Healthcare Reform and Physician Retention
The contemporary crisis in American healthcare—manifesting both as a projected shortage of 86,000 physicians by 2036 and as widespread physician burnout and early retirement—represents not merely a workforce planning challenge but a fundamental rupture in medicine's ontological foundations. This article develops a theoretical framework for understanding how bureaucratic structures, particularly the American Board of Medical Specialties' Maintenance of Certification program, function as symptoms of deeper epistemological failures within the biomedical paradigm. Drawing on phenomenological philosophy, theological hermeneutics, actor-network theory, and embodied cognitive science, I argue that sustainable healthcare reform requires moving beyond technical fixes toward a comprehensive reimagining of medical practice grounded in dialogical encounter, sacred epistemology, and recognition of healing's irreducibly relational character. The article integrates empirical workforce data with theoretical scholarship to demonstrate how bureaucratic monopolies and reductionist ontologies mutually reinforce physician alienation and proposes an alternative vision wherein medical authority emerges through relationship rather than institutional hierarchy, and where physician retention becomes possible through reconnection with medicine's deeper vocational meanings.