Connections between symptoms and life changes the patient never thought to mention. Subtle shifts in mood, energy, or weight that turn out to be early signals. Patterns across years that no chart review can substitute for, because the pattern lives in my memory of who this person is over time.
This is what evidence-based medicine looks like when it’s allowed to actually run. Not a faster algorithm. A different practice.
What patients say
The most common thing patients say to me in a 60-minute model — usually within their first three visits — is some version of no one has ever asked me these questions before.
They aren’t exaggerating. The 7-minute model structurally cannot ask those questions. Not because the physicians inside it don’t want to. Because the time isn’t there.
The patients who come into my practice from a system where they had a primary care doctor for 15 years are usually surprised by how much they didn’t realize they were missing. They thought the experience they were getting was the experience medicine was supposed to deliver. It wasn’t. It was the experience that volume-based reimbursement was structurally able to deliver. Once they see the alternative, almost no one wants to go back.
The honest cost
Sixty-minute visits cost more per encounter than seven-minute visits. That’s a math reality, and it’s the structural reason cash-pay practices use this model and insurance-based practices don’t.
But the cost calculation everyone does is wrong. The right comparison isn’t the price of one 60-minute visit vs. the price of one 7-minute visit. The right comparison is the total cost of care over a year — including the imaging the 7-minute model orders because there wasn’t time to do a real history, the referrals it makes because there wasn’t time to think, the medications it adds because there wasn’t time to manage them off, and the chronic conditions that progress because no one had time to actually address the upstream cause.
When you run that comparison honestly, sixty-minute visits often cost less per year, deliver better outcomes, and produce a relationship that compounds for decades. The seven-minute model is cheaper per encounter and more expensive everywhere else.
The minutes are the medicine
The reason I structure my practice around 60-minute visits isn’t because I prefer the pace. It’s because it’s the only format in which the medicine I trained to practice actually fits.
Seven minutes is enough to say hello. Sixty minutes is enough to do the job.
If you’ve spent your career feeling like the visits you’re running aren’t enough — that you’re missing things, that patients aren’t following through, that you’re delivering a fraction of the value you know how to deliver — you’re probably right. The structure is the problem, not you. And there’s a different structure available, where the medicine you trained for finally has room to happen.
That’s the clinical difference. The minutes are the medicine.
Maverick Medical Ventures helps physicians design and build practices outside the insurance system — across the four pillars of medicine, marketing, finance, and operations. [Learn more]
