"Every system is perfectly designed to get the
results it gets." — Paul Batalden, MD
The Most Important Healthcare Story I Read This Week Had
Nothing to Do with Healthcare.
An 18-year-old refugee fled Gaza carrying only what could
fit into her pockets.
She lost her home.
She lost her school.
She lost a year of her life.
In Saudi Arabia, she couldn't enroll in school.
She sent a message asking for help.
A Jewish educator thousands of miles away saw the message
and decided to act.
No committee.
No prior authorization.
No appeal process.
No vendor agreement.
No revenue cycle optimization consultant.
One person simply saw another human being trapped inside a
broken system and asked:
"How do I help?"
Eventually, the teenager made it to the United States,
enrolled in school, graduated, and delivered a commencement speech receiving a
standing ovation.
Politics aside, her story reminded me of something
uncomfortable.
Many physicians are trapped in systems too.
Not war zones.
Not refugee camps.
Administrative ecosystems.
And unlike refugees, physicians are paying handsomely to
remain there.
A Contrarian Observation
Physicians do not have a billing problem.
Physicians have a dependency problem.
That statement may sound provocative.
For decades, independent practices have been taught a simple
narrative:
If billing becomes difficult, outsource it.
Claims delayed?
Hire a billing company.
Denials increasing?
Hire consultants.
Revenue shrinking?
Buy another dashboard.
Collections falling?
Change vendors.
Maybe.
But perhaps the better question is this:
Why are highly educated physicians outsourcing visibility
into the financial lifeblood of their own practices?
If a surgeon outsourced operative reports and only saw
monthly summaries, we would consider that absurd.
If a cardiologist outsourced ECG interpretation without
review, we would question clinical oversight.
Yet many physicians have little idea:
- What
percentage of claims are denied;
- Which
payer creates the most friction;
- How
long receivables sit untouched;
- Whether
staff workflows are helping or hurting collections;
- How
much revenue quietly leaks every month.
That is not because physicians lack intelligence.
It is because healthcare normalized opacity.
Healthcare's Biggest Lie
Healthcare likes to call administrative burden a staffing
issue.
It isn't.
Healthcare calls physician burnout a resilience issue.
It isn't.
Healthcare calls declining margins an economic issue.
Sometimes they are.
But increasingly, these are systems design failures
masquerading as people problems.
The physician who stays until 8 PM completing charts isn't
inefficient.
The clinic manager chasing unpaid claims isn't disorganized.
The front desk employee correcting eligibility errors isn't
incompetent.
People are often performing heroically inside badly designed
systems.
And heroism is not a scalable operational strategy.
The Hidden Tax Nobody Discusses
Independent medicine is being taxed.
Not by governments.
Not by inflation.
By friction.
Tiny moments of friction.
Five minutes verifying eligibility.
Seven minutes calling payers.
Ten minutes locating missing documentation.
Fifteen minutes appealing denials.
Thirty minutes reconciling reports.
Individually insignificant.
Collectively devastating.
Thousands of micro-frustrations become:
Missed lunches.
Late evenings.
Family sacrifices.
Hiring freezes.
Delayed equipment purchases.
Reduced patient access.
Eventually, physicians start asking a dangerous question:
"Is independence worth it?"
That question should concern everyone.
A Hot Take
Most physicians did not build businesses.
They inherited administrative machinery.
And much of that machinery was designed decades ago.
Think about it.
Amazon can tell you where a $14 package is within seconds.
Banks can detect fraud in milliseconds.
Ride-sharing apps predict arrival times with remarkable
accuracy.
Yet healthcare still accepts explanations like:
"We'll follow up with the payer next week."
"The billing team is looking into it."
"We'll know more at month end."
Imagine saying that to a patient.
Healthcare tolerates operational uncertainty that other
industries abandoned years ago.
Three Insights Physician Owners Should Consider
Insight #1
Outsourcing is not inherently bad.
