My perspective is that of a general internist in private practice for the past 18 years who has no academic or administrative ties. What merits does this experience have for Annals? I raise a few questions to place Ms. Bingham's anecdote [1] in proper perspective before we strike out her general internist.

Was the author's general internist on call when she called him at home on that Saturday? If he wasn't, she should have called the internist covering for her physician that weekend. Why the author had the physician's home number is unknown; the subsequent events provide a good reason not to give one's home number to patients. If the author's general internist was on call, then his not returning her call (strike 1) is unpardonable and her grievance begins to take on credibility. What would have been her reaction if he had called her back and told her to call the physician covering for him that weekend?

When Ms. Bingham initially called her physician, he should have told her to come to his office, where he could further discuss her symptoms, examine her, and make a decision and recommendation about her symptoms. A telephone consultation for a diagnosis with recommendations just doesn't cut it these days. Doing so shows a lack of interest and questionable medical judgment (strike 2), especially because the author seems to be a noncomplainer with a new problem. She probably wasn't charged for this telephone consultation, and the adage describing the results of such free advice may be applicable here.

The fact that the author's original general internist didn't visit when she was in the hospital (strike 3) is the final straw that broke this previously long-standing relationship.

I am neither condoning nor condemning Ms. Bingham's general internist. One could make the case that her physician struck out, but additional questions need to be answered before we send him back to the dugout. For example, why did the author order reprints? Does she plan to send them to all her friends with the name of the physician? She could have written a letter to her general internist about her complaints, but publishing her experience should satisfy her therapeutic rage.