What a Waste

February 2026 | Vol. 70, No. 1
By Joseph Zawisza, DO, PCOM '05

Whether we like it or not, Medicine is a business, no doubt about it. A quick Google search indicates that the US healthcare market was valued at $4.87 trillion in 2025 and will increase to $5.15 trillion this year. Furthermore, in 2020, healthcare spending accounted for 19.7% of the U.S. economy, and currently, the healthcare sector employs over 20 million people in the United States.

As a solo practitioner, I realize that my primary care private practice makes up the most minuscule slice of the healthcare pie. What makes up a much larger slice of the pie is wasteful spending. One of the not-so-well-kept secrets in Medicine, the amount of wasteful spending is enough to give you chest pain, which will be followed by an EKG, cardiac enzymes, a stress test, a nuclear stress echo, electrolytes, a urine drug screen, an upper GI series, PFTs, a CT scan, and probably a colonoscopy, “just to be safe” of course. A 2019 study published in JAMA (Waste in the US Health Care System: Estimated Costs and Potential for Savings, William H. Shrank et al.), which reviewed studies in healthcare waste published between January 2012 and May 2019, determined that the annual wasteful spending in healthcare ranged from $760 billion to $935 billion. The potential savings from interventions that address waste were $191 billion to $286 billion. I think it is safe to say those numbers will be much higher in 2026.