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Dr. Jerry Penso leads one of the most influential organizations in American healthcare. As president and CEO of AMGA, the American Medical Group Association, Penso represents 440 medical groups and health systems that care for nearly 100 million Americans.
That vantage point makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr.
This season’s guests are being asked what they are hearing from patients, clinicians and healthcare leaders right now. For Penso, three concerns rise above the rest:
- A payment system that is fundamentally broken.
- Worsening access to care.
- A workforce under severe strain.
Penso begins with payment, especially Medicare and Medicaid. He explains that Medicare’s physician fee schedule has failed to keep up with inflation, leaving medical groups paid less in real terms while the cost of running a practice continues to rise. Medicaid cuts, he warns, will add further financial strain, especially for hospitals and medical groups that cannot choose which patients come through the emergency department or clinic doors.
The second major concern is access. Penso describes emergency rooms backed up across the country, patients waiting weeks to see specialists and primary care practices unable to accept new patients. He shares the story of his own mother, who spent five days in an emergency department before a hospital bed became available. For Penso, this is a symptom of a system in which demand is rising, the population is aging, chronic disease is growing and clinicians cannot simply “turn the hamster wheel” any faster.
That leads to the third issue: workforce. Physicians, nurses, advanced practice clinicians, pharmacists and staff are being asked to operate inside a system not designed for today’s volume, complexity or patient needs. Penso notes that most physicians are now employed by hospitals, health systems, insurers or private equity-backed organizations, a shift that has changed the psychology and day-to-day experience of medical practice. Loss of autonomy, bureaucracy and poor integration across systems all contribute to frustration and burnout.
There’s much more in this conversation, including the role of employer-sponsored health benefits, the limits of government reform, the promise and risk of generative AI, the future of physician autonomy and how AMGA is helping medical groups learn from one another.
Tune in to hear one of healthcare’s most experienced physician-executives explain what medical groups are seeing now, what must change next and why he remains optimistic that American healthcare can still move toward better payment, easier access and a more sustainable workforce.
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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.