Strained connections: Physicians, patients, and the modern health care landscape

The strained relationship between physicians and patients has reached critical levels, influenced by mounting financial constraints and the skepticism surrounding AI-generated insights. Last year alone, Americans borrowed a staggering $74 billion to cover medical expenses — an alarming statistic reported by the latest West Health-Gallup Survey. The amount underscores the growing financial toxicity in health care. These burdens, combined with systemic issues like the "Big Beautiful Bill" and geographic disparities in Medicaid coverage, are causing people to avoid care and expanding care deserts, particularly in underserved rural communities. As an industry veteran with 35 years of experience in health care revenue cycle services and innovation, I’ve seen firsthand how these challenges impact care delivery, but I’ve also witnessed transformative solutions that can restore trust and improve outcomes.

The fractured physician-patient relationship

Historically, the physician-patient bond has been the cornerstone of quality care. This connection is fraying, though, under the weight of modern pressures. Studies have found that physicians often feel their relationships with patients have been negatively impacted by financial constraints, such as rising out-of-pocket costs. Furthermore, the rise of AI in health care, while heralded for its potential to improve efficiency, has introduced a new layer of skepticism. Patients often perceive AI-driven insights as impersonal. Even worse, they sometimes see them as tools that put profits over their well-being. A 2023 Pew Research Center study found that 30% of patients believe AI reduces the quality of care, further straining trust between patients and providers.

Systemic issues: The "Big Beautiful Bill"

Portions of the "Big Beautiful Bill" have exacerbated disparities in care. Urban and rural Medicaid communities, already underserved, face additional barriers due to reduced funding, qualification restrictions, complex billing structures, and reduced provider participation. This just adds to existing problems. Research by the National Rural Health Association indicates that more than 150 rural hospitals have closed since 2010, with many citing financial pressures and Medicaid reimbursement rates as critical factors. These closures contribute to the expansion of the care desert, regions where access to adequate healthcare is alarmingly limited. Such systemic failures disproportionately affect vulnerable populations, including rural residents, older adults, and low-income families.

Geographic disparities and advocacy challenges

Geographic disparities further compound these issues. A report from the U.S. Government Accountability Office highlights that rural communities, home to nearly 60 million Americans, often lack strong health care infrastructure. This makes them more susceptible to care avoidance and medical debt. Advocacy for these populations is fragmented, leaving patients without adequate support as they try to understand and deal with a complex system. The patient journey should be centered on healing and empowerment, but instead is marked by confusion and financial strain. Physicians must take the lead in advocating for these underserved communities by collaborating with policymakers and nonprofit organizations to improve access to care.

AI: Friend or foe?

Artificial intelligence can revolutionize health care, but it must be incorporated in a deliberate and patient-centric manner. Used responsibly, AI can enhance provider documentation, automate revenue-cycle processes, and streamline operations. This will free physicians to focus on patient care. But if providers aren’t transparent about AI’s role and limitations, patients will be wary of these technologies.

Solutions to restore trust and equity

These are clearly formidable challenges, but there are also innovative solutions that can help rebuild the physician-patient relationship and address systemic failures:

Patient Advocacy Programs: Expanding patient advocacy initiatives can help patients deal with complex billing systems and secure necessary care. The priority must be on rural and underserved populations so that there is equitable support regardless of geographic location.

Transparent AI Integration: Physicians and healthcare organizations must openly discuss any AI use, and reassure patients that AI is there to enhance human judgment, not replace it. Training programs for providers can emphasize the ethical use of AI in clinical settings.

Financial Assistance and Education: Hospitals and clinics should offer financial counseling services to educate patients about payment plans, charity care programs, and Medicaid options. Streamlined billing processes also can reduce confusion.

Policy Reform: Advocacy at the legislative level is essential to address geographic disparities and ensure Medicaid expansion. Policymakers must prioritize funding for rural health care facilities and incentivize providers to serve these communities.

The path forward

Don’t underestimate the role physicians can play in driving these changes. As we reflect on the staggering $74 million Americans borrowed to cover medical expenses last year, health care providers must take accountability for fostering transparency, advocating for equitable policies, and embracing patient-centric care models. Industry innovators, policymakers, and providers must work together to reverse trends of care avoidance and financial toxicity. By rebuilding trust, integrating AI thoughtfully, and prioritizing underserved populations, we can see to it that health care serves every person with dignity and compassion.

Physicians in particular must renew their commitment to patient advocacy. By leading the charge, they can help ensure the physician-patient bond remains a cornerstone of effective and compassionate care.

Niobis Queiro is the CEO of the Queiro Group, a consulting and coaching agency that specializes in assisting healthcare professionals in improving patient care. As a certified energy leadership practitioner, Queiro helps individuals and teams set and achieve goals, and cultivate a culture of community. Prior to founding her consulting firm, Queiro had three decades of healthcare-industry experience working in the areas of revenue cycle, finance, and technology. She is also the author of Joy Notes: Balancing the Trauma with Triumph, in which she chronicles her resilience through personal losses and health crises, including a near-death experience.