Physicians and administrators: what physicians say about who runs medicine, in their own words

Last updated September 20, 2026.

Read together, the 505 KevinMD posts about physicians and the people who manage them say one thing consistently: the argument is about who decides. Physicians on the site have been counting administrators since 2014, when the growth figure was 2,500 percent, and in 2026 it is ten administrators for every physician. They describe a shift of power from the exam room to the C-suite, measured in RVUs and satisfaction scores, and they disagree about the remedy: become the administrators, leave the institutions, or make the institutions answer for their own numbers. Posts mentioning autonomy rose from 4 percent before 2013 to 15 percent in 2025 and 2026, and posts mentioning trust from 6 to 40 percent.

This page is a maintained record of what physicians, nurses, hospital administrators, and the lawyers and consultants who work between them have written about who runs medicine on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 505 essays and podcast transcripts with an administration, executive, employment, leadership, metrics, or autonomy term in the title, published between May 2006 and September 2026 by 302 named contributors, 311 of the posts bylined by physicians, 37 by authors with an MBA, and 47 of them podcast episodes with transcripts. Of the 505, 225 were published from 2023 onward and 75 in 2026 alone, the most of any year. Every claim is attributed to a named author with the month it was published, quoted in the author’s own words, and linked to the original.

This record is about the relationship between physicians and management. The exhaustion it produces is on the Physician burnout: what physicians say, in their own words record; the buyers of practices are on the Private equity and corporate medicine: what physicians say, in their own words record; the paperwork itself is on the Prior authorization: what physicians say, in their own words and The electronic health record: what physicians say, in their own words records; the exit to direct care is on the Direct primary care: what physicians say, in their own words record. Administrators who write on the site are cited here at the same weight as physicians and identified as such. Each section opens with a direct answer, then what named authors have said, in the order they said it. Where authors cite figures, the source is named alongside the author and the figures are theirs as of the date they wrote. Contributors who sell contract review, coaching, consulting, or practice models into this subject are identified where they are cited. This is physician opinion and experience, not management guidance.

What do physicians say about hospital administrators and executives?

Physicians on KevinMD have written the same sentence about administrators for twelve years, with a rising number in it: they have multiplied while physicians have not, and nobody measures what they do. The administrators who answer say they are well-intentioned people starting from a different place. Administrator or administration appears in 47 percent of posts in 2013 to 2016 and 32 percent since 2025.

Roy Poses, MD, an internist, wrote in July 2011 of a departing insurer CEO’s payout that “the disconnect between executive compensation and the mission of health care organizations,” in “Executive compensation and the rising cost of health care.” Ashish Jha, MD, MPH, a health policy researcher, wrote in November 2013 that “we found no relationship between a hospital’s quality performance and the pay of the CEO,” in “Why quality doesn’t affect hospital CEO pay.” Kevin R. Campbell, MD, a cardiologist, wrote in May 2014 that as administrators grow “Nurses and doctors are asked to care for more patients with fewer resources,” in “The salaries of health executives: What can doctors do?” Richard Gunderman, MD, PhD, a radiologist, wrote in April 2015 that “From the CEO’s perspective, health care looks like an underperforming business that needs a kick in the pants,” in “There’s a new hospital CEO in town.” Kevin R. Campbell, MD, a cardiologist, wrote in July 2015 that “It is clear that there is a role for administrators,” and that their number had risen nearly 3,000 percent in thirty years, in “Rise of the administrators: Hasta la vista, docs.” Suneel Dhand, MD, a hospitalist and the most frequent contributor on the subject, wrote in May 2016 that “Administrators aggressively monitor their physicians’ whereabouts and try to review all of their patient interactions,” in “The time a 28-year-old MBA told a physician where to round first.” Suneel Dhand, MD, a hospitalist, wrote in May 2017 of the new breed of health care leader that “Most of them have never seen, interacted with, or treated a real patient before,” in “What’s wrong with health care leaders today.” Paul DeChant, MD, MBA, a physician executive and consultant, wrote in August 2017 that “The executives in the C-suite control the resources,” in “Can health care executives help with physician burnout?” Leslie Flores, a hospital administrator turned consultant, wrote in April 2019 as a former hospital administrator, that “most of the hospital leaders I have met,” are well-intentioned people who care deeply about patients, in “How physicians and administrators can get to a place of greater trust.” Skeptical Scalpel, MD, a surgeon writing under a pen name, wrote in September 2020 that “I can think of no reason for a hospital administrator to even be a spectator in the operating room,” in “The hospital CEO who made a surgical incision. What happened?” Joe Mandato and Ryan Van Wert, MD, a board director and a physician, wrote in December 2021 that “the average tenure of a hospital system CEO is 3.5 to 5 years,” in “Why health care delivery is an exceptionally different industry: board of directors and CEOs.” Shannon Driscoll, MHA and Dr. Soumya Padala, a hospital administrator and a physician, wrote in January 2023 that “Trust is the core foundation of any relationship, and it is decreasing at alarming levels between physicians and administrators,” in “The power of physician-administrator partnership.” Dennis Hursh, Esq, a health care attorney who reviews physician contracts, wrote in February 2024 that after forty years reviewing physician contracts “I’m not altogether convinced that one health system CEO really ‘earned’ the $35.5 million,” in “Are hospital CEOs overpaid? One lawyer’s skeptical take on executive compensation.” David M. Mitchell, MD, PhD, a physician, wrote in June 2024 asking, given a ten-to-one ratio of administrators to physicians “What are those administrators doing with their time,” in “Health care administrators: a call for equal transparency and accountability.” Dan Rusu, MD, a physician, wrote in August 2026 that “There are now ten administrators for every practicing physician in America,” in “How administrative bloat broke American medicine.”

