“I Became a Physician to Practice Medicine, Not Everything Else”

Yet running an independent medical practice increasingly requires all of that.

The result is a cycle familiar to many physicians: overhead rises, reimbursement tightens, administrative work expands, and the practice responds by adding more patients to the schedule.

At some point, “see more patients” stops being a growth strategy. It becomes an operating failure.

Physicians are working more than the appointment schedule shows

In 2024, physicians reported working an average of 57.8 hours per week. Only 27.2 hours were spent on direct patient care. Another 13 hours went toward indirect care such as documentation, orders, test results, and referrals, while 7.3 hours were consumed by administrative work, according to the American Medical Association.

Prior authorization alone creates an extraordinary burden. An AMA survey found that practices completed an average of 39 prior authorizations per physician each week, requiring approximately 13 hours of physician and staff time. Forty percent of physicians reported having staff dedicated exclusively to prior authorization work.

This is also an area where technology is beginning to create meaningful efficiency. AI-enabled tools can identify when authorization is required, retrieve relevant clinical information, prepare submissions, track payer decisions, and alert staff when human intervention is needed. Practices exploring this category can review Innovaccer’s overview of the Top 5 AI

Vendors for Prior Authorization 2026, which includes Innovaccer, Waystar, Cohere Health, Surescripts, and CoverMyMeds.

The goal is not to buy AI because it is receiving attention. It is to determine whether the right solution can return meaningful time to physicians and staff while reducing delays for patients.

Physicians may finish seeing patients at 5:00 p.m., but the workday does not necessarily end there.

The economics are moving in the wrong direction

The cost of running a practice now includes salaries, benefits, rent, EHR licensing, cybersecurity, Wi-Fi, software, insurance, medical supplies, compliance, billing, and patient acquisition.

In 2024, 92% of medical group leaders surveyed by MGMA reported higher operating expenses than the previous year. In 2026, respondents whose costs continued rising reported an average increase of approximately 11%, driven heavily by wages, benefits, staffing shortages, and minimum-wage increases.

Reimbursement has not consistently kept pace. Adjusted for inflation in practice expenses, Medicare physician payment declined 33% between 2001 and 2025.

The predictable response is volume. Add another appointment. Shorten the visit. Work through lunch. Finish documentation at home.

That approach may temporarily protect revenue, but it does not address the underlying operating problem.

Ask a better business question

Instead of asking: “How do we see more patients?” Practice leadership should ask:

“Where can we create greater efficiency, and how can we deliver more value to each appropriate patient?”

Increasing value per patient does not mean unnecessary services or aggressive coding. It means identifying legitimate clinical needs that the practice is already positioned to address. That can include:

• Improving documentation and reimbursement accuracy
• Reducing denials and billing leakage
• Automating repetitive administrative tasks
• Improving scheduling and patient communication
• Expanding appropriate ancillary services
• Supporting patients between visits
• Using AI to reduce documentation and operational work
• Improving retention and continuity
• Creating additional access without relying exclusively on physician appointments

A patient with complex chronic needs may benefit from care management between visits. A patient with dementia may need caregiver support through the GUIDE Model. A patient may be monitored remotely instead of returning unnecessarily to the office.

Better care can create better economics when the program is clinically appropriate, operationally sound, and compliantly delivered.

Use technology to create capacity, not more complexity

There are more AI and automation tools available to medical practices than ever before. They can support documentation, scheduling, patient communication, coding review, revenue-cycle workflows, call handling, data analysis, prior authorization, and patient identification.

But buying AI is not the same as creating efficiency.

The systems inside a clinic must support one another and the staff expected to use them. Too often, practices implement separate platforms that work against each other. Information does not move cleanly, employees enter the same data into multiple systems, and reports present conflicting versions of what happened. The result is more fragmentation, not more efficiency.

A new solution should strengthen the existing operating environment. It should reduce handoffs, eliminate duplicate work, and make information easier to access. Leadership should understand which system serves as the source of truth, how data will move, who will manage exceptions, and what happens when an integration fails.

Before adding technology, ask:

• What task is consuming time?
• Who performs it today?
• Which existing systems are involved?
• Can the new solution integrate with those systems?
• Will staff need to enter or reconcile information manually?
• Can the task be eliminated, automated, or reassigned?
• How will the result be measured?
• Will the solution reduce work or create another system to manage?

The workflow should drive the technology decision. A strong product that does not fit the clinic’s operating environment can still become an expensive problem.

Technology should return time to physicians and staff. If it adds clicks, duplicate documentation, disconnected data, and another dashboard, it has not solved the problem.

Full-service ancillary models can expand care without expanding the physician’s day

Some ancillary service lines allow practices to support patients outside the traditional office visit while using qualified external clinical and operational resources.

The right partner may assist with patient identification, enrollment, ongoing engagement, documentation, care coordination, and escalation. Physicians retain appropriate clinical oversight without personally absorbing every operational task.

The value is not simply additional reimbursement. It is the ability to provide more continuous care without solving every need through another physician appointment.

The vendor and workflow still require diligence. A poorly designed program can add work instead of removing it. But a strong model can improve access, patient experience, and financial sustainability at the same time.

Hire business leaders who understand healthcare

Physician owners should not be expected to become experts in every business function. That is why key operational hires matter.

An office manager, practice administrator, COO, or executive leader should understand more than scheduling and employee supervision. Depending on the role, they should be able to evaluate:

• Practice financials
• Staffing models
• Revenue-cycle performance
• Payer and reimbursement trends
• Technology and AI
• Vendor capabilities
• Ancillary-service opportunities
• Workflow design
• Implementation and change management
• Performance reporting

Too many practices place underqualified employees or family members into important leadership positions because they are trusted or familiar.

Trust matters, but trust is not a substitute for capability.

A family member may be highly qualified. The relationship itself, however, is not the qualification. A role that influences millions of dollars in revenue, expenses, and enterprise value requires proven business judgment and healthcare operating knowledge.

Independent practice requires business discipline

The physician’s highest-value activity is practicing medicine. The operating model should protect that time rather than consume it.

That means hiring qualified leaders, using technology deliberately, selecting stronger vendors, reducing administrative friction, capturing appropriate reimbursement, and building service lines that create value beyond the next office visit.

The answer cannot always be another patient on the schedule.

Independent practices need to become more efficient, more informed, and more intentional about how they generate value. Otherwise, rising expenses and administrative burden will continue forcing physicians to work harder simply to preserve the same result.

You became a physician to practice medicine. Build the business so you can.