Most clinicians say U.S. health care is less stable than two years ago

Most clinicians say the U.S. health care system has grown less stable over the past two years, and even more expect it to keep sliding, according to a new survey that casts the steady loss of experienced clinicians as the system's central vulnerability.

In the survey, released June 16 by the clinician-insights firm Inlightened, 70% of respondents said the system is less stable than it was two years ago, with one in three calling it significantly less stable. Nearly three-quarters, 72%, expect further decline over the next 24 months. Just 4% anticipate improvement.

The findings come from Inlightened's Q2 2026 network survey, which drew more than 100 responses from physicians, advanced practice clinicians, nurses, pharmacists and non-clinical health care leaders between April 2 and April 24. Inlightened, a Boston-based company acquired by LocumTenens.com in 2023, sells client organizations access to feedback from a vetted network of clinicians, and the survey polled that network rather than a nationally representative sample. The number answering each question ranged from 99 to 102.

The unease is not unique to Inlightened's network, though. Richard Anderson, M.D., FACP, chief executive of The Doctors Company and TDC Group, which issues an annual forecast of the risks facing physicians, has described a health care system being "revolutionized" and "torn apart" at the same time.

"That's a very unstable situation," he said on a February 2026 episode of Medical Economics and Physicians Practice’s "Off the Chart: A Business of Medicine Podcast.”

Burnout tops the list, even as national rates fall

Asked to name the single greatest threat to the system over the next 12 to 24 months, respondents put clinician burnout first. It also led the list of forces respondents expect to worsen the system, cited by 82%, ahead of rising costs of care for patients (81%), workforce shortages and reimbursement instability (each 77%), a growing number of uninsured or underinsured patients (71%) and clinicians leaving practice (62%).

That emphasis sits awkwardly against national data. In April, the American Medical Association (AMA) reported that 41.9% of physicians experienced at least one symptom of burnout in 2025, down from 43.2% in 2024 and 48.2% in 2023, a third consecutive annual decline drawn from responses from roughly 19,000 physicians across 106 health systems.

The report acknowledges the gap. It argues that the cumulative damage to workforce capacity, including early retirements and the growth of cash-only practices, is unlikely to reverse on the same timeline as the AMA's symptom measures.

Anderson points to a structural reason the strain has been slow to lift. "The cause of burnout is basically the industrialization of medicine," he said. "It's about throughput, and as long as we prioritize throughput over quality of care and the doctor-patient relationship, burnout is not going to get better."

Beneath the burnout numbers, respondents described a problem of lost experience rather than empty slots. Forty-nine percent expected staffing shortages at their own organization to worsen over the next two years, against 5% who expected improvement.

Primary care, the backbone of most private practices, has been absorbing that strain for years. Yalda Jabbarpour, M.D., a family physician who directs the Robert Graham Center, has tied early departures directly to working conditions. Primary care clinicians "are retiring early or leaving clinical care altogether at a young age," she told Medical Economics," "because they are overburdened and under-resourced."

The pipeline meant to replenish that workforce has not kept pace where the need is greatest. A research letter published in JAMA in June found that among 1,000 new Medicare-funded residency positions allocated from 2023 to 2025, the share going to primary care fell from 53% in the first round to 31.5% by the fourth, while psychiatry and several procedural specialties gained ground. Rural counties never reached the 10% set-aside Congress wrote into the law.

Reimbursement uncertainty is making it hard to plan

For practices, the most immediate pressure in the survey was financial. Sixty-five percent said reimbursement uncertainty is actively limiting their organization's ability to plan ahead, and 55% said they were moderately or extremely concerned about their organization's financial stability. Two-thirds said federal policy and reimbursement decisions affect their day-to-day work moderately or extremely.

Lindsey Hanley, M.S.N., AGPCNP-BC, a nurse practitioner in endocrinology at Duke Health and an Inlightened network expert, framed the squeeze as a question of access.

"When private practices can't stay open and hospitals can't afford adequate staffing, the people who pay the price are the patients sitting in our exam rooms and emergency departments," she said in the report.

AI is arriving faster than the system can absorb it

On technology, respondents were less opposed than wary. A majority, 55%, said they expect artificial intelligence (AI) to improve care delivery over the next two years, and many said they already use such tools. But 69% agreed the system is adopting new technologies faster than it can responsibly integrate them, and 31% said AI will make the system less stable over the next two years, outpacing the 20% who expect the opposite.

"The problem isn't AI," said Crystal Worsena, D.O., a neurologist at BJC Healthcare and an Inlightened network expert. "It's that we're being asked to fly the plane while it's still being built, and that ultimately puts patients at risk."

The integration gap carries legal exposure as well. Anderson, whose company tracks malpractice claims, said courts and regulators are years behind the technology, leaving physicians to absorb the risk as AI tools move into clinical workflows.

"To the extent that we have humans in the loop, I guarantee you the humans will be sued," he said, noting that the standard of care for autonomous AI in medicine remains unsettled.

Related content: The new malpractice frontier: Who’s liable when AI gets it wrong?

Inlightened says health systems, manufacturers and policymakers should consult clinicians earlier and more often.

Shelli Pavone, the company's co-founder and president, said in announcing the findings that such decisions are too often "made without direct, real-time input from the clinicians delivering care."

Whether the sentiment of roughly 100 clinicians reflects the broader profession is harder to say, but the pressures the survey describes, on staffing, on margins and on the pace of change, are the same ones surfacing in larger and more rigorous datasets, even when the numbers do not always move in the same direction.