A physician who wrote a book on health insurance still could not get his own cancer treatment approved. Dr. Ben Proctor explains why care gets denied and who profits.

Dr. Derrick Hines sits down with Dr. Ben Proctor, a physician and the author of Inefficient on Purpose, to talk about how for-profit health insurance shapes the care patients actually receive. They cover how insurers use prior authorization to deny tests and treatment while keeping the premium, why tying insurance to your job makes it so hard to switch, how pharmacy benefit managers (PBMs) and rebates push drug prices up, and why doctors cannot push back the way other workers can. Ben shares patient stories, his own experience as a leukemia (CML) patient whose treatment was delayed by a denial, and the changes he believes would actually fix the system.

Key Takeaways
-- The US spends far more on health care per person than peer countries, about $14,775 against a peer average of around $7,800, yet ranks last of ten wealthy nations on access, outcomes and administrative efficiency, according to the figures Derrick shares.
-- Ben explains that health insurers profit by denying care through prior authorization: a requested MRI or CT scan is refused and the insurer keeps the premium.
-- Because most Americans get insurance through their employer, switching plans after repeated denials often means changing jobs. With premiums rising and deductibles of $5,000 to $10,000, more people are cancelling coverage or paying cash. In Derrick's clinic, cash-pay patients grew from 3 to 5 percent when he opened 13 years ago to 20 to 25 percent today.
-- The three biggest pharmacy benefit managers are owned by the three biggest health insurers, and Ben describes the rebates drug makers pay them as paying to play.
-- A denial delayed Ben's own leukemia treatment by six weeks in 2025, and his cancer came back. He cites surveys finding that about one in three doctors has seen a denial lead to a worse outcome for a patient.
-- His central question is whether health insurance should be run for profit at all. In his words, "the goal of healthcare is not to make profit, it's to make people better." He favors realistic reforms such as capping insurer profits, limiting premium increases and letting doctors practice medicine.

Questions Answered
-- Why does health insurance deny tests like MRIs?
-- What is prior authorization and how does it affect patients?
-- What are pharmacy benefit managers (PBMs)?
-- Why does the US pay more for health care and get worse outcomes?
-- What can patients do when their insurance keeps denying care?

What You Can Do
If a test or medication you need keeps getting denied, Ben suggests looking for a different insurance plan the following year, and telling your representatives and lawmakers that you want change. His book Inefficient on Purpose is available on Amazon, with an audiobook planned for November.

DERRICK
Instagram: https://www.instagram.com/derrickbhines/
YouTube: https://www.youtube.com/@DrDerrick

BEN
Website: https://www.inefficientonpurposebook.com/
Book: https://www.amazon.com/dp/B0HJGBBTRC

#HealthInsurance #Healthcare #PriorAuthorization

In this episode of the Pain and Performance Podcast, Dr. Derrick Hines sits down with Dr. Karyn Shanks to explore a different way of thinking about chronic illness, pain, and the healing process.

They discuss why a diagnosis doesn't always tell the whole story, how our environment, experiences, relationships, sleep, nutrition, movement, and sense of safety can influence health, and why healing may require looking beyond individual symptoms. Dr. Shanks also shares practical ways to build resilience through greater awareness, rest, connection, and small sustainable changes.

In This Episode
-- Why your diagnosis isn't your entire health story
-- The role of safety in the healing process
-- How chronic illness can change the way you see yourself
-- Understanding your personal "terrain of healing"
-- Why sleep, movement, food, rest, and connection matter
-- Simple, sustainable practices for building resilience

One of the strongest practical parts comes near the end, where Dr. Shanks emphasizes starting "simple, small, and slow", then identifies sleep, food, movement, rest, and learning to check in with yourself as high-yield areas to address.

Links:
DERRICK
Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick

KARYN
Website: https://www.karynshanksmd.com/
Facebook:
https://www.facebook.com/KarynShanksMD/
Instagram:
https://www.instagram.com/karynshanksmd/
LinkedIn: https://www.linkedin.com/in/karyn-shanks-md-9ba2a520/

New aches after you start running or lifting again usually do not mean you are injured. Your body is not broken. It is unprepared, and you can prepare it.

Dr. Derrick Hines explains why pain after jumping back into an activity, like a friend's knee pain after he started running again, is usually a sign the body was not ready rather than damaged. He walks through progressive loading: building up over weeks, starting with the smallest piece of a movement, and moving on only when each stage feels easy. He shares how his patients over 60 have run 200-mile races and how grandmothers now do kettlebell swings daily, and gives a simple exercise for training today for the life you want in ten years.

Key Takeaways
-- Pain when you start a new activity often means your body was not prepared for it, not that it is broken or injured.
-- As we get older, the body needs more preparation and more warning before a new activity than it did when we were young.
-- To get back to running, progress from walking to jogging to short runs to longer runs over several weeks, so muscles, tendons, joints and ligaments have time to adapt.
-- Start with the smallest piece of a movement. For a kettlebell swing, Derrick starts with mini squats for a week or two, then holds the weight while squatting, then does small swings, and moves on only when each stage gets easy.
-- Given enough time and a progressive load, the body is resilient enough to get ready for almost anything. Derrick's patients include people over 60 who have run 200-mile races.
-- Decide what you want to be doing a decade from now and train for it today. Hiking and travel, for example, need strength and a good cardiovascular system.

