From solo startups to multisite enterprises, clinical-first technology and AI tools are helping primary care practices scale smarter, cut administrative burden and stay patient-focused.
Primary care practices face a constant balancing act: managing growth, adapting workflows and keeping pace with shifting reimbursement models, workforce challenges and evolving technologies. Whether you are just launching a practice or scaling an established one, each stage brings its own pressures and opportunities. According to a 2021 report from the National Academies of Science, Engineering, and Medicine, primary care physicians only get 5% of health care expenditures. In this landscape, clinical-first technology and thoughtful workflow design can mean the difference between frustration and sustainable growth.
Artificial intelligence (AI) is adding another layer of complexity and promise, reshaping how care is delivered and efficiency is achieved. Although AI brings powerful tools for insight and automation, it also raises critical questions about integration and impact on daily operations. By looking at real-world examples of practices that have navigated these challenges, Derrike Retzlaff, customer success manager at Elation Health, highlights strategies that not only help practices survive but also thrive in today’s demanding health care economy.
Technology should adapt to clinicians and their workflows, not the other way around. This clinical-first philosophy is rooted in Elation Health's founding, as siblings Kyna and Conan Fong developed a platform to help their father modernize his independent primary care clinic. What started as coding in the family dining room grew into a system that supports care for over 20 million patients. The goal of technology is to make it an ally that simplifies complexity and supports the fundamental mission of patient care, allowing physicians to focus on patients rather than systems.
The journey of Dr. Troy Frazer of Guardian Health Center in Niantic, Connecticut, serves as a powerful example for physicians considering leaving large health systems for independent practice. Dr. Frazer launched the first new solo practice in his county in over seven years, rejecting offers from large health systems. “His mission needed modernized technology that allowed him to maintain the autonomy he desired, all while focusing on what was most important to him: real patient relationships,” explained Retzlaff.
By using an AI scribing tool, Note Assist, he saved over two hours of documentation time daily, enabling him to complete his charting during work hours. This efficiency allowed him to successfully onboard over 400 new patients in his first three months. With all-in-one billing, even revenue management became an accomplishable task. “You're not juggling vendors or workflows. You're focused on your patients. With AI reducing that documentation burden, providers can see more patients without having to sacrifice that personal time,” said Retzlaff.
The case of Dr. Andrew Pasternak of the Silver Sage Center for Family Medicine in Reno, Nevada, highlights the challenges of a growing practice navigating multiple payment models. As his high-performing Accountable Care Organizations and Medicare Advantage clinic expanded, Dr. Pasternack faced mounting documentation demands, charting at night and on weekends, and the onset of burnout. His practice needed to manage a rising patient volume while balancing the financial complexities of value-based care and fee-for-service billing. Integrated technology helped restore his work-life balance and improve operational performance.
An AI scribe tool reduced his documentation time to just two to three minutes per visit, giving him his nights and weekends back. This allowed him to be more present with his patients, strengthening the continuity of care that is central to family medicine. An integrated billing solution also transformed his practice. “Claims processing became more reliable, submissions were simpler and comprehensive reporting gave his team true visibility into their operations,” highlighted Retzlaff. Staff could now easily identify trends, track productivity and ultimately ensure claims were taken care of. A practice’s technology platform should be flexible enough to handle more than just a single payment model without requiring a complete overhaul, thereby protecting a physician’s time and preserving their mission to patient care.
One to One Health is a large primary care organization in Tennessee serving over 250,000 patients across 89 clinicians and 15 clinics. For an enterprise of this size, seamless integration and rapid scalability are essential. Their model, combining virtual and in-person care, required a platform that could innovate alongside them. By adopting a managed services offering, they achieved a 15% engineering hour savings, accelerated new clinic launches by 10%, and streamlined staff onboarding with on-demand training. Their team had more time to focus on other things, new sites were opened faster and staff were easily trained regardless of location. This partnership allowed technology to fade into the background, enabling clinicians to focus on patients instead of systems.
AI, as demonstrated in these case studies, is positioned as a tool to reduce the administrative burdens that fuel physician burnout. The goal of AI is not to replace clinical judgment but to restore the physician-patient relationship by automating time-consuming tasks. “We have to ensure that it's being used in a way that's going to support clinical judgments and protect that high level of patient trust and ultimately improve care, not just improve efficiency,” warned Retzlaff. AI-powered scribes, for instance, automate clinical documentation in real time, giving physicians back hours and allowing them to be more present during encounters. In the near term, AI is expected to continue removing friction from administrative tasks such as coding, billing and quality reporting. In the future, it may play a larger role in pattern recognition and risk identification across patient populations. However, no matter the usage, AI should always be used in a way that serves both the clinician and the patient.
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