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BMJ 1998; 317 doi: (Published 11 July 1998) Cite this as: BMJ 1998;317:S3a-7151

US doctors are generally characterised as a pretty upbeat (and wealthy) bunch, but a report in the US publication Internal Medicine News (1998 April 15, p58) suggests that disillusionment and desire for early retirement are common there too. A series of surveys published in the last eighteen months have found that around one third of US doctors express dissatisfaction with the practice of medicine, citing the twin pressures of loss of autonomy because of managed care and the ever present threat of litigation.

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