The 19th century physician William Osler wrote, “The practice of medicine is an art, not a trade; a calling, not a business; a calling.” If he were practicing today, he might concede that you can’t practice your art if your practice is not an effective business. Unlike other business models, a medical practice has limited power over prices yet operational costs constantly rise. This economic pinch affects small practices the most, so what can be done?

In order for medical practices to survive and prosper they must streamline processes, and become leaner and more efficient. The old ways of doing business just don’t work, and if you are already “doing well,” you can do better. Eliminating a few seconds here or a minute there can add up to hours a week, which means time better used seeing patients, doing paperwork, or spent with your family.

Reduce redundancy and maximize productivity:

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  • Too little or not enough staff—consider purchasing a benchmarking tool that provides average staffing ratios based on practice size and specialty.
  • Standardize the layout of exam rooms—time spent searching for equipment can add up.
  • Follow paper trails, like a patient’s bill, to determine who handles it and if it is a necessity step. Having 6 people handling 1 bill/form may be overkill.
  • Create flow charts that identify where and when an activity occurs. As these diagrams grow, you may discover redundant activities or unnecessary procedures that can be eliminated.
  • Cross-train your staff, creating competent replacements in case of illness or absenteeism. It also provides a mechanism in which redundant activities can be recognized by staff members.
  • Match your staff’s skill level to their duties. A nurse stocking an exam room instead of performing clinical duties may be inefficient and costly, especially if you have lower-paid employees on staff.
  • Determine when tasks should be completed. For instance, have a nurse sort tests throughout the day rather than end-of-day, allowing a physician to do his/her reviews without waiting.

Know your strengths and use your time wisely:

Have protocols in place

  • For patient diagnostic tests, scans, or procedures, make sure the documentation is completed correctly the first time; if necessary, use a checklist. If your staff handles submissions, give them all the necessary, specific information. For example, you want to perform a CT scan; do you need contrast or not? If a form is improperly filled out, you will have to complete it again, wasting time and resources.

Billing and claims

  • Hire dedicated personnel to handle billing and insurance claims. If your practice is small, hire a temporary medical biller to work 2 to 4 days a month. Make sure that they aggressively dispute with the insurance companies.
  • Use electronic billing; it is more efficient than paper billing. The service can be run through a clearinghouse that will quickly detect problem claims, resolving them in a few days. It also provides submission dates, making it easier to track down information needed when dealing with insurance companies.

Utilize new technologies:

Electronic medical records (EMR)

  • Incentives of up to $44,000 from the 2009 federal stimulus can help smaller practices switch to EMRs. This technology can save time on prescribing, note taking, and communicating with staff and patients. It also affords physicians a chance to receive pay-to-play bonuses from insurance companies.

Use online tools and portals to assist with administrative tasks

  • Reduce phone calls with online appointment booking.
  • Reduce time spent taking a patient medical history. Ask patients to complete a medical history online and have an office-based version for convenience.
  • Use e-mail to supply patients with laboratory and other test results. It is faster and information can be attached to the patients’ EMR files to be referenced later.
  • Utilize new software to create a virtual office. Create a single in-box for all phone calls, e-mail, faxes, and forms. This allows easy access to all necessary information in one useful location. Some services transcribe phone calls and sort them into specific mailboxes, and some are integrated with EMRs.

A physician’s time is valuable and best spent treating patients, not arguing with insurance companies, maintaining records, or filling out endless forms. Making operational changes to a small practice can be as easy a deciding to implement them. Any changes should be thought out and done in stages. Try to tackle a small issue first then move to more complicated issues. Be patient; changing a system takes time, and don’t be discouraged because you don’t see immediate results. Efficiency is the objective and time is the reward—more time for patients and more time for you.


  1. Acevedo L. Ways to improve profits in medical practice. eHow.
  2. Ho L. Seven strategies for creating a more efficient practice. Fam Pract Manag. 2007;14(8):27-30.
  3. Make your medical practice more efficient. Physicians Practice.
  4. Making your practice more efficient means fewer staff, more tools. Physicians Practice.
  5. Reynolds Lewis K. Medical practices work on ways to serve patients and bottom line. New York Times.
  6. Streamline your medical practice – save time and money. Med Billing N Coding.