Artificial intelligence is quickly emerging as the most consequential disruptor of the physician landscape, not just in diagnosis and imaging, but in documentation, billing and the day-to-day business of medicine.
Physicians also say other forces are accelerating change, from site-of-care migration to the growing push toward value-based care.
Fifteen physicians joined Becker’s to discuss what they see to be the biggest emerging disruptor of the physician landscape.
Question: What emerging disruptor do you believe will most significantly reshape the physician landscape over the next few years?
Editor’s note: Responses have been lightly edited for clarity and length.
Michael Boczar, MD. Former Emergency Physician and Chair of Contracting at Hurley Medical Center (Clarkston, Mich.): AI being integrated into all aspects of clinical medicine from care pathways and imaging interpretation.
George Chiang, MD. Neurologist at Rady Children’s Hospital-San Diego: The use of generative AI for the administrative side of operations. The flashy side of healthcare AI is clinical care but even AI scribes and CAD or other specialty diagnostic AI, which is thought to be more “threatening,” still require human final reads. As we see the rest of the corporate world embrace digital AI for business/admin operations to decrease labor costs, we physicians will need to adapt. Fortunately, healthcare is a notoriously late adopter arena so we have time to catch up!
Sandeep Goyal, MD. Medical Director, Cardiac Electrophysiology Labs at Piedmont Heart (Atlanta): Site-of-care migration will be a big disruptor over the next five years.Procedures are rapidly shifting from inpatient hospitals to ASCs, office-based labs and outpatient facilities. This alters staffing models, capital deployment, scheduling efficiency and physician productivity expectations.
Mara Hermiston, MD. Chief Medical Officer of Avera Medical Group (Sioux Falls, S.D.): AI has been the buzzword over the last few years as we have seen significant advances in AI-first platforms targeted toward healthcare. As we are better able to integrate AI directly into clinical workflows and as we continue to see advances in genomics, I believe the intersection of these developments will disrupt care delivery. My vision for medicine moves away from guideline-driven care plans toward precision, personalized care across a wide range of clinical domains. AI-enabled genomic insights can support earlier diagnosis, precise medication selection, avoidance of adverse drug reactions and targeted prevention. I envision a future where access to these tools with AI integration to the EMR will reduce cognitive burden on physicians and allow them to spend time doing what they were trained to do — providing care to patients.
Alvaro Macias, MD. Associate Professor of Clinical Anesthesia at the University of California San Diego: I think there are two massive trends that are colliding right now, and their interaction will define healthcare for the next decade.
First, the physician shortage is real and getting worse. There are lots of opinions about this. Whether the shortage is real is up for debate. I can tell you that in anesthesia, it feels real. Now, the U.S. is projected to be short 20,000 to 85,000 physicians by 2035, according to the [Association of American Medical Colleges]. About 45% of current doctors are over 55, so a retirement wave is coming fast. Meanwhile, residency training slots — funded mostly by Medicare — haven’t meaningfully expanded since 1997. We’re essentially using a 28-year-old workforce pipeline to meet demand by 2025.
Burnout is accelerating the problem. Again, the definition and perception of burnout are very wide. Physicians spend roughly two hours on paperwork for every hour with patients, and post-pandemic surveys show 20-30% have cut back hours or left practice entirely. We’ve felt this already—primary care doctors not accepting new patients, specialists booked months out, rushed appointments when you can finally get in.
We can consider AI as a potential pressure-release valve for the shortage. This is where it gets interesting. AI tools are entering clinical practice faster than most people realize:
Ambient documentation (AI that listens to visits and writes notes automatically) is saving physicians one to two hours per day at health systems that already use it. Scale that across 900,000 physicians, and you’re effectively adding tens of thousands of physicians to the workforce without training anyone new.
Diagnostic AI reading mammograms, X-rays and retinal scans now match specialist performance for specific tasks. One diabetic eye-screening algorithm already operates in primary care offices, eliminating the need for specialist referrals. Predictive tools flag deteriorating patients before obvious symptoms appear, letting smaller teams manage larger patient panels safely.
Here is the intriguing uncertainty: AI could meaningfully offset the shortage, or organizations could simply pocket the efficiency gains while patients see no improvement. If a hospital uses AI to let one doctor do the work of 1.3 doctors, do they see more patients or just cut staffing costs? The technology is neutral. Whether it helps regular people depends on who captures the benefits.
