With the ongoing health care reform experiment it is safe to say that the salary, lifestyle, and most importantly, the day-to-day work of a physician can significantly change over the next 40-50 years. One of the fears of consolidating payors (mergers of mega insurance companies, Universal Health Care/Medicare-for-all) is that physicians be forced to accept whatever payment is offered to them, and will be forced to document and work in the method that the payor demands. I am particularly concerned about payors affecting the day-to-day work of a physician: for example putting physicians in more of a managerial role over mid-levels, excessive documentation/billing/coding, and indirectly setting the pace and length of time a physician can reasonably spend with a patient. With this understanding in mind, I have a few questions for attending physicians in the USA: How real/significant are the fears listed above? Which specialties are more immune to such changes? What are surgeons doing in anticipation? What are their options for the future?