I'd be very curious as to how it works when it's not so streamlined - how they handle the exceptions to the rule.

For example, if I'm one of the 150 patients of a particular doctor, what if I don't like what he says concerning something that ails me? (Like my wife's doctor who has certain blind spots when it comes to problems that are exclusively female - not everything mind you, just a few things where he really seems out of touch). How does getting a 2nd opinion work?