Stage 1 — Practice start-up
If you’ve ever spent a day covering the front desk, chasing authorizations or solving staffing problems between patient visits, you know how quickly those demands take attention away from care. I’ve managed teams and workflows throughout my healthcare career, and I know that adding more people isn’t always the answer. The answer is putting the right people in the right roles, with clear responsibilities and standards. MedCoShare helps practices identify staffing needs, recruit and onboard support personnel, and plan for growth without taking on unnecessary payroll. Our goal is to give you a dependable team and more time for the patients who count on you.
The aim is enough support to run the day properly without carrying payroll the schedule can't yet justify.
Staffing is usually the largest ongoing expense a practice carries, and the one most likely to be set by habit rather than by analysis. New practices tend to hire the roles they saw at the last place they worked. Growing practices tend to add people when the current team is visibly struggling, which is generally a few months after the right moment.
Both approaches cost more than deciding deliberately.
We start from the work itself — how many patients per provider per day, what has to happen before and after each visit, who touches the phone, the schedule, the intake, the chart and the claim — and build the team from that. The result is usually a leaner opening roster with a clear plan for who gets added at what volume.
Hire for the work in front of you, and know what triggers the next hire.
From defining the role through to the person starting, and the plan for who comes next.
What each position actually does in your workflow, rather than a generic job title borrowed from a larger organization.
How many people, in which roles, at opening — and the patient-volume thresholds that trigger the next hire.
Sourcing candidates for clinical and administrative roles, including the specialty-specific experience that matters in your setting.
Structured interviews and reference work focused on whether someone can do the job you've actually defined.
Getting a new hire productive quickly — systems access, workflow training and a clear picture of what good looks like in your practice.
What happens when someone is sick, on leave or resigns, so a single absence doesn't close the schedule.
Which functions are better bought than built at your size — billing in particular, where one hire concentrates significant risk.
Revisiting the model as volume changes, so the team keeps matching the work rather than drifting out of step with it.
A rough shape for a solo or small practice. Specialty, procedure mix and how much is outsourced all move these considerably.
| Role | Typically needed | What it changes |
|---|---|---|
| Front desk / patient coordinator | At opening | Scheduling, check-in, calls and the first impression most patients form of the practice |
| Medical assistant | At opening for most clinical specialties | Rooming, vitals, clinical support and provider throughput per day |
| Practice manager | At opening or at a defined volume threshold | Who owns the operation day to day when the provider is with patients |
| Billing / RCM | Often outsourced at the start | Whether claims go out clean and whether anyone is watching denials |
| Second MA or clinical support | When provider throughput is capped by rooming | Usually the first hire that directly increases capacity |
| Additional front-office support | When calls or scheduling start going unanswered | Missed calls are missed patients, and they rarely call twice |
The size of the team, the size of the space and the volume you can actually see are the same question asked three ways.
Straight answers, before any conversation. If the answer you need isn't here, a short call is the fastest way to get it.
For most clinical specialties, front-desk or patient coordination and a medical assistant are the two roles needed from day one — one keeps the schedule and the phone working, the other determines how many patients a provider can actually see in a day. A practice manager comes either at opening or at a defined volume threshold, depending on how much the provider wants to own operationally.
It depends far more on workflow and procedure mix than on headcount benchmarks. A useful way in is to count what has to happen before, during and after each visit, multiply by patients per day, and see how many hours of work that creates. That number produces a roster; a generic ratio produces guesswork.
Many small practices are better served outsourcing at the start. A single in-house biller concentrates the entire revenue cycle in one person's knowledge, which creates real exposure if they leave, and it's difficult for one person to keep up with payer rule changes across a full payer mix. Outsourcing also converts a fixed salary into a variable cost while volume is still uncertain.
Set the trigger in advance rather than waiting for strain. Common triggers are provider throughput capped by rooming time, calls going unanswered or to voicemail during business hours, scheduling backlogs building past a set number of days, and administrative work regularly spilling past closing. Naming the threshold ahead of time makes the hire a decision rather than a reaction.
We help define the roles your workflow actually needs, build the staffing model and its growth thresholds, recruit and screen candidates, support onboarding, and plan coverage. The aim is a team that matches the work in front of you, with a clear plan for who gets added as volume grows.
Yes. Growing practices often find the org chart grew by addition rather than design — roles overlap, some work is done twice and some isn't owned at all. Revisiting role definitions against current workflow and volume is usually less expensive and faster than hiring into the gaps.
Build it. Grow it. Run it better.
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