We are attempting to combine the best of the old and the new. It must be our primary goal to provide and to continue to perfect the quality of care of which we have justly been cited for. To do this as medicine continues to advance and change will be challenging. We also want to remain an office that is characterized by a friendly,warm, atmosphere. This will be more difficult than it appears, as the demands of modernization continue to place increased stresses on our time. For example I have failed to maintain the speedy response time award, given by ZocDoc, but there is no way to know that that award was lost because of the time I take with a patient when in consultation. We never rush through a visit, and that costs. We have added Suboxone opioid detoxification to the list of services that we offer. This is just too time consuming to use time as a metric of quality.