Why you don’t go to the doctor, but they want to see you

If a doctor’s office says the next available appointment is several months away, it doesn’t mean they don’t want to see you. Likewise, when the doctor makes a brief cameo during an hour-long visit, they wish they could spend more time with you.

The problem is they can’t afford it.

The economics of our health care system have created a tough and difficult place for physicians, especially those who run private practices, as reimbursements shrink and patient demands increase. Instead of creating flexible scheduling times, they have to pre-book each appointment and postpone the next available appointment. One reason why they often can’t spend more than a few minutes in every patient is because the reimbursement system has placed a premium on their time. But there is more to this story.

The economic reality for practicing physicians

Two divergent trends have thrown the supply and demand of our healthcare system out of balance. The total number of physicians is shrinking as the U.S. faces a potential physician shortage more than 80,000 physicians by 2036, as the patient population with high needs continues to grow.

To compound these problems, the nation’s largest insurer — by far — has continually cut its reimbursements to physicians. Medicare Covers more than 65 million patientsand data from the American Hospital Association showed Medicare reimbursement 82 cents on the dollar compared to hospital spending in 2022, a record level. To illustrate how much of an impact this has on the entire market, Medicare covers almost 20% of all patients. Physicians must make the economics work by both maximizing the number of patient visits per day and increasing operational efficiency.

The challenges healthcare providers face are further exacerbated by the rising costs of running a medical practice. Medical groups are struggling with rising costs in several areas, including wages, supplies and utilities. A recent one MGMA Stat poll found that a significant majority, 92%, of medical group leaders reported higher operating costs in 2024 compared to the previous year.

The financial pressure on medical practices is great. To achieve a more sustainable, economically viable model, we need multifaceted solutions, including a strengthened pipeline of emerging physicians, physician-friendly legislative measures, and helpful AI and tech solutions.

The way forward

For some aspiring physicians completing medical school, their exorbitant educational debt may prevent them from practicing medicine altogether, opting instead for more lucrative positions, such as those at pharmaceutical companies or consulting firms.

Bloomberg Philanthropies tackled the pipeline issue strongly when it made donations $1 billion and $600 million at Johns Hopkins University and four historically black medical schools, respectively. The donations are specifically intended to address debt at Johns Hopkins medical schools and increase the number of practicing Black physicians, which has helped balancing inequalities in black and disadvantaged communities.

Strengthening the physician pipeline will take more than well-meaning philanthropists, and that could come from Congress. For example, he currently weighs a bipartisan measure to expand the number of government-funded positions for physicians in training. It would add 14,000 new places to stay over the next seven years, a number that is still not enough to solve the shortage, but it is a step in the right direction.

Congress could also pass legislation such as the Provider Reimbursement Stability Act. It would help make the profession more attractive to students, and at the same time, importantly, support of existing doctors. The law aims to increase Medicare reimbursement rates for health care providers to address declining payments and rising costs. Medicare payments fell 26% in real terms from 2001 to 2023. This growing gap between inflation and reimbursement rates not only threatens patient access, but also impacts the financial stability of providers, especially those serving vulnerable populations.

Artificial intelligence will also play a critical role in supporting medical practices and is already proving its value to providers by delivering measurable business benefits through increased efficiency and cost reduction. According to one report from AccentureAI applications can save the US healthcare system up to $150 billion annually by 2026. This is mainly due to AI’s ability to automate administrative tasks, which can account for up to 30% of healthcare costs. By automating routine tasks, healthcare providers can streamline operations, reduce overhead costs, and serve more patients without increasing staff workloads. This automation can also help reduce wait times and increase the number of patients who can be seen, which in turn could increase revenue.

The factors that have led patients to see their doctors less often are varied and complex. The decline in doctor visits is a multifaceted problem, rooted in decades of economic pressure on physicians. Rising education costs and increasing professional demands have put pressure on the system. While there is no single solution to this complex $5 trillion industry challenge, a combination of strategic approaches will change the course of healthcare. A robust pipeline of physicians, supportive legislation, and emerging AI solutions that drive efficiency will all help solve the supply-and-demand dilemma.