>Bill,
>
>+1 for Tamar's observations.
>
>>>I go there for colds, earwax removal, etc.
>
>For interest, does the MD herself remove the earwax?
>

Sometimes, yes.
Often it's a nurse practicioner.
One practicioner sent me home and told me how to prepare myself so that it would be less painful when I came back. I thanked him for that.
Of course it's nonsense that someone who has gone though the rigors you eloquently described has to remove my earwax, but MD's have gamed the system to make that necessary. Any certified audiologist could do it, but MD's have made that impossible.
So, my vet friend (at my age we're all deaf or close to it) makes an appointment to see an audiologist at the VA (at least 3 months.) The audiologist sees a ton of earwax in the vet's ear and says it has to be removed before the vet can be tested.
So the hapless vet makes an appointment with a VA MD (at least 3 months) gets the earwax removed, and then makes another appointment with the audiologist - another 3 months.
9 months after it all started, the vet (if still alive) gets a hearing test at the VA- unless more earwax has accumulated ... arghhh you get the point.
With a few of hours of training that audiologist could have removed the earwax and tested the vet.

I had one particularly egregious MD remove my earwax and charge Medicare for surgery - $1K. I reported him to Medicare, but as far as I know he's still free and driving his Rolls.

It would all go away if the MD's would demystify things and let qualified people do things like remove earwax and clip toenails. Why not let some of those Asian immigrants share the Medicare wealth and let that podiatrist really work at what he was trained to do... cure illness?

Yes, John, you don't have to say it... I have a "thing" about MD's.