The Hidden Cost of Staying the Same in Your Practice
Why inefficiency is silently draining your practice—and what to do about it
Ask most CPAs, attorneys, or healthcare professionals what their biggest challenge is, and you'll rarely hear "I don't know enough."
The knowledge is there. The expertise is solid.
What's missing? Time. Systems. Structure.
And underneath it all lies a cost that doesn't show up on any profit-and-loss statement—the hidden cost of staying the same.
The Real #1 Cost in Your Practice
It's not payroll, though that's substantial. It's not rent or software subscriptions, though those add up quickly.
The real cost? Inefficiency.
It's the tax preparer manually answering the same client questions via email every tax season. It's the attorney whose intake process involves ten different steps when two would suffice. It's the therapist who spends precious minutes "just quickly editing" the same documentation template for the hundredth time.
It's the constant context-switching between tools that don't communicate with each other, forcing you to be the human bridge between disconnected systems.
The Slow Leak You Don't Notice
Here's the insidious part: you don't feel these losses all at once. They don't announce themselves with alarm bells or dramatic moments.
Instead, they show up quietly as:
Longer workdays that creep past 6 PM, then 7 PM, then become the norm rather than the exception.
Less capacity for new clients, even though you feel like you should be able to handle more.
More stress that builds gradually until you realize you're exhausted by Wednesday.
Slower growth because you're too busy maintaining what you have to build what you want.
Clients who wait longer than they should—for responses, for appointments, for results—not because you don't care, but because your systems can't keep up.
This is what I call "the hidden cost of staying the same."
Why "Just Adding Tools" Doesn't Work
When practitioners recognize these problems, the natural instinct is to look for a solution. Usually, that means shopping for new software.
A new practice management system. A better CRM. An automation tool everyone's talking about.
But here's what I've learned working with dozens of professional practices: adding tools without redesigning workflows often makes things worse, not better.
You end up with more subscriptions, more logins, more things to check—and the same underlying inefficiencies, just dressed up in a new interface.
What Actually Works: Workflow Design
The real win isn't just adding new tools. It's designing workflows that fundamentally work better.
Workflows that:
✅ Run smoothly from start to finish, with each step flowing naturally into the next
✅ Reduce manual work through smart automation and thoughtful templates
✅ Scale without chaos as your practice grows and serves more clients
✅ Improve client/patient experience with faster responses, clearer communication, and seamless processes
✅ Protect confidentiality and compliance by design, not as an afterthought
This means looking at your practice operations holistically. It means asking questions like:
Where does information get stuck?
Which tasks require your expertise, and which just require attention?
What could be templated, automated, or eliminated entirely?
Where are clients confused or delayed?
Which tools actually need to talk to each other?
Real Examples: Two Different Approaches
Let me show you what this looks like in practice. The good news? You don't need expensive software to see dramatic improvements.
Legal Practice Example
Option 1: Simple Tools, Better Organization
I recently worked with a solo attorney whose client communication was chaos:
The Old Way:
Client emails a question
Attorney reads email, realizes they need case file information
Opens file folder on computer (or physical cabinet) to review details
Opens Word to check previous correspondence
Drafts response in email
Copies email and pastes into Word document for the file
Manually opens Excel to log billable time
Writes sticky note reminder for follow-up
Time per interaction: 20-30 minutes
We redesigned using Microsoft 365:
Created an Outlook category/folder system for each active client/matter
Set up OneDrive/SharePoint folder structure that mirrors email categories
Built Quick Parts templates in Outlook for common responses
Created a simple Excel tracking spreadsheet linked to emails and documents
Used Outlook's Follow Up flags and reminders for automatic follow-up
The New Workflow:
Client email arrives → automatically categorized by rule
Attorney clicks link in Excel tracking sheet → opens OneDrive folder with all documents
Reviews context, inserts Quick Parts template and customizes
Response automatically threads with previous emails, saved to OneDrive via simple process
One-click time log entry in Excel
Follow Up flag sets automatic reminder
Result: Response time dropped to 10 minutes, attorney reclaimed 8+ hours per week.
