Between artificial intelligence breakthroughs and mounting insurance and reimbursement pressures, physicians across all specialties are grappling with a rapidly evolving healthcare landscape.
Here are five trends keeping physicians up:
1. The promise and pressure of AI
Artificial intelligence is reshaping nearly every corner of medicine, from diagnostics to scheduling, bringing both opportunity and unease. Sixty-six percent of physicians reported using healthcare AI in 2024, a 78% increase from 2023, according to the American Medical Association.
“AI is impacting every facet of medicine,” Michael Baria, MD, director of orthobiologics at Columbus-based Ohio State University Sports Medicine Research Institute, told Becker’s. “It is improving the efficiency of scheduling and care delivery…but we must contend with an over-reliance on it for knowledge and decision-making.”
Richard Chazal, MD, medical director of heart health at Fort Myers, Fla.-based Lee Health Heart Institute, told Becker’s AI’s growing presence is a daily reality, affecting “the evolving electronic record, diagnostic and therapeutic breakthroughs.”
Others are more optimistic. James Constant, MD, a general surgeon at Kaiser Permanente, told Becker’s he is “excited about the promise of AI and other tech to provide real-time clinical decision support and improve quality and safety.”
In 2024, 35% of physicians said their enthusiasm for AI outweighed their concerns, up from 30% the year before. Still, worries over privacy, accountability, and preserving the humanity of care persist.
2. Economic pressures
Physicians say economic strains are undermining the stability and purpose of medicine.
“It is the economics of healthcare that is the largest disruptor affecting the physician experience right now,” Rachel Hitt, MD, associate clinical professor of radiology at Tufts University School of Medicine, told Becker’s. “We consistently are being asked to do more with much less support. Relative value units, which measure productivity, are greatly emphasized by leadership. Leadership is under pressure to perform by the payers, their board members or stockholders and by regulatory agencies. There is less money in the pot to go around, yet the cost of healthcare and our incredible world-class technologies [rise].”
Gregory Brennan, MD, a gastroenterologist at Texas Digestive Disease Consultants, said inflation and high costs are limiting care.
“I’m frequently seeing new medications being out of reach for many patients because of cost,” he said. “It is very discouraging to see my patients not being able to get recommended procedures or medications despite having insurance.”
Physicians treating Medicare patients have seen real income drop by more than 33% since 2016, according to Omniscient Health. Additionally, stagnant reimbursement, growing Medicare Advantage enrollment and rising overhead are fueling consolidation. Eighty-one percent of physicians say reimbursement policy has been a factor in the decline of independent practices, according to Doximity’s Physician Compensation Report 2025.
3. Insurance hurdles reshaping care
Many physicians say insurers actively disrupt patient care and that restoring autonomy and reducing insurer interference are key to rebuilding trust and protecting patients.
“Insurance companies have significantly ramped up their use of prior authorization hurdles in order to deny appropriate patient care for the sake of revenue,” Kurt Eichholz, MD, president of St. Louis Minimally Invasive Spine Center, told Becker’s. “We have abdicated the healthcare system to insurers and inserted them right in the middle of the patient-physician relationship.”
The frustration extends beyond paperwork. Physicians point to a broader power imbalance between insurers and practitioners, with prior authorizations and denied claims delaying care and straining trust.
The average practice completed 43 prior authorizations per physician each week in 2024, spending about 12 hours weekly on paperwork, the AMA found. KFF data shows Medicare Advantage plans denied 3.2 million, or 6.4%, of prior authorization requests in 2023, though denial rates declined slightly from 2022.
4. The disappearing independent physician
Private practice, once the cornerstone of American medicine, continues to decline. In 2024, 42.2% of physicians were working in private practice, a significant drop from 60.1% in 2012, according to the AMA’s Physician Practice Benchmark Report.
“The increased pressure from hospitals, insurance companies and CMS will cause small independent private practices to cease to exist in the next five to 10 years,” Dr. Eichholz said. “Once employed by a system, the practice belongs to the system, not the physician.”
Hospital employment now dominates the landscape: at least 47% of physicians were employed by or affiliated with hospital systems in 2024, up from about 30% in 2012, the Government Accountability Office found.
5. Burnout and erosion of purpose
Perhaps the most insidious threat is internal: burnout and disillusionment.
“There is a generalized ennui amongst medical professionals,” Matthew Smith, MD, director of neurocritical care at West Virginia University, told Becker’s. “People coming into the medical field have a belief that they are going to help people and practice the art of medicine, while generally being respected, appreciated and generally well compensated. The day-to-day actions of most medical professionals do not align with the practitioner’s belief.”
That disconnect, he said, fuels burnout, substance abuse and early exits from medicine.
Dr. Hitt added that monetizing every patient interaction “produces more opportunity to fail or fall short, for both our patients and ourselves.”
While burnout rates have fallen slightly, they remain high. Across all specialties, 29% of physicians report feeling burned out, 6% reported feeling depressed and 18% feeling both burned out and depressed, according to a Medscape survey. Neurologists reported the highest rate of burnout at 43% while oncologists reported the highest rate of depression at 15%.
