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A high-functioning pediatric practice is more than a collection of patient rooms and schedules—it’s a finely tuned healthcare delivery system built around the needs of families, staff, and the community it serves. Pediatric practice owners that understand needs of parents/families, providers/staff, payers and objectively measure, monitor and evaluate their Pediatric practice have the best chance of achieving “operational excellence” for their Pediatric practice. The Pediatric practices that under perform is usually due to suboptimal performance on multiple key parameters associated with Pediatric practices that achieve operational excellence.
Some parameters that Pediatric Practice owners need to consider to achieve operational excellence in their pediatric private practice include:
1. Optimized Staffing and Workflow
2. Access and Convenience for Families
3. Proactive Financial Management
4. Consistent Clinical Quality and Preventive Care
5. Strong Leadership and Staff Engagement
6. Consistent use of Technology and practice processes
1. Optimized Staffing and Workflow
Appropriate Levels of Staffing should be based on Average Monthly Volume of patient care.
Here are general guidelines for full-time equivalent (FTE) staffing based on average monthly patient visits:
Front Desk: Staffed with trained personnel who manage high call volumes, verify insurance in real time, and provide proactive customer service.
Consider 1-2 Full-Time Equivalent (FTE) per 800–1,000 visits/month.
Duties include scheduling, check-in/out, insurance verification, collection of copays/deductibles/balances and phones.
High call volumes, complex billing environments, or walk-in traffic may increase needs.
Clinical Support (MA or Nurse): Medical assistants (MAs) or nurses are effectively deployed to room patients quickly, handle immunizations, and support documentation—minimizing provider burnout.
Consider 1 FTE MA per 12–20 patients per provider per day.
This ensures proper patient flow, timely rooming, immunization prep, and clinical documentation support.
Consider additional support during peak seasons (e.g., back-to-school, flu season).
Scheduling: Balanced provider and staff schedules aligned with patient demand, ensuring minimal wait times and maximizing exam room use. Note that this role can be combined with the front desk role.
Pediatric Providers: Balance provider schedule with needs of the parents/community. Consider that a Pediatric provider full time should be managing more than 350 patient visits per month.
For part-time clinicians, scale proportionally.
Team-based care models (e.g., provider+ MA) may allow for more efficient throughput.
Consider that understaffing leads to burnout and decreased patient satisfaction. Overstaffing can lead to an unprofitable Pediatric practice. Regular productivity reviews are essential.
2. Access and Convenience for Families
Same-Day Sick Visits: Guaranteed availability reduces urgent care use and boosts continuity.
Consistent Availability: Patients and families have busy lives and usually place a high value on Pediatric practices that are consistent on their operating hours available. A Pediatric practice that is less consistent usually has lower rates of new patient additions.
Operating Hours Aligned with Patient Needs: Operating hours can significantly affect your pediatric practice’s ability to attract and retain patients—especially in competitive urban or suburban areas where parents often choose providers based on convenience as much as clinical quality.
Recommended Operating Hours for Urban/Suburban Practices:
Weekdays: 8:30 AM – 5:30 or 6:00 PM (with staggered staff/provider shifts to extend coverage).
Evenings (at least 1–2x/week): Open until 7:00–8:00 PM to accommodate working parents and school-age children.
Saturdays (highly recommended): At least 3–4 hours, especially during winter and back-to-school season (e.g., 9:00 AM–12:00 PM).
Same-Day Appointments: Always reserve slots for same-day sick visits—critical for patient satisfaction and retention.
Operating a successful pediatric practice requires more than delivering quality care—it demands making strategic operational decisions that balance patient volume, staffing levels, and financial sustainability.
Impact: Practices with after-hours care and convenient access often see higher patient retention, increased visit volume and more consistent practice revenue.
3. Proactive Financial Management
Staffing Based on Visit Volume: Evaluate and staff the practice based on the visit volumes of the office. A practice that is overstaffed results in higher payroll than the practice can afford. A practice that is understaffed results in missed opportunities to optimize completion of preventative care well visits per the AAP well visits schedule. The appropriate staffing levels is probably the most important factor for financial healthy Pediatric practice.
Revenue Cycle Excellence: Ensure that the Front Desk team members are consistent with checking each and every insurance the day of the appointment. Checking in a patient with inactive insurance can result in delayed or even no payment for the visits. Pediatric providers should consistently capture the visit codes and close charts within seven days of the visit.
