For 30 years I have worked as an academic physician treating patients, teaching trainees of all levels, and conducting research. I find my job tremendously gratifying spiritually, emotionally, and intellectually, which is why it is so painful to watch it decline in front of my eyes.

In recent years forces arising from inside and outside my profession have worked to degrade core tenets of medical practice like physician autonomy, professional excellence, and the physician-patient relationship. These forces are succeeding in large measure because of increasingly centralized power among a variety of actors and a suffocating blanket of regulations and bureaucracy. The result? Physician dissatisfaction and burnout and deterioration of the medical profession. As physicians go so goes the health care system, so this is a crisis that affects every American.

I believe, however, that it is not too late to reverse this trend. That is why I would like to bring to the attention of the incoming Trump administration, which ran on a platform of reform, my personal list of restorative strategies. I believe instituting reform in the specific areas I outline below would correct some of the worst problems that physicians are currently facing, reinvigorate the medical profession, and improve medical care.

In large part, the key to succeeding involves decentralizing and demonopolizing power and rolling back regulatory hurdles within the system. My list is by no means exhaustive (for example, I don’t touch on reimbursement issues) nor is it presented in any particular order, but it is one that speaks directly to my personal experience: