Cover -- Title Page -- Copyright -- Preface -- Contents -- Figures -- Tables -- Executive Summary -- Acknowledgments -- Abbreviations -- Chapter One: Introduction -- Methodology -- Organization of This Report -- Chapter Two: Background: Scan of the Literature on Physician Professional Satisfaction -- Overview -- Physician Demographics -- Physician Age -- Domestic Versus Foreign Medical School -- Physician Race and Ethnicity -- Physician Specialty -- Workplace Factors -- Practice Structure -- Geographic Location -- Patient Population -- Working Environment -- Relationships with Coworkers -- Perceived Quality of Patient Care -- Electronic Health Records -- Physician Income -- Health System Changes -- Downstream Effects of Physician Professional Satisfaction -- Summary -- Chapter Three: Methods -- Overview of Methodological Approach -- Justification for Mixed Methods -- Data Collection -- Overview -- Practice Sample -- Qualitative Data Collection: Semistructured Interviews During Site Visits -- Quantitative Data Collection -- Data Analysis -- Overview -- Theory Refinement: Developing a Conceptual Model -- Qualitative Analyses -- Quantitative Analyses -- Limitations of Study Methods -- Chapter Four: Conceptual Model -- Chapter Five: Characteristics of the Survey Sample -- Chapter Six: Quality of Care -- Overview of Findings -- Qualitative Findings -- Providing High-Quality Care Is Inherently Satisfying -- Perceived Barriers to Providing High-Quality Patient Care -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Seven: Electronic Health Records -- Overview of Findings -- Qualitative Findings -- Improved Professional Satisfaction: EHRs Facilitate Better Access to Patient Data -- Improved Professional Satisfaction: EHRs Improve Some Aspects of Quality of Care.

Improved Professional Satisfaction: Better Communication with Patients and Between Providers -- Worsened Professional Satisfaction: Time-Consuming Data Entry -- Worsened Professional Satisfaction: User Interfaces That Do Not Match Clinical Workflow -- Worsened Professional Satisfaction: Interference with Face-to-Face Care -- Worsened Professional Satisfaction: Insufficient Health Information Exchange -- Worsened Professional Satisfaction: Information Overload -- Worsened Professional Satisfaction: Mismatch Between Meaningful-Use Criteria and Clinical Practice -- Worsened Professional Satisfaction: EHRs Threaten Practice Finances -- Worsened Professional Satisfaction: EHRs Require Physicians to Perform Lower-Skilled Work -- Worsened Professional Satisfaction: Template-Based Notes Degrade the Quality of Clinical Documentation -- Future Effects on Professional Satisfaction: Physicians Express Optimism About EHR Development in the Long Term -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Eight: Autonomy and Work Control -- Overview of Findings -- Qualitative Findings -- Ability to Choose Colleagues and Coworkers -- Control Over Business and Managerial Decisions -- Ability to Earn Desired Income -- Ability to Choose Hours and Schedule -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Nine: Practice Leadership -- Overview of Findings -- Qualitative Findings -- Values Alignment with Practice Leadership -- Balancing Leadership Initiatives with Physician Autonomy -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Ten: Collegiality, Fairness, and Respect -- Overview of Findings -- Qualitative Findings -- Collegiality, Teamwork, and Respect Among Physicians and Staff Within Practices.

Respect from Practice Leaders -- Regular Interpersonal Contact Can Foster Collegiality -- Relationships with Providers and Delivery Systems Outside the Practice -- Respect from Patients -- Respect from Payers -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Eleven: Work Quantity and Pace -- Overview of Findings -- Qualitative Findings -- Excessive Time Pressure Worsens Physician Professional Satisfaction -- Work-Life Balance -- Practice Improvement Strategies to Manage Workload -- Too Few Patients or Concern About Practice Sustainability -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Twelve: Work Content, Allied Health Professionals, and Support Staff -- Overview of Findings -- Qualitative Findings -- Work Content -- Specific Components of Work Content -- Allied Health Professionals and Support Staff -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Thirteen: Payment, Income, and Practice Finances -- Overview of Findings -- Qualitative Findings -- Stability of Income -- Fairness of Income -- Payment Reform -- Concerns About Practice Financial Sustainability -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Fourteen: Regulatory and Professional Liability Concerns -- Overview of Findings -- Qualitative Findings -- Cumulative Effect of Many Rules and Regulations: Frustration and Burnout -- Meaningful-Use Requirements Are Perceived as Good for Patient Care but Are Time Consuming and Frustrating for Some Physicians -- Improvements in the Professional Liability Environment Contributed to Better Professional Satisfaction -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research.

Chapter Fifteen: Health Reform -- Overview of Findings -- Qualitative Findings -- Uncertainty About the Effects of Health Reform as Leading to Consolidation -- Transitions from One Payment Model to Another -- Medical Homes -- Quantitative Findings -- Comparison Between Current Findings and Previously Published Research -- Chapter Sixteen: Conclusions -- Improvement Targets: Internal to Physician Practices -- Improvement Targets: External to Physician Practices -- Implications for Health Policy and Systems -- Appendixes: A. Advisory Committee Members -- References.