Off the Chart: A Business of Medicine Podcast · Medical Economics

The biggest risks for physicians in 2026, with Peter Reilly of HUB International

·27 min·1 clip

Jury awards are hitting thermonuclear levels because of distrust in healthcare.

Todd Schreier opens by framing 2026 as another hard year for physicians and medical practices. Peter Reilly, North American Healthcare Practice Leader at HUB International, maps out the biggest sources of risk. Reimbursement uncertainty sits near the top, along with the broader legal climate. Reilly says healthcare still has not shaken off the COVID-era hangover and describes hospitals, insurers, and physicians as all feeling the strain. The conversation then turns to malpractice risk and the size of jury awards. Reilly says the old benchmark for a nuclear verdict does not really fit what is happening in some cases anymore. He points to larger awards becoming more common, including thermonuclear verdicts in the $20 million to $40 million range. He also notes that some markets are seeing those awards more often than they did five or 10 years ago. That shift matters because it raises the cost of doing business and can shape where physicians decide to practice. Reilly says there is growing distrust of healthcare in some jury pools, and that mistrust can drive punishment-oriented outcomes. He adds that doctors ultimately pay for those verdicts through premiums and operating costs. Reilly does not treat tort reform as a universal fix, and he says he is cautious about overcorrection. Even so, he points to states where reasonable reform efforts are gaining traction and urges physicians to work with their state associations or other groups to keep these issues in front of lawmakers. He warns that some parts of the country could turn into primary care and general care deserts if the liability environment keeps getting worse. New Mexico comes up as an example of a state where jury awards are especially hard to absorb. The episode closes by stressing action over resignation. Reilly says the insurance industry, the AMA, and some state associations are taking a more active role, and he encourages physicians to participate directly, including through letter-writing campaigns and related advocacy. The result is a conversation that treats malpractice and reimbursement as business threats with real operational consequences.

As heard by us

A practical look at how reimbursement pressure, malpractice risk, and tort reform are shaping physician practice in 2026.

The conversation follows the pressures facing physicians in 2026, especially reimbursement uncertainty, malpractice risk, and policy choices that shape daily practice.

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You want a clear read on the 2026 pressures facing doctors and medical practices.

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