Curbside Consult with Dr. Jayne 1/5/26

People embrace many traditions to ring in the New Year. My extended family enjoys Hoppin’ John, but my personal ritual is to skip straight to dessert.

I started at midnight by toasting 2026 with an assortment of delightful tarts. I then kept my energy up on New Year’s Day with Fluffy Frosted Orange Rolls, a delightful alternative to cinnamon rolls. Fortunately, the sugar boost helped because I was working clinically later that day.

Nearly every patient I treated had influenza. If the “flu-pocalypse” has not made it to your area yet, chances are it is on the way. If you are at high risk for influenza complications or simply want to avoid forced downtime, I recommend masking up in crowded places.

I had the opportunity over the weekend to chat with several physician executive colleagues. Each shared ideas about what to expect in the coming year.

• Hospitals will focus on cost control, especially those that have high numbers of Medicaid and uninsured patients. For organizations that have not outsourced functions such as food service or human resources, doing so may look more attractive. One local hospital has dramatically cut non-patient food service, making it difficult for night-shift workers to get a hot meal. Overnight options are limited to self-service, with only a couple of microwaves available in the cafeteria. Since the hospital is already outsourcing, may I suggest a third-party food truck? Staff would love it, although the food service vendor might not.
• Hospitals will continue to scrutinize pricing for everything from software to patient care supplies to landscape maintenance. Organizations that are not already doing this need to start. One health system is trying to trim several million dollars from its technology budget and is taking steps it would normally avoid, such as asking vendors for discounts mid-contract. Its EHR teams have not attended conferences or user group meetings for the past three years due to budget constraints, and they do not expect that to change. As an interesting side note, leadership teams are also skipping these events, so at least they are showing solidarity.
• Primary care physicians are extremely worried about patients who have let their insurance coverage lapse due to rising costs. A major concern is that those patients, along with those who still have insurance but now face high deductibles, will avoid seeking care. That avoidance could lead to poorer outcomes and higher costs overall. The old adage about an ounce of prevention being worth a pound of cure does not resonate with people who cannot afford preventive services. A gastroenterologist in the group noted that a cash-pay colonoscopy costs $2,200 at her surgery center, which limits demand. Some patients instead choose cheaper screening tests that may not be appropriate for their individual risk profiles.
• Many suspect that mergers and acquisitions will increase as organizations try to scale for contracting leverage with vendors and payers. Smaller community hospitals will face greater challenges, particularly if they lack natural partners. The group universally agreed that more practices will sell to private equity firms.
• Medicare Advantage plans will continue their efforts to grow market share. One group I know is expanding into new markets that are not traditional retiree destinations, such as Wisconsin and Missouri. Physicians are intrigued by promises of employment and robust care team models, but they should perform due diligence. Speaking with former colleagues who had poor experiences could be particularly informative.
• Organizations will keep adopting AI solutions, especially for ambient documentation and revenue cycle management. Leaders still express concern about AI use in research and treatment planning, which is driving tougher questions about hallucination risk and patient safety. One leader whose organization has gone all-in on AI-based revenue cycle tools said the results are no better than human performance, but the tools are far cheaper than even offshore labor.
• Regarding the EHR market, the group agreed that Oracle Health / Cerner will continue to struggle and will lose customers to Epic. Sentiment was cautiously optimistic that smaller platforms, such as Meditech and Altera, will hold their ground. Informatics leaders wonder when consolidation will begin in the ambient documentation space, given that a few clear leaders have emerged.
• One leader is especially excited about 2026. He oversees a relatively new primary care residency program that has been approved to expand its class size in the next match cycle. The program is based at a community hospital rather than a major academic center, and competition for the July start slots was intense. He expects applications to rise further as the program builds a reputation for training strong community-based generalists rather than subspecialists. Kudos to him and his team. I look forward to seeing how the next year unfolds.

During the discussion, I learned a new term: job hugging. It describes people who dislike their current roles but stay put because they fear that moving elsewhere could be worse. At least two participants admitted to this mindset. They worry that other environments may be just as toxic, if not more so, and that mid-career physician leadership roles are increasingly vulnerable to downsizing.

One person noted, “If I’m at risk for a layoff, I would rather stay where I have been for 15 years so I might receive a severance. If I start somewhere new and similar cuts occur, recent hires will not get anything.” Another said he would consider consulting but is too concerned about the cost of health insurance to make the leap.

How did you ring in the New Year, and what are your predictions for 2026? Leave a comment or email me.

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