BACKGROUND During the past decade, dramatic changes have occurred in the way family physicians deliver health care. OBJECTIVE To examine how satisfied family physicians are with their practice and compensation and what factors are associated with higher or lower satisfaction. METHODS As part of a larger study examining decision making for specific medical problems, a random sample of board-certified family physicians were asked to rate on a 5-point Likert scale their satisfaction with practice, satisfaction with compensation, and likelihood that they would again select their current specialty. Responses were collapsed into those satisfied or highly satisfied vs those who were neutral or dissatisfied. The likelihood of again selecting family practice as a specialty was dichotomized similarly into those very likely or likely vs all others. Bivariate and multiple regression comparisons were made with demographic and practice characteristic variables. RESULTS The overall response rate was 58.1% (N = 537). Most family physicians (82.4%) are satisfied with their careers, most (65.5%) are satisfied with the compensation they receive, and, if given the opportunity, most (74.9%) would again select family practice as their specialty. Factors that appeared to be associated with lower levels on more than 1 satisfaction measure included working in a group of physicians with 3 or fewer members and not including maternity care in one's practice. In addition, older physicians stated they were less likely to enter family practice again, and those who worked more hours were less satisfied with their compensation. CONCLUSIONS Overall, family physicians are satisfied with their careers and compensation. The observation that those in smaller group practices were less satisfied suggests that practices with smaller numbers of members will continue to decline while the number of family physicians employed in larger group practices grows. This may have implications for health care delivery, especially in rural areas where smaller practices are more common.