The rapid rise of GLP-1 receptor agonist prescribing has added another layer of strain on the backs of already overextended primary care clinics. Use of these agents among US adults grew from 0.3% in 2013 to 1.3% in 2023, according to a JAMA Network Open analysis — a dramatic increase that reflects both expanding clinical indications and intensifying patient demand.

For many primary care physicians (PCPs), however, each new prescription sets off a cascade of prior authorizations, data follow-ups, and documentation loops that stretch the limits of clinic capacity and provider workload.

A Mounting Administrative Drag

In a  2024 AMA survey, physicians reported completing an average of 39 prior authorizations per week and spending roughly 13 hours on related tasks. Nearly 93% said those delays affect patient care, and 89% linked them to burnout. For PCPs, the process can be particularly painful when it involves newer weight management medications.

“Primary care physicians at our institution tell us they simply don’t have the bandwidth,” said Taraneh Soleymani, MD, obesity medicine specialist at Penn State Health Medical Group, Middletown, Pennsylvania. “Their clinics are already stretched, and the prior authorization pathway for GLP-1s can be extremely complex. They end up referring patients to us because it’s just too much to manage on top of everything else.” 

Soleymani said that each insurer, and often each employer, sets its own rules for coverage.

“One of the most frustrating things is that many of the criteria are not scientifically based,” she said. “We’ll see an employer decide that patients must have a BMI over 40 to qualify, when both the FDA and professional societies clearly recommend treatment starting at 30, or 27 with comorbidities. Those arbitrary cutoffs mean patients are forced to get sicker before they qualify for therapy.”

Soleymani said that many patients with employer-provided insurance don’t understand that in many cases, it’s their employer who’s setting these standards for who’s covered and who’s not.

Clinical Fallout From Process Friction

The cumulative weight of these tasks inevitably affects care. Soleymani said that delays in GLP-1 approvals can derail patient momentum, while inconsistent communication between specialists and PCPs adds confusion.

“The hardest part is the back-and-forth,” Soleymani said. “Patients call their primary care office asking, ‘What happened to my prior auth? Why is it not going through?’ Meanwhile, the PCP is trying to juggle 10 other issues in a 15-minute visit.”

Soleymani said that her clinic has built a dedicated infrastructure to handle these cases.

“We’ve standardized the process so we can give patients clarity quickly — you do qualify, you don’t, here’s what you need to do. That shortens the wait and takes pressure off primary care,” she explained. “When we operationalized it, everybody benefited: Patients were happier, and PCPs felt relief that someone was managing the details.”

Even when systems like that within the Penn State system exist, PCPs remain the front line, and time dedicated to chasing prior authorization paperwork or parsing continuous glucose monitoring data are hours not spent on prevention or chronic care counseling. Some practices now dedicate staff roles to prior authorization, a strategy that helps but further strains budgets already tight from declining reimbursement.

Digital Health Can Be a Lifeline if Built Correctly

Because much of the strain stems from data handling and documentation, digital health tools can offer real relief — if they actually simplify clinicians’ work rather than add layers. For example, embedding medication-response data directly in the electronic health record (EHR), with templated workflows and digestible dashboards, is a must, Soleymani said.

“Integration is everything,” Soleymani said. “If information doesn’t flow back to the primary care physician automatically, the patient ends up being the messenger — and that’s where errors happen.”

When asked if artificial intelligence could play a role in easing the load on PCPs, Soleymani agreed that it could help, but warned that standardization must come first.

“If every insurer requires a different form and a different justification, no algorithm will fix that,” she said.

Shared dashboards and structured messaging can also ease coordination between endocrinology, obesity medicine, and primary care.

“Our EHR allows the PCP to see everything we’ve done,” Soleymani said. “When the patient leaves our clinic, the note and the decision go right back to their doctor. That transparency prevents duplication and builds trust.”

Practical Strategies for Clinicians

Experts recommend quantifying the administrative load — tracking how many GLP-1-related prior authorizations are submitted each week and how many are denied or delayed — as the first step toward reform. Soleymani offered several additional tactics based on her experience running an obesity medicine program.

“First, dedicate a separate visit just to assess obesity and discuss treatment — that focused time makes everything more efficient,” she said. “Second, ask patients before the appointment to check their insurance plan so you know whether coverage exists. That step alone saves multiple phone calls. Third, if possible, assign one or two staff members to handle prior auth and reauthorization requests. It really lifts the burden from the provider.”

When coverage barriers persist, she advised flexibility.

“If a patient doesn’t qualify for a GLP-1 under their plan, talk through alternatives — first-generation medications, bariatric surgery, whatever’s evidence-based and accessible,” she said. “The goal is to treat the disease with what you can use, not to demonize options that work.”

She also encouraged PCPs to explore local partnerships.

“Seek out comprehensive obesity-medicine programs in your community,” she said. “Creating a referral pathway can make a huge difference for patients — and it lightens the administrative load for the primary care team.”

Where Primary Care Goes From Here

Primary care remains the backbone of managing chronic diseases like obesity, yet it risks being hollowed out by procedural friction and ever-expanding data streams. Soleymani said that the answer lies in structural change, not individual endurance.

“Primary care physicians do an incredible amount of work,” she said. “They’re managing complex patients, tight schedules, and all the administrative barriers that come with modern medicine. If we want this to be sustainable, we have to give them systems that support them — not systems that exhaust them.”

Overall, Soleymani’s vision for a solution encompasses thoughtfully designed digital tools, consistent payer criteria, and closer collaboration between obesity specialists and PCPs as a way toward restoring balance. For now, each incremental improvement — a shared dashboard, a dedicated staff member, a streamlined prior-auth template — represents a step toward the PCP reclaiming time for what matters most: caring for patients rather than navigating the paperwork that stands in their way.

Soleymani reported receiving honoraria from Novo Nordisk for speaking engagements.