John. Agree that rank is a far from perfect system, just as is seniority for an airline. But, it is better than basing it on how many procedures you can justify. Jon's vision might be closer. I am just sure that personal income has to be separate from procedures and drama, and seniority is less onerous to me than the schemes that are based on how many checkboxes you can tick off during a visit.

David Grauman MD, FACP
Flagstaff, Arizona