What a physician, a veteran facing amputation, and a cello reveal about physician time, administrative burden, and the healthcare system we are building.
“The administrative burdens physicians shoulder each day
directly affect the patient-physician relationship and unnecessarily interrupt
the delivery of care.” — American
Medical Association (AMA)
Then came the cello.
On September 2, 2026, a remarkable human-interest story
emerged from Loma Linda, California.
Leon Allan Loyd, a U.S. Army veteran, was facing
another amputation.
His medical journey had already taken something enormous
from him. Now another surgery was approaching.
The day before the operation, his physician, Dr. Paul
Kalmansson, did something unusual.
He played the cello.
Not because music could reverse the disease.
Not because Bach could change the surgical plan.
Not because the hospital needed another intervention on the
chart.
Kalmansson played because he wanted his patient to feel that
someone was there.
Kalmansson had earned a master's degree in music before
attending medical school. He chose Bach's Prelude from the G Major Cello Suite
for Loyd.
Loyd later described what the music gave him:
more strength and more hope.
His wife, Sheri Loyd, said Leon called her afterward
and became emotional.
He was grateful.
Very grateful.
And the story became public after the couple's granddaughter
shared video of the performance on social media.
Think about that for a moment.
A physician.
A veteran.
An impending amputation.
A cello.
Bach.
And a few minutes in which nobody was talking about
productivity.
Nobody was talking about throughput.
Nobody was talking about claims.
Nobody was talking about reimbursement.
Nobody was talking about artificial intelligence.
Someone was simply caring for another human being.
And that is where this story becomes much bigger than music.
Because I think healthcare has a time problem.
Not merely a staffing problem.
Not merely a burnout problem.
Not merely an administrative problem.
A time problem.
And we have been trying to solve it with more technology
without first asking the uncomfortable question:
What if the technology is sometimes consuming the very
time it was supposed to save?
The Contrarian Take
Here is my unpopular opinion:
Healthcare does not have a technology shortage.
We have a friction shortage.
Actually, let me say that differently.
We have too much friction.
Physicians have EHRs.
Patients have portals.
Staff have payer websites.
Billing teams have clearinghouses.
Administrators have dashboards.
Executives have analytics.
Everyone has another login.
Everyone has another password.
Everyone has another notification.
Everyone has another queue.
And somehow, after all this technology, someone still ends
up calling the insurance company to ask:
“Where is the claim?”
That should make us laugh.
Except it doesn't.
Because somebody is paying for those minutes.
Usually with time.
And in healthcare, time is not a trivial resource.
Time is clinical capacity.
Time is attention.
Time is listening.
Time is explaining.
Time is thinking.
Time is teaching.
Time is reassuring.
Time is human connection.
Sometimes, apparently, time is also five minutes with a
cello.
The Cello Is the Point
It would be easy to read the story of Dr. Kalmansson and
Leon Allan Loyd and conclude:
“Isn't that nice?”
It is nice.
But I think that misses the point.
The more interesting question is:
Why does this moment feel so extraordinary?
Why does a physician sitting with a frightened patient and
playing music feel almost surprising?
Because modern healthcare has become remarkably good at processing
people.
We are less good at being with people.
We have become very sophisticated at moving information.
We are less sophisticated at protecting attention.
We can transmit a claim electronically.
We can route an authorization.
We can generate a note.
We can calculate a risk score.
We can predict a denial.
We can automate a message.
But none of those things can sit beside a human being who is
about to lose a limb and say:
I am here.
That still requires a human.
And that is precisely why administrative efficiency matters.
Not because we need physicians to see more patients.
Not because every minute must produce another billable unit.
Not because the healthcare system needs to squeeze another
percentage point of productivity from exhausted professionals.
But because human attention is finite.
If we waste it on work that machines and better-designed
systems could handle, we are making a choice.
We are choosing administration over attention.
Even when nobody intended to.
The Healthcare Industry Has a Strange Definition of
Efficiency
Healthcare loves the word efficiency.
But what does efficiency actually mean?
For some organizations, efficiency means:
More patients.
More encounters.
More claims.
More revenue.
Fewer employees.
Shorter cycle times.
Higher collections.
Lower cost per encounter.
All of those metrics can matter.
But there is a dangerous assumption hiding underneath them.
The assumption is that the purpose of efficiency is to
create more throughput.
I disagree.
The highest form of healthcare efficiency should create more
capacity for care.
