“…These factors, when combined with other problems such as limited resources and excessive legal regulation, may place doctors in difficult ethical dilemmas that can cause them much distress (Forde & Aasland, 2008). In fact, heavy work load (Tinti et al, 2009; Virtanen et al, 2008), poor job satisfaction (Cyr‐Taro, Kotwall, Menon, Hamann, & Nakayama, 2008; Kankaanranta et al, 2007; Volker et al, 2010), perception of unrealistic expectations from patients and their families, communication with colleagues (Falkum & Vaglum, 2005; McIntosh & Macario, 2008; Smith, Waldman, Hood, & Fottler, 2007), poor lifestyle (Hebbard & Wirtzfeld, 2009), limited resources (Forde & Aasland, 2008), interaction with patients (Geller, Bernhardt, Carrese, Rushton, & Kolodner, 2008; Mjaaland & Finset, 2009), and the threat and reality of medical malpractice litigation (Papadopoulos, 2007) can all be causes of job insecurity and resulting occupational stress in a medical practice. High levels of occupational stress may result in a medical practitioner's negative perception of job satisfaction and a more negative attitude about health care as a profession (Richardsen & Burke, 1991).…”