The staffing squeeze: A conversation with Rihan Javid, D.O., J.D., of Edge

Staffing is no longer just a human resources headache — it is a strategic threat to how physician practices function day to day.

In a conversation with Medical Economics, psychiatrist and Edge co-founder Rihan Javid, D.O., J.D., explained how rising minimum wages, tight margins and fierce labor competition are landing inside small practices and rural hospitals first. Sudden pay bumps that look good on paper can blow up a budget in real time, especially when wage hikes trigger a local salary arms race that practices cannot win.

Javid walked through which roles are truly “critical path” — from front-desk and medical assistant positions to billing, coding, claims and prior authorization — and what happens operationally when those slots sit vacant. Turnover rarely shows up as a single vacancy, he notes; it shows up as physicians taking on refills, prior authorizations and even billing themselves, while documentation piles up and patient experience suffers.

He also shared practical guidance for leaders planning the year ahead: build flexibility into staffing budgets, assume continued wage pressure, and focus on retaining a core group of long-tenured employees instead of constantly replacing half the team. He outlined when it makes sense to look beyond the local labor market, how remote roles can stabilize back-office functions, and why clarity, fairness and day-to-day respect matter just as much as hourly rates.