If you’ve ever been stuck at the DMV watching the line creep forward at glacial speed, you’ve experienced poor workflow design firsthand. Remember Flash, the slow-moving sloth from Disney’s Zootopia? He’s the perfect visual for a bottleneck—a single point in a process that slows everything else down.
In operations management, we study how systems function—whether it’s a DMV, a car assembly line, or yes, even a busy DPC practice. When one step takes longer than the others or is poorly coordinated, it creates a logjam that impacts the entire patient experience. The good news? These inefficiencies can be identified, improved, and even eliminated.
The DMV Example (and Why It Matters)
Imagine a simplified DMV workflow:
Now imagine that Flash is the one verifying identities—and he takes 10 minutes per person while all other steps take 2 minutes. What happens? The line backs up at Flash’s station. Staff at other stations sit idle. Customers wait, annoyed. Throughput drops, and satisfaction tanks.
That’s exactly what happens in DPC practices when workflow bottlenecks go unaddressed.
Where DPC Practices Get Clogged
Even though DPC is leaner than traditional insurance-based practices, many of us still suffer from Flash-style bottlenecks—especially as our practices grow. Here are some common areas where DPC docs tend to get overwhelmed:
- New patient inquiries: Without a clear intake process, new patient interest can sit in your inbox for days, or worse, never get converted into a visit.
- Monday morning messages: A flood of texts and messages from the weekend or overnight can derail your entire morning if there’s no triage system in place.
- Email overload: Inbox sprawl is real. If you check email throughout the day without batching or delegation, it can eat up hours of deep focus time.
- Vaccines and documentation: Administering vaccines is quick. Logging them into the EHR, notifying the registry, updating the school form, and tracking inventory? That’s the real time sink.
- Membership billing follow-up: If no one’s monitoring failed charges, missed payments can pile up. Without a clear protocol for follow-up, you risk revenue loss and uncomfortable conversations.
Key Operations Concepts to Know (and How to Apply Them in DPC)
1. Identify Bottlenecks
In operations management, a bottleneck is the slowest point in a process that limits the overall flow. It’s where work backs up, frustrations grow, and your time gets swallowed. The key is to spot the bottleneck early—then fix it strategically.
In practice
Start by observing your day or week. What repeatedly derails your schedule? Maybe you spend too much time trying to track down vaccine records or answering non-urgent patient questions that pile up overnight. Make a short list of the top 2–3 time drains and ask, “Could someone else do this? Could this be automated or streamlined?”
Use a simple log for one week to track how much time you’re spending on admin tasks versus clinical work. The patterns will help you identify your “Flash” (bottleneck) in disguise.
2. Reduce Variability with Standardization
Standardization isn’t so great when it comes to dealing with our patients, but can be a lifesaver when managing operational processes. When every process is done slightly differently each time, it creates confusion, mental load, and wasted time. Standardization—using checklists, templates, and protocols—helps you perform repeatable tasks faster, more consistently, and with fewer errors.
In practice
Instead of handling every new patient inquiry manually, develop a standard response template and intake form that can be sent automatically or by an assistant. For vaccines, use a laminated step-by-step checklist in your exam room: administer the shot, log it in the EMR, update the state registry, mark inventory, print documentation if needed.
Create standard operating procedures (SOPs) for 3–5 tasks you repeat regularly: new patient onboarding, vaccine documentation, failed billing follow-up, and end-of-day review. Use these SOPs to train a part-time MA or virtual assistant to take those tasks off your plate. AI tools like ChatGPT can help you create SOP templates that you or your staff then customize to your office’s needs.
3. Batch Tasks to Minimize Context Switching
Jumping between tasks is one of the biggest hidden productivity killers. Every time you shift from patient care to email to billing to texting, you lose time regaining focus. Batching allows you to group similar tasks together, work more efficiently, and reduce burnout.
In practice
Instead of checking messages and email constantly throughout the day, set aside dedicated blocks—like 8:00–10:00 AM on Monday mornings—for admin tasks only. This gives you space to catch up on weekend messages, update charts, return calls, and prep for the week.
Batch your inboxes: handle text messages at 8 AM and 4 PM, process email once per day (not hourly), and review billing issues every Friday. Let patients know your message turnaround window so they don’t expect real-time responses, and use an auto-reply if needed.
4. Delegate or Automate Low-Value Tasks
Many DPC physicians try to do everything themselves at first. But as your panel grows, this leads to overwhelm. Delegation doesn’t just mean hiring a full-time employee—it can start small, and grow as you do.
In practice
Hire a part-time office assistant, MA, or virtual assistant (VA) for just 5–10 hours a week. They can help with tasks like new patient communication, reconciling billing issues, scheduling, logging vaccine inventory, and following up on missing labs. Premedical students at your local university can make great and eager assistants who are willing to work part-time.
Start by outsourcing one category of task (e.g., follow-up on overdue membership payments or scheduling new patients). Train your assistant once using Loom or SOPs, and you’ll save hours every week going forward.
5. Build Slack Into the System
Running at 100% efficiency sounds ideal—but in reality, it leaves you no room for surprises. A sick kid, broken EHR, or missed delivery can derail your day if you don’t have built-in flexibility. That’s where slack comes in: purposeful breathing room in your schedule or systems that allows you to absorb small disruptions without panic.
In practice
Instead of booking your schedule solid from 8 to 5, leave a buffer after lunch or at the end of the day for catch-up or overflow. Consider seeing patients only 3.5 to 4 days per week, and using half a day for administrative work and system improvement.
Protect Monday mornings as a non-patient time block to catch up on messages and prep for the week. Use a calendar system that reflects your true availability and builds in time to breathe. Patients will adapt if the care they receive is consistent and responsive.
Final Thought
Running a DPC practice means being both the doctor and the operations manager. As your panel grows, what worked when you had 50 patients might not work at 150. If you’re feeling stressed or scattered, chances are your system—not your skills—is the problem.
Operations management gives us the tools to work smarter, not harder. And the sooner you spot your own “Flash,” the sooner your day starts flowing again.
If you’d like more guidance launching or growing your own direct care practice, DPC Pediatrician offers a free startup guide, a Startup Foundations group coaching program, on-demand courses, and even one-on-one consulting.
