Medical practice is stressful. Although much of the burden comes from the content of the work, physicians' personalities and emotions contribute greatly. Few traditions or structures are available in the medical community to help physicians deal with this stress and prevent disillusionment and impairment. This article describes the 5-year evolution of a physician-support group that has provided supervision and psychodynamic insight. The key elements of the group's effectiveness are leadership, connecting work issues to personal dynamics, defusing defenses, and ensuring confidentiality. Competitiveness, mistakes, anger, difficult patients, death, fear of malpractice, and family-work tensions are issues that have been addressed. Psychodynamic supervision groups differ from peer-support groups and therapy groups. Psychodynamic supervision in support groups, as used in the supervision and training of pastoral counselors, offers a simple and powerful means to ease the burdens of medical practice and thus prevents disillusionment and subsequent impairment among physicians.