What do physicians say about being employed?

The employed physician is the newest permanent fact in this record. Physicians on KevinMD describe the moment a practice was bought and a father became an employee at 62, contracts whose notice clauses and intellectual-property terms they never read, an emergency physician fired for a social media post, and, since 2023, a market in alternatives to employment sold by the physicians who left. Employed or employer appears in 20 percent of posts in 2013 to 2016 and 22 percent since 2025.

Brian J. Secemsky, MD, an internist, wrote in December 2014 that after a corporate system bought the practice “at 62, my father started his first employed job since finishing his medical training,” in “The rise of the employed physician: What it means to new doctors.” Elizabeth Shubov, JD, an attorney, wrote in July 2019 that “Professional liability or ‘malpractice’ insurance protects a physician and the employer from claims,” in “Understanding professional liability insurance in physician employment contracts.” Peter D. Sleman, JD, an attorney, wrote in March 2020 that physicians notice the non-compete but “few ever look at the intellectual property provisions, and are later surprised,” in “Intellectual property provisions in physician employment agreements.” Kara Grant, a journalist, wrote in October 2021 that an emergency physician employed by a staffing firm “was immediately fired for using social media to air his grievances with COVID protocols,” in “Why private equity is a dangerous employer.” Dennis Hursh, Esq, a health care attorney who reviews physician contracts, wrote in October 2022 that “An academic physician employment agreement is usually light on provisions,” in “Things to know before signing an academic physician employment agreement.” Dennis Hursh, Esq, a health care attorney who reviews physician contracts, wrote in July 2023 that if a physician leaves without the contract’s notice “the employer may recover damages it suffers as a result of this breach,” in “What happens if I don’t give the notice required under my physician employment agreement?” Tod Stillson, MD, a family physician who sells that arrangement, wrote in March 2024 of a physician he converted to a contractor arrangement that “The physician was so thrilled about the return of autonomy and the financial benefits,” in “Physician employment 2.0: Unveiling the secret world of employment lite.” Justin Nabity, CFP, a financial planner who advises physicians, wrote in July 2025 that “Employment has been one of the primary drivers in this loss of physician autonomy,” in “Why hospital jobs are failing physicians: burnout, pay, and lost autonomy.” Dana Y. Lujan, MBA, a consultant on direct care models, wrote in March 2026 that “Physicians left because institutional employment extracted their autonomy incrementally,” in “Securing physician autonomy with employer-sponsored direct primary care.” Richard A. Lawhern, PhD and Richard Willner, DPM, wrote in July 2026 that of an employer that “selecting the wrong one may end your career as a doctor,” in “Why the wrong physician employer can end your career.”

What do physicians say about metrics, RVUs, and productivity?

On metrics the record is nearly unanimous and has been since 2012: a number chosen to measure care starts to replace it. The dissent, from a physician who asks colleagues to help write the metrics they mock, is also here. Metrics or productivity appears in 12 percent of posts before 2013 and 40 percent since 2025; RVU in 6 percent in 2023 and 2024.

