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Calming fears, alleviating suffering, enhancing and saving livesthis is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it.Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forwardamidst jarring changes in our health care systemis not always clear.