A physicians’ approach to medical practice and patient care was once thought of as highly personal, almost sacrosanct.
However, increasing corporatization among physicians, as well as other economic and regulatory pressures in healthcare, have started to strain physicians’ autonomy and ability to nurture the patient-physician relationship.
Christopher Magiera, MD, joined Becker’s to discuss the biggest disruptors to his practice.
Editor’s note: This response has been lightly edited for clarity and length:
Question: Beyond reimbursement and staffing, what unexpected disruptions have you encountered in 2025? How have they impacted your operations?
Christopher Magiera, MD. Gastroenterologist in Oshkosh, Wis.: The biggest disruption in my practice are the rampant medication prior authorization denials from the pharmacy benefit managers employed by both commercial and governmental insurance companies/entities. This negatively impacts patient care.
I work as a locum tenens gastroenterologist in Oshkosh, Wis. The system to which I am assigned is part of Advocate Health of North Carolina. Corporate dictates on compensation are not keeping up with prevailing levels. This is making recruitment of permanent staff physicians nearly impossible. The mid-size nature of the city makes recruitment and retention difficult. Granted, I am a locums, so my compensation is adequate and fair. Soon, locums will make up a majority of specialists in rural communities. Again, this is not optimal for patient care.
Lastly, corporate bureaucracy inhibits innovation in patient care and procedures.
