Confession: I used to keep playback at 1.0x, but 1.25x with 500 ms backstep on pause is giving me cleaner flags and about 6% faster turnaround on H&P sections. on a 12-minute op note yesterday.
This reminds me of how I watch lectures at 1.2–1.3x and tap back for tricky bits. Small tip: map a press-and-hold key to temporary slow-play (drop to 0.9x only while held) so you don’t need to toggle speeds when you hit dense lists or mumbled sections. Do you tweak backstep length by note type, or keep 500 ms across H&P, op notes, and consults? Also, a light silence-skip for short pauses pairs well with 1.25x without clipping words. Sounds like your setup is dialed for speed and accuracy.