title: Physician discontent: challenges and opportunities.
abstract: Most physicians continue to report overall career satisfaction, but increased public and patient expectations and administrative and regulatory controls contribute to perceptions of increased time pressures and erosion of autonomy. Increasingly, knowledgeable patients armed with information from the media, as well as guidelines developed by health plans, government, specialty societies, professional organizations, and advocacy groups, confront physicians with a bewildering array of new expectations and demands. Although physicians are spending more time with patients than in earlier periods they feel themselves on a treadmill. Strategies to ease pressures include increased use and enhanced scope of nonphysician clinicians, adoption of information technology and disease management programs to reduce errors and to increase efficiency and quality, and thoughtful practice design. Use of such strategies, combined with leadership and a clear sense of direction, can empower physicians, provide them with expanded knowledge and expert systems, and relieve some practice burdens and frustrations.
authors.affiliation: Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ 08901, USA. mechanic@rci.rutgers.edu
authors.forename: David
authors.initials: D
authors.lastname: Mechanic
mesh_terms: D002908:Chronic Disease; D003695:Delivery of Health Care / Q000639:trends; D005194:Family Practice; D033161:Government Regulation; D007588:Job Satisfaction; D007857:Leadership; D010358:Patient Participation; D010819:Physician's Role; D010820:Physicians / Q000523:psychology*; D011209:Power, Psychological; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy; D013997:Time Factors; D014481:United States