Measures include PCC discussion of depression (the PCC asked about depression or gave the patient a treatment for depression or emotional problems at the last visit); recent depression treatment (the patient took an antidepressant or had at least 4 mental health specialty visits in the past 6 months); and high or low depression symptoms by CESD score. Significance is by Chi-Square. RESULTS: Of 567 patients with major depression, 414 (73%) had been recognized as depressed (64% HMO, 76% VA) as indicated either by PCC discussion of depression (333 or 59%) or by recent depression treatment in the absence of PCC discussion (81 or 14%). A total of 290 of the 567 (51%) reported recent depression treatment; treatment rates were significantly higher among the 333 patients who had discussed depression with their PCC than among the 233 who had not (63% vs 35%, p < .001). Excluding patients reporting recent treatment, PCCs who discussed depression were more likely to assess suicidality, mania, and alcoholism. Among the 567 patients, those whose PCC discussed depression were more likely to be treated with an appropriate antidepressant (35% vs. 18%, p < .001), and to visit mental health (51% vs 33%, p < .001). Results comparing treatment for patients with PCC discussion and those without remained similar and significant when analyzed separately for patients with high or low CESD scores. CONCLUSION: In two organizations with direct primary care patient access to mental health specialty, discussion with PCCs remains an important determinant of depression treatment quality. These findings support the importance of PCC recognition of depression, and the need for better integration of mental and physical health care. There are limited data about minority physicians' satisfaction with their professional lives. Previous studies suggest that among academic physicians, minorities may be less satisfied than whites. In this study, we describe, by race and ethnicity, satisfaction and job stress among a national sample of physicians. METHODS: We analyzed data from 2,326 respondents to a career satisfaction survey of physicians drawn from the AMA Physician Masterfile. Scales (from 1 ± 5) measuring overall job satisfaction, career satisfaction, and work-related stress were constructed from Likert-response items and tested using factor and reliability analyses. We examined the association between physician ethnicity and each of these scales. We also examined how the proportion of patients from ethnic backgrounds other than the physician's own affected satisfaction and job stress. RESULTS: Respondents included 56 black, 136 Hispanic, 409 Asian, and 1,651 white physicians. Black and Hispanic physicians, as compared with others, cared for higher proportions of minority, non-English speaking and uninsured patients. Scores for job and career satisfaction and stress by ethnicity are displayed in the table. Higher scores indicate higher satisfaction or stress, and p-values refer to comparisons of the highest and lowest scores. After adjusting for physician age, gender, practice setting, specialty, and patient panel characteristics (proportion of patients who were female, elderly, non-English speaking, medically complex, psychosocially complex, or substance-abusing), Hispanic physicians had higher job and career satisfaction than all other groups. The proportion of physicians' patients from ethnic groups other than their own was associated with lower job satisfaction and higher stress (p < .001). In adjusted analyses, these findings persisted but were most consistent among white and black physicians. CONCLUSION: Hispanic physicians were more satisfied with their jobs and careers than physicians from other ethnic groups. For white and black physicians, caring for ethnically dissimilar patients was associated with lower job satisfaction and higher stress. Future study should investigate how physician cultural factors and cross-cultural relationships with patients affect physician worklife and professional satisfaction. Family physicians were more likely (OR 1.254, 95% CI 1.253 ± 1.255) to see patients for acute problems unrelated to chronic medical conditions. Family physicians performed more pelvic exams (OR 1.447, 95% CI 1.446 ± 1.448) and Papanicolaou smears (OR 1.391, 95% CI 1.390 ± 1.392), and more frequently provided counseling on smoking cessation, mental health, injury prevention, family planning and sexually transmitted diseases (p < 0.001 for all). Family physicians were more likely to prescribe medication at patient visits (OR 1.229, 95% CI 1.228 ± 1.230) than internists, but internists more frequently ordered advanced radiologic tests such as CT, MRI, and ultrasound (p < 0.001 for all) even after adjustment for age, gender, and number of ICD-9 diagnoses. CONCLUSION: Significant differences exist between ambulatory practice patters of primary care physicians independent of patient age and gender.