of medicine don't always understand. You can't just let them sit. Because if one of them actually matters, if a patient genuinely needs that approval and you miss it, they don't get their medication. Sometimes that medication is a blood pressure pill. Sometimes it's chemotherapy. Sometimes the stakes are very, very high.

So even the paperwork that doesn't need to be completed still takes your time, your attention, and a piece of your mental bandwidth. Every time.

That is not a hassle.

Why "The Hassle Factor" Is Both Useful and Completely Insufficient

There's a term circulating in physician spaces right now called the hassle factor, and it's being cited as one of the leading reasons physicians are leaving medicine, leaving their jobs, or burning out entirely. I came across it recently in a post by Dr. Corinne Rao (On Linked In), and while I agree that it captures something real, I also think it dramatically undersells what's actually happening.

The hassle factor isn't just about more work. It's about moral injury. It's about knowing that the thing creating friction for you is also the thing standing between your patient and the care they need. It's about being a surgeon in the middle of an operation while an insurance company calls to deny your patient's hospital stay. (If you're not following Dr. Elizabeth Potter online, that is a real and documented example.)

When you add that kind of weight to the word hassle, you start to understand why so many excellent physicians are walking away.

This Is Not a "Just Suck It Up" Conversation

I want to be really clear about that. I am not here to tell you that this is an attitude problem. The system is genuinely broken and the burden on physicians is genuinely unsustainable.

But here is what I know to be true: we are the ones feeling what we are feeling. And we owe it to ourselves to feel better, not because the system deserves our peace, but because we do.

So here is the process I work through when the hassle factor is running high.

Step One: Radical Acceptance

This is not the same as agreement. You are not saying the situation is okay. You are not resigning yourself to it forever. What you are doing is seeing it clearly and believing it is real.

When those prior authorizations kept coming, my first instinct was to treat them as flukes. But as they kept arriving, I had to accept that something had changed. Something was happening systematically. And until I accepted that, I had no ability to respond to it. I could only react, over and over, every time a new one showed up.

Accepting what is actually happening is the foundation of everything else.

Step Two: Check In With How You Feel

Before you decide what to do, you need to know what you are feeling. That might sound simple, but for a lot of us, it is not. We have been trained to push feelings down and keep moving. We are doers. We solve problems. We do not stop to sit with frustration or grief or anger.

But here is why it matters: your emotions are giving you information about your thoughts. And your thoughts are what is driving your actions. If you skip this step, you will keep reacting instead of responding, because you have not yet understood what is actually running the show underneath the surface.

This is a great time to talk to a trusted friend, a colleague, or a coach. Someone who can help you pull apart what you are thinking and feeling so that you can move forward with clarity.

Step Three: Decide How You Want to Respond

This is where you get your power back.

Responding might look like setting a clear boundary. For me, an FMLA form dropped off without any context means the patient needs to schedule an appointment, full stop. That used to frustrate me enormously. Now it just is what it is, because I have decided how I handle it and I am no longer surprised by it.

Responding might look like creating a new workflow. With the GLP-1 prior authorization situation, I am building a process that shifts more of the tracking responsibility to my patients and sets clearer expectations upfront.

Responding might even look like intentional non-participation. Years ago, my employer started circulating a paper at morning huddle where physicians were supposed to mark their preferred double-book slots. I disagreed with the policy. I understood the potential consequences. And one day I just stopped filling it out. I passed the paper along and said nothing. That went on for a long time. It lowered my hassle factor considerably.

Was that the right choice for everyone? Maybe not. But it was a choice I made from a clear, informed, intentional place, not from a reactive one. That distinction matters enormously.

And yes, responding might mean leaving your job. It might mean leaving medicine. If that is where you land after working through this process, that is a valid answer. But you want to make that decision from a grounded place, not from the peak of a reaction.

You Are Worth the Work

The hassle factor is not going away. There will always be new policies, new automation glitches, new layers of administrative friction. The insurance companies are not going to call us and apologize.

What we can do is take ourselves seriously enough to slow down, look at what is happening, understand what we are thinking and feeling about it, and choose deliberately how we are going to respond.

You deserve to not be consumed by this. You deserve to practice medicine, or leave medicine, or redesign your life, from a place that feels like you.

If you are ready to do that work with some support, I would love to connect. Book a free discovery call with me at https://calendly.com/healthierforgood/coaching-discovery-call and let's talk about what you need and where you want to go.

Life really is better on the other side.