Scrapping routine consultant check-ups for post-op patients six weeks after surgery could save the NHS up to £2bn a year, plans propose.
An aim is to free up surgeons' time
Instead, patients could see their GP, practice nurse or decide for themselves that they do not need to be seen, says Primary Care tsar Dr David Colin-Thomé.
It is envisaged that the changes for England would free up surgeons' time, enabling more operations to be done.
In turn, this could cut waiting times to help meet targets.
But health experts stressed some patients would still need to see a consultant.
Dr Colin-Thomé, who will publish his service report in January, said the current system is inefficient, with more than one in 10 patients failing to attend their routine post-op check-up.
A total of 4.2m appointments were wasted in 2005/6, costing the NHS £378m.
The Department of Health calculates the changes could save around £1.9b a year.
Dr Colin-Thomé said many patients already opted to see their GP about any health concerns after surgery rather than wait six weeks to see a consultant.
He said many others did not need to be seen at all and that patients could be trusted to judge for themselves if they are better.
Dr Colin-Thomé said: "We waste consultants' precious time and expertise if we force them to spend hours sitting in a room simply telling patients they're recovering fine...It is like asking a Michelin-star chef to cook microwave meals all day."
Consultants could still chose to see any post-operative patients that they were worried about, he added.
He said patients also had the right to choose who they were seen by.
But Geoff Martin of the NHS campaigning group Health Emergency warned that in some cases the "penny-pinching" changes could be dangerous, as well as compromise continuity of care.
He said: "This major policy shift has not been tried and tested and is fraught with potential danger, yet it is being driven through regardless as the government seek to clamp down on NHS spending across the country."
Shadow health minister Andrew Lansley said: "Too many appointments are routine and unnecessary.
"Consultants should decide if follow-up is necessary, and patients should be able to see them."
Liberal Democrat shadow health secretary Norman Lamb MP said: "Such major changes should be the result of trials showing clear benefits to patients.
"Otherwise at a time of cuts and closures, there will be suspicion that the decisions are being driven by financial pressure rather than improving front line care."