Nearly half do. In athenahealth's 2026 Physician Sentiment Survey of 1,045 physicians, 49% said they worry more about claim denials than about declining reimbursement rates. The share was 66% at small group practices and 36% at enterprise organizations.
Who answered the survey
The Harris Poll ran the survey online from October 14 to 29, 2025, for athenahealth. It reached 1,045 U.S. physicians: 752 primary care physicians and 291 specialists. Only 7% of respondents use athenahealth's EHR, according to HIT Consultant's March 4, 2026 coverage. Medical Economics published the financial findings on March 30, 2026.
athenahealth sells EHR and practice management software, so the survey also serves its marketing. The questions were asked of physicians, not administrators, which makes the numbers a view from the exam room. Practice managers can use them as a read on what owners and employed physicians expect from the back office.
How physicians rate their practice finances
Most physicians describe their own practice as stable. Medical Economics reports that 67% say their practice is on solid financial footing. Even so, 75% worry at least once a year about whether the practice can stay financially viable.
Physicians named the pressures behind that worry in the same survey:
| Financial concern | Share of 1,045 physicians |
|---|---|
| Lower Medicare and Medicaid reimbursement | 56% |
| Cost of staff retention and recruitment | 47% |
| Labor shortages | 46% |
| Worry more about denials than declining rates | 49% |
Source: athenahealth 2026 Physician Sentiment Survey, as reported by Medical Economics, March 30, 2026. Respondents could name more than one concern.
Two of the four rows are labor costs. Staff retention and labor shortages together touch the same payroll line that a practice manager already controls.
Denials against rates, by practice size
The 49% figure hides a wide gap by size. Medical Economics reports 66% of small group physicians worry more about denials than about falling rates. At enterprise organizations the share is 36%.
A likely reason is staffing. A large organization often has a central denial team and a payer contracting team, so a physician there sees rates as the open question. A five-physician practice has one biller or none, and a denied claim lands on the same desk that posts payments. The survey does not test that explanation, so treat it as a hypothesis to check against your own denial log.
Small practices also report the strongest fear of losing independence. Medical Economics puts that at 88% of small practices, while HIT Consultant's summary rounds it to 90%. Either figure means close to nine in ten. Worry about denials and worry about independence both come from the same pressure on cash flow.
Where physicians say AI use grew
Comfort with AI rose to 54% of physicians in 2026 from 46% in 2025. Small groups trail: 43% are comfortable at small group practices, against 65% at enterprise organizations.
The areas of increased use look different from the areas that matter to an administrator. The share of physicians reporting more AI use by function:
- Clinical documentation: 38%
- Clinical and patient care: 31%
- Nonclinical and administrative work: 23%
- Patient outreach and communication: 21%
- Revenue cycle management: 13%
Revenue cycle sits last at 13%, even though the same survey shows denials as a top worry for small practices. Physicians may not see billing tools, since billing staff or vendors run them. Still, the gap suggests that most AI spending reaches the exam room before it reaches the claims queue.
Opinion tracks personal experience. Among physicians comfortable with AI, 63% say it reduces administrative burden. Among those who are not comfortable, 16% say so. Overall, 42% report that AI reduced their administrative burden, up from 37% a year earlier, per HIT Consultant.
Workload and retention signals
The same survey gives practice managers a read on staff-adjacent risk. Medical Economics reports that 53% of physicians feel constantly burned out, and 45% call their workload unsustainable. That second number fell from 48% in 2025 and 49% in 2024, so the trend is slightly better.
Intent to leave medicine fell more. About 52% of physicians have considered leaving, down from 62% in 2024. Rural physicians stand apart: 69% have considered leaving, against 51% of urban and suburban physicians. Rural burnout runs at 67%, against 52% elsewhere. Only 32% of all physicians report a good weekly work-life balance.
Replacement cost is the administrator's concern here. A physician vacancy ends the revenue that physician's schedule produced, and 47% of respondents already list recruitment and retention cost as a financial worry.
Data sharing and value-based care
Physicians point to data exchange as a daily cost. According to Medical Economics, 73% have difficulty exchanging data across EHR platforms, and 80% say gaps between systems add stress. At the same time, 63% feel overwhelmed by the volume of data in patient charts. The survey's reading is that the right data at the right time matters more than more data, a view 92% share.
Value-based care shows a similar split between interest and confidence. Some 69% want to learn more about it, and 55% accept that it could bring financial benefits. Only 36% are comfortable with shared risk models, and 33% are confident it will improve practice sustainability over five years.
Physicians named the barriers in this order:
- Administrative burden and reporting: 43%
- Uncertain revenue: 31%
- Patient engagement challenges: 29%
Age matters here. Millennial physicians are comfortable with shared risk at 39%, against 28% of boomers. Administrative burden is the top barrier, which puts the reporting work on the practice manager's side of the ledger.
Sources
- Medical Economics, Affordable care overtakes paperwork as physicians' top concern, athenahealth survey finds, March 30, 2026
- HIT Consultant, athenahealth 2026 Physician Sentiment Survey: AI Adoption, EHR Efficiency, and VBC Trends, March 4, 2026
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