My bet is we’ll see both. Some systems will expand access; others will prioritize margins. Patients in competitive healthcare markets will probably fare better than those with limited choices.
Tom McGue, MD. Former Physician in Newport, R.I.: AI will be the big disruptor reshaping the physician landscape. This will involve leveraging AI to assist in assessment of patients, their risks and recommendations in addressing the individual risks to their health. AI will also continue to be developed to assist in capturing the documentation of individual patient encounters. Community infection biograms can be incorporated into these encounters to assist physicians in appropriate antibiotic choice. AI could meld all data to create options for treatment based on likely diagnoses covering diagnoses such as hypertension, diabetes, hypercholesterolemia. This also brings medical legal issues into play. If a misdiagnosis, wrong treatment, or other adverse event occurs … whose fault is it? The physician, the AI company who provided the software, or was it incorrect data acknowledged or entered by the patient. Much must be sorted out going forward.
Mary Meyer, MD. Emergency Medicine Physician in Dublin, Calif.: I suspect the biggest disruptor we are going to see in the next few years is the rise of value-based care and the slow fall of fee-for-service care. There is just so much anger and frustration with the current state of healthcare — I think we’re reaching a tipping point. Every day, I meet people who are dumbfounded at the cost of their care. I have multiple friends who won’t leave jobs they hate because they worry about losing their healthcare.
This is clearly going to mean a big shift for corporate medicine and an equally big shift for many physicians across all specialties. Change is hard, and this one means realigning health systems’ priorities so that they truly match our patients’ priorities — to stay healthy and get good care when ill. But I’m excited to watch the transition — it holds tremendous promise.
Jean-Perre Mobasser, MD. Neurologist at Goodman Campbell Brain and Spine (Carmel, Ind.): I believe we are currently in the midst of a disruptive shift driven by private equity’s attempt to capitalize on the massive scale of healthcare spending. Unfortunately, because the healthcare “pie” is largely fixed, private equity often acts as another entity seeking a slice of that revenue. This often results in a zero-sum game where the cost is either passed to the patient or extracted from physician compensation. Since most independent practices already operate leanly, the promise that private equity will solve systemic inefficiencies has yet to materialize. We are already seeing the initial rush toward this model slow as stakeholders realize it is not a silver-bullet solution to medicine’s financial struggles.
The next, and perhaps more profound, disruptor will be AI. We are currently in the discovery phase, exploring how AI can improve clinical outcomes while addressing the administrative inefficiencies and rising costs that plague our system. Over the next five to 10 years, it is vital that physicians take the lead in this movement. By maintaining professional oversight, we can ensure that AI is implemented ethically and responsibly, serving as a tool that enhances patient care and minimizes risk, rather than just another layer of automation.
Kian Modanlou, MD. Hepatobiliary Surgeon at Surgone (Englewood, Colo.): I feel like the emerging disruptor most likely to significantly reshape the physician landscape will be the increase in physicians leaving a traditional practice either part time or full time in order to participate in locus tenens opportunities to enhance their reimbursement and provide relief from corporate medicine burnout. I feel that more and more physicians will realize that their willingness to work is the only lever they have to pull in this increasingly hostile environment where they never seem to be the winners. This is something I have coined as “physician arbitrage,” where providers will go to wherever they are most needed for the higher pay and more control over their professional lives.
Brandon Ortega, MD. Orthopedic Spine Surgeon at Long Beach Lakewood Orthopaedic Institute: From a financial perspective, I think the biggest disruptor will be the shift toward value-based and data-driven reimbursement combined with rapid advances in AI. Historically, physicians were primarily compensated based on volume. That model is clearly evolving. Payers and health systems are now pushing toward predictable costs, measurable outcomes, and efficiency across the entire episode of care. At the same time, AI is dramatically reducing administrative overhead and changing how clinical decision-making and patient engagement occur. The practices that will remain financially strong are the ones that use these tools to improve access, streamline operations and diversify revenue beyond traditional clinic and surgical income.
Neil Parikh, MD. Gastroenterologist at Connecticut GI (Farmington): The most significant disruptor will not be a single technology but a convergence of digital health forces that will change how we practice. This is beyond the buzzwords of “artificial intelligence,” but rather better described under the umbrella of digital health. Digital health will be a pervasive physician partner. Remote patient care monitoring will allow us to have more longitudinal clinical data. Virtual care platforms will accompany brick-and-mortar physician practices to provide patient contact and fill the current clinician access gap. AI-enabled tools, from AI agents to virtual scribes, are already reducing the administrative burden on physicians, but in the next few years, we will see the true emergence of AI-driven clinical algorithms that will allow us to deliver precision medicine.
