After just a few rotations, I've noticed a huge difference in the ways that primary clinics and specialty clinics work. In my experience, the primary care clinic is usually jammed with patients that are assigned short appointments. This clinic is usually well-staffed with allied helath personnel (MAs, RNs, NPs, etc.), and the patient is handled by scores of people before the attending walks in. The interaction with the attending is very focused and brief, and the visit is wrapped up by allied health, while the attending runs off to see the next of ~30 patients that day. In contrast, the scheduling in the specialty clinic tends to be very loose, with generous appointments (30-45-60 minutes). There is little allied health, and in fact, the attending may be the only medical professional the patient sees (calling the patient in from waiting room, taking vital signs, etc.). The visit is very relaxed and leisurely, and the patient has plenty of time to describe all of their concerns, whether they are relevant or not. There is ample time to answer questions, and the patient feels satisfied with the amount of time and attention from the doctor. The attending may see 10 patients maximum in a day. The ironic thing is that the physician in scenario #2 is likely the one to have the larger income! Are my impressions of primary and specialty care clinics generally true, or am I being led astray by a sampling error? And, basically, is it just that specialists charge more for their appointments than generalists?