Those are not the same thing.
Imagine a clinic saves two hours per physician every week.
There are two ways to use those two hours.
Option A:
Book more patients.
Option B:
Give physicians more time to think, communicate, review
complex cases, call patients, mentor staff, coordinate care, or simply finish
the day without taking another pile of work home.
We tend to assume Option A is automatically better.
Why?
Because Option A is easier to measure.
Revenue is measurable.
Claims are measurable.
Visits are measurable.
Hours saved are measurable.
But human connection is harder to put on a dashboard.
That doesn't make it less valuable.
It makes it easier to ignore.
The Administrative Tax Nobody Sees
The American Academy of Family Physicians has described
administrative burden as a major problem for physicians, noting that
administrative tasks can consume approximately half of physicians' time in some
settings.
The AMA likewise describes administrative burden as
something that consumes physician time and focus, interrupts patient care, and
contributes to burnout.
That should change how we talk about medical billing.
Billing is often treated as something that happens after
medicine.
I think that is outdated.
The revenue cycle starts much earlier.
It starts with the information captured during the
encounter.
It starts with documentation.
It starts with coding.
It starts with payer requirements.
It starts with whether the right information is available at
the right time.
It starts upstream.
By the time a claim is denied, the problem may have already
existed hours, days, or weeks earlier.
And then we call someone in the billing department and ask
them to fix it.
That is like discovering a leak in the basement and
congratulating ourselves because we bought a better mop.
The mop matters.
But perhaps we should also fix the pipe.
Three Experts, One Bigger Message
Several physician leaders and professional organizations
have been making versions of this argument for years.
Their approaches differ.
Their specialties differ.
Their technologies differ.
But the direction is remarkably similar.
1. Dr. Paul Kalmansson: Medicine Is Still Human
Kalmansson's contribution to this conversation is not a
policy paper.
It is a cello.
His story reminds us that medicine is not simply the
delivery of clinical interventions.
There is also the experience of being a patient.
Fear matters.
Uncertainty matters.
Dignity matters.
Hope matters.
Presence matters.
Kalmansson explained that he wanted his patient to know he
cared and that music allowed him to communicate that more effectively than
words.
That is a powerful lesson for technology leaders.
Technology should protect the conditions in which
physicians can be human.
It should not make physicians more efficient at becoming
machines.
2. Makrina Shanbour, MD: Fix the System, Not the
Physician
Physician well-being discussions increasingly recognize that
burnout cannot simply be solved by telling physicians to become more resilient.
That is important.
Because if a workflow is dysfunctional, giving the physician
a meditation app does not repair the workflow.
If the EHR is unnecessarily complicated, telling doctors to
“practice self-care” does not simplify the EHR.
If prior authorization is consuming hours, yoga does not
complete the authorization.
If claims repeatedly fail because information is missing
upstream, motivational speeches do not fix the claim.
The system needs work.
The AMA has repeatedly emphasized organizational approaches
to physician well-being and the need to remove obstacles that interfere with
patient care.
That leads to a provocative principle:
Do not train physicians to tolerate broken systems. Fix
the systems.
3. Steven Waldren, MD, MS: Technology Can Help — If We
Use It Correctly
Dr. Steven Waldren, Chief Medical Informatics Officer at the
American Academy of Family Physicians, has written extensively about
administrative burden, documentation and the promise and limitations of AI in
primary care.
His work reflects an important reality:
Technology can reduce burden.
But technology can also create burden.
AI is not automatically the answer simply because it has
“AI” in the name.
A poorly designed AI workflow can become one more system
clinicians have to monitor.
One more dashboard.
One more alert.
One more verification step.
One more thing to learn.
The objective should therefore not be:
“Where can we put AI?”
The better question is:
“Where is human time being wasted, and what is the safest
way to remove that waste?”
That distinction matters.
The AI Industry Has a Problem
Here is another contrarian thought:
The best AI in healthcare may be the AI nobody notices.
We have become fascinated with spectacular demonstrations.
AI writes a note.
AI summarizes a chart.
AI generates an answer.
AI produces an image.
AI writes an email.
Fine.
But what if the most valuable healthcare AI is much less
glamorous?
What if it quietly prevents a claim error before submission?
What if it identifies missing documentation before the
billing team sees the claim?
What if it understands payer-specific rules?
What if it checks eligibility?
What if it recognizes that a seemingly minor documentation
issue is likely to create a denial?