Steven Rich, MD. Geriatrician in Rochester, N.Y.: The greatest disruptor in the next five years will be the need to take value-based purchasing seriously. Fee-for-service still is the dominant paradigm for clinicians and health systems, but the runway is short, and the can cannot be kicked down the road much longer.
The only time we successfully “bent the curve” on American healthcare costs was during the HMO boom of the late ’80s and early ’90s. Although unpopular, such successes were based on having broad-based, properly incentivized, primary care physicians at the helm. Most physicians were self-employed at the time with relationships through independent practice associations, which no longer exist.
Unfortunately, the last two decades have dismantled that function. We have substituted advanced practice practitioners for physicians, and altered the training and experience of physicians to make the dual role of high-quality primary care and cost-effective practice virtually impossible.
Establishing an effective primary care function will require a new relationship to evolve . The accountable care organizations are largely health-system based, and continue the volume based practices of the hospitals, and ask their employed physician to do the same. Direct employment by payer has not worked well in the past except in systems like Kaiser.
Physicians will need new skill sets to be effective in the quality/cost balance, and will need to evolve a new structure to support them.
Marc Shelton, MD. Associate Chief Medical Officer—Strategic Initiatives at the University of Missouri Health System (St. Louis): In my opinion, the clear answer is AI. But how will it help in just a few years? Probably mostly in terms of help with documentation, coding and billing, narrowing diagnosis, helping to review therapeutic options, monitoring early results and longer-term outcomes. The real-world possibilities are very exciting. Nonetheless, I think it might be a bit naive to think that it will happen quickly in medicine in the U.S., and things are likely a bit overhyped. The high med-mal risk in the U.S. will slow widespread development, adoption and implementation. Nonmedical applications of AI will be ahead of real-world applications in healthcare. Other countries will move ahead on this as well in advance of the U.S.
But also, at the end of the day, over the next few years, we are still going to need enough Physicians, APPs and staff to cover 24/7 calls in most medium to large sized hospitals. AI can’t place a stent or operate. It can’t change sheets and place IVs. The concept that an AI robot can operate seems fanciful to me in the short term, since humans have so much variability from one person to the next.
Joshua Siegel, MD. Director of Orthopaedic Sports Medicine at Access Sports Medicine and Orthopaedics (Exeter, N.H.): As insurance companies lag behind the science and speed at which medicine advances, I believe we will see many more options for cash-paying services that are currently not covered under traditional insurance plans. We are seeing that with biologics in many fields and an entire field of functional medicine has responded to the market changes where people want to not only react to injuries or disease, but rather alter and prevent subclinical manifestations of future disease processes. Functional health, Galleri and many others have met that need for more diagnostics while traditional insurances are sorting out if and how to respond or pay. Information in this new world is critical and AI such as DoxGPT and others allow patients to be their own advocates, and search for doctors who will provide what they want. The days of only providing a limited scope of services and not informing patients of their many choices are over.
Also, whole-body scans, comprehensive biomarkers, microdosing and biologics hold the promise of not only curing disease or prolonging life, but also enhancing health and performance and creating opportunities for people that we have never had before.
Frank Vrionis, MD. Neurosurgeon at Baptist Health South Florida (Boca Raton): There is not a single emerging disruptor in the physician landscape. The two most prominent ones are affordability and consolidation. Affordability is becoming a major issue with average insurance premiums close to $15,000 per person per year and climbing. With looming Medicaid cuts, unaffordable private insurance, new expensive technologies and an aging population, the healthcare system is marching into a potential crisis. As most physicians are currently employed, their fate is linked to the financial viability of the entities (hospitals, private equity, universities) that employ them. Any financial stress on those entities due to decreased affordability translates into stress to the physician force in the form of increasing [relative value unit] thresholds, pressure to deliver more expeditious care and decreasing autonomy.
Consolidation is also an emerging disruptor, as private physician groups are getting bigger as a necessary survival strategy to more effectively negotiate with payers. Hospitals are also following into the same paradigm by expanding their footprint and acquiring practices, opening new offices or buying existing health care facilities. The end result is the “death” of the solo practitioners and the emergence of corporate medicine.
Opinions expressed by Dr. Vrionis are his own.
