Physicians are precise about the value of their time in exactly one context: when someone else is paying for it. In a contract negotiation that precision is real, the figure gets built from actual numbers, and nobody signs something that prices an hour below what it’s worth.
Then the negotiation ends. The same physician spends Tuesday evening at the kitchen table verifying insurance eligibility for the next morning’s schedule, and the figure that took weeks to settle never enters the calculation.
The math you already know how to do
The contract figure comes out of two numbers. Take net professional fee, subtract overhead, and what remains is a defensible hourly rate, the actual value of an hour of your time.
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When a contract prices call coverage or committee duty, that rate is what gets applied, using the established method for valuing physician time spent away from patients. The method exists because hospitals and physicians both accept that an hour of clinical capacity has a price and somebody should be accountable for it.
Nothing about that method stops working after hours. Twenty-five minutes on an eligibility check, at whatever your rate is, produces a real number. It doesn’t round down because no payer is being invoiced for it. The hour cost what your hour costs.
The scale is where it gets uncomfortable. Take your rate, multiply by the non-clinical hours in a normal week, then multiply by fifty. Most physicians have never seen that product written down. It’s often the largest unexamined figure in an independent practice, and it appears on no statement anywhere, because the person absorbing it also happens to own the place.
What the hours actually are
A 2014 study in the International Journal of Health Services found administrative work consuming roughly 16.6 percent of physicians’ working hours, close to 8.7 hours a week, with some specialties running considerably higher. That study is over a decade old, and AMA data from 2024 points to the same reality. A survey of nearly 18,000 physicians found the average workweek running 57.8 hours, with 13 hours going to indirect patient care like order entry and documentation, and another 7.3 hours to administrative tasks including prior authorizations and insurance forms.
Two surveys, a decade apart, land in the same place: Somewhere between a fifth and a quarter of the working week happens without a patient in the room.
That’s not one bad Tuesday. It’s a standing weekly figure, at your rate, running for as long as you’ve owned the practice.
Some of those hours genuinely need you, a borderline authorization where the clinical reasoning actually matters. The eligibility check doesn’t. Neither does chasing a fax that should have arrived on its own, or confirming a schedule the front desk already confirmed once. Those tasks land on your desk for reasons that have nothing to do with whether they require your training.
The honest objection is that there’s nowhere else for the work to land. The front desk is already covering phones and check-in and the fax queue. The medical assistant is turning rooms. Adding to anyone’s plate means something else falls off, and whatever falls off tends to come back to the physician anyway, which is how the work arrived there originally.
That objection is legitimate. It’s also a description of the problem rather than a reason it can’t be solved. A practice operating at capacity doesn’t have a delegation problem. It has a capacity problem that ends up absorbed by the one person whose hour costs the most.
Why the math never gets run
No invoice arrives for the twenty-five minutes. Nothing in the practice’s books marks that time as physician capacity spent on clerical work, so it never enters the ledger as a cost, even though the hour was worth exactly what the hour you spent seeing patients that morning was worth.
Handing the task to someone else works the other way around. That cost is immediate and legible: explaining the process, building the workflow, watching the first several eligibility checks closely enough to know they’re right. Every hour of that is visible. Weighed against an alternative that generates no line item at all, the kitchen table wins on paper every time.
The timing makes it worse. The cost of handing something off arrives in week one, all at once, while you’re already behind. The savings arrive slowly, in twenty-minute increments, over months, and by the time they’ve accumulated into anything noticeable, nobody’s tracking the comparison. Every decision to delegate gets evaluated at the exact moment it looks most expensive, which is why the decision almost always goes the same way.
The kitchen table isn’t free, though, and the expensive part isn’t the money. Somewhere in that week a patient’s case deserved more attention than it got. Or a Tuesday evening belonged to your family and went to a payer portal instead. Nobody records that trade anywhere, so it keeps happening, and the work that actually requires a physician keeps sliding toward the back of the line.
Run the number once
None of this happens because physicians are careless with money. The gap has nothing to do with discipline. One option generates a bill and the other one doesn’t, and anyone weighing a visible cost against an invisible one picks the invisible one, every time, rationally.
The practices that close this gap arrive at the same structure. The work moves to someone whose time is priced for it, and the responsibility for whether it runs correctly moves at the same time.
Whoever trains that person, supervises them, and answers for a mistake is someone other than you. That last part is what separates this from hiring cheaper help and supervising it yourself, which relocates the hour rather than recovering it. You stop doing eligibility checks and start managing the person who does them, and the figure at the bottom of the page barely moves.
So run it once. Take your rate from the contract math, multiply it by the non-clinical hours in a real week, and write the product somewhere you’ll see it again. Then decide whether that’s a reasonable price for work that never needed a physician.
Karan Kanwar is the CEO of Central AI and Wing Assistant. Central AI provides an AI operating system for appointment-driven medical practices, handling calls, texts, web chat, and messages around the clock, qualifying patients and booking appointments directly into a practice’s existing systems. It is HIPAA compliant and designed to complement the tools practices already use.
Wing Assistant pairs that technology with skilled virtual assistants who take on the administrative work that pulls teams away from patient care. Kanwar writes on where automation and human support meet in health care operations, and how practice leaders can adopt both effectively. He shares updates on LinkedIn.
