I thank you for the opportunity to reply

I would refer the author to our work previously published in Anesthesiology. belive this work speaks for itself and adresses the writers concerns. Perhaps he should have read it before submitting his letter

Sandberg WS, Daily B, Egan M, Stahl JE, Goldman JM, Wiklund RA, Rattner DW.

Deliberate Perioperative Systems Design Improves Operating Room Throughput.

Anesthesiology 2005;103:406–18