There have been numerous changes in the health care system, including cost-containment efforts, the increased growth of managed care, and shortages of many health professionals. It is important to assess the impact these changes are having on the quality of health care delivery and the way various health professionals view their jobs. To accomplish this assessment, a sample of experienced nursing and allied health professionals were asked to provide their assessment of positive and negative changes in the health system over a 5-year period. They also were asked to indicate their level of satisfaction with their profession, their current job, and various aspects of that job. A Health Care Environment Survey was mailed to six groups of graduates of a mid-Atlantic college of health professions. Three of the groups had been in practice for 5 years, and three of the groups had been in practice for 10 years. The survey asked respondents to assess the magnitude of certain changes in the health system over the previous 5 years and to provide an assessment of their satisfaction with their current job. A total of 1,610 surveys were mailed, and 787 were returned for a rate of 49%. Nursing and allied health professionals who responded to the survey reported that there have been many more negative than positive changes in the health care system, including less job security, efficiency, and time available to spend with individual patients and increases in workload, paperwork, and control of health care by insurance companies. Even with these negative changes, nurses and allied health professionals report a high level of satisfaction with their jobs. In investigating the aspects of their jobs that were most related to satisfaction, having a feeling of worthwhile accomplishment from their job, opportunities for personal and professional growth, recognition and satisfaction with their workload were found to be the best predictors of job satisfaction.