I would like to respond to some of the resolutions described by Dr. Mitchell Cohen in his essay “Auld Lang Syne: Practice Management Resolutions for the New Year” [The Last Word, January 2007].

1. “See one more patient BID.” That translates to one more chart and potentially multiple phone calls and follow-ups to attend to after hours. Dr. Cohen suggests squeezing in an additional patient before lunch. What lunch? The additional $15,000 would be nice but not at the expense of my family and my physical and mental health.

2. “Attend a local AAFP meeting.” When? I certainly cannot go during office hours or in the evening because squeezing in extra patients on an already full or over-booked schedule makes my days even longer. Should I give up a weekend to go? Dr. Cohen, I believe you mean well, but it is good to be a part of the non-doctor world – as a doctor and as a person.

3. “Take a vacation, or two.” When? I am paid for my clinical work based on my productivity, and each vacation costs me income. Why not just forgo vacations altogether and add another several thousand dollars in income?

I know there will be many who read this and think that I am lazy. I am not. I am a hard-working doctor in a busy clinic who is finding that my work is invading all aspects of my life, and I am looking for methods that can help me improve my efficiency while allowing me to continue to provide medical care of the highest quality. I have learned billing and coding and use our electronic health record quickly and efficiently. I don't know what else to do other than set some limits.

It is important for us as physicians to be able to say “no” without the stigma of being a lazy physician. It is also important that physicians not be forced to replace their family time and personal lives with more work. Patient care comes first, but does it have to come at the physician's expense?