This is enough of a problem for small medical practices in the US that it outweighs a good bedside manner and confidence in the doctor's medical ability.

I am confident that this has a large effect on the success of an individual practice; it may fall under the general heading of business advice for the individual practitioner. Even for a single-doctor office, a good secretary and record system will be key to success.

This information comes chiefly from experience of and interviews with specialists (dermatology and gynaecology) in the US.