Book excerpt: A Fateful Meeting A year and a half ago, I was sitting at a conference listening to Ed Noffsinger speak, and suddenly had the most profound ‘‘Aha’’ moment of my professional career. Here was someone presenting a practical and tested solution to some of the most challenging problems currently plaguing the US healthcare system, problems such as poor access to primary and specialty care; the uncontainable and rising costs of healthcare; our nation’s relatively poor quality outcomes; and finally, the sense of frustration, disempowerment, loneliness, and disenfranchisement that patients and their families too often experience. Dr. Noffsinger’s solution seemed deceptively simple—shared medical appointments (SMAs) that afford the highest quality healthcare to be delivered in the highest quality care experience—a group setting. Experience collected over a decade and involving more than 100,000 patient visits throughout the United States, Canada, and parts of Europe has demonstrated that SMAs, when used in primary care as well as in the medical and surgical subspecialties, lead to increased access to care, enhanced quality of care, and improved patient satisfaction. For physicians, the efficiency gains and team support from their participation in SMAs translate into much needed relief and improved career satisfaction.