All over Europe, health care systems are currently scrutinized for their efficiency. Solutions that maintain the best possible care for patients and lead at the same time to substantial reduction of costs are looked for at all levels and domains of the existing health care systems. This quest often enough leads to constant changes in the daily practice work with patients and –at least on the political level- to claims that the professional dissatisfaction among medical doctors is constantly increasing. For Germany we tried to get an empirical perspective of this situation. OBJECTIVES: It was our aim to analyze the complex health system from the physician’s point of view and provide data for a problem oriented political discussion and reform strategy. METHODS: A questionnaire was mailed to a random sample of 7000 German medical doctors across specialties. The final sample consists of 1094 institutional employed medical doctors and 1071 general practitioners. Measures included (among others) personal and job characteristics, perceived working conditions, research and teaching activities, life satisfaction, organisation and management, continuous medical education. Statistical analysis was performed using Analysis of Variance (ANOVA), t-test, regression analysis, and chi-square test. An alpha level of 0.01 was considered significant. RESULTS: The average working time, including on-call service is 66.7 hours/week, excluding on-call service 51.3 hours/week. Over-time is not monitored at all in 54.6%. Issues related to organisation and management were seen and interpreted significantly different among directors and chiefs versus residents and attendants. Issues related to research and teaching, life satisfaction and income presented statistically different results between male and female, formerly eastern and western Germany and different hierarchical positions. CONCLUSIONS: The high response rate in this empirical study allows for further analysis of specific subgroups (i.e. Urologists, family doctors, surgeons etc.) among the highly motivated German physicians.