In his final address to the House of Medicine, outgoing AMA president Bruce A. Scott, MD, who has taken the message of practicing physicians to America this year, called upon physicians to step up and unite to lead the charge to heal the country’s broken health system.
“Despite all the efforts of everyone in this room, and colleagues across the country, our health care system is failing in fundamental ways,” he said. “It's failing physicians and, more importantly, it’s failing our patients.”
In his years addressing the AMA House of Delegates as vice-speaker, speaker, then president, Dr. Scott developed a reputation for his humor-tinged approach to public speaking. His remarks during the 2025 AMA Annual Meeting were urgent, impassioned and even angry.
Why did “angry Bruce” come out in Dr. Scott’s final speech?
“I’m angry because physicians are bearing the brunt of a failed Medicare payment system,” he said. “And while our pay has been cut by 33% in 25 years, we see hospitals and even insurance companies receiving annual increases.
“I’m angry,” he added, “because earlier this year Medicare Advantage plans are rewarded with a scheduled increase while doctors suffer yet another cut—or, as one member in this House accurately said, a ‘gut punch to physicians.’”
Insurers’ outsized role in patient care
Another reason behind Dr. Scott’s anger is the role insurance companies are playing in the delivery of necessary care.
An otolaryngologist from Kentucky, Dr. Scott, shared the story of a patient with a large sinus tumor pressing into her eye. Despite his recommendation for urgent surgery, her insurance plan initially denied the procedure, deeming it “not medically necessary” and suggesting antibiotics and nasal spray instead. Dr. Scott emphasized that the decision was made by someone with no medical training, leaving the patient confused and stressed.
“Sadly, we all know cases like this are not outliers or isolated events,” he said. “What insurance companies are doing to our patients is wrong. Stepping between us and our patients is wrong. Denying necessary and even lifesaving care is just plain wrong. It’s no wonder that so many physicians are frustrated at a system that is undermining our judgment and eroding our patients’ trust.”
Dr. Scott has highlighted throughout his time as AMA president that the current conditions are driving more physicians out of the profession. At a time when the country is already facing a significant shortage of doctors in the coming decades, frustrations are boiling over in the profession. (Read Dr. Scott’s full speech.)
Data indicates that one in five physicians hope to leave their practice in the next two years, one in three plan to reduce their hours and 40% of medical students are unsure they ever want to enter clinical practice.
“Physicians are retiring early and leaving the practice of medicine in droves because eventually these frustrations and loss in pay become too much to overcome—especially for physicians like me in private practice,” Dr. Scott said.
Fighting for Physicians
Get updates on how the AMA is fighting for physicians on critical issues—delivered to your inbox.
Taking action
Unleashing anger itself is not an especially productive move, Dr. Scott conceded. What is productive is harnessing that anger to drive meaningful action.
Dr. Scott highlighted several arenas in which the AMA’s advocacy efforts (PDF) can help change the realities in the ground for the better.
The AMA continues to press for legislation that would finally tie future Medicare payments to the rising cost of delivering care—a long-sought fix to a broken system. At the same time, the AMA is pushing back against harmful provisions that would limit access to care for low-income Americans. The AMA continues to engage in shaping the legislation now being debated in the Senate and hopes for improvements to these policies.
“Despite our frustrations, there are still reasons for optimism,” Dr. Scott said. AMA advocacy “has brought us close to achieving Medicare payment reform that ties future reimbursement to inflation, representing a foundational step forward for the reform that the AMA and all of you have sought for a long time.”
Dr. Scott also spotlighted other major advocacy priorities, including:
- Reforming prior authorization to reduce care delays and increase transparency.
- Lowering the cost of medical education to ensure a strong pipeline of future physicians.
- Defending physician-led care through by fighting inappropriate scope of practice expansions, with 180 wins in dozens of states in recent years.
Progress requires a unified physician voice fighting for the fixes that can revitalize the nation’s health system.
“While screaming from the window feels good, it’s not going to achieve the lasting results and change our health care system needs,” Dr. Scott said. “That change will come from uniting as a profession. Channeling our anger into a unified voice. That’s the work of the AMA. Finding consensus on issues where disparate opinions exist—that’s why we’re all here. Our disagreements and debates aren’t symptoms of dysfunction; they are emblematic of our democratic process in action.”
Dr. Scott discovered the power of a unified physician voice attending his first AMA meeting 35 years ago. It has kept him coming back for three and a half decades.
“You and I would not be here today if we didn’t believe in the power of physicians working together,” he said. “And so, we must meet the challenges of this moment with our own call to action. True reform—lasting reform—won’t happen without you.”
Read about the other highlights from the 2025 AMA Annual Meeting.
