Interviews with district general practitioners in a large Swedish city in 1978-1979 solicited their perspectives on the frustrations and satisfactions they felt in their work, and on the successes and failures of the Swedish medical care system. With respect to work, four themes emerged: medical routine, patient centered care, overwork and isolation. Five themes emerged with respect to the system: financing, relationships with hospitals and specialists, involvement in political decision making, the size of districts and care centers. These themes are discussed with relation to the influence of the social situation of practice to the influence of the social situation of practice and the conditions for physician satisfaction.