Navigating the ins and outs of running a successful private medical practice is a bit like juggling — you've got the vital patient care on the one hand and the operational puzzle on the other.

And right at the heart of this balancing act is the age-old question: "How many staff members do I need?"

It's like finding the perfect tempo for a symphony; too few players and the music falls flat; too many, and it turns into a cacophony.

Some practices follow a simple rule: if things get sticky, hire more; if costs rise, cut staff. But that's when things can go out of tune.

If you have a small practice that sees fewer than 20 patients a day, you might assume one person at the front desk is sufficient. Well, here's a nugget of wisdom: the most dangerous number in the business world is one. Having just one of anything can send your practice into a nosedive. What happens when that solo act takes a break or leaves?

Let’s break down the factors that really matter in healthcare workforce management and figure out how many staff your practice needs.

What's the Staffing Ratio?

The staffing ratio refers to the optimal number of full-time administrative and clinical team members required to support a single full-time physician effectively. That said, there isn’t a one-size-fits-all “perfect” number. The ratio of full-time equivalent (FTE) support staff to each FTE physician can vary widely depending on your specialty, patient volume, and even the level of technology in your practice. For example, a high-volume primary care clinic may need more medical assistants and front-desk staff than a smaller specialty office that sees fewer patients but handles complex procedures.

Furthermore, the real driver of effective healthcare workforce management isn’t headcount; it’s how effectively your team works together. A practice with a highly trained, well-coordinated team can often achieve more with fewer people than a larger, poorly organized staff. The effectiveness of your staffing mix depends on how well team members collaborate, how efficiently tasks are delegated, and how much your systems (like EHRs and automation tools) reduce manual workloads.

How Do I Calculate the Staffing Ratio for My Practice?

A medical practice's optimal staffing ratio is determined by its specific operational requirements and workforce needs.

Understanding your distinct staffing needs involves a nuanced approach. It's essential to recognize that there's no universal solution; staffing demands can differ based on factors such as the practice's size, the range of medical specialties offered, patient volume, and the scope of services provided. But here’s a practical way to get started.

Step 1: Calculate physician FTEs

First, count the number of doctors who are part of your team, but let's put that in terms of FTEs (Full-Time Equivalents). So, if you've got a doctor working full-time, that's a straightforward 1. But if someone's not working the whole week, we're talking a fraction of an FTE. Just divide their average weekly hours by your practice's standard full-time hours. For example, 30 hours per week equals 0.75 FTE (30 ÷ 40 = 0.75).

Step 2: Calculate support staff FTEs

Next, count your entire non-physician workforce, which usually includes nurses, medical assistants, billing specialists, front-desk coordinators, patient care coordinators, and administrative staff. For each role, convert their hours into FTEs using the same method you used for physicians (individual’s average weekly hours ÷ 40).

For example:

• A medical assistant working 20 hours per week = 0.5 FTE.
• A nurse working 36 hours per week = 0.9 FTE.
• Two front-desk staff working 30 hours each = 1.5 FTE.

Add all these numbers together to get your total support staff FTEs.

Step 3: Divide support staff FTEs by physician FTEs.

Now, take the total number of support staff FTEs you calculated in Step 2 and divide it by the physician FTEs from Step 1. The result is your staffing ratio. For instance, if you have 10 support staff FTEs and 3 physician FTEs, your ratio is 10 ÷ 3 = 3.3 staff per physician. This number helps you see whether your team is lean, balanced, or potentially stretched too thin.

Remember, physicians often spend just as much time on indirect tasks (charting, patient portal messages, reviewing labs) as they do in face-to-face visits. For instance, a doctor with 28 hours of scheduled appointments may actually work closer to 56 hours when you add the “hidden” workload. Keeping this in mind ensures you don’t underestimate the staff support your physicians truly need.

Factors that Influence Your Staffing Needs

There’s no magic formula for the “perfect” staffing ratio, because every practice runs differently. Instead, think of your ratio as something shaped by multiple moving parts. Here are a few that often make the biggest difference:

‎1. Administrative Considerations

• Billing & Revenue Cycle Management — If billing is handled in-house, you’ll need staff with expertise in coding, claim submission, and denial management. If you outsource to an RCM vendor, you may get by with fewer internal staff but still need a point person to oversee vendor performance.
• Prior Authorization Handling — Practices that manage prior authorization internally often require dedicated staff who are skilled at navigating payer requirements. Outsourcing can shift that burden away, reducing your staffing needs.
• Task Outsourcing — Reception duties, billing, credentialing, or referral management are commonly outsourced. Each task you move externally reduces headcount but may increase your need for vendor oversight.
• Cross-Training Potential — Can your full-time staff be cross-trained to cover various part-time roles? For instance, an administrative team member trained in billing, prior authorizations, and referrals. If yes, it can offer versatility within your team structure.

2. Clinical Workflow

• Procedure Frequency — The more in-office procedures you offer, the greater the need for nurses, MAs, or technicians to prep patients, assist physicians, and handle follow-up.
• Team Role Clarity — Clearly define what your clinical and non-clinical staff can (and should) do. The roles of both your clinical and non-clinical staff will contribute to the overall staffing picture. 
• Telehealth Integration — Virtual visits often require scheduling support, patient onboarding assistance, and sometimes technical troubleshooting, which means unique roles you might not need in a purely in-person setup.
• Exam Room Dynamics — More rooms often mean more staff to manage room turnover, prep patients, and keep schedules on track. Even the physical layout of your space matters; if staff need to cover long distances, productivity can dip.

3. Patient Demographics

• Patient Panel Size & Daily Load — A larger or busier practice will naturally need more support staff per physician.
• Complexity of Care — Patients with chronic conditions or those requiring more in-depth assessments demand longer visits and more support behind the scenes.
• Social Determinants of Health (SDOH) — Patients facing barriers, including transportation issues, language differences, or limited health literacy, often require additional care coordination and support, which influences the staffing mix.

4. Other Considerations

• Specialty Society Standards – Many specialty societies publish best-practice guidelines for staffing (e.g., recommended nurse-to-physician ratios in oncology or pediatrics). These benchmarks can serve as a starting point when shaping your team.
• Technology & Automation – The right tools can dramatically reduce manual workload and boost efficiency. For example, Glenwood’s practice management solutions — GlaceEMR, GlaceRCM, GlaceScribe, and GlacePhoneSmart — streamline critical tasks like scheduling, prior authorizations, coding, and documentation. By integrating technology into daily workflows, practices can ease staff dependency, optimize productivity, and allow teams to focus on delivering higher-value patient care.
• Financial Resources – Striking the right balance between cost control and quality care is essential. While keeping your team lean may look efficient on paper, chronic under-staffing can backfire, leading to physician burnout, higher error rates, reduced patient satisfaction, and even lost revenue from missed opportunities.

Aligning Staffing with Care, Compliance, and Efficiency

Determining the ideal staffing balance requires more than tallying roles; it demands a thoughtful, strategic outlook. Practices must balance care delivery, compliance, and operational efficiency while considering the many factors that shape workforce needs.

Equally important is the smart use of technology. Advanced practice management tools can maximize physician time, enhance communication, engage both staff and patients, and ultimately create a more efficient, patient-centered practice environment.