AMA President highlights growing crisis facing U.S. physicians
The American Medical Association (AMA) President Bruce Scott, MD, issued a stark warning about the deepening crisis facing American physicians, highlighting a growing confluence of challenges that threaten both the profession and patient access to care nationwide. He spoke with Health Exec in an interview on June 8 during the AMA House of Delegates 2025 meeting.
Scott, an otolaryngologist in private practice in Louisville, Kentucky, pointed to an escalating physician shortage, mounting administrative burdens, and declining Medicare reimbursements as among the key pressures driving many doctors out of clinical practice.
He said physician burnout is leading to a rising number of physicians who want to leave clinical practice. Key issues leading to burnout include increasing administrative burdens like prior authorizations that take away from time to treat patients, increasing workloads, and reimbursements being lowered and not even keeping up with inflation.
"Reducing reimbursement at the same time that we're being asked to do more and more, the administrative burdens are piling up on physicians, and unfortunately some physicians are calling it quits. We have studies that show that as many as one in five physicians say that they hope to retire or leave practice in the next two years. At the same time, we already have an access challenge for patients to get in to see a doctor, particularly in rural areas and underserved areas," Scott explained.
Physician shortage will impact all areas of care
According to the Association of American Medical Colleges (AAMC), the United States is on track to face a shortage of over 80,000 physicians in the next decade. The situation is already dire in rural and underserved communities, where up to 90% of counties lack access to essential specialists, including cardiologists and OB-GYNs.
"When the doctors in rural areas close their practice, sometimes [it takes hours] for the patient to [drive] to the next closest doctor, if they can even find one who's taking new patients. And the access problems are great is for some of the most vulnerable patients. Our seniors, we have an increasing number of people aging into Medicare. Their medical problems are getting more and more complex, needing your complex radiology services, cardiology services, and yet we have a shortage of doctors that's only getting worse," Scott said.
The pressures are hitting at both ends of the physician workforce pipeline. On one side, seasoned doctors are leaving in record numbers. On the other, medical students face massive educational debt and a bottleneck in training opportunities due to a lack of federally funded residency positions.
"The number of residency spots in the United States has not been increased significantly in many years. We've increased the number of medical schools and we actually have more medical school graduates now than we had a few years ago. But we've not made an equal increase in the number of residency spots. A lot of times it comes down to funding. Medicare doesn't want to pay, Congress doesn't want to extend those. They actually control the number of residency spots that exist," Scott explained.
At the same time, the average medical school graduate finishes training with more than $200,000 in debt. With debt relief programs for doctors currently on hold for more than a year due to policy court challenges, clinicians are unable to make payments while at the same time accruing interest. These programs are also in limbo with the Trump administration, and their future may be in question.
“This debt burden, combined with uncertainty about training positions and future pay, is discouraging the next generation of doctors,” Scott explained.
The Trump administration's crackdown on immigration has spilled over to impact the visas of a large number of foreign students studying medicine at U.S. universities or doing residencies at academic medical centers. Scott said the U.S. should be supporting international medical graduates, who now provide roughly 25% of rural care in the U.S. But they face increasing immigration barriers by the current administration.
Medicare reimbursement cuts continue
Since 2000, Medicare payments to physicians have declined by 33% when adjusted for inflation, Scott noted.
“What industry can sustain a one-third cut over two decades, while inflation and complexity go up?” he asked.
"What industry can survive in today's inflation rates where they're getting paid less to do the same services you were doing in 2000. And then you pile on top of that the prior authorization burdens. We know prior authorizations costs physician practices money, that it wastes physicians' time, but more importantly, it delays and denies needed care for our patients. Then the physicians get frustrated with all this," Scott said, adding some just walk away and do not get treated for their conditions.
AMA working with Congress
The AMA is pushing for several policy reforms to address the physician workforce crisis. These include:
• Fixing Medicare’s payment formula to reflect the cost of modern medical care.
• Reducing administrative burdens, like prior authorization delays, which impact both patient care and provider morale.
• Expanding federal funding for residency positions, which are currently capped by Congress and tied to outdated Medicare funding formulas.
• Encouraging state and private sector investment in medical education and training programs through an “all-payer” system for residency slots.
• Some hospitals and states have started funding their own residency positions to secure talent locally. Scott emphasized that broader action is needed at the federal level.
Scott added that the AMA continues to lobby Congress and partner with healthcare stakeholders to prioritize physician workforce sustainability as a national health priority.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]