Michael Appel, MD, an anesthesiologist, wrote in April 2012 that “Productivity and protection are not at odds with one another,” in “The problem of mixing productivity with patient safety.” Brandon Betancourt, a practice manager, wrote in October 2012 that “RVUs are meaningless unless they are attached to a dollar amount,” in “Why the RVU system gives a false sense of productivity.” Michael Cetta, MD, an emergency physician, wrote in November 2013 that “it’s worth noting just how many of the CMS metrics relate to one thing: time,” in “What is the best metric to measure a hospital?” Jennifer Gunter, MD, an obstetrician-gynecologist, wrote in July 2014 that “metrics also have a very dark side because not everyone is honest,” in “The VA scandal exposes the folly of metrics.” Robert Centor, MD, an internist, wrote in September 2017 that “Productivity implies that we can count patient units,” in “It’s time to ban productivity from medicine.” Sarah E. Jorgensen, RN, a nurse, wrote in January 2019 that “The metrics you’re shoving down our throats are asphyxiating us,” in “Stop shoving metrics down nurses’ throats.” Sarah Gebauer, MD, an anesthesiologist, wrote in September 2019 that “one of the reasons so many physician metrics are wrong is that physicians have not participated in the process,” in “Should doctors take more responsibility for quality metrics?” David M. Mitchell, MD, PhD, a physician, wrote in May 2021 that “pressured providers begin to base their clinical decisions on achieving a metric rather than on their best clinical judgment,” in “Metric shock: the unintentional consequence of measuring.” Sara Bajuyo, MD, a family physician, wrote in February 2022 that in value-based care “there are over 90 metrics spread across six areas of care,” in “Metric fever will decimate our primary care workforce.” Archana Reddy Shrestha, MD, an emergency physician and coach, wrote in October 2023 that “many of my colleagues and I started to feel like our worth was based on these numbers,” in “Metric shaming in medicine and 3 ways to overcome it.” Shideh Shafie, MD, an emergency physician, wrote in June 2024 that “These are not the metrics that define our professional ethos,” in “Navigating profit-driven metrics: Upholding core values in medicine.” Mick Connors, MD, a pediatric emergency physician, wrote in October 2024 that “the RVU system is fundamentally biased toward procedures and volume-based care,” in “Why the RVU system makes attaining the quadruple aim laughable: a deep dive into a broken health care model.” Mick Connors, MD, a pediatric emergency physician, wrote in November 2024 that “many doctors are still desperately defending the RVU system,” in “Why physicians can’t let go of the golden RVU ring.” Ben Reinking, a pediatric cardiologist and physician coach, said on The Podcast by KevinMD in May 2026 that “that metric-based mindset has really driven how we start acting in the system as pre-med students,” in “Metrics got you into medicine and are making you unhappy in it [PODCAST].”

What do physicians say about autonomy?

Autonomy is the word this record uses for what was lost. Physicians on KevinMD compare their control over a visit to a pet groomer’s, cite a survey in which 38 percent of employed physicians report significant clinical autonomy against 67 percent in independent practice, and, since 2023, are sold routes back to it by the physicians who found one. Autonomy appears in 4 percent of posts before 2013 and 15 percent since 2025.

