A chief operating officer walks into one clinic and sees patients backed up at the door. A few blocks away, another clinic has open rooms, available staff, and so little traffic that it barely appears operational.
For Chris Seaman, vice president of enterprise sales at QGenda, that contrast exposes one of ambulatory care’s most expensive problems: Health systems frequently have capacity, but they just can't see, coordinate, or deploy it.
“You’re questioning if it’s even open or not because there’s no patients in there, but they have a fully staffed team with a lot of available space that could be leveraged,” Seaman told Daniel Williams, senior editor and host of the MGMA Insights Podcast.
The conventional response is to recruit another provider, add staff, or lease more space. But Seaman argues that those investments will not fix patient access when provider schedules, clinical staffing, exam rooms, equipment, and patient demand remain trapped in separate systems.
“There’s no way to hire our way out of this,” he said. “There’s no way to build our way out of this.”
A lesson from an overloaded industry conference
Seaman had just returned from a Becker’s Healthcare conference in Chicago, where the conversations ranged from artificial intelligence and patient access to leadership lessons from Wayne Gretzky, Jimmy Johnson, and a former combat pilot known as “Fly Girl.”
The celebrity keynotes were memorable, but Seaman kept returning to a discussion with Dr. Sable of Hackensack about preventing ambulatory access problems from spilling into the emergency department. When patients cannot secure timely outpatient care, the consequences do not stay in the clinic.
“How do we solve the access problem up front to prevent the overflow that continues to pour into the ED?” Seaman asked. “It’s its own challenge in itself, but it overflows and creates other challenges across the ecosystem of healthcare from a cascading effect.”
That cascading effect also works in the opposite direction. A provider schedule change can release an exam room, staff time, and equipment. If the change is recorded only in the provider scheduling system, the room may continue to appear occupied elsewhere. Staff members may remain assigned to demand that no longer exists, while another location struggles with a full waiting room.
The question is not whether a health system owns enough resources. It is whether those resources can be assembled around a patient at the same time.
Why headcount is an incomplete measure of capacity
Medical groups are already testing larger, differently configured care teams. The 2026 MGMA APP, Staffing and Access Data Report found that 51% of surveyed groups added net-new advanced practice provider positions beyond backfills in the previous 12 months. Yet one in four leaders whose staffing ratios were flat or increasing still described staffing as inadequate or only marginally adequate.
Those findings reinforce Seaman’s distinction between nominal capacity and actual capacity. Nominal capacity is the plan on the schedule. Actual capacity is what remains after cancellations, absences, reassigned rooms, staffing changes, and equipment constraints reshape the day.
“The perceived capacity is the plan. It’s what’s scheduled to occur,” Seaman said. “But as we all know within healthcare, that plan changes very regularly, very often.”
A provider alone is not usable capacity. Neither is an empty exam room or an available medical assistant. The practice creates capacity only when “the right provider, the right care team, the right space, the right equipment, the right operating conditions” align around the service a patient needs.
Hidden capacity lives between systems
Seaman calls the unused combination of people, time, and space “hidden capacity.”
“We know there’s capacity that exists, but we just can’t see it,” he said. “It’s hard to manage what you can’t see.”
A provider session may open after a cancellation. Another site may have an underused procedure room. A clinical team may possess the right skills but be scheduled at a location where demand is low. Each resource is visible to someone, but no one has the enterprise view needed to connect them.
“It especially exists across a distributed ambulatory network,” Seaman said. “One clinic may appear fully booked, while another one has the right combination of provider availability and staff to support the patient demand.”
That distinction should change how leaders respond to a capacity complaint. Before approving a requisition or construction project, the practice can compare actual provider sessions with staffed room hours, equipment availability, open appointment inventory, and demand by location. Persistent shortages across all four measures point toward a real resource problem. Mismatches between them indicate a coordination problem.
The 2025 MGMA Financials and Operations Data Report similarly urges practices to examine whether staffing produces financial and operational yield. Its examples include template tuning, same-day appointment salvage, protected scheduling blocks, and role redesign, all aimed at determining when added help converts into visits and when it merely adds expense.
The problem is bigger than communication
When Williams asked whether ambulatory care’s recurring failures amount to a communication problem, Seaman drew a sharper distinction.
“I wouldn’t necessarily call it a communication issue, but it becomes a communication issue because of the lack of intelligence and the lack of data that’s feeding one another across the organization,” he said.
The fragmentation has accumulated over years. A department purchases technology for one scheduling problem. Another group selects a different tool because the first does not fit its physicians. Credentialing, staffing, timekeeping, room management, and clinical communications develop their own records. Each system can work locally while weakening the enterprise view.
“Most technologies start for a specific use case, and then they grow and grow and grow into potentially an enterprise use case,” Seaman said. “It leads to this kind of fragmented approach of technology, which ultimately leads to all these disconnected workflows.”
QGenda describes its platform as covering scheduling, credentialing, on-call management, clinical capacity, time and attendance, residency management, and workforce analytics. More than 4,500 healthcare organizations use its workforce management technology. The relevant operational test, however, applies to any technology stack: When one schedule changes, do the staffing, room, equipment, and patient-access workflows update with it?
Clinical supply intelligence as air traffic control
Seaman uses “clinical supply intelligence” to describe an actionable enterprise view of the resources required to deliver care. The idea begins with provider schedules, but it does not end there.
“Ultimately, the provider’s schedule is what does create that cascading effect,” he said. “Because the provider is seeing X number of patients in this room, they’ve got this care team supporting them for those sessions.”
If all provider schedules feed a common operational layer, a cancellation or added session can trigger decisions about rooms, staff, equipment, and appointment inventory. Seaman compares the result to an air traffic control system: Local operators still manage individual clinics, but enterprise leaders can see where demand and resources are moving.
“You can’t have them on separate sources of truth because then you have competing sources of truth,” he said. “That leads to mistakes and lack of updated data.”
The concept also changes capital planning. A simple executive question Seaman often hears is: How many clinics does the organization have, and how many does it need? Without reliable utilization data, the answer can be, “We have 400 clinics, and we need somewhere between one and 400 clinics.”
- A free MGMA webinar, Putting the Pieces Together for Ambulatory Growth: How Clinical Supply Intelligence Unlocks Hidden Capacity, extends this framework to staffing, space utilization, access, and growth planning
The capacity question leaders should ask first
Before adding another employee or location, Seaman recommends testing the operating foundation:
Are provider schedules unified?
Can leaders see the staff, rooms, and equipment associated with those schedules?
When the plan changes, does appointment availability change with it?
“Do we have the foundation in place that we need to be able to grow, to be able to expand, to be able to make more intelligent decisions across our inventory space?” he asked. “Do we have all of our systems connected?”
Practices can make that review concrete by tracking four measures together: third-next-available appointment, same-day appointment availability, provider-session utilization, and staffed-room utilization. Segmenting each measure by site and specialty exposes the clinic that appears full because its resources are poorly synchronized, as well as the genuinely constrained location that needs investment.
The patient-access agenda remains divided amongst the MGMA community. In a December 2025 MGMA Stat poll, practice leaders identified no-shows as their leading 2026 priority at 27%, followed by online scheduling at 24%, phone access at 22%, and wait times at 21%. Those problems are usually addressed separately, but each one changes the usable capacity available on a given day.
The larger opportunity is to stop treating every full schedule as proof that a practice is full. “That source of truth,” Seaman said, “is really what’s going to unlock the potential to be much more intelligent about the overall operation across the ambulatory.”
Resources
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