I have noticed that also. The appointment lasts longer and covers a range of topics. That said, I have only seen my physician a handful of times in the last dozen years: when I was a new patient, in order to make a referral (to see a rheumatologist), and when to signoff to pronounce me fit for surgery (knee, for example). Most of my visits to that office are for things that aren't a medical mystery, like poison ivy, sinus infection, etc. and the nurse gives the shot or issues the prescription and we're finished. I go to my ob/gyn for my annual physical ("Well woman check") and now I have to play Medicare games if I want to go every year; Medicare approves a physical every two years. In the off year I was told that I should make an appointment with a euphemism like "vaginal dryness" and they can do the same checks.