What US Health Care Will Look Like in 2035: Key Takeaways from The Doctors Company

In a recent executive summary titled What U.S. Healthcare Will Look Like in 2035, Dr. Richard E. Anderson, chairman and CEO of The Doctors Company and TDC Group, outlines the significant challenges and transformations shaping the future of health care in the United States. The report examines trends in liability, workforce dynamics, technological advancements, and structural shifts within the healthcare system.

Escalating Malpractice Verdicts and Their Ripple Effect

One of the key concerns highlighted in the executive summary is the rising trend of nuclear malpractice verdicts—those exceeding $10 million—which have become increasingly frequent and severe. The report attributes these verdicts to social inflation and strategic litigation tactics, driving up malpractice insurance costs and, consequently, healthcare expenses for both healthcare providers and patients.

As The Doctors Company notes, these unpredictable verdicts put upward pressure on settlement negotiations and threaten long-standing medical liability reforms. Elizabeth Healy, vice president of government and community relations at The Doctors Company, emphasizes, "In the current environment, it is essential that we continue fighting to preserve medical liability reforms, including caps on noneconomic damages."

Continued Healthcare Consolidation and the Push for Regulation

The Doctors Company reports that healthcare consolidation continues to reshape the industry, with nearly 77 percent of physicians now working in employed models. While consolidation was expected to reduce costs, evidence suggests it has led to higher prices. The report states, "Lawmakers are increasingly critical of investor-driven decisions undermining the availability and affordability of essential services." Additionally, cyber-security risks have intensified as larger healthcare organizations become prime targets for cyber attacks.

The Expanding Role of Advanced Practice Clinicians

With an ongoing shortage of primary care physicians projected to reach 48,000 by 2034, The Doctors Company predicts that nurse practitioners (NPs) and physician assistants (PAs) will play an expanded role in care delivery. By 2031, the NP workforce is expected to grow by 80 percent, while PAs will see a 50 percent increase. While these professionals help address healthcare gaps, evolving roles bring new liability risks that require appropriate malpractice coverage and oversight.

Hospital-at-home programs are also growing, allowing patients to receive acute care in their homes while alleviating hospital overcrowding. While The Doctors Company notes the potential benefits, remote care introduces additional liability concerns that must be addressed as health care shifts toward decentralized models.

Trust in Health Care at an All-Time Low

The report highlights a crisis of trust, with patients increasingly skeptical of healthcare organizations due to financial motivations and perceived biases. Simultaneously, practitioners face burnout, safety concerns, and administrative burdens. The rise of misinformation on digital platforms further strains patient-practitioner relationships, making effective communication more crucial than ever.

Obstetric Safety Risks and Post-Dobbs Implications

Following the Dobbs v. Jackson Women's Health Organization decision, The Doctors Company outlines how legal uncertainties surrounding emergency maternity care have led to treatment delays, increased medical risks, and worsening maternity care deserts. The departure of obstetricians from restrictive states further exacerbates these challenges, raising concerns about the long-term stability of maternal healthcare access.

AI and Emerging Liability Concerns

Artificial intelligence (AI) is transforming health care, offering benefits in clinical decision support while also introducing new liability risks. Legal frameworks have yet to catch up with AI's rapid integration into medical decision-making, leaving questions about responsibility in cases of AI-driven errors, according to the report.

To address these issues, the report says, "In February 2024, the Congressional Digital Health Caucus was formed with the goal of educating policymakers about digital advancements and their potential benefits and risks for American patients, hopefully eventually clarifying liability questions surrounding AI use in health care."

Challenges of Ambient Listening Technologies

Ambient listening tools, such as AI-powered scribe technologies, are being tested in major healthcare systems to reduce administrative burdens. The Doctors Company notes that while these tools improve efficiency and clinician satisfaction, they also present challenges related to data accuracy and liability.

As these technologies evolve, The Doctors Company stresses the need to balance efficiency gains with maintaining accurate, secure, and legally compliant medical records.

Cybersecurity Risks in an AI-Driven Era

With AI playing an increasing role in health care, cyber criminals are exploiting system vulnerabilities. Recent ransomware attacks and data breaches underscore the need for robust cyber-security measures. The Doctors Company advises healthcare organizations to proactively implement AI-driven security solutions while ensuring Health Insurance Portability and Accountability Act compliance to mitigate risks.

The Shift in Retail Healthcare Models

Retail giants such as CVS, Walmart, and Walgreens have faced challenges in sustaining their healthcare initiatives. Many are now pivoting toward partnerships and subscription-based models. According to The Doctors Company, this shift highlights the tension between traditional healthcare and the demand for lower-cost, more accessible services.

Pharmaceutical Companies Enter Direct-to-Patient Health Care

Pharmaceutical companies are increasingly offering direct-to-consumer services, including telehealth and medication sales. While this approach enhances accessibility, The Doctors Company warns that it introduces liability concerns for healthcare professionals and life sciences companies. Stronger communication between providers, pharmaceutical firms, and patients will be key to mitigating these risks.

Source: R.E. Anderson, What U.S. Healthcare Will Look Like in 2035, The Doctors Company (2025).