From Capitol Hill to the Clinic: Incoming MGMA Board Chair Jeff Smith on Burnout, Prior Authorization, and the Future of Care

This episode of the MGMA Insights Podcast opens with Jeff Smith, CEO of Piedmont Healthcare and MGMA’s incoming board chair, delivering testimony before the U.S. Senate Special Committee on Aging. Speaking on behalf of MGMA members, Jeff laid out the real-world consequences of administrative burden — from prior authorization and regulatory pressure to physician burnout, staffing strain, and threats to patient access.

Following the opening testimony, Jeff joins host Daniel Williams, Sr. Editor at MGMA, for a wide-ranging conversation that expands on those themes, exploring what policymakers often miss, how payment and workforce challenges are reshaping independent practice, and what it will take to reduce burnout and let physicians — and their teams — focus on caring for patients again.

Episode Takeaways

• Burnout is no longer theoretical — it’s driving physicians out of practice.
  In MGMA’s 2026 administrative burden survey, more than half of responding practices reported losing a physician to burnout in the past three years, with over 75% citing regulatory burden as a major contributor.
• Prior authorization is compounding workforce and access problems.
  More authorizations and denials increase staff workload, push physicians into unpaid administrative work, and delay or prevent patient care — often leading to higher downstream costs when patients end up sicker in the ER or hospital.
• Payment policy and administrative skepticism are sending mixed signals to physicians.
  While E&M codes have increased, physicians feel continuously second-guessed through audits, measures, and utilization controls — undermining the message that they are truly the “quarterbacks of care.”
• Primary care faces a pipeline problem.
  Medical students increasingly choose higher-paying specialties, leaving fewer physicians entering family medicine and internal medicine. Without incentives and reduced administrative burden, access gaps will continue to widen.
• Front desk staff may have the hardest job in health care.
  Jeff highlights that burnout isn’t limited to clinicians. Front-line staff are expected to be insurance experts, mental health buffers, and patient advocates—all while navigating HIPAA and frequent conflict.
• Congress is listening—but complexity remains a barrier.
  During Senate testimony, burnout resonated clearly across party lines. However, programs like MIPS and the Quality Payment Program are often difficult for policymakers to fully grasp, even as they shape daily practice operations.
• Inadequate Medicare updates threaten independent practice viability.
  Without inflationary payment adjustments — unlike hospitals — physician practices are squeezed financially, fueling consolidation and making it harder for small and mid-sized groups to survive.
• If reform starts anywhere, start with predictable, fair payment updates.
  Jeff argues that a reasonable annual Medicare update would relieve constant financial anxiety, allowing physicians to focus on patient care rather than volume, survival, or selling their practices.

Jeff Smith

• Contact Jeff on LinkedIn
• Jeff's full U.S. Senate testimony (YouTube video) - U.S. Senate Special Committee on Aging, Feb. 11 , 2026.

Related Resources

• MGMA member‑exclusive Medical Practice Staffing Solutions Playbook - practical strategies to recruit, onboard, and retain staff across the full employment lifecycle in today’s competitive labor market.
• Managing physician transitions for long-term team building (MGMA Insight article) - how to manage physician departures and coverage‑critical transitions in ways that protect operations, staff morale, and long‑term team stability.
• Rebuilding trust in revenue cycle teams after turnover and burnout in critical access hospitals (MGMA Insight article) - how leadership stability and psychological safety are essential to restoring performance and trust in revenue cycle teams after prolonged turnover and burnout
• Upcoming! How One Organization Connected the Pieces of Workforce Operations (MGMA webinar)- An upcoming fireside chat on reducing administrative burden by streamlining scheduling, time tracking, payroll, and credentialing across a multi‑site practice (April 30, 2026).

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