Changes in the practice of medicine.

In constructing this report, the author interviewed physicians to ask them how the practice of medicine has changed and what changes bother them most. She also talked to physician executives to find out how they were managing an increasingly disgruntled group of doctors. Four changes in the professional environment that physicians face dominated these conversations--lowered income, loss of control, the threat of litigation, and greatly increased paperwork. This article is a summary of comments in these four areas.