Changes in Career Satisfaction Among Primary Care and Specialist Physicians, 1997-2001

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Abstract
A confluence of forces has changed the practice of medicine in unprecedented ways during the past decade. There is increasing focus on, and concern about, the quality of medical care,1,2 financial constraints are being applied more frequently and stringently, and the practice and management of medical care have become increasingly centralized and dominated by managed care and physician organizations.3-5 Whereas physicians once practiced primarily alone or in small autonomous groups, they now are more likely to practice in large groups and are increasingly subjected to profiling, administrative requirements, and preapproval for procedures and treatments. Evidence suggests that some physicians are becoming unhappy in this environment.6