Medical practices have spent years treating operational dysfunction as a staffing issue.
When work backs up, they hire another coordinator. When phones go unanswered, they add call center support. When prior authorizations stall, they assign another person to support the queue. When referrals disappear off the fax machine, they create a spreadsheet. When staff cannot keep pace, they blame turnover, burnout, or staffing shortages.
Sometimes those problems are real. But often, the practice does not have a staffing problem, it has a workflow problem. Adding more people to a poorly designed process does not fix the underlying problem. It simply gives more people the opportunity to enable and reinforce what is already broken.
The symptoms are familiar: duplicate data entry, disconnected systems, manual follow-up, inconsistent handoffs, workarounds, spreadsheets, sticky notes, institutional knowledge that lives entirely inside one employee’s head, and the beloved fax communications, which, despite everyone’s best efforts, remain a critical piece of modern healthcare infrastructure. Staff spend their days moving information between systems rather than moving work toward an outcome.
Then leadership concludes that the team just needs more capacity, but what they often need is less friction.
If Your EHR Had Solved These Problems, You Would Not Still Be Doing It Manually
Your electronic health record system is essential. It is also not an end-to-end operating model for your practice.
This distinction matters. Many healthcare practices continue to assume that because a workflow touches the EHR, the EHR should be able to manage the entire process. Yet staff are still manually routing documents, chasing missing information, checking payer portals, monitoring shared inboxes, updating spreadsheets, and tracking exceptions outside of the core system.
If your EHR had solved these problems, you would not still be doing them manually. That is not an indictment of the EHR. It is a recognition that the EHR was not designed to orchestrate every administrative, financial, and operational function across a medical practice.
The problem begins when leaders confuse having technology with having a well-designed workflow.
A digital form is not a workflow.
A shared inbox is not a workflow.
A task list is not a workflow.
A spreadsheet is certainly not a workflow, despite the heroic confidence often placed in it.
A workflow is the deliberate design of how work moves from trigger to outcome. It defines what happens, in what order, under which conditions, with what information, and with clear accountability when the process does not go as planned.
Most practices have never taken the time to design their workflows; they have simply inherited them. One employee creates a workaround. Another employee creates a tracking sheet. A manager introduces a new worklist. A department buys a new digital solution. Over time, the process becomes a collection of local fixes rather than a coherent operating model. Each fix may help one person complete one task but collectively, they often make the broader work stream harder to manage.
Stop Designing Work Around Individual Roles
One of the most persistent mistakes in healthcare operations is designing processes around job descriptions rather than desired outcomes.
Workflows span across multiple teams, each operating from a different source of truth, and optimizing only for its own portion of the process. While each role executes its piece of the process, no one is accountable for the end-to-end integrity of the workflow itself. The result is operational fragmentation.
Consider a patient referral. The desired outcome is not that the referral coordinator enters the faxed data correctly into the EHR. The desired outcome is that the patient reaches the right clinician, at the right time, with the right information, and the right context in order to provide that patient with the appropriate level of care. That outcome may require patient intake, document collection, eligibility verification, clinical review, scheduling, prior authorization, and patient outreach.
Optimizing only one step in the process does not optimize the entire workflow. A process can be efficient for one employee and still fail the patient, the practice, and everyone else downstream. This is why healthcare practices must take a step back and examine the work that needs to be done from beginning to end. Not from the perspective of one role, but from the perspective of the outcome they wish to achieve.
Technology Should Support the Workflow, Not Define It
Healthcare practices often begin operational improvement by asking which technology they should procure. That is fundamentally the wrong starting point. The first question should always be, “what problem are we trying to solve?” Then the immediate next question is, “what does operational success look like in practice and how will it solve the underlying problem?” Only after the problem is defined and future-state vision is clear should the practice determine which tools are required to support it. Otherwise, technology decisions are made in reverse. Leaders purchase a tool, then reshape the workflow around the tool’s limitations. Staff create new workarounds to bridge the gaps, another platform is added to the tech stack, another dashboard appears from siloed offices and ultimately the organization becomes more digital but not more efficient.
Technology should reduce unnecessary work, enforce consistency, surface exceptions, and make accountability visible. It should not require staff to become human middleware. Technology may automate routine steps, route work based on defined rules, request missing information, trigger communication, synchronize data, or track status. But technology only creates value when it is applied to a workflow that has been intentionally designed. Automating a broken process does not make it better. It makes the dysfunction more ambiguous.
Measure the Friction, Not Just the Activity
Practices frequently measure how much work the staff complete. They should also measure how much unnecessary work the process creates.
How many times is the same information entered?
How many handoffs occur?
How often does work return because something is incomplete?
How long does it wait between steps?
How many cases require manual intervention?
How much work depends on someone remembering to check a queue?
These are not minor inconveniences. They are operational costs.
They contribute to burnout, delays, inconsistent patient experiences, missed revenue, and the ongoing sense that the practice is perpetually understaffed. The solution is not always to hire another team member. Sometimes the solution is eliminating three handoffs, two spreadsheets, four status checks, and a workflow no one has questioned in six years.
Fix the Work Before You Add More Workers
Medical practices do face real workforce constraints, but headcount should not be used to compensate for poorly designed operations. Before adding staff, outsourcing a function, or buying another platform, leaders should examine the full work stream and ask a more disciplined question: Is this the best possible way for this work to happen?
If the answer is no, redesign it.
Define the desired outcome. Map the work from beginning to end. Remove unnecessary steps. Clarify ownership. Design for exceptions. Then select the technology required to make the process repeatable, visible, and scalable.
A well-designed workflow does not eliminate the need for people. It allows people to spend their time on work that requires judgment, expertise, and human connection.
That is the point.
Your practice may need more staff. But before posting another job opening, make sure you are not hiring people to compensate for a workflow that was never designed to work in the first place.