To the Editor:

Dr. Carrie Nankervis put a personal face on the tension many of us feel among evidence-based medicine, patient-centered care and systems improvement [“Choosing Between Clinical Practice and Administration,” January 2003, page 39]. She tried to use her business-school protocol for rational decision making to guide her own career. Management methods pointed her to full-time administration, but patient relationships drew her back to practice. I trust she is a better doctor with the added training and broader interests. Her experience demonstrates what most of us feel. Management expertise does not provide understanding of the deep joys of patient care and the fulfillment of family practice. In this doctor’s final analysis, warm heart prevailed over cool head. Let’s give her a hand.