Queues solve some problems. Others that are read heavy, but rarely updated (queries for which Doctors are on the system) can be cached and read from slaves. Pro

Queues solve some problems. Others that are read heavy, but rarely updated (queries for which Doctors are on the system) can be cached and read from slaves. Problems that benefit from being async should be async, those that aren't shouldn't. It's usually pretty easy to do both in a system.