Bill,

+1 for Tamar's observations.

>>I go there for colds, earwax removal, etc.

For interest, does the MD herself remove the earwax?

IMO the key issue is the one that Tamar identified: continuity of care. There *is* value in seeing the same doctors and to having family associations with practices. As an example, despite the Health Information Exchange (HIE) sharing of synopsis data (not entire health records,) patient confidentiality prevents a walk-in practice physician seeing family histories or drawing connections that can save lives. In addition, even something trivial like "earwax" can benefit from review by somebody who knows you and has a canny sense of problem solving. It's not the best example, but earwax is not the only possible cause of its usual symptom profile.

This was hammered home to me when as a young resident I was asked in the night to prescribe a sleeping pill for a patient who could not sleep. Something caused me to go see this patient rather than scrawling the usual response to such a commonplace request. The patient was sitting upright in bed and seemed slightly short of breath, with a quick exam confirming she was in fact in heart failure and had experienced a silent cardiac infarct. The point is that even physicians can make an ass of you and me by "assuming" and that sometimes a level of care that may seem excessive to patients or relatives is not just done to rort more money. When you look at the research, patients are adept at assessing the quality of premises or food, but are not that competent at judging the quality of care they receive. Which is why IMHO it's worth establishing a relationship with somebody you trust and sticking with them.