Outsourcing blindness is.
Delegation without transparency creates dependency.
Transparency creates trust.
Insight #2
AI should not replace billing staff.
AI should replace waiting.
Waiting for reports.
Waiting for answers.
Waiting for vendors.
Waiting for month-end surprises.
Insight #3
The future winners in independent medicine may not be those
with the most patients.
They may be the physicians who understand their own
operational data better than anyone else.
Three Experts We Should Listen To
Sir William Osler
Medicine succeeds when patients remain at the center.
Peter Drucker
"What gets measured gets managed."
Healthcare often measures clinical outcomes while neglecting
operational dysfunction.
Atul Gawande
Complex work benefits from systems, checklists, and
thoughtful process design.
Healthcare administration deserves the same discipline
applied to surgery.
Questions Worth Asking Yourself
If your billing company disappeared tomorrow:
Could you explain your denial rate?
Could you identify your top five payers?
Could you estimate your clean claim rate?
Would you know where cash flow problems begin?
If not, perhaps the issue isn't billing.
Perhaps it is ownership.
Practical Advice for Small Practices
Start simple.
Track five metrics.
Days in Accounts Receivable
Denial Rate
Net Collection Percentage
First Pass Resolution
Average Days to Payment
Review them monthly.
Look for trends.
Ask uncomfortable questions.
Don't accept "that's just healthcare" as an
answer.
Final Thoughts
An 18-year-old refugee rebuilt her future because someone
challenged the assumption that broken systems must stay broken.
Healthcare needs more people willing to challenge
assumptions.
Maybe physicians don't need more vendors.
Maybe they need more visibility.
Maybe burnout isn't inevitable.
Maybe independent medicine is still worth saving.
And maybe the next era of physician entrepreneurship won't
be defined by seeing more patients.
It will be defined by reclaiming ownership over the systems
that quietly determine whether independent practices survive.
Here's my question:
What is one administrative task in your practice that
consumes energy but creates almost no value?
Share your experience below.
Someone else may discover they are not struggling alone.
If this perspective resonates, consider ♻️
reposting to help physicians and clinic owners rethink what billing should look
like in modern medicine.
About the Author
Dr. Daniel Cham is a physician and medical consultant with
expertise in medical technology, healthcare management, and medical billing. He
focuses on delivering practical insights that help professionals navigate
complex challenges at the intersection of healthcare operations and innovation.
Connect with Dr. Cham on LinkedIn to
learn more.
Continue the Conversation
Explore practical insights, evidence-based strategies,
and behind-the-scenes perspectives that help physicians and clinic leaders
navigate complex challenges.
- Visit
the personal website
- Listen
to the podcast on Spotify
- Subscribe
and watch on YouTube
- Follow
updates on X (Twitter)
- Follow
on
Facebook
- Discover AI-powered medical billing solutions for busy physicians
- Connect professionally on LinkedIn
Knowledge drives progress — start your journey today.
#HealthcareLeadership #PhysicianEntrepreneur
#IndependentPractice #MedicalBilling #HealthcareAI #RevenueCycleManagement
#PracticeManagement #BurnoutPrevention #DigitalHealth #PhysicianLeadership
References
1. Physician burnout continues to improve overall, but
administrative burden remains a major contributor to professional
dissatisfaction and workforce instability.
American
Medical Association – Physician Burnout Rates Are Falling, but Specialty Gaps
Remain
2. Electronic prior authorization initiatives are intended
to reduce unnecessary paperwork, improve interoperability, and lessen
administrative demands on clinicians.
Centers
for Medicare & Medicaid Services – Electronic Prior Authorization Overview
3. Physicians spend substantial time outside scheduled
clinic hours completing documentation and administrative tasks, highlighting
the need for workflow redesign and technology-enabled efficiencies.
American
Medical Association – Doctors Work Fewer Hours, but the EHR Still Follows Them
Home
No comments:
Post a Comment