Medical Practice Workflow: Do You Need More Staff, or Does the Work Need to Change?

When the phones keep ringing, patients are waiting, and everyone stays late, adding another employee can feel like the only reasonable answer.

Sometimes it is the right answer. A practice cannot operate safely or sustainably without enough qualified people.

But before approving another position, I want to understand what is consuming the time of the people already there. Are they doing necessary work once, with the information and authority they need? Or are they repeatedly fixing, checking, searching, and asking for decisions that should already be clear?

Medical practice workflow improvement is not about asking a stretched team to work harder. It is about understanding the demands placed on that team before deciding how to support it.

Follow the work, not just the job description

A job description might say that an employee handles referrals. It rarely tells you how many times that person has to request a missing note, locate an order, clarify an instruction, or answer a patient who has not heard back.

Start with a specific process that is creating difficulty. Follow a few real examples from beginning to end, using appropriate privacy safeguards. Include routine cases and exceptions, because the exceptions often explain why a seemingly simple task takes so much time.

Record where the work enters, what information is required, who receives it next, and what counts as completion. Pay particular attention to queues that no one owns and steps that depend on someone remembering to follow up.

Do not build the process map from a policy manual alone. Ask the people doing the work to show you what actually happens.

Count repeated work as workload

Suppose a hypothetical practice schedules a procedure before the necessary information is available. The authorization team discovers the gap, sends it back, waits for a response, and follows up again. The patient calls for an update. Scheduling checks with authorization. Someone eventually asks the physician.

Several employees have now touched the same unresolved issue. A report may count one appointment or one authorization. The team has experienced a much larger workload.

The answer might include earlier information collection, a clearer scheduling rule, or a designated exception owner. It might also require more capacity. You cannot tell until the rework is visible.

This is why I would be careful about judging an employee's productivity from a simple completed-task count. The same task can require very different effort depending on what arrives with it.

Look at coverage by time of day

A weekly staffing total can look adequate while the practice is short of help during its busiest hours.

Look at when patients arrive, when calls peak, when procedures need dedicated support, and when people are available to complete administrative work. Include breaks, absences, training, and tasks that require uninterrupted attention.

One person cannot provide hands-on support in a procedure room and cover the front desk at the same time. Listing both responsibilities under the same position does not create capacity.

The solution may involve start times, appointment templates, cross-training within appropriate role boundaries, protected work periods, or another position. The coverage plan should reflect actual simultaneous demands, not just the total number of employees on payroll.

Make handoffs and decision rights explicit

“Everyone helps with that” can mean nobody knows whether it was completed.

For each important handoff, identify the sending role, the receiving role, the information that must accompany the work, and the next action if something is missing. Then identify who can make an exception and who must approve a change.

Physician preferences matter, particularly where they affect clinical care. But if a business process changes depending on which physician is in the office, the team needs a clear way to recognize and manage those differences. Staff should not have to guess which instruction takes priority.

A referral is a useful example. Sending a document may complete one employee's step, but it may not complete the practice's responsibility to track the referral. The clinical and administrative leaders should define the follow-up process and the point at which responsibility has actually been met.

Test one change before changing everything

A practice already under pressure does not need six new workflows introduced at once.

Choose a problem with a clear owner and a change the team can reasonably test. Establish a starting point using a representative sample, agree on what success looks like, and review the result after a defined period.

Depending on the problem, useful measures could include the age of an authorization queue, repeat calls about the same issue, the time from a completed visit to a billable claim, or overtime associated with a particular task.

Pair those measures with staff feedback and patient-facing consequences. Completing a queue faster is not an improvement if errors increase or another team inherits the unfinished work.

A small test can reveal that the process needs adjustment, that the software is not supporting it, or that the team truly does not have enough time. Each finding is useful.

Recognize when the practice really does need more staff

Workflow review should not become a reason to postpone a necessary hire indefinitely.

If the work is necessary, responsibilities are clear, avoidable repetition has been addressed, and demand still exceeds qualified capacity, the practice has a staffing need. The review should help define the role and the coverage required, not produce another request for employees to stretch.

It may also show that the missing resource is supervision or decision-making support rather than another person doing front-line tasks. A capable team can lose hours waiting for approvals or resolving conflicting instructions.

Our article on hiring the right person looks at why defining the role matters before filling it.

Support the people who will have to make the change work

Staff are often protecting the practice through informal workarounds that leadership does not see. Ask what they are compensating for before taking those workarounds away.

At MMC, medical practice workflow consulting starts with how the practice actually operates. We look at the work, the handoffs, the leadership decisions, and the resources needed to support patient care.

The goal is not a leaner-looking organizational chart. It is a practice where necessary work can be completed reliably, the team understands its responsibilities, and the physician is not the answer to every operational question.