Total cost: Included with existing Microsoft 365 subscription
Option 2: Integrated Practice Management System
For practices ready to invest in comprehensive solutions, the transformation is even more dramatic.
I worked with a small law firm using disconnected systems for everything. When a client asked a question:
The Old Way:
Check email for client message
Open practice management system to pull up case
Switch to document management to find relevant files
Draft response in email
Manually copy to case notes
Log time in separate system
Create follow-up task
We implemented an integrated system:
Technology Stack:
Practice management platform (like Clio, MyCase) as central hub
Built-in client portal for secure communication
Integrated document management
Automatic time tracking
The New Workflow:
Client message arrives in secure portal
Attorney opens message → sees unified view with case timeline, documents, previous communications, and billing—all in one screen
Uses smart templates that auto-populate case details
Sends response → automatically logs to file, tracks time, creates billing entry
Follow-up tasks generate automatically based on response type
Result: Response time dropped from 30 minutes to 8 minutes per interaction, firm reclaimed 10+ hours per week per attorney.
Key difference: Everything lives in one system—single source of truth, no redundant data entry, built-in security and compliance.
CPA Practice Example
Option 1: Simple Tools, Better Organization
I worked with a solo CPA whose tax season was drowning in disorganization:
The Old Way:
Client sends tax documents via email attachments
CPA downloads files, saves to desktop
CPA manually creates folder structure for client and tax year
CPA moves files from desktop to folder
CPA replies to confirm receipt
CPA adds task to paper to-do list or separate task app
Week later, CPA searches through emails to remember what client said about documents
At tax time, hunts through folders to find all relevant files
Time per client setup: 15-20 minutes, plus ongoing "where is that file?" searches
We redesigned using Microsoft 365:
Set up OneDrive shared folders for each client with standardized structure
Created Outlook Quick Parts for common client communications
Built Excel client tracking dashboard with links to folders and status updates
Used Microsoft To Do (integrated with Outlook) for task management tied to specific clients
Set up Outlook rules to automatically tag and file client emails by sender
The New Workflow:
Client uploads documents directly to their OneDrive folder (no email attachments)
CPA gets automatic notification when files arrive
One-click confirmation email using Quick Parts template
Excel dashboard updates with client status: "Docs received" → "In progress" → "Review" → "Filed"
All communication threads are automatically organized and searchable
To Do tasks link directly to client folders and emails
Result: Setup time reduced to 5 minutes per client, eliminated document hunting, reclaimed 12+ hours during tax season.
Total cost: Included with existing Microsoft 365 subscription
Option 2: Integrated Practice Management System
A growing CPA firm with multiple preparers needed better coordination:
The Old Way:
Documents scattered across email, desktop folders, and shared drives
Staff manually updating separate spreadsheets for client status
Partner constantly asking "Where are we with the Johnson return?"
Time tracking in QuickBooks, client files elsewhere
Missing deadlines because reminders were manual
We implemented an integrated system:
Technology Stack:
Practice management platform (like Canopy, Karbon, or CCH Axcess) as central hub
Client portal for secure document exchange
Integrated workflow management
Automatic deadline tracking and notifications
Built-in time tracking and billing
The New Workflow:
Client uploads documents to secure portal → automatically sorted into correct project
System assigns tasks to appropriate staff based on service type
Staff sees complete client file, previous returns, and notes in one place
Time automatically tracks while working in the system
Deadline alerts trigger automatically 30/14/7 days out
Partner sees real-time dashboard of all client statuses
Result: Firm eliminated missed deadlines, improved staff utilization by 25%, reduced admin time by 15 hours/week.
Key difference: Everything flows through one system with built-in accountability and visibility.
