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In 2026, physicians are facing a familiar mix of pressure — reimbursement uncertainty, rising labor and supply costs, staffing shortages and growing exposure to legal and cyber risk. Medical Economics Managing Editor Todd Shryock caught up with Peter Reilly, North American health care practice leader at HUB International, to talk about what those risks look like in practice, and which ones physicians can no longer afford to ignore. Reilly explains why reimbursement instability is unlikely to ease in the near term, why rural hospitals and critical access facilities remain especially vulnerable, and how burnout and disengagement continue to affect retention. He also breaks down what’s happening in the medical professional liability market, including the rise of “nuclear” and “thermonuclear” jury verdicts and what that means for rates moving into 2026. He shares practical guidance on planning, mitigation and why proactive steps matter more than ever in an increasingly unpredictable health care environment. Register now for Physicians Practice's Practice Academy event: Practice Management Track, on March 19, 2026, from 1:00 PM-5:00 PM EDT. Don’t miss our recent episodes on staffing, marketing, what patients are hearing and financial independence. Music Credits: Neon Rainfall by Cephas - stock.adobe.com A Textbook Example by Skip Peck - stock.adobe.com Editor's note: Episode timestamps and transcript produced using AI tools. 0:00 — Cold open Why health care hasn’t fully emerged from its post-COVID-19 hangover. 0:21 — Intro Austin Littrell introduces the episode and previews the conversation with Peter Reilly. 1:31 — Interview begins Todd Shryock welcomes Reilly and frames the challenges facing physicians. 1:35 — Why pressures aren’t easing in 2026 Reimbursement uncertainty, labor shortages and lingering instability. 3:34 — Rural hospitals under strain Why critical access facilities remain especially vulnerable. 5:29 — Burnout and disengagement What practices can do now to support staff and improve retention. 7:39 — The medical professional liability market Competition, consolidation and what it means for rates. 10:06 — Nuclear and thermonuclear verdicts Why outsized jury awards are becoming more common — and costly. 13:06 — Cyber risk and vendor exposure Common misconceptions about data ownership and responsibility. 16:29 — P2 Management Minute Keith Reynolds shares practical tips for practice leaders. 17:21 — Enterprise risk management Why even small practices need a formal risk mindset. 20:10 — Blind spots in physician practices Risks practices don’t always see coming. 22:23 — Physical and location-based risk Why storefront care and parking lots matter. 23:16 — Weather and disaster planning Natural disasters as a growing operational risk. 25:33 — Closing thoughts Why proactive planning beats constant reaction. 26:00 — Outro Wrap-up, subscription reminder and Practice Academy note.