Burnout skyrockets as corporate owners place profits over patients, employed docs say

Nearly nine in 10 physicians employed by hospitals, private equity firms or health insurers report at least occasional professional burnout, and 44% are looking for a new job or considering one, according to a new study.

The Physicians Advocacy Institute (PAI) has published its 2026 PAI Employed Physician Survey conducted by Healthsperien's Center for Health Research, Policy & Strategy. The survey gathered responses from 1,003 employed physicians through an online questionnaire fielded in April and May this year.

Physicians' commitment to their patients does not change simply because they work for corporate employers, institute CEO Kelly Kenney, J.D., said in a news release. But the PAI survey results show that commitment is often at odds with corporate policy.

“Until recently, physicians generally worked for themselves or in physician-owned practices that were fundamentally aligned with their oath to put patients’ well-being first. That oath doesn’t waver simply because they now work for a corporate owned medical practice,” Kenney said.

Even so, “corporate owners’ primary allegiance is to profits, not patients,” she said.

“These new data show that this misalignment is evident in many corporate owners’ policies, which all too often restrict physicians’ ability to ensure their patients receive the best possible care,” Kenney said.

Consolidation accelerates

For the survey of employed doctors, respondents included physicians employed by hospitals and health systems, venture capital or private equity firms, and health insurance companies. A full 39% identified as primary care physicians, including those in family medicine, general internal medicine and general pediatrics.

The survey arrives amid a sharp shift in practice ownership. In 2012, about one in four physicians was employed, according to prior PAI-commissioned research. Today, more than four in five physicians (82%) are employed by hospitals or other corporate entities, and nearly two-thirds of physician practices (64%) are corporately owned. At the start of 2026, insurers, private equity firms and other non-hospital corporations owned more physician practices (33%) than hospitals and health systems did (31%), the report found.

A vanishing point of comparison

Most physicians in the survey have never practiced any other way. Among respondents, 72% said they have only ever worked under corporate ownership, and that share rose to 87% among physicians under 40. Among the 28% who once practiced in a physician-owned setting, better work-life balance (59%) and higher compensation (52%) were the most common reasons they gave for leaving independent practice.

That smaller group of physicians with physician-owned practice experience reported starker views of corporate employment than their peers. Thirty-five percent cited a lack of clinical autonomy as a reason for considering a new job, compared with 21% of physicians who have only known corporate ownership. For the respondents, 20% said they plan to leave clinical practice before retiring, compared with 12% of physicians without that experience.

Burnout and the health care exodus

For employed doctors, 88% reported at least some level of professional burnout, and more than a third (36%) described symptoms as regular, persistent or worse. Burnout was most acute among younger and mid-career physicians, with 40% of those age 41 to 60 reporting significant burnout. The figure was 36% for those under 40, and 26% for physicians 61 and older.

Among the 44% of physicians looking for a new job or considering it, physicians under 40 were the most likely to be actively job hunting, at 23%. By comparison, 12% of physicians 61 and older were looking for new work or considering it. Among those looking for or considering a new job, inadequate compensation (59%) and issues with management (49%) were the most common reasons cited.

One in seven physicians (14%) said they plan to leave clinical practice altogether before retiring, most often citing professional dissatisfaction (54%) or personal reasons such as health or family (53%).

Pressure on clinical decisions

The survey results showed patient preferences and employer preferences both influence how physicians recommend treatments:

• 63% said their employer has policies that create barriers to referring patients outside the company’s network, regardless of medical need. That share climbed to 77% among physicians employed by health insurance companies, compared with 63% at hospitals and health systems and 57% at practices owned by venture capital or private equity firms.
• 59% percent of physicians said they feel pressure to keep patients within their health system even when that isn’t the best option for the patient.
• 47% said they frequently feel pressure to prioritize seeing more patients per day over spending adequate time with each one.

Asked what most influences their clinical decision-making, physicians cited patient preferences and expectations most often (68%), followed by the financial burden a treatment would place on the patient (61%) and the availability of on-site resources such as diagnostic equipment (61%). More than half (54%) said quality metrics and performance indicators factor into their decisions, and 46% cited clinical guidelines tied to value-based payment programs, arrangements that reward physicians for meeting cost and quality targets rather than for the volume of services they provide.

Gaps in care delivery

Despite those pressures, 89% of physicians said they are satisfied with the quality of care they personally provide. But most described a delivery system that frequently falls short around them:

• 88% said medical equipment was broken or needed repair at least once in the past year.
• 79% said test results or chart notes were unavailable when needed for a patient visit.
• 73% said patients are unable to get timely appointments.
• 45% said patients could not get an appointment within 48 hours for an acute or serious problem several times a year or more.

Helping or hurting care?

With the nation facing a shortage of physicians and other clinicians, scope of practice for physician assistants, nurse practitioners and other advanced practice providers (APPs) has evoked advocacy and opposition. For employed physicians:

• 41% said the ratio of APPs to physicians compromises the quality of care.
• 31% said it supports or enhances care. APPs, which include physician assistants and nurse practitioners, can independently manage some aspects of patient care.

Among the share of physicians who are not fully satisfied with the care they can provide, insufficient staffing (74%) and administrative burden (64%) were the most commonly cited obstacles. Inadequate time with patients and pressure to prioritize financial metrics over clinical care also were factors, with both named by 58% of respondents.

Administrative burden mounts

Documentation in electronic health records (EHRs) was the most commonly cited administrative burden, with 78% of physicians calling it burdensome. About four in five physicians (81%) said they spend at least some time each week on prior authorization, insurers’ practice of requiring advance approval before covering a treatment or service.

Among physicians who spend at least one hour a week on prior authorization, 76% said the requirement delays patient care, and 61% said it leads patients to abandon or forgo recommended treatment altogether. A full 60% said prior authorization had led them to change a clinical recommendation based on what would be approved rather than what they considered optimal, and 34% linked it to adverse patient outcomes.

Physicians also reported limited say in how their practices are run. Only 16% described having substantial input into key practice management decisions, while 40% said they have minimal or no input.

‘Disturbing trends’

Kenney said the findings should inform policy debates over the expanding role of private equity firms, insurers and other corporations in physician practice ownership.

“It’s vital for those considering the future of health care in America to understand what corporatization and financialization are doing to patients and the physicians who want nothing more than to put their care first,” Kenney said in the news release. “Only when we understand these disturbing trends can we consider policies to better align physician and patient interests with practice ownership.”