Probably the area as well. The best surgery I've ever been registered at was one in a very rural part of Devon. It covered a huge but sparsely populated area and most of the patients were hard up farmers or gardeners who were fairly tough and would only take time off work to come in if there was no other option. The GPs had the attitude that if you had bothered to make an appointment then it must be important, so you were never ever brushed off. Then I moved to another rural area, but this time with a lot of wealthy couples with young children. We had huge waiting lists as the mums would bring their kids in for every sniffle or rash. Consultations were much more rushed there and unless you went in with something really obviously wrong, the GPs were inclined to dismiss you.