Key Takeaways
- •The hearing established a bipartisan consensus that excessive administrative and regulatory burdens are driving physician burnout and reducing patient access to care.
- •Dr. Lee Gross explained how federal regulations forced him to opt out of Medicare, creating his direct primary care model to escape cumbersome insurance systems.
- •Senator Moody (R-FL) pressed Dr. Gross on how direct primary care addresses the physician exodus, and he clarified the distinction from concierge medicine.
- •Chairman Scott (R-FL) and Ranking Member Gillibrand (D-NY) both highlighted administrative burden and regulatory requirements as key drivers of physician burnout.
- •Witnesses urged Congress to support regulatory reform, administrative simplification, and full funding for the Dr. Lorna Breen Act to retain healthcare workers.
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Hearing Analysis
Overview
The Senate Special Committee on Aging met on February 11, 2026, for a hearing titled "Hearings to examine how Washington's rules drove physicians out of medicine." Chaired by Sen. Rick Scott (R-FL), the hearing focused on the systemic drivers of physician burnout, the exodus of healthcare providers from traditional practice models, and the resulting impact on access to care for older Americans. The committee explored how federal mandates, administrative burdens, and a "top-down" regulatory approach have strained the doctor-patient relationship and contributed to a looming workforce crisis.
Chairman Scott opened the session by arguing that physicians are victims of a "broken system" that prioritizes paperwork over patients. He emphasized that federal mandates and unstable Medicare policies force doctors to spend more time on compliance than on care, particularly in rural and underserved areas. Ranking Member Kirsten E. Gillibrand (D-NY) agreed that burnout remains a prevalent issue, though she also highlighted the role of private equity investment, anti-competitive non-compete agreements, and the stigma surrounding mental health support as contributing factors.
Key Testimony
The testimony from the witness panel provided a stark look at the human and operational costs of the current regulatory environment. Dr. Alma Littles, Dean and Chief Academic Officer of the Florida State University College of Medicine, reported that approximately 400 physicians take their lives each year, and medical students face depression rates 15% to 30% higher than the general public. She noted that when one physician leaves a practice, 2,000 to 3,000 patients lose access to care. Dr. Littles emphasized that while physicians understand the need for oversight, the sheer volume of mandates and reporting systems has become unsustainable.
Policy Proposals
Dr. Lee Gross, Founder of Epiphany Health Direct Primary Care, shared his experience "firing" the federal government to escape the traditional insurance-driven system. He criticized the certification process for Electronic Health Records (EHRs), noting that government-mandated systems often prioritize billing compliance over clinical workflow, turning the medical record into a "cash register." Dr. Gross highlighted a significant policy barrier: federal law requires physicians to "opt out" of Medicare entirely if they wish to contract directly with even one Medicare beneficiary. This prevents doctors from moonlighting in hospitals or emergency rooms, which Dr. Gross argued disproportionately hurts rural healthcare delivery.
Key Testimony
Jeffrey Smith, CEO of Piedmont HealthCare and incoming board chair for the Medical Group Management Association (MGMA), testified that more than half of physician practices have lost a doctor to burnout in the last three years. He identified Medicare Advantage (MA) as the most burdensome payer, citing a lack of standardization in quality metrics and excessive prior authorization requirements. Smith noted that his organization, which oversees 70 offices, must dedicate at least one staff member per office solely to managing prior authorizations, a cost he estimated at $35,000 to $50,000 per employee.
Corey Feist, CEO and Co-Founder of the Dr. Lorna Breen Heroes' Foundation, provided an emotional perspective on the mental health crisis. He shared the stories of Dr. Lorna Breen and Dr. William West, a 34-year-old resident who took his life due to the "information ocean" and pressures of training. Feist warned that the U.S. faces a projected shortage of over 500,000 health professionals by 2038. He advocated for full funding of the Dr. Lorna Breen Health Care Provider Protection Act, noting that while billions are spent on workforce creation, very little is spent on retention.
