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With the signing of the Affordable Care Act in 2010, there were immediate questions raised as to how healthcare providers would compensate for the surge of newly insured Americans with the expansion of Medicare. Due to the historic and continuing physician shortage in the United States, it is necessary to investigate how, and if, the Affordable Care Act had unintended effects on physicians’ empathetic attitudes towards patient care as a result of the changes in the shift to a patient satisfaction payment model. By investigating the secondhand effects on physician autonomy, this systematic review of peer-reviewed publications between 2010-2025 examined how these factors have an overarching effect on potential physician burnout, compassion fatigue, and physician leadership attitudes.