From artificial intelligence to insurance hurdles straining patient care, nine physicians joined Becker’s to discuss the biggest disruptor affecting physicians right now.
Question: Which new disruptor (technological, regulatory or economic) do you feel is most affecting the physician experience right now?
Editor’s note: These responses were edited lightly for clarity and flow.
Richard Chazal, MD. Medical Director of Heart Health at the Lee Health Heart Institute (Fort Myers, Fla.): While we as clinicians often obsess about regulatory and economic effects on our experiences, technological disruptors impact us daily. The increasing penetration of AI into work, the evolving (hopefully in the right direction) electronic record, diagnostic and therapeutic breakthroughs…all affect us every day. Much, though not all, of the changes are positive. Nonetheless adjusting to the pace of transformation in the context of patient care, teaching and research presents challenges
James Constant, MD. General Surgeon at Kaiser Permanente (San Francisco): There have always been and probably always be ‘disruptors’ but the ‘new’ can also further compete for physician attention and make it harder to spend more direct time with patients.
Michael Baria, MD. Director of Orthobiologics at The Ohio State University Sports Medicine Research Institute (Columbus): Artificial intelligence is impacting every facet of medicine. This will likely continue. It is improving the efficiency of scheduling and care delivery. It is providing a safety net in diagnostic assessments. It is being integrated into Medicare’s WISeR program, which could have a far reaching impact. If managed well, AI is a useful tool that can eliminate redundancy, improve access and minimize medical errors. However, physicians (especially those in education) must contend with an over-reliance on it for knowledge and decision-making. Physicians must maintain their ability to make clinical decisions in real-time. We also must grapple with ethical concerns, such as data privacy, accountability if/when errors occur, and how to safeguard the humanity of medical care.
Gregory Brennan, MD. Gastroenterologist at Texas Digestive Disease Consultants (Mansfield): Right now in 2025, I would have to say economic factors are having a significant impact. Inflation is a factor right now, with rising costs of living and healthcare costs playing a big role. I’m frequently seeing new medications being out of reach for many patients because of cost. Procedures in my field (gastroenterology) can be expensive based on a patient’s individual coverage, which can limit our options in providing the recommended care. It is very discouraging to see my patients not being able to get recommended procedures or medications despite having insurance. Being able to adapt to these challenges is going to be critical to success in the future.
Kurt Eichholz, MD. President of St. Louis Minimally Invasive Spine Center: Insurance companies will continue to disrupt the patient-physician relationship for the sake of their own profit. The only participants in the healthcare industry that take an oath to care for the patient is the physician…. Not hospitals, not executives, not CMS, not legislators and certainly not insurance companies. Insurance companies have significantly ramped up their use of prior authorization hurdles in order to deny appropriate patient care for the sake of revenue. This will continue to expand. It has become clear that we have abdicated the healthcare system to insurers, and inserted them right in the middle of the patient-physician relationship.
Rachel Hitt, MD. Medical Director of Patient Experience, Chief of Breast Imaging and Associate Clinical Professor of Radiology at Tufts University School of Medicine (Boston): All three certainly affect the physician experience. Technology has the incredible potential to enhance our day-to-day work activities, but it needs to be designed to be more streamlined into our encounters with patients, rather than “an extra step.” AI will certainly help with that integration. Regulatory factors have and will always be an important factor since as a profession and nation, we want to ensure uniform high quality and standards. This unfortunately does often result in significant additional paperwork.
I believe, however, it is the economics of healthcare that is the largest disruptor affecting the physician experience right now. We chose medicine as our lifelong profession to help others, and their loved ones navigate sometimes life and death situations with our keen interest in human physiology. This sometimes takes more than 15 minutes to do. 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 cost more. In the future, I worry patients will be charged for every “billable hour or minute” for the time we spend talking with them or holding their hand. I think that would be unfortunate, as sitting at the bedside of our patients buoys us and helps heal our patients. Ultimately this economic way of managing healthcare leads to more clinician burn out, reduced patient outcomes and overall decreased financial bottom lines for institutions and practices.
Richard Kozarek, MD. Executive Director of the Digestive Disease Institute at Virginia Mason Medical Center (Seattle): The biggest disrupter affecting physician practice is not AI. It is the loss of Medicaid/Obamacare for up to 14,000,000 people. It will lead to a major shift in uninsured patients, significant risk in insurance premiums for the insured, and lead to an accelerated hospital consolidation or closure.
Stephen Quinnan, MD. Orthopedic Surgeon at the Paley Institute (West Palm Beach, Fla.): There are many disruptors having a major impact on the current physician experience. Technology is moving forward rapidly and changing the way we work on multiple levels from innovative devices for improved surgical execution to new ways to run clinics and evaluate patients. Meanwhile, the increasing financial challenges of running a practice and the many potentially frightening changes that are set to go into effect can’t help but drive anxiety and concern for the future.
Matthew Smith, MD. Director of Neurocritical Care at West Virginia University (Morgantown): There is a generalized ennui amongst medical professionals, which is manifesting as burnout and practitioners leaving the field. I think that this comes down to a cognitive dissonance in the field. Moral distress could apply, but I think the more general term as proposed by Leon Festinger fits better. 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. This misalignment of belief and action causes cognitive dissonance. Once the dissonance reaches a certain level, the stress is too much for the individual, and something has to be done to reduce the dissonance. The dissonance reduction can be changing the action, changing the belief or changing the perception of the belief. These methods of reducing dissonance can be healthy or unhealthy. Some unhealthy examples are the high amount of suicide and substance abuse by medical practitioners.
