Family physicians' observations of their practice, well being, and health care in the United States.
OBJECTIVE
Our goal was to characterize how family physicians perceive recent changes in the health care system and how content they are with various factors.


METHODS
We performed a cross-sectional mailed survey.


METHODS
The survey was completed by a random sample of 361 family physicians practicing in the United States.


METHODS
The survey evaluated attitudes about corporate managed care, health care reform, career satisfaction, compensation, personal life satisfaction, workload stress, personal well-being, and residency training. We reported percentages for Likert-rated survey items, factor analysis of the survey, and a regression model for statistical prediction of the 4 major factors.


RESULTS
Relative to survey data gathered in 1996, fewer family physicians in our survey reported that they were satisfied with their careers (59% vs 82%); fewer were satisfied with their compensation (55% vs 65%); and fewer would again choose family practice as their specialty (66% vs 75%). Thirty-one percent worried that they were "burning out" as physicians, and 48% reported that they had experienced more stress-related symptoms in the past year. Only 7% agreed that corporate managed care is the best way to provide the health care America needs at a cost society can afford, but only 36% unequivocally endorsed the concept of a national health plan. Forty-two percent of the respondents reported that they had witnessed bad patient outcomes they perceived to be attributable to managed care business processes.


CONCLUSIONS
The morale and career satisfaction of family physicians seems to have eroded in recent years, and discontent is common. As a group, family physicians are unhappy with the current health care system and quite unified about certain specific reforms, yet they are far from such consensus about more sweeping reform.
Shearer
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Department of Family Practice, Franklin Square Hospital Center, Baltimore, MD, 21237, USA. steves@helix.org
Toedt
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D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000639:trends*; D005260:Female; D018166:Health Care Reform; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States