Finally, satisfaction with practicing academic medicine decreased after implementing work targets. Eighty-nine percent of physicians said that they had been satisfied with practicing medicine in the years before work was measured, but only 16% described themselves as satisfied after productivity was measured. Many respondents wrote in comments about the model's harm to physician morale, collegiality, and job satisfaction. Importantly, these findings do not appear specific to this institution, since many respondents stated that colleagues at other institutions, who work in a similar system, have mentioned a negative impact of work targets on their practice. Finally, 94% of physicians were pessimistic about the future of academic medicine under a work-productivity model.