Bert,
What do you do when you go on vacation? What do your patients do then? Unless you bring in a locum, the patients realize they cannot see you... and they accept it.
I agree with Leslie, stop the Medicaid equivilant, if you want, create a quota (like one a month) and allow for a waiting list for new pts. We have a waiting list we open in January, close in February, to accomodate the slight slowing of the March/ April time frame. We open the waiting list in April, and close it at the end of June, to accomodate the summer months. Of course, IF we see that the schedule has a slot, we go back to that list, and offer that slot.
I have found that most will wait, and appreciate more that they are seeing an MD that has a wonderful reputation, with such a list.
You don't want a patient to treat you like a fast food "drive-thru" you are not a piece of meat the pt can have "done their way." You are the only one that can claim that. Its tough, and pts demands are non stop.
Maybe its time for a little flyer that outlines new policies for the office, outlining the schedule policies you choose, reminding the patient of your committment to their care, and that it can only be done one patient at a time; educating the staff on these rules, and always allowing for a breather for you somewhere so you can get caught up.( and check up on the gang here and bestow some of your much sought after advice).
You want to be able to hear the thank yous that come to you, rather than mumble under your breath that you are still at work when you could be at home, like the rest of the families that come to see you.
It is a right, not a luxury.
