Are doctors funding their own extinction? | Opinion
As a retired vascular surgeon and leader of a large multispecialty surgical group, the existing American health care system has me distraught.
Doctors are witnessing its collapse firsthand as decisions are increasingly made with little regard to patient care.
Doctors have given up control to health insurance companies, pharmaceuticals, device manufacturers, brokers, lobbyists, hospitals, fake research, private equity, and so on.
By having accepted a dispersion of dollars away from patient care for decades, doctors are in effect funding their own extinction. In addition, the administrative burden — which detracts from patient care — is overwhelming and is a primary cause of physician burnout.
Likewise, accrediting bodies for medical schools and residency programs have promoted limited work hours and shift-based models for years, both of which relinquish patient care to being secondary to a punch-in, punch-out mentality.
Once personal trust and accountability have been built between patient and doctor, that should not be negated because a maximum number of hours have been clocked by the professional. This contradicts long-held beliefs established by the Hippocratic Oath.
Doctors should be available when their patient needs them.
An elderly patient who is sick in the hospital and has seen their family doctor for 30 years now sees a different, unfamiliar physician every eight- to 10-hour shift. While a “work-life balance“ is important, that should not come at the expense of the continuity of care we provide to our patients, which oftentimes does not neatly fit into a predetermined schedule or timesheet.
Adding further frustration is that the American health care system has little to no transparency.
Hospital bills have multiple columns of vastly inflated charges that no one can interpret, for which doctors get blamed. Moreover, Medicare reimburses outpatient hospital surgeries and services at rates two to four times greater than for the same services provided by physicians in private practice.
This has driven a majority of physicians to become employed by hospitals directly — institutions that can afford higher compensation, but consequently encourage a greater amount of rigidity and formulaic processes which limit competition and ultimately drives up the costs passed along to patients.
Another example is the cost of drugs. A one month’s supply of the diabetic and obesity drug Ozempic is $83 in France and $936 in the U.S.
A device manufacturer may charge up to six times more for an arterial stent in the U.S. compared to European countries.
A significant number of clinical research studies are dishonest because of financial conflicts of interest.
Health insurance companies make it difficult and administratively costly to schedule a procedure or an X-ray and frequently deny claims.
Furthermore, the physicians in my private-practice surgical group see all patients regardless of their ability to pay, providing approximately $1.5 million of free care annually. Our efforts receive little to no recognition and an unwillingness of state and federal legislators to consider a tax break, tax incentive, or tax credit as they have done at much greater levels for competing “nonprofit” hospitals.
When adjusted for inflation, Medicare physician reimbursement has increased less than 10% since 2001, whereas practice expenses have increased by upwards of 60%.
Doctors are in training up to 12 years beyond college, incur $300,000 or more of debt after residency training, and deal with medical malpractice risk. Who would accept this?
Patients deserve better and so do doctors. Both need to take urgent action before the increasingly inevitable collapse of the American health care system becomes a reality.
— Dr. Alex Ammar is president and CEO of Wichita Surgical Specialists.
This story was originally published October 22, 2025 at 5:09 AM with the headline "Are doctors funding their own extinction? | Opinion."
