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Our Voice, Our Future: Confronting Physician Burnout, Shortages, and Other Challenges through Collective Advocacy

Jul 23, 2026, 11:46 by Lee Tian, MD

 

Healthcare needs have drastically outpaced the supply of physicians in the United States,1 and this trend has inspired a record number of students to pursue careers in healthcare. Medical school applications are at an all-time high, and residency positions continue to expand each year in an effort to meet growing demand.2 The message is clear: there is no shortage of people who want to help others.

However, the healthcare system has failed to keep pace with the basic economics of delivering care. Despite an exponential increase in physician workload, equitable compensation has remained relatively stagnant over the past two decades.3 At the same time, healthcare monopolies continue to restrict access and create administrative barriers to life-changing therapies, some of which fundamentally affect our specialty.4 Over time, these forces have created a widening chasm that has left our healthcare system increasingly fragile. The COVID-19 pandemic exposed these vulnerabilities, pushing our ability to deliver high-quality care to its limits.5-7 Unfortunately, the system is poised to face another major challenge, as the United States is projected to face a shortage of nearly 150,000 physicians across 30 of the 35 recognized medical specialties by 2038, especially in anesthesiology, physical medicine and rehabilitation, and many others.1

From visionary leaders representing a truly multidisciplinary specialty to the countless individuals working tirelessly behind the scenes with allied organizations to shape healthcare policy, our Society's influence extends far beyond what most members ever see.

These systemic challenges and their potential solutions were never taught in medical school or residency. They are lessons that most physicians learn only after entering practice. Quietly, these forces have fueled an alarming trend that has driven many once-altruistic physicians away from medicine altogether. According to a 2021 study, more than one-third of physicians reported an intention to leave the profession, and over 70,000 physicians exited clinical practice between 2021 and 2022.8

Despite these headwinds, the tide is beginning to turn. Physicians across the country are recognizing the precarious state of healthcare and are taking an active role in combating consolidation, vertical integration, private equity interests, and the devaluation of patient care.9-10 Medical societies are raising awareness through advocacy initiatives to fight for both patients and providers, and policymakers from across the political spectrum are taking notice. Advocacy has become one of the highest priorities across medicine. Now, more than ever, it is time for us to stand together and advocate for ourselves and for our patients.

Among the organizations leading this effort, the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) has distinguished itself by giving its members a meaningful voice in organized medicine. Through the foresight of its leadership, our members have had the opportunity to advocate for themselves for nearly a decade. Through collaboration with the American Society of Anesthesiologists, the American Academy of Physical Medicine and Rehabilitation, and the International Pain and Spine Intervention Society, our multidisciplinary Pain Medicine Coalition has established a meaningful presence in the policymaking rooms on Capitol Hill. This coalition was formed in 2024 in an effort to advance shared priorities across the pain medicine community and promote responsible, patient-centered care. Working alongside the American Medical Association (AMA)—the nation's largest physician advocacy organization, with more than 175 years of history—we have successfully advanced policies that directly benefit our members and our patients.10-11

Over the past five years, our delegation at ASRA Pain Medicine has had the privilege of serving as both front-row observers and active participants in this process. This level of engagement at the local and national levels is exactly what we needed to see from a professional society that genuinely cares about its members during one of the most challenging periods in modern medicine. From visionary leaders representing a truly multidisciplinary specialty to the countless individuals working tirelessly behind the scenes with allied organizations to shape healthcare policy, our Society's influence extends far beyond what most members ever see.

As a society, ASRA Pain Medicine continues to lead the fields of acute and chronic pain medicine by using high-quality evidence to define and improve the delivery of patient care.12-14 We have leveraged our collective voice to communicate the needs of our members and to advocate for the issues affecting our specialty. These efforts directly contributed to the pause of the proposed Medicare coverage restrictions on peripheral nerve blocks, preserving our ability to provide evidence-based care while ensuring that our specialty maintained a seat at the table as future policies are developed.10, 15

Our work, however, is far from finished. Several critical issues still demand our attention. For example, after adjusting for practice-cost inflation, real physician reimbursement has declined for more than 20 years, while budget-neutrality requirements and efficiency cuts continue to erode payments—unlike the reimbursement increases seen in hospitals and ambulatory surgery centers. Together with colleagues across organized medicine, we continue to advocate for a more sustainable physician reimbursement model, addressing evolving challenges in payment policy, preventing scope creep, advocating for ethical implementation of artificial intelligence, and maintaining physician leadership and autonomy.16,17

These collective efforts to advocate for ourselves as healthcare providers over the years are beginning to make a measurable difference. Physician burnout has steadily declined since the height of the pandemic, physicians increasingly report feeling valued by their organizations, and participation in organized medicine has reached some of its highest levels in recent years.18-20 We cannot allow this momentum to fade. We must continue to stand together and advocate on behalf of ourselves, our profession, and—most importantly—our patients.

As a young physician navigating an increasingly complex healthcare environment, I find these challenges daunting. However, ASRA Pain Medicine has consistently provided me with the resources and guidance I need in research and education, as well as opportunities to engage in advocacy and mentorship. My mentors, Dr. David Provenzano, Dr. Richard Chou, and others in the Society, have helped shape me into the physician I am today; but none of this would be possible without members like you.

We encourage you to continue supporting ASRA Pain Medicine, the American Medical Association, and our specialty societies during this pivotal moment in medicine. Our future—and the future of our patients—depend on it.

 

Thank you to Dr. David Provenzano and Dr. Richard Chou for their contributions to this article.