What if it helps structure information before the
downstream mess happens?
Nobody will make a viral video about that.
There will be no robot dancing.
No cinematic soundtrack.
No dramatic product launch.
Just fewer problems.
And fewer problems are often more valuable than impressive
demonstrations.
We Have Been Automating the Wrong End
Much of healthcare technology has historically focused on
what happens after information is created.
The claim is generated.
Then someone checks it.
The claim is denied.
Then someone works the denial.
The authorization is rejected.
Then someone appeals it.
The chart is incomplete.
Then someone chases the physician.
The payer changes a rule.
Then someone discovers it.
The patient receives a bill.
Then someone calls.
This is downstream automation.
It can help.
But it is still reactive.
The bigger opportunity is upstream.
Prevent the problem before it becomes a workflow.
That means asking:
- Was
the right information captured?
- Was it
structured correctly?
- Does
it support the intended code?
- Does
it satisfy payer requirements?
- Is
something missing?
- Is
something contradictory?
- Is
this likely to trigger a denial?
- Can
the problem be corrected while the encounter is still fresh?
This is where clinical-to-claims intelligence becomes
interesting.
The objective is not to turn physicians into coders.
Quite the opposite.
The objective is to keep physicians focused on medicine
while the infrastructure quietly makes the administrative consequences of that
medicine more reliable.
The Five-Minute Test
Here is a simple test I would give every healthcare
technology company.
Ask this:
“What will the physician do with the five minutes your
product saves?”
Not:
“How many clicks did you remove?”
Not:
“How many claims did you process?”
Not:
“What is the accuracy rate?”
Those metrics matter.
But ask the next question.
What happens to the five minutes?
If the answer is:
“Now the physician can see another patient,”
that's useful.
But it is not the only possible answer.
Maybe the physician calls a patient who received a
frightening diagnosis.
Maybe they review a complicated case.
Maybe they explain a treatment plan properly.
Maybe they mentor a younger clinician.
Maybe they eat lunch.
Yes.
Lunch.
Healthcare has somehow reached a point where eating lunch
can sound like a technology use case.
Maybe they go home fifteen minutes earlier.
Maybe they play with their child.
Maybe they sleep.
Maybe they simply stop working.
Those are not failures of productivity.
They are evidence that time was returned to a human being.
The Great Healthcare Productivity Trap
There is a dangerous cycle:
- Technology
saves time.
- Organizations
discover the time.
- The
organization fills the time with more work.
- Productivity
rises.
- The
time savings disappear.
- Everyone
asks for another technology solution.
Repeat.
This is the productivity treadmill.
We keep making people more efficient at doing more work.
At some point we should ask:
What if efficiency is supposed to make work more humane
rather than merely more abundant?
That is a radical idea in modern healthcare.
But perhaps it should not be.
Medical Billing Is Not the Enemy
I want to be careful here.
Medical billing is not evil.
Revenue matters.
Claims matter.
Accurate coding matters.
Compliance matters.
Physician practices cannot survive if they do not get paid.
A clinic with beautiful patient relationships and terrible
cash flow eventually becomes a clinic that closes.
That helps nobody.
So the answer is not:
“Forget billing and focus only on patients.”
That's romantic nonsense.
The answer is:
Build billing infrastructure that respects the clinical
mission.
A physician should not have to choose between caring for
patients and running a financially viable practice.
A clinic should be able to do both.
That requires better infrastructure.
Why Small and Independent Practices Matter
This conversation becomes particularly important for small
and medium-sized physician practices.
Large health systems can have entire departments dedicated
to revenue cycle management.
They can employ analysts.
They can negotiate contracts.
They can build internal teams.
They can absorb implementation costs.
A small physician practice has a different reality.
The office manager may be handling five different functions.
The physician may still be involved in billing decisions.
The staff may be switching between the EHR, payer portals,
clearinghouse systems, spreadsheets, phone calls and email.
The technology stack becomes a patchwork.
One vendor handles one problem.
Another vendor handles another.
A third vendor promises to integrate them.
Eventually the practice needs a consultant to explain why
the integrations don't integrate.
We laugh because it is absurd.
Then somebody gets another denial.
This Is Why I Believe the Future Is Upstream
My own interest in this problem led me to build OnnX
around a simple idea:
Revenue-cycle intelligence should begin closer to the
point where clinical information is created.
