Jan 6, 2026
Written By Elizabeth Cifers
2026 is ushering in positive financial changes, including increased reimbursement for office visits and procedures, but with decreases in facility-based procedures. Additionally, the challenges from 2025 persist in 2026, with funding for co-pay assistance from national charities all but gone. These changes are forcing practices to examine how they operate their practice. One financial aspect that is frequently overlooked is the efficiency of service and information flows. The more efficient the practice is, the less redundancy, waste, and time spent fixing errors or issues.
Efficiency can be strengthened with strategic clinic design, which intersects efficiency and quality, quietly shaping physician workflow, staff performance, and the practice's long-term sustainability long before coding or reimbursement issues surface.
Clinic design is often treated as a tactical issue focused on room counts, scheduling templates, or throughput targets. In reality, it is a strategic decision that directly affects how efficiently physicians and staff operate throughout the day. Limited room availability, poor room placement, or excessive walking distances create friction that compounds over time, turning a busy clinic into one that consistently runs behind schedule.
Once the clinic is running behind, physicians have a choice: move through patients more quickly or continue to run behind. Either way, physicians typically feel rushed, documentation becomes secondary, coding accuracy decreases, and physician and staff burnout increase. However, when clinic design is approached proactively rather than reactively, efficiency and quality of care go hand in hand, supporting and strengthening each other rather than competing.
In all clinics, the physician is the limiting factor; however, inefficiency rarely stems from slow physicians. That is not to say there aren’t slow physicians; there are, but more often it stems from overbooking the schedule, failing to account for emergency add-in patients, or patients who require longer face-to-face time with the physician. The bottlenecks include patients waiting for work-up and diagnostic testing, staff, patients, and physicians retracing steps between rooms, and physicians managing constant interruptions.
As discussed in How to Improve Retina Clinic Flow Without Sacrificing Documentation, unpredictable clinic flow constrains time when it matters most: during clinical decision-making and defensible documentation. A well-planned clinic layout creates predictable staff and patient movement during the clinic. When workflow is intentional, efficiency naturally improves, preventing hurried care, shortcuts in documentation, and inaccurate coding.
Clinic design affects more than movement; it also affects thought. Retina physicians make complex diagnostic and treatment decisions throughout the day, often under time pressure. Poorly designed environments, such as overflowing waiting rooms, crowded hallways, and limited workspace, introduce mental noise, increasing the risk of clinical and documentation errors.
Strategic clinic design strengthens clinical decision-making by ensuring efficiency in diagnostic testing and exam flows, supporting real-time physician (or scribe) documentation with adequate workspace, and sequencing rooms to follow a logical flow rather than simply by room availability.
These principles are grounded in the operational considerations outlined in How to Improve Efficiency at Your Retina Practice: Clinic Layout, but they extend beyond physical space. The objective is not merely a better layout; it is an environment that supports thoughtful, defensible care.
Many practices try to address financial or growth challenges by assuming that adding more patients to the existing workflow will resolve the problems. However, over time, this approach creates bottlenecks, staff burnout (and potential apathy), and greater reliance on workarounds, aka cutting corners. In other words, the system fails because it wasn’t designed to support the current workflow. Inefficiencies grow until the system breaks or is redesigned. Strategic clinic design reverses this pattern by ensuring that volume is supported by design rather than imposed on it.
Redesigning the workspace requires an honest assessment of:
• Diagnostic testing capacity relative to physician schedules
• Integration of injection and laser workflows into the clinic day
• How informal staff-driven workarounds and workflow preferences influence physician decision-making and clinic operations
When volume exceeds design capacity, the integrity of documentation and patient care often first appears in chart documentation errors, inappropriate or incorrect modifier use, and medical necessity vulnerabilities stemming from rushed or cloned documentation, long before it surfaces in patient complaints or denials.
Clinic design is often evaluated from the physician's perspective, but staff workflow is equally critical. Technicians, photographers, scribes, and front-desk teams are essential to maintaining flow and accuracy. Inefficient layouts can lead to unclear task ownership and frequent errors, which, in turn, create additional inefficiencies and waste resources. Strategic design aligns staff workflows with clinical processes, allowing physicians to spend more time on patient care.
Retina practices face increasing scrutiny of documentation, modifier use, and diagnostic testing. Clinics operating at or beyond capacity often resort to shortcuts, increasing risk. They do so not intentionally but predictably, failing to understand the bigger picture and the consequences of their actions. A clinic designed to function well with high-volume patient loads is inherently more defensible than one that depends on constant correction and recovery.
Clinic design decisions shouldn't be made reactively in response to financial or growth issues. Instead, they should be integrated into a long-term plan that considers economic, staffing, flow, efficiency, and patient care. In retina, efficiency and quality are complementary rather than opposing. A strategic approach to clinic design that optimizes flow, staffing, thought, and compliance leads to improved patient care, better documentation, and stable operations over time.
Clinic design should logically support clinical workflow, not strain it. Elizabeth helps retina practices evaluate whether their current design supports efficient care delivery, documentation integrity, and long-term sustainability.
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