And in an ideal world, one could report this as a bug or improvement and get it fixed for every single user without them needing to do anything at all.

Well, it isn't every user. We use a version of Epic called Epic Radiant. It's designed for radiologists. The tab that always opens is the radiologist worklist. The thing is, we don't use that worklist for procedures (I'm an interventional radiologist). So that tab is always there, always opens first, and always shows an empty list. It can't be removed in the Radiant version of Epic.

But why would Epic spend money improving or fixing their software? If they spend money developing their product then they can't spend that money on their adult playground of a campus!