Phillip Kim, MD, MPH, a physician, wrote in November 2014 that “For most physicians joining a large organization, autonomy and control must be respected and granted,” in “When joining a medical practice: The importance of autonomy.” Christina Dewey, MD, a pediatrician, wrote in September 2019 that “The loss of physician autonomy plays a huge role in feelings of hopelessness and frustration,” in “To extinguish burnout, bring back physician autonomy.” Victoria Silas, MD, an orthopedic surgeon and coach, wrote in December 2021 that “The PetSmart groomers have the ability to book longer appointments for clients that they know need it,” in “Groomers at PetSmart have more autonomy than physicians.” Gail Gazelle, MD, a physician coach, wrote in March 2023 that “there is no question that autonomy over our working conditions has been vastly eroded,” in “Physicians in crisis: the battle for autonomy and happiness in a broken system.” Grace Torres-Hodges, DPM, MBA, a podiatrist, wrote in May 2023 that “I advocate for the direct care model because it aligns with and gives clarity in purpose,” in “Breaking free: the power of physician autonomy in patient care.” Tod Stillson, MD, a family physician who sells a contractor arrangement, wrote in May 2023 that “One thing that fuels Gen Z’s passion for starting a small business is the autonomy it provides them,” in “Revolutionizing physician work: Embracing location-independent careers and professional micro-corporations for autonomy and success.” Arthur Lazarus, MD, MBA, a psychiatrist, wrote in September 2024 that “The erosion of patient autonomy is a growing concern in contemporary health care,” in “The erosion of autonomy in sports and medicine.” Justin Nabity, CFP, a financial planner who advises physicians, wrote in July 2025 citing a survey of 3,500 physicians in which “67 percent of those in independent practice reported having ‘significant autonomy’ in clinical decision-making,” against 38 percent of those employed by hospitals, in “Why hospital jobs are failing physicians: burnout, pay, and lost autonomy.” James Rudolph, MD, a physician, wrote in April 2026 that “Professional status does not eliminate the right to autonomy,” in “Why ABIM’s use of Medicare claims data violates physician autonomy.”

What do physicians say about administrative burden?

Administrative burden is where this record meets the prior authorization and electronic record records: physicians on KevinMD have called it the primary driver of lost joy since 2019, and in 2024 an internist and MBA gave it a name, administrative harm, that a hospital ethicist took up three months later. The 2026 posts are about whether AI removes the burden or merely automates it.

Jeremy Lazarus, MD, then president of the AMA, wrote in August 2012 that “The AMA has called for a transparent and standardized claims process,” in “AMA works to reduce administrative burden for physicians.” Sid Schwab, MD, a surgeon, wrote in February 2014 that “It’d be easy to quantify the amount of paperwork, if I had the desire and the money,” in “Physician burnout: The additive effect of bureaucracy on the psyche.” Philip A. Masters, MD, an internist, wrote in November 2019 that administrative burden that “has emerged as a primary driver of the loss of joy in the practice of medicine,” in “How the administrative burden contributes to physician burnout.” Arthur Lazarus, MD, MBA, a psychiatrist and MBA, wrote in July 2024 that “Administrative harm can manifest in excessive paperwork, rigid protocols that do not allow for individualized patient care,” in “Administrative harm is destroying the practice of medicine.” Paul B. Hofmann, DrPH, MPH, a hospital ethicist, wrote in October 2024 that “the term administrative harm is unfamiliar to most health care executives,” in “Hospitals should recognize and address administrative harm.” Shiv K. Goel, MD, an internist, wrote in January 2026 that “This isn’t medicine; it’s paperwork with a stethoscope,” in “Claude for Healthcare vs. administrative burden: a physician’s review.” Jeffrey Shuhaiber, MD, a surgeon, wrote in June 2026 that “This is the tangible patient risk created by bureaucratic processes that delay, distort, or fragment medical care,” in “Administrative harm is the burnout we don’t measure.”

Should physicians run hospitals? What physicians say about physician leaders.

Physicians on KevinMD agree that they should lead and disagree about whether they can: a medical group CEO listed five reasons physicians fail as leaders, a family physician wrote that doctors are bad leaders, and a former Army officer says medicine has no leadership training at any stage. Since 2023 the posts are less about the C-suite and more about leadership without a title. Trust appears in 40 percent of the 2025 and 2026 posts.

