How I Built a Fulfilling, High-Volume Practice Without Burnout
Primary care is often seen as one of the most challenging fields in medicine—high patient volumes, evolving regulations, and increasing administrative burdens. Yet, after more than 25 years in practice, I still love what I do.
My days are fast-paced, dynamic, and rewarding. I’ve built a thriving, high-volume practice, taken on leadership roles, and diversified my income streams—all while maintaining a fulfilling personal life.
In this article, I’ll share:
How to build a high-efficiency practice without burnout
The importance of diversifying income streams in medicine
Strategies for work-life balance as a woman in medicine
Why staying adaptable is the key to long-term success
Whether you're a medical student, resident, or seasoned physician looking to refine your approach, I hope my journey provides insight and inspiration.
How I Built a High-Efficiency Primary Care Practice
Running a busy primary care practice means seeing 30-40 patients a day. While that might sound overwhelming, I’ve structured my workflow to make it efficient and sustainable.
The key?
Delegation and a well-trained, happy team.
I’ve had the same core team for nearly two decades. Each staff member has a specific role—one handles referrals, another manages home health paperwork, another oversees medication adherence. This structure allows me to focus on patient care without getting buried in administrative tasks.
Keeping my staff happy is also crucial. I invest in their growth, cover extra education costs, and create a workplace culture where they feel valued. We celebrate holidays, have fun traditions, and make sure work is a place they enjoy coming to. When your team feels respected and supported, they work more efficiently, and the entire practice benefits.
Here are some of my top tips:
The Power of Delegation: Building a Strong Support Team
A high-volume practice only works if you have a well-trained, efficient team that you can trust. My staff members each have designated roles—handling referrals, medication adherence, home health paperwork, and more—so I don’t get bogged down with administrative tasks.
By clearly defining responsibilities, I ensure smooth workflows and better patient care.
Keeping Your Staff Happy: The Key to Retention and Efficiency
My team has been with me for 17-26 years, which is almost unheard of in medicine.
Retaining great staff means investing in them—whether it’s paying for extra education, creating a positive work environment, or simply buying lunch every Friday.
A happy team works more efficiently, leading to better patient experiences and a more sustainable practice.
Streamlining Workflows to Reduce Physician Burnout
Efficiency isn’t just about delegation—it’s also about creating systems that reduce unnecessary work.
I use electronic medical records (EMRs) to track labs, imaging, and medications in real time. I also review and sign off on paperwork daily to avoid it piling up.
These small habits prevent burnout and allow me to focus on actual patient care instead of administrative chaos.
On-Site Lab Services: A Game Changer for Patient Compliance
One of the smartest decisions I made was bringing lab services in-house. When patients have to go elsewhere for labs, only 50-60% actually follow through.
By offering labs on-site, I ensure better patient compliance, faster diagnoses, and improved continuity of care.
Why Diversifying Income Streams is Essential
In an era of falling reimbursements, financial stability in medicine requires more than just patient visits. I’ve intentionally built multiple revenue streams to ensure my practice remains viable while allowing me flexibility.
Here’s what that looks like for me:
Aviation Medicine: As an FAA-certified aviation medical examiner, I see pilots and air traffic controllers for required physicals. This is an all-cash service that supplements my income.
Teaching: I work with UT Southwestern medical students, which is both fulfilling and an additional income source.
Hospice Directorship: I serve as a hospice director, adding another revenue stream while allowing me to care for patients throughout their lives.
Medicare Quality Metrics: Primary care physicians are increasingly graded on quality metrics like medication adherence and preventative care. By meeting these benchmarks, I maximize reimbursements for my practice.
Having diversified income streams protects me from financial instability and allows me to practice medicine on my terms.
Takeaway: If you’re in medicine, look beyond patient visits for income. Consider consulting, teaching, directorship roles, or niche certifications that align with your interests.
Work-Life Balance as a Woman in Medicine
Balancing a demanding career with motherhood hasn’t always been easy, but I’ve learned that having a strong support system is non-negotiable.
I had my first child in medical school and my second in residency—both incredibly tough periods. My saving grace was my mother, who stepped in as a caregiver. Later, daycare became an essential part of my children’s upbringing, offering socialization and early education.
One thing I always emphasized with my kids: Yes, my work is important, but nothing is more important than them. They knew they could call me anytime, and I would be there. That constant reassurance built a strong bond, despite my busy schedule.
Now, my daughter is a physician herself, juggling residency and motherhood. I remind her—and every other working mom—that a fulfilled, happy mother makes a better mother. Whether your fulfillment comes from staying home or from working, what matters most is that your child sees you thriving.
Takeaway: Don’t let guilt hold you back. Prioritize quality time with your kids and build a support system that allows you to succeed at work and at home.
The Key to Longevity in Medicine
One of the biggest mistakes I see in medicine is failing to adapt.
The healthcare landscape is constantly changing—whether it’s Medicare rules, new technology, or evolving patient needs. The physicians who struggle most are the ones who resist these changes instead of learning how to navigate them.
I approach medicine the way I approached sports: It’s a game. You learn the rules, play smart, and adapt when the rules change.
Every year, Medicare introduces new metrics and regulations, and instead of feeling overwhelmed, I see it as just another challenge to tackle.
I also embrace technology. My practice implemented electronic medical records (EMRs) 25 years ago—long before it was the norm. Today, I can’t imagine running a practice without one. While new systems always have a learning curve, they ultimately improve efficiency and patient care.
Takeaway: Medicine is an ever-evolving field. Stay adaptable, embrace technology, and view challenges as opportunities to grow.
Final Thoughts
After 25+ years in medicine, I still wake up excited to go to work. I love the relationships I’ve built with patients—many spanning four generations. I love the variety in my day. And I love knowing that my work makes a tangible difference in people’s lives.
If you’re a woman in medicine, know this: You can build a career that is both fulfilling and financially sustainable. Invest in your team, diversify your income, embrace change, and most importantly, find a way to enjoy the journey.
What’s one change you can make this week to create a more sustainable and fulfilling medical career?
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