I had the privilege of delivering the keynote address at the PCC Conference 2025 in Washington, D.C. The event, titled “Scaling What Works for Better Health,” brought together hundreds of leaders, clinicians and advocates committed to elevating primary care in the United States.
I want to express my sincere thanks to Ann Greiner, President and CEO of the Primary Care Collaborative for her visionary leadership and Clive Fields, founder of Village MD, for his introduction and interview. I’m equally grateful to the staff and volunteers who made this incredible event possible.
Their work, and this conference, reflect what I’ve long believed: Primary care is the foundation of American medicine. But while patient needs have risen, the time, respect and resources devoted to primary care have failed to keep pace.
Today, we stand at a crossroads. Primary care physicians face mounting pressures from the rise of chronic disease, the increasing weight of administrative tasks and the growing demand for more personalized care. Fortunately, over the past two years, a powerful new tool has emerged with the potential to reshape the profession: generative AI.
If harnessed wisely, GenAI can help primary care doctors reclaim their time, reduce burnout and rebuild the doctor-patient relationship. But that future will only materialize if clinicians lead the way.
That was the core message of my keynote this year.
Why primary care is in crisis and how GenAI can help
According to a 2022 study published in The Journal of General Internal Medicine, a primary care physician would need 26.7 hours a day to deliver all the preventive, chronic and acute care recommended for their panel of patients. That’s more than a full day’s work – even before documentation, inbox management or follow-ups begin.
It’s absurd, impossible and unsustainable. And it’s no wonder so many primary care doctors feel overwhelmed and burned out. In response to this crisis, multiple health systems have turned to technology, hoping AI can serve as a lifeline. But here’s where the conversation and solutions are overly constrained.
To date, the most common use of generative AI in healthcare has been administrative. Applications that feature ambient listening and transcription, note-writing, referral drafting and prior authorization support can reduce documentation time and offer modest relief. But as the chronic disease epidemic intensifies, today’s problems will continue to grow. To prevent that, generative AI can’t be viewed as a glorified scribe. It must be relied on as a clinical partner.
Already, generative AI systems are outperforming physicians in accuracy on numerous diagnostic tasks. Studies from Stanford and Harvard have shown that large language models can evaluate complex patient histories with skill that rivals or exceeds human performance. And with GenAI doubling in power annually, these tools are improving rapidly with ever greater clinical capability.
Soon, GenAI will help doctors flag care gaps, triage urgent issues, recommend personalized treatment plans and manage chronic disease in real time. Connected to wearable devices and trained on interactions between the best disease management clinicians and their patients, these tools will be skilled at identifying when medical problems aren’t well controlled and therefore require medication adjustment.
Further, artificial general intelligence (AGI)—a level of AI that can reason, learn and problem-solve like a human across multiple domains—will arrive within the next five years, according to technology leaders in the AI field. When it does, AI will no longer serve merely as an assistant. It will be recognized as a capable collaborator that matches or exceeds human skill and accuracy in a broad range of medical functions.
With thoughtful implementation and strong clinical leadership, these tools will save time and lives. They will restore the doctor-patient relationship and reignite meaning in the practice of medicine. However, success will depend on clinicians embracing the opportunity and taking the lead.
The leadership moment is upon us
According to CDC data, if all clinicians managed chronic diseases as effectively as doctors in the nation’s top-performing medical groups, the result would be staggering: 30% to 50% fewer heart attacks, strokes, cancers and cases of kidney failure. However, under the current fee-for-service (FFS) payment model, elimination of a third to a half of these life-threatening problems would compromise clinician income and devastate hospital revenue.
That’s the paradox of American healthcare. And at its heart is the fee-for-service (FFS) method of provider payment. The more doctors and health systems succeed with keeping patients healthy, the more their income suffers.
Luckily, there’s another path forward that is better aligned with the goals and values of primary care. Under “capitation,” physicians are prepaid based on the number of patients they serve and the severity of their medical conditions, not based on the number of services they provide. This model rewards prevention, early intervention and effective chronic disease management. It’s also where generative AI thrives. When doctors are no longer pressured to see more and more patients per day, they can devote time and attention to the individuals who will benefit the most. And in a pay-for-value reimbursement system, they will have incentives to recommend generative AI tools that offer immediate and reliable expertise to patients.
When doctors and hospitals (not insurance companies) are capitated, primary care physicians earn more, burn out less, avoid prior-authorization requirements and reclaim control over their work. And the value of primary care rises rapidly both in perception and income as clinicians are rewarded as much for preventing a heart attack or stroke as treating one.
But if the transition process is led by for-profit companies or private equity, the change won’t be for the benefit of clinicians and patients. As such, the biggest risk for the future of primary care and medicine overall isn’t that AI will replace doctors. It’s that inertia and fear of change will lead to clinician passivity.
Reclaiming control, restoring humanity
With the physician shortage estimated to grow to 86,000 by 2036, failure to embrace generative AI will exacerbate today’s primary care crisis. However, if doctors take the lead and effectively leverage GenAI to empower and support patient care, our nation can save tens of thousands of lives each year, make medical care affordable for all Americans and reduce burnout.
For those who attended PCC 2025, thank you for your commitment to the future of primary care and American medicine overall. With AGI on the horizon, we have the opportunity to enter medicine’s golden era. Now is the time to get ready.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Check out Pearl’s newest book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine with all profits going to Doctors Without Borders.