Dike Drummond, MD, a family physician and coach, wrote in June 2012 that “this leadership vacuum is a natural consequence of our medical training and medicine’s unique business model,” in “The frustrating gap of physician leadership skills.” Kevin R. Campbell, MD, a cardiologist, wrote in July 2012 that “Current medical education certainly falls short in formal leadership training,” in “How to train more physician leaders.” Davis Liu, MD, a family physician, wrote in May 2013 that “No longer can we let others dictate how health care should look,” in “Doctors need to be the leaders of health care change.” Robert Pearl, MD, a physician executive, wrote in February 2016 as CEO of the largest medical group in the nation, that “I’ve had the opportunity to observe hundreds of physician leaders and their impact on nearly ten thousand doctors,” in “5 reasons why physicians fail as leaders.” Maiysha Clairborne, MD, a family physician, wrote in April 2017 that “We were taught that expertise equals authority, and increasing our authority is the automatic path to leadership,” in “Face it, doctors are bad leaders.” Alexi Nazem, MD, a physician and entrepreneur, wrote in July 2018 of Atul Gawande’s appointment, that “a physician is exactly what this new company needs,” in “Health care needs more physician CEOs.” James Turner, MD, an anesthesiologist, wrote in August 2019 of the Marine Corps rule that leaders eat last, that “It is a powerful example of effective leadership,” and asked whether hospital administrators follow it, in “Do hospital administrators eat last?” Travis Bias, DO and Ashley Ramirez, CPNP-AC, a family physician and a nurse practitioner, wrote in September 2019 that health care delivery that “is being led by practitioners who have ascended to leadership roles primarily through years of loyalty,” in “Seniority is the worst metric for health care leadership.” Sasha K. Shillcutt, MD, a cardiac anesthesiologist, wrote in October 2019 that “we need what I call hybrid physicians,” who work clinically and have a foot in leadership, in “We need physician leaders who understand our problems.” Leon Moores, MD, a neurosurgeon and former Army officer, wrote in November 2024 that “All physicians are leaders, not just those with designated leadership titles,” in “How better physician leadership can benefit our health care systems.” Amir Atabeygi, MD, MHA and Christina Mitchell, MHA, a family physician and a hospital administrator, wrote in July 2025 that “Implicit trust is the core foundation of a successful dyad,” in “Building trust in dyad leadership partnerships.” Ronald L. Lindsay, MD, a developmental pediatrician, wrote in December 2025 that “There is no formal leadership training in medical school, residency, or continuing medical education,” in “Why medicine needs military-style leadership and reconnaissance.” Matt Hasan, PhD, a health care executive, wrote in June 2026 that “The system is not a sentient, external entity that dropped from the sky,” in “Why health care leaders keep blaming the system.” Ronald L. Lindsay, MD, a developmental pediatrician, wrote in September 2026 that in four consecutive positions he met “toxic bosses and non-clinical administrators dictating how physicians should practice,” in “Toxic leadership in medicine punishes doctors who speak up.”

What do physicians say about the MBA and the business of medicine?

The MBA is the credential this record argues with. Physicians who earned one say it bought options and a better salary; physicians who work under MBAs describe a 28-year-old telling a physician where to round, an ethics of customers that conflicts with the Hippocratic one, and a satire of a clinic day as an MBA imagines it. MBA appears in 7 percent of posts in 2013 to 2016 and 5 percent since 2025; 37 of the 505 posts are by authors who hold one.

Joseph Kim, MD, MPH, an internist, wrote in February 2011 that “I’m now enrolled in business school and I’m pursuing an MBA,” in “Does a physician need an MBA degree?” Jordan Grumet, MD, an internist, wrote in May 2013 of a transfer policy written to fill a new cardiovascular institute’s beds that “The business aspects of medicine are starting to trump appropriate care,” in “When the business of medicine trumps appropriate care.” Shraddha Dalwadi, an MBA student, wrote in June 2015 that “perhaps business and medicine are not at odds,” in “4 reasons why business and medicine go together.” Suneel Dhand, MD, a hospitalist, wrote in May 2016 of a colleague told by a 28-year-old MBA that “the administration for some reason or another wanted him to round first on a particular floor,” in “The time a 28-year-old MBA told a physician where to round first.” Sanjana Vig, MD, MBA, an anesthesiologist, wrote in June 2018 that “an MBA means I can work in any hospital, any clinic or any government or private sector health care organization,” in “Why this physician has an MD and an MBA.” Manpreet Samra, MD, MBA, a physician, wrote in November 2020 that “The MBA did empower me to negotiate a higher salary,” in “To MBA or not to MBA as an MD: a physician’s journey.” Arthur Lazarus, MD, MBA, a psychiatrist who holds an MBA, wrote in March 2023 that “It pains me to admit it, but I wished the doctor did not have an MBA degree or industry ties,” in “When an MBA degree meets medicine: an eye-opening experience.” G. David Leveaux, MD, a physician, wrote in January 2025 that “MBA-trained health care administrators and their clones do see patients as customers,” in “The clash between MBA ethics and the Hippocratic tradition in medicine.” Susannah Eastwick, who directs a physician MBA program, said on The Podcast by KevinMD in March 2025 that “an MBA program is ultimately just a strategic training tool,” in “Essential skills for physician leaders in health care [PODCAST].” Santoshi Billakota, MD, a neurologist, wrote in May 2026 that “we receive almost no formal education in the business of medicine,” in “Why medical training ignores the business of medicine.” Harsha Moole, MD, an internist, wrote in July 2026 that “It was just never on the syllabus, and that is a fixable thing,” in “The business of medicine was never on my syllabus.”