Not after the claim fails.
Not after the payer rejects it.
Not after the billing team spends an hour figuring out why.
Earlier.
Much earlier.
The vision is not “AI replaces the billing department.”
It is not “AI replaces physicians.”
It is not “AI replaces staff.”
That would miss the point.
The goal is to create infrastructure that helps humans make
fewer preventable administrative mistakes.
The system should do the repetitive work.
Humans should handle judgment, exceptions, relationships and
accountability.
That is a much more interesting future than simply replacing
people.
Human-in-the-Loop Is Not a Weakness
There is a strange obsession in technology with eliminating
humans from workflows.
I think that is backwards in healthcare.
Healthcare is full of ambiguity.
Clinical judgment is contextual.
Patient preferences matter.
Exceptions happen.
Payers behave inconsistently.
Documentation can be nuanced.
Rules change.
Data can be incomplete.
So the best system is often not:
Human → machine disappears
It is:
Human → machine assists → human verifies when needed
That is not failure.
That is good system design.
The machine handles scale.
The human handles judgment.
The machine remembers rules.
The human understands context.
The machine watches the queue.
The human decides what deserves attention.
That division of labor is much more realistic.
What We Should Stop Automating
Here is where I will be deliberately contrarian.
We should not automate something simply because it is
technically possible.
Some things should remain deeply human.
1. Empathy
Don't automate the moment when someone is scared.
2. Difficult conversations
A chatbot should not become the default interface for every
emotionally significant conversation.
3. Clinical judgment
Decision support can be valuable.
Decision abandonment is not.
4. Accountability
If an automated process causes a serious problem, someone
must own the outcome.
5. Trust
Patients should understand when technology is involved in
their care.
6. Exceptions
The strangest cases are often the ones that require human
attention.
7. The physician-patient relationship
If technology gives physicians more time with patients,
excellent.
If technology becomes another barrier between them, we have
solved the wrong problem.
What We Should Automate Aggressively
Now the other side.
There are tasks where healthcare should be much more
aggressive.
Automate repetitive work.
Automate data checking.
Automate routine status checks.
Automate predictable workflows.
Automate duplicate entry.
Automate claim-quality checks.
Automate administrative reminders.
Automate repetitive payer-rule matching where
appropriate.
Automate the hunting.
Automate the copying.
Automate the reconciliation.
Automate the things humans hate doing and machines are
good at doing.
Then give the human back the time.
That's the deal.
A Practical Five-Step Test for Clinic Owners
If I were running a physician practice today, I would not
begin by asking:
“What AI should we buy?”
I would ask five questions.
Step 1: Find the Time Leaks
Track where physicians and staff spend time for one week.
Not estimates.
Actual time.
Phone calls.
Portal checks.
Claim follow-up.
Prior authorization.
Documentation.
Coding questions.
Denial work.
Eligibility.
Faxing.
Data entry.
Find the leaks.
Step 2: Separate Clinical Work From Administrative Work
Create two buckets.
Only a human should do this.
And:
A machine should probably do this.
You may be surprised how much work sits in the second
bucket.
Step 3: Attack the Upstream Cause
Don't only count denials.
Ask why the denial happened.
Was documentation incomplete?
Was coding wrong?
Was eligibility incorrect?
Was the payer requirement misunderstood?
Was information entered inconsistently?
Was the claim scrubbed properly?
Was the problem detectable earlier?
Move upstream.
Step 4: Measure Time Returned
Do not measure only revenue.
Measure:
- Physician
minutes returned
- Staff
minutes returned
- Denial
rate
- Clean-claim
rate
- Days
in A/R
- First-pass
resolution
- Administrative
touches per claim
- Manual
payer interactions
- Rework
- After-hours
administrative work
And then ask the most important metric:
What did people do with the time we returned?
Step 5: Protect the Savings
This is the step most organizations skip.
If automation saves five hours, don't automatically schedule
five more hours of work.
Decide what the recovered capacity is for.
Patient communication.
Complex cases.
Staff development.
Quality improvement.
Professional development.
Or simply sustainability.
Otherwise, automation becomes a machine for creating more
work.
The ROI We Don't Put on the Spreadsheet
Suppose an administrative improvement saves a physician one
hour a week.
The obvious calculation is financial.
But there are other returns.
One hour may mean:
One difficult patient conversation.
One family phone call.
One chart reviewed more carefully.
One trainee taught.
