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Field Notes Clinical infrastructure, in practice
EMR Data Migration: What Actually Works
Oct 2, 2026 ·6 min read

EMR Data Migration: What Actually Works

Every EMR vendor will tell you migration is "straightforward." It isn't. I've been through four of these now, and the gap between what gets promised in

Staffing Concierge Practices Without Bloating Headcount
Oct 1, 2026 ·6 min read

Staffing Concierge Practices Without Bloating Headcount

The economics of concierge medicine look great on a spreadsheet until you hit about 400 members per physician. Then something breaks. The MA who used to handle refills an

How to Audit Your Patient Intake Workflow
Sep 30, 2026 ·6 min read

How to Audit Your Patient Intake Workflow

Every practice I've walked into believes their intake is "pretty tight." Then we time it. The average new-patient intake at a concierge or compounding-adjac

Beyond Staffing Ratios: How AI Agents Extend Clinical Capacity
Sep 29, 2026 ·6 min read

Beyond Staffing Ratios: How AI Agents Extend Clinical Capacity

Every practice owner I know can quote their staff-to-patient ratio from memory. One MA per 250 active patients. One RN per 400. One front-desk FTE per 800. These numbers

503A vs 503B: An Operator's Guide for Clinics
Sep 28, 2026 ·6 min read

503A vs 503B: An Operator's Guide for Clinics

If you run a concierge or compounding-focused practice, the 503A/503B distinction shows up in almost every operational decision you make: which pharmacy you can order fro

Multi-Tenant EMR Migration Risk for Concierge Practices
Sep 27, 2026 ·5 min read

Multi-Tenant EMR Migration Risk for Concierge Practices

Why architecture matters before you ever touch a migration checklist Every concierge practice I have worked with hits the same wall around year two or three. The EMR you

Fix Scheduling Bottlenecks Leaking Clinic Revenue
Sep 26, 2026 ·5 min read

Fix Scheduling Bottlenecks Leaking Clinic Revenue

Your schedule looks full. Your revenue says otherwise. If you run a busy practice and your collections are flat or slipping, the first place I look is the schedule. Not

Compound Medication PA Playbook for Clinics
Sep 25, 2026 ·6 min read

Compound Medication PA Playbook for Clinics

Prior authorizations for compounded medications are a special kind of operational pain. The formulation is often non-standard, the payer's system doesn't recogniz

AI Agents for Compound Order Review: A Staged Rollout
Sep 24, 2026 ·6 min read

AI Agents for Compound Order Review: A Staged Rollout

Compound order review is where a lot of concierge and wellness practices quietly bleed hours. A provider signs off on a GLP-1 titration, a peptide stack, or a hormone ble

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