What do physicians disagree about?

On the administrators themselves, Kevin R. Campbell, MD, says there is a role for them, Leslie Flores says most are well-intentioned, and Dan Rusu, MD, counts ten for every physician. On the fee-for-service payment model that metrics were built to replace, Matthew Hahn, MD, a family physician, wrote in March 2018 that “the fee-for-service payment model is not the problem, and this value-based payment model is not the answer,” in “The bureaucratic myth harming American health care.” On whether physicians should write the metrics, Sarah Gebauer, MD, says yes and Robert Centor, MD, says the word itself should go. On the MBA, Sanjana Vig, MD, MBA, says it bought options and G. David Leveaux, MD, says its ethics conflict with medicine’s. On whether the system is to blame, Matt Hasan, PhD, a health care executive, wrote in June 2026 of the familiar refrain, that “It casts doctors, administrators, and clinical leaders as helpless victims of an invisible and rigid machine,” in “Why health care leaders keep blaming the system.” The record does not resolve these; it dates them.

What would fix it? What physicians propose.

Asked what would fix the relationship between physicians and management, physicians on KevinMD propose leadership training from the first day of medical school, hybrid physicians with a foot in both worlds, administrators held to the same transparency as physicians, metrics written with the people measured, and an RVU system replaced rather than repriced. Several propose leaving.

Stephen C. Schimpff, MD, an internist, wrote in March 2011 that “I believe it should be something much different than what leaders do now,” in “What should we expect of a physician leader today?” Kyle Bradford Jones, MD, a family physician, wrote in January 2013 that “patients need to be involved in the creation and implementation of quality metrics that have meaning to them,” in “Patients need to be involved in quality metrics.” Amy Baruch, MD, a pathologist, wrote in March 2018 that “Make the effort to get to know your administrators at a personal level,” in “5 ways to build a relationship with hospital administrators.” Sasha K. Shillcutt, MD, a cardiac anesthesiologist, wrote in October 2019 that “We must elect and encourage physicians to lead system change,” in “We need physician leaders who understand our problems.” David M. Mitchell, MD, PhD, a physician, wrote in June 2024 that “health care administrators seem to have escaped a similarly high degree of transparency and accountability,” in “Health care administrators: a call for equal transparency and accountability.” Mick Connors, MD, a pediatric emergency physician, wrote in November 2024 that “the RVU system incentivizes revenue and volume over the very outcomes health care is meant to achieve,” in “Why the RVU system is failing health care and how to fix it.” Kayvan Haddadan, MD, a pain physician, wrote in May 2025 that “Insurers should act as facilitators, not arbiters of care,” in “Bureaucracy over care: How the U.S. health care system lost its way.” Leon Moores, MD, a neurosurgeon and former Army officer, wrote in September 2025 that “Leadership is foundational to the doctor’s role,” in “Why physician leadership should be taught from day one of medical school.” Tod Stillson, MD, a family physician who sells a contractor arrangement, wrote in February 2026 that “our profession must shape the technology, not the other way around,” in “AI governance in health care: Why physicians must lead the design.”

How has the physicians-and-administrators conversation changed since 2006?

The record starts with Kevin Pho’s short commentaries from 2006 to 2011, 20 of them, counted here but not cited; the first, in June 2006, was already about non-physicians managing health care. The 2011 to 2015 posts are about executive pay and the count of administrators. The 2016 to 2019 posts add the employed physician, the MBA in the hallway, and metrics as a cause of burnout. The pandemic years are about autonomy. Since 2023 the record has more than doubled, and its subjects are administrative harm, the RVU, leadership without a title, contracts, and the alternatives to employment sold by physicians who left. AI is mentioned in 32 percent of the 2025 and 2026 posts against 0 percent in 2017 to 2019.

Two things did not change. Burnout is named in 5 to 42 percent of posts in every period since 2013, because this record and that one are the same argument from two sides. And the physicians most critical of administrators are hospitalists and emergency physicians, the specialties that are almost entirely employed.

