Bruce, I know it might be counter intuitive but in fact that more efficient (high volume) physicians tend to have better outcomes. So, yes, I want the surgeon doing high volume, but I also want to be his first patient of the day. You might enjoy reading these links. They are consistent with my experience and research.

https://pubmed.ncbi.nlm.nih.gov/34053278/

https://pubmed.ncbi.nlm.nih.gov/26542187/

The second article is particularly interesting in that when a high-volume surgeon leaves a high-volume hospital and joins the staff at a low volume hospital the quality of outcomes goes up as the volume goes up.

When I was CFO of one of the largest Medicare program administrators, we did a study on outcomes and there is no question, you want the surgeon that is scheduling procedures one after another.

As for the fifteen-minute physician appointments. Actually, they are 10-12 minutes apart.

I ran a large physician group of 400 primary care physicians, and we focused on streamlining our processes and even hired the Disney company to consult on how to make "the experience" better.

The results were that our average physician was far more efficient, we ranked among the highest in the community for patient satisfaction with their experience and most importantly our insurance carriers confirmed that our total cost of care per patient was 8% lower even though our fees were at or above market.

One of the problems was physicians felt "rushed" to gather the info and so we had a med tech do a history and physical summary, rather than a doctor standing in front of a computer inputting data at $200/hr.

Instead, you got the full 10-12 minutes of physician focusing on the reason you came and any "triggers" that came from the interview.

In addition, we hired nurse practitioners, who we could afford to have them spend 20-30 minutes with you doing patient education when a regular doctor would spend those "15 minutes". Nurses are better "teachers" than physician on average and so if you had diabetes, asthma, were pregnant and a host of other conditions that called for patient education, you got it. Inefficient physicians don't have the time and the office does not generate the revenue to support these other activities.

There is a lot about health care that simply is not all the intuitive.