References

  1. Health Resources and Services Administration. The Physician Workforce: Projections and Research Into Current Issues Affecting Supply and Demand. US Department of Health and Human Services. Nov 2024. Available: https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/physicians-projections-factsheet.pdf [Accessed 12 Jul 2026].
  2. National Resident Matching Program. 2026 Main Residency Match Outcome and Demographic Reports. May 2026. Available: https://www.nrmp.org/about/news/2026/05/new-reports-2026-main-residency-match-outcome-and-demographic-reports/ [Accessed 12 Jul 2026].
  3. American Medical Association. Medicare Physician Pay Has Plummeted Since 2001. Find Out Why.  2025. Available: https://www.ama-assn.org/practice-management/medicare-medicaid/medicare-physician-pay-has-plummeted-2001-find-out-why [Accessed 12 Jul 2026].
  4. American Academy of Pain Medicine. Medicare Releases Proposed LCD on Peripheral Nerve Blocks. 2025. Available: https://painmed.org/medicare-releases-proposed-lcd-on-peripheral-nerve-blocks/ [Accessed 12 Jul 2026].
  5. Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians during the COVID-19 pandemic. Mayo Clin Proc. 2022;97:2248-58. doi: 10.1016/j.mayocp.2022.09.002
  6. American Medical Association. Pandemic Exposes Dire Need to Rebuild Public Health Infrastructure. 2021. Accessed July 12, 2026. https://www.ama-assn.org/about/leadership/pandemic-exposes-dire-need-rebuild-public-health-infrastructure [Accessed 12 Jul 2026].
  7. Stanford Center on China's Economy and Institutions. Exposing the big fail: How COVID-19 revealed America's health divide. Published 2021. Accessed July 12, 2026. https://casi.stanford.edu/news/exposing-big-fail-how-covid-19-revealed-americas-health-divide [Accessed 12 Jul 2026].
  8. Sinsky CA, Brown RL, Stillman MJ, Linzer M. COVID-related stress and work intentions in a sample of US health care workers. Mayo Clinic Proceedings. 2021;5(6):1165-73. doi:10.1016/j.mayocpiqo.2021.08.007
  9. Cornell University ILR School, Scheinman Institute. Physician Unionization: A Hot Topic at the American Medical Association. 2024. Available: https://www.ilr.cornell.edu/scheinman-institute/blog/healthcare-insights/physician-unionization-hot-topic-american-medical-association [Accessed 12 Jul 2026].
  10. American Society of Regional Anesthesia and Pain Medicine. AMA Adopts ASRA Pain Medicine-Led Resolution Opposing Proposed Medicare Limits on Peripheral Nerve Block Coverage. 17 Nov  2025. Available: https://asra.com/news-publications/asra-update-item/asra-updates/2025/11/17/ama-adopts-asra-pain-medicine-led-resolution-opposing-proposed-medicare-limits-on-peripheral-nerve-block-coverage [Accessed 12 Jul 2026].
  11. American Society of Regional Anesthesia and Pain Medicine. ASRA Pain Medicine Commends House Appropriations Committee on WISER Pause. 13 Nov 2025. Available: https://asra.com/news-publications/asra-update-item/asra-updates/2025/11/13/asra-pain-medicine-commends-house-appropriations-committee-on-wiser-pause [Accessed 12 Jul 2026].
  12. Kopp SL, Vandermeulen E, McBane RD, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (fifth ed). Reg Anesth Pain Med. Published Online First: 29 January 2025. doi:10.1136/rapm-2024-105766
  13. Provenzano DA, Hanes M, Hunt C, et al. ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine. Reg Anesth Pain Med. Published Online First: 20 January 2025. doi:10.1136/rapm-2024-105651
  14. McCormick ZL, Hurley RW, Anitescu M, et al. Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group. Reg Anesth Pain Med. Published Online First: 29 November 2025. doi:10.1136/rapm-2025-107387
  15. American Society of Regional Anesthesia and Pain Medicine. AMA Urges CMS to Withdraw Proposed Coverage Limits on Peripheral Nerve Blocks. 8 Dec 2025. Available: https://asra.com/news-publications/asra-update-item/asra-updates/2025/12/08/ama-urges-cms-to-withdraw-proposed-coverage-limits-on-peripheral-nerve-blocks [Accessed 12 Jul 2026].
  16. American Medical Association. Sign-On Letter Supporting the Provider Reimbursement Stability Act (H.R. 8163). 19 May 2026. Available: https://searchlf.ama-assn.org/letter/documentDownload?uri=/unstructured/binary/letter/LETTERS/lfh.zip/2026-5-19-AMA-Sign-on-Letter-to-HR-8163-re-Provider-Reimbursement-Stability-Act.pdf [Accessed 12 Jul 2026].
  17. American Society of Regional Anesthesia and Pain Medicine. ASRA Pain Medicine + ASA: Impacting the Future Together. 8 May 2026. Available: https://asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2026/05/08/asra-pain-medicine---asa--impacting-the-future-together [Accessed 12 Jul 2026].
  18. American Medical Association. Nearly 55% of physicians feel valued by their organization. 2025. Available:  https://www.ama-assn.org/practice-management/physician-health/nearly-55-physicians-feel-valued-their-organization [Accessed 12 Jul 2026].
  19. American Medical Association. Physician burnout rate continues to decline, falling to nearly 42%. 2025. Available:   https://www.ama-assn.org/practice-management/physician-health/physician-burnout-rate-continues-decline-falling-nearly-42 [Accessed 12 Jul 2026].
  20. Sequence Consulting. AMA Health Systems Membership Strategy. 2025. Available: https://sequenceconsulting.com/ama-health-systems-membership-strategy/ [Accessed 12 Jul 2026].
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