Most of that, of course, is the better support structure that offloads ancillary tasks to nonphysicians, so the physicians can devote more time to being physicians.
Speaking of support.
@narcusprince and I were at the same anesthesia dept a couple years ago, before we finished our time in the Navy.
One thing that always frustrated me, and that I'm sure he'll relate to, when it comes to the civ vs mil cultural differences - every day our dept scheduled people in "support" roles. Their only job was to cover people for meetings and to offer morning, lunch, and afternoon breaks. We also burned a body in a "consult" role. The most charitable thing I can say about that arrangement was that sometimes it was very helpful to have an extra set of hands available to do something complex or urgent.
Part of the reason we had "support" assignments was prompted by the fact that there were SO MANY meetings and nonclinical duties distributed to people in the department. But this kind of staffing waste is unthinkable outside of government service - I mean it was a nice luxury to have such frequent and reliable breaks, I guess, but there was a price. It reduced the number of ORs we could actually run cases in. It also came at the cost of raising the floor of our minimum staffing numbers. Which impacted whether or not leave could be approved.
I can't fathom having four of my current partners assigned to do nothing but give breaks for coffee or to get someone out of the OR to go a lean sigma nine green belt whiteboard brainstorming session. It's insane.
I'm a glass-half-full kind of guy and in the grand aggregate I was basically happy throughout my time in the Navy. But I can't begin to express the soul crushing frustration and exhaustion that came with getting your leave or TAD denied, only to find yourself assigned to give coffee breaks to colleagues who typically had 30-40 minute turnovers between cases.
Side note to that - for the last year or so that I was on AD, I was the primary scheduler and leave approver, and I informally polled the dept to see if anyone would object to a more liberal approval policy, if it meant fewer people assigned to support and that maaaaybe sometimes you missed a break. No surprise - nobody on active duty objected. I was able to run things a little leaner (but still absurdly fat by civilian standards) and I only had to deny a couple of leave requests. My tenure as leave approver was popular.
The sticking point was that the civilians needed their contractually obligated breaks, so I couldn't really cut the support assignments to the bone the way I wanted to. Insult to injury: getting your leave or TAD denied, just to be a break giver to civilians earning 2x what you make while taking no weekend or call shifts.
We talk a lot about vague and nebulous "government inefficiency" but for me the hardest bits to bear were the self-inflicted wounds like this. There was just no need to run the place that way. But we did it to ourselves.