If medical practice leaders were allowed to redesign their business cards based on what they actually do all day, some familiar titles might disappear, and plenty of the surviving ones would need a few more slashes. 

Administrator? Maybe. COO? Sometimes. Practice manager? On paper, sure. 

But after our Sept. 8, 2026, MGMA Stat poll, a few alternative titles, supplied by respondents themselves, seem equally appropriate: Chaos coordinator. Firefighter. Ring master. Magician. Jack-of-all-trades.  

Of the 227 medical practice leaders who responded, only 8% said no new functions had been added to their role in the past two years. More than half reported adding four or more functions, and nearly one in 10 said 10 or more had landed on their desk.  

That means for most leaders, the job is getting busier and broader — and judging from the follow-up responses, "broader" might be an understatement. 

Asked to name the one role they do every day that no one knows if part of their job, one respondent described managing provider behavior. Another handles credentialing. Others cited facilities oversight, supply inventory, cash-flow monitoring, staff coaching, data collection, custom reporting, scheduling adjustments, authorizations, employee retention efforts, and even watering the office plants. And one admitted to scrubbing toilets when the janitorial service isn't getting the job done.  

Welcome to healthcare leadership in 2026. 

The comments also hint at how the job has grown. Some of it comes with growth, such as a promotion or adding new providers. Some of it is new territory, like AI research and implementation. And some is plain gap-filling, described by one practice leader as "clerical work my staff should be doing." 

That need for gap-filling echoes our July 7, 2026, poll on staff-to-physician ratios, in which roughly one in four leaders whose ratios held steady or rose still said support staffing wasn't adequate for patient demand. While physicians and advanced practice providers (APPs) absorb overflow when support teams run thin, these responses suggest practice leaders also absorb some of it. 

The most common hidden responsibility was centered around people management tasks that don't always appear on a formal job description. No practice administrator will find that surprising. After all, spreadsheets don't call in sick. Dashboards don't have interpersonal conflicts. A/R aging doesn't need a coaching conversation. People do. 

The people-focused answers describe two different jobs. On the staff side, that means HR, retention, culture, a company social committee, and "emotional support to teams." On the provider side, it means coaching providers through performance issues, adjusting provider schedules throughout the day as cancellations come in, and making sure provider charts have been closed. In physician-owned groups, that second job can mean coaching the people the administrator ultimately reports to. It's also where people work meets revenue, since an unclosed chart holds up a claim and an unfilled cancellation is a lost visit. 

Money came next, in about one in five answers, from working the claim A/R list and difficult accounts to reviewing incoming bank EFTs and explaining insurance to patients. The building came third, in roughly one in six, with answers ranging from facilities and restocking to backorder mitigation. And, yes, the plants and the toilets. 

Especially in groups too small for a dedicated HR department, many practice leaders have become the de facto head of human resources, whether that title appears anywhere on the organizational chart or not. 

The responses also suggest that today's practice leader increasingly serves as the place where unresolved work goes to live. 

A scheduling problem? Send it to the administrator. A provider issue? Same. The facilities concern, the technology question, the employee conflict, and the patient complaint tend to land on the same desk. 

"Solving problems that come up during the day so others don't have to," one respondent wrote. Another pointed to recognizing when "two seemingly related things are actually connected." That's organizational connective tissue: bridging teams and departments, catching the handoff that fell between two functions, and stepping into gaps before those gaps become crises.  

Some of the most revealing answers came from the question asking respondents to name the  job title that would actually describe their typical day. While about 4 in 10 gave a single, recognizable leadership title (e.g., practice manager, CEO, executive director), about one in three abandoned traditional titles altogether. 

Instead, they described themselves as "firefighters," "chaos coordinator," "ring master," "jack-of-all-trades," "chief solutions officer," and even "data wrangler and insight hunter in the information ecosystem."  

These humorous, remarkably honest responses describe jobs organized around interruption rather than routine, with the day's agenda set by whatever problem appears next. 

And perhaps that's the most important takeaway from this poll: Wearing multiple hats comes with the territory, and the hat rack keeps getting larger, and the hats come in different sizes. That reality can be exhausting. Even among the 8% who reported no new functions, one respondents — asked about hidden duties, wrote, "Not sure, but if you added one more thing I'd BREAK." 

But it also speaks to something unique about medical practice leadership. At their core, these responses describe professionals who keep organizations moving forward regardless of what shows up on any given day. They solve problems, connect people, fill gaps, calm tensions, answer questions, manage change, and help their teams deliver care in an increasingly complex environment. 

Or, to borrow from the respondents themselves, they serve as firefighters, magicians, ring masters, and chaos coordinators. Not necessarily the titles they applied for — just the ones they've earned.  

But what if it was always like this?

While these responses might point to the job of a practice manager changing in these modern times, it might surprise many to learn that even at the first gathering of clinic managers in 1926 — that helped create the organization we know today as MGMA — there was a sense that this work required a jack-of-all-trades. In fact, it was even explained with a deck of cards. In "The Roots of the Profession: What a Practice Manager is Expected to Know," you can read more about Col. Joseph W. Jackson, how he called together that gathering, and how he spelled out the first body of knowledge for this work.