2025 Physician Year in Review: What This Year Taught Us — and What to Expect in 2026
“Two opposing truths can be true at the same time. And honoring both helps us chart a path forward.”
Reimbursement Declines: Hard Truths and Quiet Opportunities
One of the clearest themes of 2025 was the ongoing squeeze of reimbursement. Medicare’s physician fee schedule declined again. Adjusted for inflation, physician payment has dropped steadily for two decades. Meanwhile, costs for staffing, rent, malpractice, and EHRs continue rising. (Read more: 2025 Medicare Physician Fee Schedule)
If you noticed your paycheck tightening, you weren’t imagining it. Groups adjusted productivity expectations. More patients were added to schedules. Financial tension slowly trickled down from the system to the people doing the work.
And yet, there is another truth we can’t ignore:
Physicians remain among the highest-earning professionals in the country—even amid reimbursement pressure.
That doesn’t fix the frustration. But it does mean financial independence is still possible. It’s just no longer automatic. Intentionality matters. Savings rates, spending choices, boundaries, and avoiding lifestyle creep. Small steps compound over time.
Both things can be true: reimbursement is falling, and you can still build a financially independent future that allows you to practice because you want to—not because you have to.
Patient Complexity: When Every Visit Feels Big
Another defining theme of 2025 was rising patient complexity. More multimorbidity. Worsening chronic disease. Increasing mental health needs. Unaddressed social determinants weighing on every interaction.
So when you catch yourself thinking, “Every visit feels like a huge case,” you’re not being dramatic. You’re reading the reality accurately.
But in the middle of that heaviness, there were also real clinical wins. Some of our tools are better than ever. New cardiometabolic therapies are changing lives. Innovations in obesity treatment are altering long-term risk profiles (See NEJM SELECT trial results). There is genuine progress even as complexity grows.
“This is heavier than it used to be, and we’re better equipped than we’ve ever been.”
Looking ahead, 2026 will require us to match the complexity of our patients with care models that make sense: team-based care, realistic panel sizes, longer visits when needed, and workflows that don’t expect one clinician to carry it all alone.
Workforce Shortages: A Challenge—and an Opening
Workforce shortages continued to shape daily experience in 2025. Recruiting was harder. Retirements accelerated. Burnout thinned the workforce further. Many specialties, including pediatric subspecialties, struggled to fill essential roles.
But here is the hidden truth inside that strain:
Shortage creates leverage. And leverage creates options.
Physicians have more power than we sometimes realize:
- Renegotiating schedules
- Creating hybrid clinical/nonclinical roles
- Developing portfolio careers
- Setting boundaries that would have been dismissed a decade ago
The system cannot function without physicians. The shortage makes that more obvious than ever. This is an invitation—not to do more, but to practice more sustainably. (Learn more: AAMC Physician Workforce Projections)
AI in the Exam Room: A Tool, Not a Threat
2025 was the year AI stopped being theoretical and became practical. Ambient scribe tools. Chart summarizers. EHR copilots. Documentation assistants. Early trials showed reductions in documentation time and cognitive load.
Is AI perfect? Absolutely not. It makes mistakes. Supervision is required. It sometimes makes work easier and sometimes adds friction. But something quietly profound happened this year:
AI gave many clinicians their first real taste of relief in years.
Even 20–30 minutes saved per day felt like oxygen. Not enough to transform the system. But enough to remind us what presence feels like—what it’s like to make eye contact during a visit without the pressure of charting concurrently. (See ULCA Study on AI Scribe)
AI won’t save medicine. But it might save some physicians from leaving it. And that matters.
Looking Toward 2026: A Year for Intentionality
If 2025 was a year of clarity, 2026 can be a year of intention. We cannot control reimbursement. We cannot reverse complexity or immediately solve workforce shortages. AI will continue evolving faster than policy can keep up.
But we can control how we respond.
- We can design careers that feel sustainable.
- We can set boundaries that protect our humanity.
- We can build financial resilience one choice at a time.
- We can embrace helpful innovation without surrendering our judgment.
And most importantly:
Medicine is harder than it has ever been—and still profoundly worth doing.
As you step into 2026, you don’t need to fix healthcare. But you can move your own life and career a few degrees closer to the version you’ve always hoped for.
Additional Resources for Intentional Improvement in 2026
