To the Editor:

I really enjoyed Dr. Marshall Zaslove's article, “What Your Body, Mind and Spirit Can Tell You” [September 1999]. It validated many of my recent thoughts.

When I turned 50, I decided to do some soul searching, because I didn't want stress or overwork to destroy my well-being or create resentment for my job. Even though I had begun taking more time off for family and hobbies, I knew that I also needed to modify my work environment if I wanted to remain sane for the long haul. Leaving private practice (and all the inefficiencies of institutional management) to become a self-contracted, salaried employee for the local hospital made this undertaking easier.

I began punting some of my more complex and demanding adult patients to one of the new internists and more routine care to our physician assistants. I limited my inpatient load and busy obstetrics practice. I relied more on the emergency and on-call doctors to evaluate my patients after hours, and I accepted committee appointments or teaching assignments only if they could be done during regular hours.

Despite these changes, I still maintained a relatively large and loyal following. I simply had to accept the reality that, in contrast to some of the self-destructive behaviors we acquired during medical school and residency, I couldn't and shouldn't try to be everything to everybody.

Since the first step in resolving some of these issues is merely talking about them, perhaps articles such as Dr. Zaslove's will stimulate meaningful discussion.