As Turnbull said above, most NP's and PA's are adequate and motivated...for good reason...they are given straight forward cases by the supervising MD/office staff and are only required to see a select # of pt's per day....but you make a very good point about MD's being under the gun time-wise. The majority of MD's today are "employed"...meaning that the hospital or organization that they work for is keeping very close track of how many pt's they see per day and how much time that they are spending per pt encounter. If you really want to be a "wise shopper" you may want to seek out a private MD...that is not to say that all or most "employed" MD's aren't just as capable.