Physician Efficiency & Effectiveness
Posted Nov 29, 2024
Medicine is an art — we spend years learning how to heal. But there's a second art we're almost never taught: how to run a practice well. That's the art of being efficient and effective — and combining those two words is exactly where MD Efficacy comes from.
Two Arts: Healing, and Running a Practice
Through medical school, residency, and fellowship, we learn the art of helping patients heal. What fascinated me was the other art — practicing medicine well beyond the medical knowledge itself: how to be efficient and effective. I'm an endocrinologist at Indiana University School of Medicine, lucky to practice both clinical and academic medicine — and that fascination is why I created MD Efficacy, joining those two ideas into one.
What Efficiency Means
Efficiency is the easy one to picture: start on time, finish on time, with everything done — and no work before or after hours. If my clinic runs 8 to 4, I start around 7:50 and finish by 4:10 or 4:15, with nothing spilling outside that window. The second layer is throughput: can I see more patients in that same interval while staying effective? I treat it as a challenge — how far can I climb the ladder without sacrificing quality?
What Effectiveness Means
Effectiveness is getting the right job done — and it has several dimensions:
Clinical outcomes. Are my diabetes patients reaching target A1c when they engage — below 7%, even below 6.5%? Are my thyroid patients well controlled and feeling well? Every specialty has its version of this question.
Patient satisfaction. In an era where every patient can review you, are they satisfied, and are your reviews strong?
Quality metrics. We're assessed on them — are your leaders happy with your results?
Billing, coding, and productivity. Do you know the ins and outs well enough to be genuinely productive?
When trainees join my clinic, they come to learn medicine — completely valid. But I also ask them what they know outside the medicine: patient satisfaction, quality metrics, billing and coding. It's usually a revealing conversation.
A Formative Lesson in Billing and Coding
As a fellow, one of our societies offered a billing and coding course. I invited my colleagues and mentors to join me — and, as you'd guess, no one wanted to. But I came back transformed. I learned that what I considered complex, CMS and the American Medical Association — who set the guidelines — might not; and what I thought was simple, they might score as complex. The only way to bridge that gap is a common language, written clearly in your notes. (That insight reshaped how I document — a topic worth its own discussion.)
The House With Many Walls
Here's the framing that matters most. Picture your life as a house with several walls. Your career is one wall — and we hope to build it well, with good outcomes, productivity, and a real return on all those years invested. But there are other walls: your family, whose presence you alone can provide; your social life; your community, which completes your sense of purpose. Career isn't everything. Medicine isn't everything.
This gets hard when we have no boundaries — when there's no stop. The goal I hold, and recommend to you, is simple: do excellent work during work hours, get everything done, and leave with no tails — no reopening the EHR at home, no in-basket at 9 p.m., no pre-charting the next day from the couch.
That's the opposite of what training taught us. We were told that calling a patient at 10 p.m. makes you a devoted physician. I think that's wrong — it quietly wrecks lives. I've watched brilliant mentors end up with broken families, lost hobbies, and lives consumed by patient care. We don't want that. We want to be genuinely effective at work and whole at home.
Complainer or Doer?
I'll leave you with a choice: you can be a complainer or a doer. Both see the problems and feel them — but only one acts. I chose to act, which is why I fell in love with continuous quality improvement: every week or two, I change or refine something small. Stacked over months and years, those small changes produce a dramatic difference in how you practice. It's also why I wrote No Work After Hours — so we stop working before and after hours — and Physician Revenue Secrets — so we truly understand how to make and manage our income.
The Bottom Line
Efficacy is the fusion of efficiency and effectiveness: finishing on time and doing the right things well — clinically, financially, and for your patients — so your career strengthens without collapsing the other walls of your life. Recognize the problems, then act on them, one small improvement at a time.
Want the full framework? Physician Revenue & Efficiency Mastery brings both halves together — CME-accredited and built for practicing physicians.
References & Further Reading
Centers for Medicare & Medicaid Services — Physician Fee Schedule: https://www.cms.gov/medicare/payment/fee-schedules/physician
American Medical Association — CPT coding: https://www.ama-assn.org/practice-management/cpt/medical-coding-mistakes-could-cost-you
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