The other day I was at the Subaru dealership in Dallas, having my car repaired. I was struck by how spacious and comfortable the waiting area was. In addition to simple creature comforts, the facility offered free coffee, free soft drinks, and free snack items including peanuts, candy, cookies and nutrient bars.
By contrast, a typical doctor’s office is quite spartan. The seating is usually austere, the flooring is low-budget (if there is carpeting, it is probably worn), and there are no free drinks or free food. If there is a restroom, it is probably located somewhere else in the building.
Doctors cannot afford to offer uncompensated services. Nor can they raise their fees. The only way they can pay the rent and other costs is by seeing more patients and spending less time with each of them.
This is an age-old question. There is really no objective evidence that boosting primary care for asymptomatic people decreases cost (actually it increases costs). However, it would increase satisfaction among patients who would probably pay a little more for the privilege. I have not researched it lately but it used to be that about one-third of a primary care practice revenue was gross profit and overhead consumed two-thirds. That suggests that a physician could fire most of the staff, keep a smaller office and utilize phone and video, then lower prices per hour by half but spend twice as long with patients. Patients would pay cash. Everyone would be happier, the doctor would make as much money if not more while being responsive to patients. Patients would get more of the doctor’s time. Maybe with artificial intelligence we will see more of this. AI could manage patient care, while the doctor would oversee the AI.