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To the Editor: Drs Murray and Berwick¹ discussed the advanced-access model of patient scheduling, in which patients calling to see their physician are offered an appointment the same day. The authors claim that physicians can offer both quality and convenience to everyone all the time. In reality, however, these 2 goals often conflict. Furthermore, I suspect that most physicians and patients would not embrace greater convenience if it led to decreasing the quality of care they provide.

Advanced access seems ideal for a world in which all physicians work full time, take no vacations, and have no family demands. It also seems well suited for any patient who prefers to receive same-day care all the time for every type of health care need. However in the world in which I practice, physicians often work part-time, take 4-week vacations, 1-week continuing education leave, 3-month maternity leaves, and 2-week hospital rounding rotations. . . . [Full Text of this Article]

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