I don't know how things have changed over the past 25 years, but I used to work as a defense contractor and would frequently have to visit the Navy Annex in Virginia which was also HQ US Marine Corps.
It always struck me as weird that the guardhouse gate to enter was manned by a $12 hour off-brand security guard. I mentioned it to someone at one point, and I was told "Do you know how much it costs to train a Marine? It would be an outrageous waste of resources to staff that guardhouse with a Marine."
A relative who put in over 20 years in the army told me that a lot of their post gate guards were contractors these days. Considering that when he told me this it was the height of the occupation of Iraq ('05, maybe?), and that lots of the soldiers on these posts would soon be guarding gates and checkpoints in Iraq, it struck me as super fucking weird that they didn't use that as a training opportunity to get them experience doing that stateside—very different, sure, but any experience beats none, surely, and training's a ton of what they do when not deployed anyway, so seems like a win-win, but I guess either that's not true or whoever landed those contracts had some really good lobbyists.
In Germany, the "nurse" (it's a separate profession from nursing) performs a variety of medical tasks (like vaccinations, blood tests, allergy tests) and does prioritization of incoming patients based on initial assessments. I've also had the "nurse" complete initial medical history with me.
This model is strongly influenced by the size of the clinic: we usually have small clinics owned and run by the only doctor in the clinic (though they sometimes team up). As the amount of patients per day is hard-limited by the doctors time, such small clinics have no need for a full-time receptionists.
In the US it would be something like:
Receptionist: 30k / year
Nurse: 80k / year.
So you have:
Doctor's office 1: 3x Nurse, 240k per year in salary
Doctor's office 2: 2x Nurse, 1x Receptionist, 190k pear year.
That 50k in extra cost has to come from somewhere. Lower paid doctors, higher costs, ???