One staff member supported.
One less late night.
One less weekend spent catching up.
One additional moment of presence.
Not everything valuable in healthcare appears as revenue.
Some things appear as capacity.
Some appear as trust.
Some appear as better decisions.
Some appear as less exhaustion.
And some appear as a physician sitting beside a frightened
patient with a cello.
The Most Dangerous Word in Healthcare Technology
The word is:
More.
More patients.
More claims.
More automation.
More dashboards.
More data.
More alerts.
More productivity.
More throughput.
More revenue.
More features.
More integrations.
More AI.
More.
More.
More.
Perhaps the healthcare technology industry should become
obsessed with another word:
Enough.
Enough alerts.
Enough clicks.
Enough duplication.
Enough portals.
Enough manual reconciliation.
Enough administrative noise.
Enough work that nobody should have been doing manually in
the first place.
Because sometimes the greatest technology achievement is not
producing more.
It is eliminating what never needed to happen.
A Myth We Need to Kill
Myth:
“If AI makes physicians more productive, healthcare
automatically improves.”
No.
Not automatically.
Productivity without purpose can make a bad system worse.
If AI helps a physician complete documentation faster and
the organization immediately fills the recovered time with more appointments,
the patient may not experience the benefit.
If AI helps billing process twice as many claims but creates
another verification queue, staff may not experience the benefit.
If an AI tool saves ten minutes but requires twenty minutes
of setup, training and monitoring, congratulations:
You invented a new job.
Technology should be judged by net burden, not
theoretical efficiency.
Another Uncomfortable Question
Why do we celebrate technology that saves a physician ten
minutes...
and then use those ten minutes to schedule another patient?
Maybe that's appropriate.
Sometimes it is.
But sometimes the better question is:
What would happen if we used those ten minutes to make
the existing patient experience better?
Healthcare has spent decades optimizing volume.
Perhaps the next era should optimize attention.
The Cello and the Claim
This brings us back to Leon Allan Loyd.
Imagine two versions of healthcare.
In Version One, Dr. Kalmansson finishes his administrative
work late.
He has charts.
Messages.
Documentation.
Billing questions.
Administrative interruptions.
He is exhausted.
There is no cello.
There is no extra time.
There is no special moment.
In Version Two, the infrastructure around him works better.
The repetitive administrative work is reduced.
The physician has more capacity.
And one day, instead of clicking through another queue, he
sits down with his patient.
He plays Bach.
The disease is still there.
The operation is still coming.
The medicine has not changed.
But the experience of medicine has changed.
That difference matters.
Recent Healthcare News Is Telling Us Something
The broader healthcare conversation is moving in the same
direction.
The AMA continues to focus on reducing administrative burden
and identifying workflow and technology barriers that prevent physicians from
spending more time with patients.
The AAFP has similarly emphasized administrative burden as a
major threat to the physician experience and has highlighted technologies that
can reduce burdens such as documentation and prior authorization.
And current physician discussions around AI increasingly
recognize that its value is not simply generating impressive outputs. The real
opportunity is reducing work that consumes professional time without adding
equivalent clinical value.
The trend is clear.
The question is whether we will use technology to give
time back or simply to fill every empty minute with more work.
Three Things I Would Change Tomorrow
If I had the authority to redesign a physician practice
tomorrow, I would start with three rules.
Rule #1: Protect Physician Attention
Do not allow low-value administrative interruptions to
compete constantly with clinical work.
Attention is a scarce resource.
Treat it like one.
Rule #2: Move Problems Upstream
Don't celebrate fixing a denial.
Celebrate preventing the denial.
Don't celebrate correcting missing information.
Celebrate capturing it correctly the first time.
Don't celebrate finding a billing error.
Celebrate never creating it.
Rule #3: Measure Human Capacity
Revenue matters.
Productivity matters.
But measure physician time and staff time too.
Because a healthcare system that collects more money while
consuming every remaining minute of its people may be financially efficient and
humanly bankrupt.
The Legal and Ethical Question
There is also an important compliance issue here.
Automation does not eliminate responsibility.
Healthcare organizations still need appropriate controls
around:
HIPAA and privacy.
Data security.
Access controls.
Auditability.
Coding compliance.
Documentation integrity.
Payer requirements.
Human oversight.
Transparency.
Vendor accountability.
A system that automatically makes a decision should not
become a black box that nobody understands.
The more consequential the decision, the more important
explainability and oversight become.
