I was talking to someone a few days ago who works in another physician’s office. I asked her how many staff members there are in that office. She said seven. Seven! For one doctor! I don’t understand how a solo practice can afford seven employees. OK, maybe a surgeon, a dermatologist, or another subspecialist that has a lot of procedures, but primary care? Pediatrics? Or a specialty that has no procedures like mine.

I asked why so many. Apparently, there is a biller, a nurse, an office manager, two front office people, and two medical assistants. I was told that the office is very busy and that this doctor sees many patients a day. Unless she is really churning patients out, I don’t see how she can afford to pay that many staff members.

I have a small office. When I was still solo, I had one front office person and a medical assistant. OK, my husband was doing the billing, so I got away with saying I only had two staff members. Otherwise, I either would have had to outsource the billing or hire a biller. I can only see so many patients a day, and refuse to double book or shorten office visits, so I would not have been able to afford any more employees. Once I hired a second physician, I hired a part-time receptionist, who, as doc number two became busier, was eventually brought on full time. Having the EHR, I think, helps to keep the need for staff lower. No one has to pull charts, or file papers. My receptionists almost never even have to stand up. Scanner, shredder, telephone, copier, and computer are all within arm’s reach, or at most within chair rolling distance.

We now have a part-time nurse practitioner. Once her schedule is full, I will probably hire a part-time medical assistant.

I have yet to hire an office manager. I have been advised by readers of this blog that I would benefit from hiring one. While I’m sure it would relieve me of a few hours of work each week, I am so involved in the day-to day operations that I can’t think of 40 hours of work that I would relinquish to someone else. Maybe, as the office continues to grow. We have been very fortunate, and if things continue the way they are, we will probably need a third physician in another year or two.

I know I am not alone. There is one physician I know who has two part-time receptionists, and that’s it; no MA, no manager. She outsources her billing. I know another who has a receptionist and no other employees. As he put it, he doesn’t want to work just to pay someone else’s salary. We’ll never be rich practicing this way. Well, let’s face it, we couldn’t get rich the other way either.

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