Questions Answered
-- Why does my knee hurt after I started running again?
-- How do I start exercising again without getting injured?
-- How should I build back up to running?
-- How do I learn a new exercise like a kettlebell swing safely?
-- How should I train now for the activities I want to do in ten years?

A Thought Exercise
Write down what you want to be doing ten years from now. Then ask how you can start preparing your body for it this week. If you get stuck, share your goal with Derrick.

DERRICK
Instagram: https://www.instagram.com/derrickbhines/
YouTube: https://www.youtube.com/@DrDerrick

#InjuryPrevention #ExerciseTips #HealthyAging

In this episode of the Pain and Performance Podcast, Dr. Derrick Hines explains why improving your health starts with understanding where you are right now. Instead of guessing or trying to change everything at once, Derrick shares the measurements he looks at to build a clearer picture of a person's health and identify where improvement may have the greatest impact.

He walks through movement and mobility, body composition, muscle strength, VO₂ max, blood markers, micronutrients, and emerging measures of cellular health. Derrick also explains how putting these pieces together can help identify your “low-hanging fruit” and give you a more focused approach to improving health, performance, and longevity.

In This Episode

-- Why you should measure your health instead of guessing
-- What movement and mobility can tell you
-- Muscle mass, body fat, and visceral fat
-- Why strength should be considered relative to age
-- VO₂ max and cardiovascular fitness
-- Blood testing, micronutrients, and cellular health
-- How to identify your biggest opportunity for improvement

#HealthOptimization #Longevity #VO2Max #HealthyAging #PreventiveHealth

Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick

In this episode of the Pain and Performance Podcast, Dr. Derrick Hines breaks down senescent cells, often called “zombie cells,” and why researchers are increasingly interested in their role in aging, inflammation, and age-related disease.

Derrick explains what happens when cells become senescent and explores several areas being studied for cellular health, including exercise, fasting and autophagy, nutrition, and emerging senolytic compounds. He also discusses why reducing the accumulation and effects of dysfunctional cells has become an important area of longevity research.

In This Episode

-- What “zombie cells” are and why they accumulate
-- How cellular senescence relates to aging and inflammation
-- Autophagy and the body's cellular recycling processes
-- What we're learning about fasting and cellular health
-- How exercise may influence markers of cellular senescence
-- Emerging research into senolytics, quercetin, fisetin, and dasatinib
-- Why cellular senescence is becoming a major area of longevity research

#CellularHealth #HealthyAging #Longevity #SenescentCells #Autophagy

Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick

In this episode of the Pain and Performance Podcast, Dr. Derrick Hines shares a simple framework he uses personally and with patients to better navigate stressful periods: the 3 B’s of stress, Body, Brain, and Breathing.

Derrick explains why we cannot eliminate every source of stress from our lives, but we can work on how we respond to it. He walks through using movement, identifying and reframing the source of stress, creating a clear next action, and breathing practices to help manage the physical and mental response to stressful situations.

In This Episode

-- Why eliminating stress completely isn't the goal
-- The 3 B’s of stress: Body, Brain, and Breathing
-- How exercise can change your response to stress
-- Why identifying exactly what you're worried about matters
-- How to shift your attention toward an ideal outcome and next action
-- Using breathing techniques during stressful periods
-- Building your own stress-management routine

#StressManagement #MentalHealth #Breathwork #Exercise #HealthyLiving

Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick

In this episode of the Pain and Performance Podcast, Dr. Derrick Hines shares three simple habits he calls “health multipliers,” habits that can positively influence multiple areas of your health while making other healthy behaviors easier to build.

Derrick explains why consistent sleep and wake times, walking after meals, and strength training are three powerful places to start. Rather than trying to change everything at once, he discusses how a few sustainable habits can create a ripple effect that compounds over time.

In This Episode

-- What makes a habit a “health multiplier”
-- Why consistent sleep and wake times matter
-- The benefits of walking after meals
-- Why strength training affects more than your muscles
-- How one healthy habit can lead to another
-- Why consistency matters more than trying to change everything at once

#HealthyHabits #StrengthTraining #SleepHealth #HealthyAging #HealthOptimization

Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick

In this episode of Tea with Dr. D, Dr. Derrick Hines answers common questions about herniated discs, spine health, and what it really takes to recover from a disc injury.

He explains how spinal discs heal, why an MRI doesn’t always tell the full story behind your pain, and how reducing pressure, restoring movement, and gradually rebuilding strength can help create a more resilient spine. He also addresses common concerns about recurring pain after surgery, shoulder and hip pain related to the spine, and whether you can safely return to lifting after a herniated disc.

In This Episode
-- How herniated and injured discs can heal
-- Why MRI findings don't always explain your pain
-- Disc pain vs. muscle and nerve-related pain
-- Why pain can flare up again after surgery
-- How to gradually rebuild strength and resilience
-- Whether you should lift weights after a herniated disc

#HerniatedDisc #BackPain #NeckPain #SpineHealth #PainRelief

Instagram:
https://www.instagram.com/derrickbhines/
Youtube:
https://www.youtube.com/@DrDerrick