The goal is not:
“The AI did it.”
The goal is:
“The system assisted, the workflow was auditable, and the
appropriate human remained accountable.”
That distinction will become increasingly important as AI
moves deeper into healthcare operations.
The Five Questions Every Healthcare Founder Should Ask
If you are building healthcare technology, ask yourself:
1. What human problem am I actually solving?
Not what feature are you building.
What problem?
2. Am I removing work or moving work?
This is a killer question.
If you eliminate one task but create three verification
tasks, you haven't eliminated burden.
You've redistributed it.
3. Does my technology protect attention?
If not, why not?
4. Can the user understand why the system made a
recommendation?
If not, what happens when it is wrong?
5. What does the human do with the time I give back?
If you cannot answer that question, you may be optimizing
the wrong thing.
The Future of Healthcare May Be Less About AI Than We
Think
The future will certainly contain more AI.
But I don't think the defining question will be:
“How intelligent is the AI?”
It may be:
“How intelligently did we redesign the work?”
AI inside a broken workflow can simply create a faster
broken workflow.
AI inside a well-designed workflow can remove friction.
That is a much bigger opportunity.
The winners may not be the companies with the most
impressive demonstrations.
They may be the companies that quietly remove thousands of
tiny frustrations every day.
No applause.
No headlines.
No futuristic robot.
Just fewer interruptions.
Fewer errors.
Fewer denials.
Fewer clicks.
Fewer calls.
Fewer unnecessary handoffs.
More attention.
More capacity.
More human work.
And That Is Why I Keep Thinking About the Cello
Dr. Paul Kalmansson could not save Leon Allan Loyd from the
reality he was facing.
But he could change how Leon experienced that reality.
That distinction is enormous.
Medicine cannot always change the outcome.
But physicians can influence the experience.
And technology should help them do that.
Not by pretending machines can replace compassion.
Not by turning every human interaction into a workflow.
Not by measuring every minute solely by revenue.
But by removing unnecessary work around the people doing
necessary work.
That is the promise I see in healthcare technology.
Not a hospital full of robots.
Not physicians replaced by algorithms.
Not endless automation.
Something much more practical.
A physician with enough time to be a physician.
My Hot Take
We have spent years asking:
“How can we make doctors more productive?”
I think we should ask:
“How can we make doctors less interrupted?”
Those are not the same thing.
A more productive physician can see more patients.
A less interrupted physician may listen better.
Think more clearly.
Notice something subtle.
Explain something better.
Call someone back.
Teach.
Rest.
Or sit down and play music for a patient who is afraid.
Maybe that is the future we actually want.
What I Got Wrong About Efficiency
For years, healthcare has trained us to think about
efficiency as doing something faster.
But speed is only one dimension of efficiency.
The deeper question is whether the work should exist at all.
A five-minute task that should never have existed is not
efficient just because we completed it in four minutes.
That is not efficiency.
That is optimized waste.
And healthcare has plenty of it.
The future belongs to organizations willing to ask:
What should disappear?
The OnnX Thesis
This is ultimately what drives my work with OnnX.
I don't believe physicians need another piece of software
demanding their attention.
They need infrastructure that quietly removes friction.
I don't believe AI should replace the people who understand
patients.
I believe AI should help remove repetitive administrative
work that keeps those people away from patients.
I don't believe the objective of medical billing technology
should be to make healthcare feel more transactional.
I believe it should help make the administrative side of
medicine less visible to the people who are trying to practice medicine.
That means moving from:
reactive → predictive
downstream → upstream
manual → intelligent
fragmented → connected
transactional → contextual
more work → more capacity
That is a different vision of healthcare technology.
And I think it is worth pursuing.
A 30-Day Experiment for Any Practice
You don't need to buy a new AI system tomorrow.
Start with observation.
For 30 days, track five things:
1. Administrative interruptions per physician
2. Manual billing touches per claim
3. Preventable denials
4. Time spent on payer-related work
5. After-hours administrative work
Then ask:
What are the top three sources of wasted human attention?
Don't start with technology.
Start with the waste.
Then decide whether technology, process redesign, staffing,
training or policy change is the best solution.
Sometimes the answer will be AI.
Sometimes it won't.
That's okay.
Good healthcare innovation is not about selling AI.
It is about solving problems.
Metrics That Actually Matter
Healthcare leaders should continue tracking traditional
financial metrics.
