Forbes January 17, 2025
Spencer Dorn

“Trust me, I’m a doctor.” This refrain was typically enough to satisfy payers, administrators, and patients throughout the so-called “golden age of medicine” (1950-1980s), when physicians worked in small practices they owned, set their payment rates, and were highly regarded and rarely scrutinized.

Times have changed. Over the past several decades, various forces have eroded physician autonomy, leaving many dissatisfied and burned out. Artificial intelligence will likely further this trend. Let me explain how.

Increasing Accountability

For much of the 20th century, physicians practiced with few limits. They mostly ordered tests and treatments they felt were indicated and charged whatever they wanted.

Starting in the 1970s, public and commercial payors launched a series of models—most notably HMOs, PPOs, and ACOs—designed...

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