Despite advances in technology that improve outlook at the practice level, physician optimism for the future of the U.S. healthcare system remains stubbornly low

According to athenahealth’s fifth annual Physician Sentiment Survey, access to affordable healthcare has surged as the top policy concern among physicians, climbing 14 points over three years to reach 52% — up sharply from 44% in 2025 and 38% in 2024. This trend indicates that access to healthcare is no longer solely a patient issue but also a critical challenge for the physicians responsible for delivering care. The survey is the latest from athenaInstitute, the company’s research and intelligence hub, and is fielded by The Harris Poll on behalf of athenahealth, polling 1,045 primary care and specialist physicians nationwide.

While physicians are increasingly optimistic about technology advances within their own practices, this positivity has not extended to the future of the U.S. healthcare system. Despite growing confidence in healthcare technology, overall optimism about the system's future remains low at around 30% for the third consecutive year. At a time when access to affordable healthcare is a mounting concern, physicians continue to face system strains.

The survey reveals that physicians are experiencing meaningful technology gains, with 62% reporting increased efficiency from their EHRs (up from 54% in 2024) and 55% saying EHRs support better patient care decisions. AI adoption is also rising, as 42% of physicians have experienced AI-driven reductions in administrative burdens, up from 37% last year, and they are also more comfortable with AI (54% up from 46% last year). However, the full potential of these technologies is limited by growing information overload and ongoing interoperability challenges. More than half of physicians (56%) struggle to find relevant data for patient visits and 69% report difficulty accessing recent medical history from outside providers. Both information overload (59%) and interoperability challenges (80%) are viewed by physicians to contribute significantly to their stress.

"Physicians today are more receptive than ever to adopting new tools and innovative ways of working, signaling a positive shift within clinical practices,” said Nele Jessel, chief medical officer at athenahealth and athenaInstitute co-chair. "Yet persistent structural barriers — like affordability challenges, care fragmentation, and information overload — continue to shape the daily realities of care delivery. The feedback from physicians underscores the critical work ahead: removing these burdens so clinicians can focus on what matters most — delivering exceptional patient care."

Additional findings from the survey highlight the significant challenges physicians across practices of all sizes face, including financial anxieties, workload pressures, and variations in AI and value-based care adoption:

• Physicians feel financially stable, but remain anxious about practice sustainability:
  Current financial indicators appear strong, with 67% of physicians expressing confidence in their financial footing, driven by patient retention (59%) and patient growth (50%). However, the fact that 52% still report concern — and that 90% of small practices fear losing independence — signals underlying structural strain. Persistent reimbursement pressure from Medicare and Medicaid suggests that without policy or payment reform, today’s stability may give way to consolidation and reduced practice autonomy.

• Rural physicians grapple with greater burnout, access struggles, and career doubts compared to urban counterparts:
  Rural healthcare faces a growing workforce stability crisis. Compared to urban and suburban peers, rural physicians experience higher burnout (67% vs. 52%), greater concern about affordable care access (63% vs. 51%), and are more likely to consider leaving medicine (69% vs. 51%). Persistent difficulties in accessing clinical information and low confidence in EHRs to reduce administrative burdens add to the strain, threatening care continuity in rural areas. These systemic inefficiencies and ongoing challenges could further accelerate physician shortages in these communities.

• Smaller practice risk being left behind as AI adoption accelerates:
  Lower AI comfort among small practices compared to enterprise organizations (43% vs. 65%) signals more than a technology gap — it highlights the divide between small and large practices driven by a disparity in resources, data infrastructure, and regulatory expertise. As AI comfort rises among larger practices but remains stagnant in small settings, smaller practices risk missing out on operational gains that can help their practice run more smoothly.
  
  Findings also indicate that physicians more comfortable with AI tend to be more optimistic about healthcare’s future (42% vs. 20%) and are significantly more likely to believe AI is helping to reduce administrative burden (63% vs.16%). Expanding AI readiness and support could play a meaningful role in strengthening overall physician outlook and engagement.

• Physician hesitancy stalls adoption of value-based care:
  While 69% of physicians want more information about value-based care (VBC), fewer support implementing it in clinical practice (49%), and only 33% are confident it will improve practice sustainability in five years. Over half (53%) are uncomfortable with shared risk models that hold them accountable for patient outcomes. This suggests that curiosity about VBC hasn’t turned into strong commitment. Without better education, evidence of positive outcomes, and operational support, many physicians may remain hesitant, slowing wider adoption of VBC.

The Physician Sentiment Survey offers a comprehensive view of physician attitudes toward the profession, industry challenges, and evolving perceptions of emerging technologies. The 2026 survey was conducted online within the U.S. by The Harris Poll on behalf of athenahealth from October 14-29, 2025, surveying 1,045 physicians (752 PCPs, 291 specialists), with 7% using athenahealth’s EHR. Where applicable, results are compared to prior waves from January 2025 and October-November 2023.

Learn more about the 2026 Physician Sentiment Survey, including additional findings.

About athenaInstitute

athenaInstitute is athenahealth’s home for advancing ideas and actions that help cure complexity in ambulatory care through publishing insights, convening experts, and amplifying innovation. Learn more at athenahealth.com/athenainstitute.

About athenahealth

Since 1997, athenahealth has been curing complexity for ambulatory healthcare practices and the patients they serve, empowering them to deliver the best possible care and business outcomes through innovative clinical, financial, and patient engagement solutions. athenahealth connects practices, health systems, payers, partners and patients to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Learn more at athenahealth.com.

About The Harris Poll

The Harris Poll is one of the longest running surveys in the U.S. tracking public opinion, motivations, and social sentiment since 1963 that is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times. We work with clients in three primary areas: building 21st-century corporate reputation, crafting brand strategy and performance tracking, and earning organic media through public relations research. Our mission is to provide insights and advisory to help leaders make the best decisions possible. To learn more, please visit www.theharrispoll.com.

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Physicians today are more receptive than ever to adopting new tools and innovative ways of working, signaling a positive shift within clinical practices