Term 2006 to 2012 (52 posts) 2013 to 2016 (85 posts) 2017 to 2019 (75 posts) 2020 to 2022 (68 posts) 2023 to 2024 (81 posts) 2025 to 2026 (144 posts)
Administrator or administration 15 percent 47 percent 51 percent 25 percent 27 percent 32 percent
CEO, executive, or C-suite 60 percent 38 percent 55 percent 35 percent 42 percent 40 percent
Employed or employer 15 percent 20 percent 17 percent 19 percent 35 percent 22 percent
Metrics or productivity 12 percent 25 percent 29 percent 24 percent 22 percent 40 percent
RVU 6 percent 1 percent 9 percent 0 percent 6 percent 6 percent
Autonomy 4 percent 13 percent 9 percent 12 percent 19 percent 15 percent
Burnout 2 percent 5 percent 35 percent 25 percent 56 percent 42 percent
MBA 12 percent 7 percent 8 percent 4 percent 7 percent 5 percent
Private equity or corporate 12 percent 12 percent 17 percent 13 percent 17 percent 16 percent
Trust 6 percent 6 percent 9 percent 12 percent 17 percent 40 percent
AI 0 percent 0 percent 0 percent 0 percent 27 percent 32 percent

Term frequencies are the share of posts in each period whose text contains the term at least once, computed on the September 20, 2026 corpus of 505 posts with one stored expression per term.

The KevinMD physicians-and-administrators corpus by the numbers

These figures describe the set of KevinMD posts this page draws on. They are counts of what KevinMD has published, not workforce data.

Measure Value
Posts in the corpus 505
Published 2023 or later 225
Published in 2026 (through September) 75
Named contributors 302
Posts bylined by physicians (MD or DO) 311
Posts by authors holding an MBA 37
Podcast episodes with transcripts 47
Kevin Pho’s 2006 to 2011 commentaries, counted but not cited 20
Posts not indexed, counted but not cited 29
Most frequent contributors Suneel Dhand, MD (14); Arthur Lazarus, MD, MBA (9); Ronald L. Lindsay, MD (9); Dennis Hursh, Esq (7); Dana Y. Lujan, MBA (6)
Title matches excluded 130: posts whose text mentioned the subject fewer than four times, and patient-autonomy titles

How this page was built and how it is updated

The corpus was assembled from title searches for administrator, administration, CEO, executive, C-suite, chief medical officer, MBA, the business of medicine, physician leader, leadership, manager, middle management, management consultant, employed physician, employer, board of directors, governance, bureaucracy, metrics, productivity, RVU, quota, consultant, autonomy, and non-physician. Titles about patient autonomy were excluded, as were posts whose text mentioned the subject fewer than four times, 130 in all. Term frequencies were computed against the full text of each post. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. 29 posts in the corpus are not indexed, including Kevin Pho’s 2006 to 2011 commentaries and podcast episodes without transcripts; they are counted but not cited. A sponsored post announcing a leadership certificate program is counted but not cited. Quotations are taken verbatim from the original posts and were checked against the source text by script. Author credentials are as they appeared in the byline at publication; where the byline gave none, the credential is the one the post itself states. Administrators, attorneys, journalists, and nurses are cited at the same weight as physicians and identified as such. Contributors who sell services into this subject are identified where they are cited: Dennis Hursh reviews physician contracts for a fee; Tod Stillson, MD, sells a contractor arrangement he calls employment lite; Dana Y. Lujan, MBA, consults on direct care models; Justin Nabity advises physicians on finances; Paul DeChant, MD, MBA, Dike Drummond, MD, Gail Gazelle, MD, Archana Reddy Shrestha, MD, Victoria Silas, MD, and Ben Reinking, MD, coach or consult; Susannah Eastwick directs a physician MBA program. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The closest archives are the Practice Management and Hospital Medicine tags. Related records: Physician burnout: what physicians say, in their own words, Private equity and corporate medicine: what physicians say, in their own words, Physician personal finance: what physicians say about their own money, in their own words, Prior authorization: what physicians say, in their own words, and The electronic health record: what physicians say, in their own words.

This page is updated as new essays about physicians and management are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Physicians and administrators: what physicians say about who runs medicine, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/physicians-and-administrators

The 86 KevinMD posts cited on this page, in order of publication