Therapy Practice Example
Option 1: Simple Tools, Better Organization
I worked with a solo therapist whose clinical documentation was consuming her evenings:
The Old Way:
Sees 6-8 clients per day
After each session, opens Word to write progress notes
Manually opens client file folder to review treatment plan
Types mostly similar content with slight variations
Saves note, manually adds to client's folder
Opens separate Excel sheet to track session attendance and billing
Emails client appointment reminders manually
Spends 15-20 minutes per note = 2-3 hours daily on documentation
We redesigned using Microsoft 365:
Created Word templates with Quick Parts for different note types (intake, progress, discharge) with common phrases
Set up OneDrive folder structure by client with subfolders (assessments, treatment plans, progress notes, correspondence)
Built Excel client dashboard tracking appointments, billing status, treatment goals, and session count
Used Outlook calendar with automatic appointment reminder emails
Created Quick Parts library for common client communications (appointment confirmations, policy reminders, resource lists)
The New Workflow:
After session, opens pre-formatted progress note template
Uses Quick Parts to insert standard sections, customizes client-specific content
Saves directly to client's OneDrive folder (organized, dated automatically)
One click updates Excel dashboard with session date and billing status
Appointment reminders send automatically 48 hours before session
Common client questions answered with one-click template emails
Result: Documentation time reduced to 7-10 minutes per note, reclaimed 10+ hours per week, no more evening note-writing.
Total cost: Included with existing Microsoft 365 subscription
Option 2: Integrated Practice Management System
A group therapy practice with 5 clinicians needed HIPAA-compliant coordination:
The Old Way:
Paper intake forms in waiting room
Admin manually enters data into EHR
Clinicians use separate systems for scheduling, notes, and billing
Treatment plans stored in Word docs, not connected to session notes
Insurance verification done manually for each client
No visibility into clinician caseloads or availability
Billing submitted in batches, often with errors requiring rework
We implemented an integrated system:
Technology Stack:
EHR/Practice management platform (like SimplePractice, TherapyNotes) as central hub
Client portal for intake forms, secure messaging, and appointment scheduling
Integrated treatment planning and progress notes
Automated insurance verification and billing
Real-time scheduling and clinician availability
The New Workflow:
Client completes intake forms in secure portal before first appointment
Data automatically populates into EHR
Clinician sees complete client history, treatment plan, and previous notes in one screen
Progress notes use treatment plan goals as prompts (built-in clinical accountability)
Insurance verified automatically, eligibility alerts trigger if issues
Billing codes auto-populate based on session type and note
Claims submit electronically with one click
Group practice dashboard shows all clinician schedules, caseloads, and revenue in real-time
Result: Intake time reduced by 60%, documentation time cut in half, billing errors reduced by 80%, admin time reduced by 20 hours/week across the practice.
Key difference: HIPAA compliance built into every workflow, clinical and administrative functions integrated, real-time practice visibility.
Both Approaches Work—Here's Why
Whether you use the tools you already have or invest in specialized software, the principles are the same:
Centralize information - Stop searching across multiple locations
Reduce manual steps - Template what repeats, automate what's predictable
Connect your tools - Information should flow, not require copying
Build in follow-up - Don't rely on memory or sticky notes
Make it searchable - Past work should be instantly accessible
The right approach depends on your practice size, budget, and complexity. Solo practitioners often see the biggest gains from simply organizing what they already have. Growing practices benefit from purpose-built tools that scale with them.
There Has to Be a Better Way
If you've been thinking, "There has to be a better way to run my practice…"
You're right. There is.
It starts with acknowledging that the way you've always done things—however well it worked in the past—might be holding you back now.
It continues with honest assessment: Where is time leaking? Where is manual work hiding? Where are your systems creating friction instead of flow?
And it results in a practice that runs more smoothly, serves clients better, and gives you back the time and energy to do the work you actually trained for.
Take the First Step
This is exactly what I help CPAs, attorneys, and healthcare professionals do—design efficient, compliant, client-focused practices that scale without burning out the practitioner.
Whether you're working with Microsoft 365, other basic tools, or ready to implement comprehensive systems, the key is designing workflows that actually work for how you practice.
If you're ready to identify where your practice is losing time and efficiency, I've created a Practice Efficiency Blueprint Checklist that walks you through the key areas to assess—regardless of your current tech stack.
Because staying the same has a cost. And you don't have to keep paying it.
Elliott Friedman is a Holistic Business Advisor who helps CPAs, attorneys, and healthcare professionals reclaim their time through smarter systems and workflows. With extensive experience in technology and business operations, he specializes in designing practices that run efficiently without requiring expensive overhauls—because the best system is the one that actually works for how you work.
