An Open-Access Doctor's Office

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While the question, "How big should my practice be?" seems simple, it's actually a complex calculation—one that Murray says requires doctors to think differently "by relying only on data, rather than anecdotes or feelings."

That's no small feat, especially for smaller practices that don't typically collect the relevant data.

Columbia's Spreadsheet

But as Columbia University Professor Linda Green realized, answering the size question was a matter well suited to her expertise in operations research. Working with a department colleague, Professor Sergei Savin, the researchers designed a mathematical model that doctors could use—in the form of a simple Excel spreadsheet—to determine how many patients they could accommodate and help predict how many hours of overtime they'd need to work to keep up with changing levels of demand.

A paper about their research is set to be published in the April issue of the Joint Commission Journal on Quality and Patient Safety, but Green and Savin have already gotten more than a dozen e-mails from interested doctors who read about the model on Columbia University's Web site, including requests from several large Midwest practices. Green admits, "There's more interest in this than we ever expected."

Some of that interest may be due to the fact that—at least for now—Green and Savin are giving the spreadsheet for free to any doctor who asks, though they have begun talks with at least one software vendor interested in licensing the technology. Green says the model has potential applications not only in other areas of health care, but in any setting—such as a busy salon—that deals with serving a defined amount of customers in a limited amount of time.

Of course, ending wait times at doctor's office will take more than a spreadsheet. "It will help, but it's not the Holy Grail," Murray says. The underlying challenge, the researchers say, is to change the way doctors think about the management aspects of health care. "We think we're different—that things like supply and demand don't apply to us. But we're no different from Starbucks or Wal-Mart (WMT)," Murray says.

Miller is a New York-based staff writer covering startups and small business. Miller is a graduate of Brown University.