US Front Line of Healthcare
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Executive Summary
The physician experience is deteriorating for new reasonsInvesting in the clinician experience is the right thing to do. Beyond that, satisfied and empowered clinicians deliver higher quality care, better patient experiences, and save their organizations from significant turnover expenses. Moreover, our data indicates that clinician involvement is also a critical enabler for AI to deliver value on the front line. However, clinician sentiment continues to deteriorate. The overall employee Net Promoter ScoreSM (eNPS) for physicians fell from 33 in 2024 to just 6 in 2026, the lowest Bain has recorded since 2017. Our longitudinal data also reveals a consistent and striking score gap—88 points—between physicians who feel engaged in decision making and those who do not (see Figure 1). The gap signals that long-standing challenges in the clinician experience remain unaddressed in US health systems.
Figure 1
Overall, 25% of physicians are considering switching employers—a 5-percentage-point jump since 2024 that is mostly driven by physicians in management-led organizations. These physicians are more than twice as likely to switch employers compared with their peers in physician-led settings. The reasons physicians want to leave changed sharply in 2026. In the past, burnout and excessive workload were the top non-pay-related reasons for switching. This year, being treated with a lack of respect and dignity and a lack of recognition rose to the top of attrition drivers (see Figure 2). Physicians now share the top frustrations historically reported by their nursing colleagues. This sentiment is especially pronounced in management-led organizations.
Figure 2
Note: pp is percentage points Source: Bain US Front Line of Healthcare, June 2026 (n=400 physicians)The impact of ownership structure is not new. Bain has noted a gap in physician eNPS between physician- and management-led organizations every year since 2017, with the gap ranging between 25 and 40 points. In 2026, that divide decreased to 15 points, as eNPS scores in physician-led settings dropped. Despite the dip, physician-led practices remain the most preferred place for clinicians to work. For administrators, the declining physician experience adds to existing labor pressures. About 55% of administrators say physician recruiting has become more challenging, up from 35% in 2024. About half of administrators report the same for nurse recruiting, and roughly 40% for advanced practice practitioner and allied health professional recruiting. Many administrators are counting on AI to help reverse this trajectory: About 65% expect AI adoption to flatten or slow clinical headcount growth across roles over the next three years. Whether that bet pays off will depend on health systems’ ability to achieve meaningful capacity expansion with AI. Our survey findings show that neither consumers nor clinicians are comfortable with AI replacing clinicians anytime soon. Clinicians see benefits from AI but skepticism remainsApproximately one in three physicians uses AI in diagnostic or treatment decision-support tools, and 56% of them reach for AI-enabled tools multiple times a day. Users say these tools provide value by helping them stay current on clinical evidence, improve diagnostic accuracy, and increase diagnosis speed. In fact, physicians report improvements to their work from using AI tools across clinical decision support, patient-facing, and administrative use cases (see Figure 3). Only 1% report no meaningful value from AI tools.
Figure 3
Like consumers, clinicians remain cautious about AI despite the benefits. Both groups are comfortable with AI playing a supporting role but draw a hard line at clinician replacement. Use of AI for clinical triage received the sharpest opposition, with almost 40% of clinicians rejecting AI incorporation completely, regardless of whether there is human oversight (see Figure 4).
Figure 4
Note: Not all bars add to 100% due to rounding Source: Bain US Front Line of Healthcare, June 2026 (n=400 physicians, n=100 nurses)Elevating the physician experience is largely within health systems’ control. Physicians are very clear on what they value and need from employers: to participate in the decision making that shapes their work, to feel respected, and to be recognized. Clinician satisfaction and engagement will be critical to the disruptive AI-driven transformation ahead, but AI is only one reason to act. Clinician sentiment is at its lowest point since our records began in 2017, and fixing it is a priority on its own. Physicians are clear about what they want from employers: a voice in the decisions that shape their work, respect, and recognition. Physician-led organizations have consistently delivered better in these areas, and closing these gaps remains an untapped opportunity for most health systems today. US Front Line of Healthcare 2026Explore more |