A family member of mine is an orthopedic surgeon in Vancouver. Several years ago he split his time between a teaching hospital and a private practice, doing knee surgeries at both. At the hospital waiting times were typical. At his private practice waiting times were very short, on the order of days, I think. IIRC, the way surgeons get around the rules is by charging by the hour, not by the procedure. And it's completely out-of-pocket. For the kind of cookie-cutter, out-patient operations he specialized in it worked very well for him and his well-heeled patients.