Planning of Practice Expenses: Practice owners and leaders that manage the finances should develop an annual budget and plan that includes a monthly breakdown of expenses including payroll, vaccines, rent and EHR/Billing.
Vaccines for Children (VFC) and Private Inventory: Carefully managed the inventory and administration by the MA staff and providers to avoid waste and ensure cost recovery.
Key Performance Indicator (KPI): Days in A/R under 35; collection rate over 98%; visit volume per FTE provider above 350/month.
4. Consistent Clinical Quality and Preventive Care
Well-Visit Recall System: Automated or manual outreach ensures children are seen on schedule. This includes using the work list to identify patients due for a well visit and have the front desk call and schedule these patients or use the email reminder feature.
Vaccine Rates: Maintain high immunization compliance via strong reminder/recall workflows. Use the PediatricXpress tools that identify patients behind on their immunizations.
Clinical Guidelines: Providers follow AAP standards for screenings, developmental assessments, and behavioral health. The clinical templates can incorporate this information to reduce the admin work on documentation by the provider.
Clinical Dashboarding: Track well visit adherence, immunization rates, and screening completions monthly.
5. Strong Leadership and Staff Engagement
Leadership Focus: Practice leaders that focus their time and staff time on largest opportunities achieve the highest results and team engagement. Practice leadership that focuses on the low opportunities or has much crisis management miss achievement of the practice goals and can frustrate team members of the practice.
Defined Roles: Solid practice leadership results in everyone understanding their responsibilities and scope of work.
Realistic and Solid understanding of Payers in Market: Reimbursements vary based on the market location and the payer mix. Pediatric practice leadership needs a solid understanding of the reimbursements, ability to negotiate payer terms and achievable potential of quality incentive programs.
Monitoring and Feedback: A practice owner should have a consistent monitoring approach to critical processes and provide feedback to team members. Practice owners should consistently evaluate visit volume, practice patient profile to understand the opportunity in revenue and the associated provider staffing.
Regular Communication: Weekly huddles and regular staff meetings help identify challenges and celebrate performance achievements.
Culture: A positive culture and work-life balance options for staff members can enhance the culture and performance of a pediatric practice
Consider: Leadership is an important aspect of successful Pediatric practices. Team members need to understand their roles, responsibilities and receive feedback. Practice owners that plan, budget, monitor and manage key processes with objective data information achieve higher success rates than owners that either use non-objective data to make management decisions and choices.
6. Consistent Use of Technology and Practice Processes
A well-run private pediatric practice team members should consistently leverage the technology available in a manner that aligns to the practice processes. There are various technology tools used by each team member:
Front Desk: Front desk should be checking in each and every patient in a manner that includes verifying each insurance for the date of service, collecting copays/deductibles. The PediatricXpress EHR provides much automation on the checking in process but there are a few areas the front desk team needs to confirm including scanning in the insurance card and verifying the data is correct. Additionally, Front desk team members are critical to confirm if the patient is VFC eligible. Additionally, front desk team members should be consistently reviewing the patients on the well visit work list (patients due for well visits) and call and then schedule these patients.
Medical Assistants/Nurses: The MA/Nurses leverage the PediatricXpress EHR for vitals, entering or fulfilling procedures and entering details of vaccines. Additionally, MA/nurses can electronically send and receive lab orders to LabCorp and/or Quest. The consistency in the vaccine management usually enhances the practice operation related to patient engagement and RCM.
Providers: The Pediatric providers leverage the PediatricXpress EHR to complete visits including sending electronic prescriptions, orders for MAs/Nurses to complete and completion of their clinical charts. The consistency on selecting the codes as well completely charts within 7 days is a major factor in the Revenue Cycle Performance of the practice.
Leaders/Owners: Regular review of visit trends, no-show rates, payer mix, and productivity to guide decision-making. Review the monthly reports sent and identify trends in visits/revenue that change over time. Consider comparing this to the monthly report received a year earlier to identify the growth of the practice in visit volume and new patients.
Summary
A well-run private pediatric practice is:
Patient-centered in care and convenience
Staff-efficient with lean operations and role clarity
Financially sound with strong RCM and provider productivity
Quality-focused with data-driven preventive care and clinical outcomes
Growth-ready with strategic planning and adaptability
Practices that embody these traits are not only more profitable but also more resilient in a changing healthcare landscape—able to compete with health systems, adapt to parent expectations, and retain the trust of the families they serve.