Overview
Several policy proposals were discussed throughout the hearing. There was bipartisan support for the Improving Seniors' Timely Access to Care Act, which aims to streamline prior authorization in Medicare Advantage. Sen. Raphael G. Warnock (D-GA) discussed the Resident Physician Shortage Reduction Act, which would fund 14,000 new residency slots over seven years. Witnesses also called for reforming the Merit-based Incentive Payment System (MIPS), addressing Medicare Part B under-reimbursement, and removing intrusive mental health questions from licensing applications.
Partisan dynamics emerged regarding the root causes of the crisis. Republican members, including Sen. Ashley Moody (R-FL), focused on how government overregulation has destroyed the "free market" in healthcare and driven physicians toward concierge or direct primary care models. Democratic members, such as Sen. Angela D. Alsobrooks (D-MD), emphasized the need for federal OSHA standards to address workplace violence against nurses and physicians, as well as the potential dangers of Medicaid cuts proposed in other legislation.
Notable exchanges included Dr. Gross’s description of "parking lot care" during Hurricane Ian, which he was able to provide only because his Direct Primary Care model allowed him to bypass the need for insurance coding and authorization. Additionally, Jeffrey Smith highlighted the "moral injury" felt by physicians when they are forced to spend "pajama time" on EHR data entry rather than with their families or patients.
The hearing concluded with Chairman Scott reiterating the need for regulatory reform to put the doctor-patient relationship back at the center of healthcare. He noted that the hearing record would remain open for additional questions and statements until the following week, signaling that the committee would continue to investigate legislative solutions to reduce administrative red tape and bolster the physician workforce. Organizations mentioned during the proceedings included the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), the National Academy of Medicine, and the Medical Group Management Association (MGMA).
Transcript
[Gavel sounds.] The U.S. Special Committee on Aging will now come to order. Across the nation, older Americans are feeling it is harder than ever to get timely access to the doctors and care they need to live happy, healthy lives. And even when seniors do find a doctor, many feel rushed and disconnected from them. Doctors aren't the villains here. Like their patients, they are victims of a broken system. Doctors want to care for and connect with their patients, but our rigid, top-down healthcare system is making that job nearly impossible. This is especially true for doctors who see patients on Medicare or other government-run or subsidized healthcare programs. Federal mandates, administrative requirements pile on paperwork and paperwork and force doctors to spend more and more time on compliance than on care, making patients face one obstacle after another just to get help. The results: patients can't get the care they need from doctors, and doctors can't give patients the care they deserve. Absolutely no one benefits from this. We are forcing our doctors to operate in a system that prioritizes paperwork over patients and federal mandates over professional judgment. The demands on doctors to focus on compliance over care are higher than ever. Doctors must navigate unstable insurance and Medicare policies, different reporting standards, and excessive administrative burdens just to take care of their patients. And again, no one benefits in this situation. Not patients, and certainly not doctors, who got into this profession because they want to help patients. And the result is less care, less access, and worse outcomes. This is especially true in rural and underserved areas that already struggle to find and maintain healthcare providers, and the regulatory burden is especially tough for those who treat older Americans. It's no wonder that doctors regularly report feeling higher levels of burnout than other U.S. workers. That burnout leads to more doctors quitting their jobs, which creates more doctor shortages, which leads to increased administrative burden, which creates more disconnection and fewer rewarding interactions with patients, which results in more burnout. In the most serious cases, this burnout contributes to devastating mental health consequences for physicians and their families, including serious depression and even suicide. We owe it to all of our constituents, but especially our aging population and those responsible for caring for them, to stop this cycle. Today, we'll look at how Washington's regulations and red tape play into this crisis and what we can do to fix it so that our doctors can spend more time caring for patients and less time navigating bureaucracy. We'll hear from witnesses who interact with physicians at all levels. They train our doctors, they manage them in medical practices, they treat them, and they work with them as colleagues and are doctors themselves. They will tell us about their real-life experiences navigating and preparing doctors to deal with Washington's top-down, one-size-fits-all approach to regulating medicine. They'll also share their experience working to solve these problems and what steps we can take to help our doctors and the patients they serve put the doctor-patient relationship back at the center of healthcare. I look forward to a productive discussion today with our witnesses. I'd now like to recognize Ranking Member Gillibrand for her opening statement.
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