6:10 am     -  pulling into the parking lot of the hospital, you check last night's surgery schedule on your computer to find that one of your partners induced labor to another one of your patients, (you've seen the patient for nine months, but payment goes to the physician who delivers).

6:50 am     -  finally arriving at hospital A, you reach the OB ward and as you approach your patient's bedside you overhear a loud argument regarding care team responsibilities, your patient asks you what it's all about and wonders if it's possible to be transferred to another location on the floor.

7:50 am     - three patients later, as you read the chart, you find that last night's covering physician changed your orders, (which you severely disagree with based on all lab results), (the nursing supervisor approached you last week amid concerns among her staff of the physician's questionable judgment).

8:10 am     -  approaching the bedside of your fourth patient you find the patient praying with the covering physician (the patient is seriously ill, very afraid, relying on doctors, and an agnostic).

8:50 am     -  arriving at the office you find a note on your desk that all physicians within the practice are being investigated for possible insurance fraud stemming from one of the physicians who has a bad habit of up-coding.

9:45 am     -  between seeing patients, one of the non-partners wants a meeting as soon as possible regarding her contract, which she says allows her to take call only on week days, but the new schedule has her on call the next Saturday and Sunday, (the partners presently take call on weekends and are very annoyed over her contract provision).

10:30 am   -  slipping into the coffee room between patients, you find one of your colleagues obviously exhausted, red eyed, abrasive, and unable to focus on questions you're asking him about a mutual patient.

11:29 am   -  moving into the small conference room/library to lead an 11:30 meeting to address a serious issue of an unacceptable hospital protocol, you're confronted with terrible attendance, (only six out of 13 doctors), three people who would rather eat lunch than discuss anything, and one person who is already insisting that his point of view on the protocol matter is the correct one.

1:30 pm     -  you answer a call from the hospital CEO who is requesting that someone represent the practice on a hospital committee now being formed to provide input for the renovation of the OB ward, triage, and operating rooms, he needs to know who the person will be by tomorrow noon, (and your previous attempts to fill such requests have met with failure).

2:15 pm     -  once again, you steal a few minutes between patients to review the month-end financial statement for each physician relating to shared and non-shared expenses to rudely discover that six of your partners have been submitting monthly auto lease expenses to the practice for the past three years, but you have paid your lease out of your own pocket.

3:20 pm     -  just before seeing your last patient, you glance at the list of responsibilities for next year, distributed by the physician manager, to realize that, for the third year in a row, someone else has been given the role of chairperson for the Medical Records Committee, (and you've been fighting for this position for almost two years).

5:10 pm     - you're now preparing tonight's planning meeting agenda, and in so doing, review an e-mail from two of the doctors who will be attending; one of them has a truck load of information to convince everyone that next year we should open up two new offices in a nearby community, the other partner wants 45 minutes on the agenda to convince everyone that it's now time to begin taking out practice profits, not expand and in fact, close one marginal location down and concentrate on obtaining research grants.

10:25 pm   -  the above planning meeting that was supposed to begin at 5:45 convened at 6:10 and lasted until 10:25 instead of 9:00, with no significant agreements, decisions, or action plans.

10:35 pm   -  you stop by your favorite frozen yogurt store for a medium size sugar cone of non-fat coffee flavored yogurt only to find that the place closed at 10:30, (even though the lights are still on).

11:05 pm     - in the grip of temporary mental instability, you reach into the travel duffel and tear up all return airline tickets.

...and all you ever wanted to do was to treat patients, feel accomplished as a physician, grow professionally, and enjoy your colleagues…