But add human-capacity metrics.
Consider measuring:
- Physician
administrative minutes
- Staff
administrative minutes
- Denial
rate
- Clean-claim
rate
- Days
in accounts receivable
- Claim
rework
- Number
of manual touches
- Payer
portal interactions
- Prior-authorization
turnaround
- After-hours
work
- Physician
satisfaction
- Staff
satisfaction
- Patient
communication time
The goal is not to make every metric rise.
The goal is to understand where the system is consuming
human capacity.
Questions Worth Asking Your Team
At your next practice meeting, don't ask only:
“Are we collecting enough?”
Ask:
What administrative task annoys everyone?
What task do we repeat every day?
What information do we enter twice?
What do we manually check that should be automatically
checked?
What causes the most rework?
What creates the most interruptions?
What keeps physicians after hours?
What could we prevent rather than repair?
And finally:
If we gave everyone five hours back next month, what
would we want them to do with it?
That answer tells you what your technology strategy should
actually be.
The Bigger Lesson
The story of Leon Allan Loyd and Dr. Paul Kalmansson is
emotionally powerful because it contains something technology cannot
manufacture on command.
Presence.
A physician saw a human being.
Not a case.
Not a diagnosis.
Not a claim.
Not an encounter number.
A person.
And for a few minutes, he gave that person something
medicine sometimes struggles to find:
time.
That is why the story matters.
Because healthcare technology should ultimately be judged by
what happens to the human beings on the other side of the screen.
If technology gives physicians more time to care, it is
doing something valuable.
If it gives staff more capacity to solve problems, it is
doing something valuable.
If it reduces errors before they become expensive downstream
problems, it is doing something valuable.
If it allows a frightened patient to receive more attention
from the person caring for them, it is doing something valuable.
But if technology merely creates more screens, more alerts,
more workflows, more verification and more work...
we shouldn't call that innovation.
We should call it administrative inflation.
Three Things I Want Healthcare Leaders to Remember
Protect physician attention.
Move administrative problems upstream.
Measure success by the human capacity your technology
creates—not simply the transactions it processes.
Get Involved
Here is the uncomfortable question I want to leave with
physicians, clinic owners, healthcare executives and healthcare technology
builders:
If we could give every physician five additional minutes
with every patient, what would they do with those five minutes?
Would they listen?
Explain?
Think?
Teach?
Reassure?
Call a family member?
Or perhaps, once in a while, do something completely
unexpected.
Like play Bach.
I would genuinely like to hear your answer.
Comment below: What is the single administrative task
that steals the most valuable time from you or your clinical team?
And if this perspective resonates with you, share or
repost it.
The conversation about healthcare technology should not be
limited to what AI can do.
It should include what humans can finally do when
unnecessary work gets out of their way.
Final Thoughts
Technology should not make physicians better machines. It
should give physicians more room to be human.
The best administrative system is not the one that
processes the most work. It is the one that prevents unnecessary work from
reaching the people who should be caring for patients.
The ultimate ROI of healthcare technology may not be
another claim processed. It may be another human moment made possible.
Frequently Asked Questions
Is this article arguing against medical billing
technology?
No.
Quite the opposite.
Accurate, efficient billing is essential to practice
sustainability. The argument is that billing technology should be designed
around the clinical mission rather than operate as an isolated financial
function.
Is AI going to replace medical billing staff?
Some repetitive tasks will increasingly be automated.
That does not necessarily mean humans disappear.
The more likely model is that technology handles repetitive
work while people handle exceptions, judgment, communication, compliance and
accountability.
Why connect a cello performance to medical billing?
Because both involve the same scarce resource:
human time.
The cello story demonstrates what can happen when a
physician has the time and inclination to provide meaningful human presence.
Administrative inefficiency can reduce that available
capacity.
Isn't physician productivity important?
Absolutely.
But productivity should not automatically mean seeing more
patients.
It can also mean spending more attention on complex
patients, improving communication, reducing errors, mentoring staff or
sustaining a healthier clinical practice.
What is the upstream revenue-cycle problem?
Many downstream billing problems originate earlier in the
workflow.
Documentation, coding, eligibility, payer requirements and
data quality can influence what happens when a claim is eventually submitted.
The earlier a problem can be identified, the less expensive
and disruptive it may be to correct.
Should every medical practice adopt AI?
No.
A practice should adopt technology when it solves a clearly
identified problem better than the alternatives.
