It seems like working with a developer you trust would go a long way in answering your questions, and would probably make your life easier, but I guess that's not something we can fix here.
What are you asking? I'm no VM expert, but it seems like the checkout process is the checkout process and that's it. I've seen feature requests for one-page checkout, but I haven't seen it implemented. If you're talking about the product pages and the like, there ARE different ways to display your products that put the buy-it-now option up front - I like to have a couple 'buy' buttons on my homepage, just for good measure.
All that said, I don't think you're going to lose business because there are three pages of shopping cart - how many times do you get an email or a call saying "hey, I didn't put this on my order!" and then you have to show the customer the 47 places that they were asked to review their order before it shipped across the country next-day air to their door? It happens here a lot.