Sometimes that means AI.
Sometimes it means workflow redesign.
Sometimes it means better training.
Sometimes it means hiring the right person.
Technology should serve the problem, not the other way
around.
What should physicians look for in healthcare AI?
Look beyond the demo.
Ask:
Does it reduce net workload?
Does it integrate into the existing workflow?
Can users understand its recommendations?
Does it preserve human oversight?
Is patient data protected?
Can the organization audit what happened?
Does it actually save time?
And perhaps the most important question:
What will the physician do with the time saved?
Three References From This Week
1. Dr. Paul Kalmansson and Leon Allan Loyd: The Cello
Before Amputation
ABC7 Los Angeles reported on September 2, 2026, how Dr. Paul
Kalmansson played Bach on the cello for U.S. Army veteran Leon Allan Loyd
before Loyd underwent amputation surgery, giving him strength and hope during
an extraordinarily difficult moment.
ABC7
Los Angeles — Loma Linda doctor's cello performance gives veteran patient hope
2. AMA: Reducing Administrative Burden
The American Medical Association continues to emphasize that
administrative burden consumes physician time and focus and can interfere with
patient care, reinforcing the need to redesign workflows rather than simply ask
physicians to work harder.
AMA
— Reducing Administrative Burden
3. AAFP: Relieving Administrative Burden
The American Academy of Family Physicians identifies
administrative work as a major burden on physicians and highlights technology
and workflow innovations designed to reduce documentation, prior authorization
and other administrative demands.
AAFP — A Guide
to Relieving Administrative Burden
Tools and Resources
For practice leaders evaluating administrative technology,
start with the fundamentals:
Workflow mapping — identify where information enters,
moves and breaks.
Denial analysis — determine the actual causes of
denials rather than simply counting them.
Time tracking — measure administrative minutes rather
than relying on assumptions.
Payer-rule monitoring — identify changes before they
create downstream problems.
Documentation review — find recurring information
gaps.
Human-in-the-loop AI — automate repetitive work while
preserving appropriate human oversight.
Audit trails — make important automated decisions
traceable.
Security controls — protect patient information
throughout the workflow.
The Future Outlook
Healthcare is not heading toward a world where machines
simply replace people.
It is heading toward a much messier and more interesting
world.
Humans and machines will work together.
The challenge will be deciding which work belongs to
which.
Machines are exceptionally good at repetition.
Humans are exceptionally good at context.
Machines can monitor thousands of transactions.
Humans can recognize when something doesn't feel right.
Machines can remember rules.
Humans understand relationships.
Machines can identify patterns.
Humans decide what those patterns mean in context.
The future belongs to systems that understand this division
of labor.
And the best healthcare technology may ultimately be almost
invisible.
Patients may never know it exists.
Physicians may barely notice it.
Staff may simply wonder why the day feels less chaotic.
Claims may move more cleanly.
Errors may be caught earlier.
Denials may decline.
Workflows may become quieter.
And somewhere in that quieter system, a physician may have
enough time to sit beside a patient.
Maybe talk.
Maybe listen.
Maybe hold a hand.
Maybe play a cello.
That is not a productivity failure.
That is the point.
About the Author
Dr. Daniel Cham is a physician and medical consultant
whose work spans medical technology consulting, healthcare management and
medical billing. His focus is practical: helping healthcare professionals and
organizations navigate complex challenges at the intersection of medicine,
technology, operations and the business of practice.
Connect with Dr. Cham on LinkedIn:
This article represents the author's professional
perspective and is intended for educational and informational purposes. It does
not constitute legal, medical, coding, billing or compliance advice. Healthcare
organizations should obtain appropriate professional guidance for decisions
involving their specific circumstances.
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One Last Thought
If this perspective resonates with you, consider reposting
it.
Not to promote a product.
Not to promote a technology.
But to help other physicians, clinic owners and healthcare
leaders rethink a deceptively simple question:
What would healthcare look like if we stopped asking
humans to do work machines could safely do—and started giving humans back the
time to do what only humans can do?
Because Leon Allan Loyd did not need another transaction.
He needed a physician.
And for a few minutes, Dr. Paul Kalmansson gave him
exactly that.
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#HealthcareTechnology #DigitalHealth #PatientCare #MedicalPractice
#PhysicianWellbeing #AIinHealthcare #HealthcareInnovation #IndependentPractice
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