By Jill Allen | Hey Docs! Podcast with Amanda Ketcham of My Mountain Mover
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When an orthodontic practice gets busier, the traditional response is often to hire another person.
The phones are overwhelming the front desk. Insurance tasks are piling up. Follow-up is falling behind. The team is stretched thin. So, the immediate assumption is that the practice needs another employee in the building.
But adding headcount is not always the same thing as adding capacity.
In this episode of the Hey Docs! Podcast, Jill Allen sits down with Amanda Ketcham, CEO of My Mountain Mover, to discuss how remote staffing and artificial intelligence are changing the way healthcare practices think about their teams.
Their conversation explores an important shift for practice owners. Instead of asking how many people you need in the office, start by asking what work needs to get done, who is best equipped to do it, and whether that person actually needs to be physically present.
As practices grow, so does the amount of work happening behind the scenes.
More patients mean more phone calls, scheduling, insurance verification, follow-up, data entry, administrative coordination, and communication.
Eventually, the existing team reaches capacity.
That is often interpreted as a staffing problem, but Amanda encourages leaders to look deeper.
It may actually be a capacity problem.
Before immediately hiring another in-office employee, evaluate where the workload is coming from. Which responsibilities require someone physically present in the practice? Which could be handled remotely? Which could be automated? And which may not need to be done at all?
This distinction becomes increasingly important as a practice scales.
Growth should not automatically mean adding one employee for every increase in patient volume. Strong systems allow the practice to increase capacity without creating unnecessary complexity.
JA&A Insight: Before adding another position, identify the work first. You may discover that the practice needs additional capacity, not necessarily another person in the building.
Remote staffing works best when practices begin with the work rather than the job title.
Look at what your current team is doing every day.
Are highly skilled team members spending significant time on repetitive administrative tasks? Is the front desk constantly interrupted by work that could happen somewhere else? Are important follow-up responsibilities getting pushed aside because urgent tasks always come first?
These are signs that responsibilities may need to be redistributed.
Amanda recommends starting with straightforward administrative work that consumes significant time.
Depending on the practice and the systems in place, remote responsibilities may include tasks such as scheduling support, insurance-related work, administrative follow-up, data entry, and other back-office functions that do not require someone to be physically present.
One helpful exercise is to document recurring responsibilities and ask three questions:
The answers can reveal opportunities to create capacity without simply expanding the in-office team.
One of the biggest mistakes practices can make with remote staffing is treating remote employees as invisible labor.
If someone contributes to the success of the practice, they need clarity, communication, accountability, and connection just like an employee working inside the office.
Amanda emphasizes the importance of investing in remote team members rather than simply assigning them tasks.
That means including them in communication, establishing clear performance expectations, providing feedback, and helping them understand the culture and goals of the practice.
Culture is not created by sharing a physical address.
It is created through behavior.
A remote team member can understand the practice's values, contribute to team goals, communicate effectively with colleagues, and feel connected to the organization. But leaders have to intentionally create the systems that make that possible.
JA&A Insight: Remote does not mean removed. If a team member affects your patients, systems, or results, they should understand the same expectations and culture as the people inside your office.
Some practice owners are uncomfortable with remote staffing because they cannot physically see what the person is doing.
But physical presence has never guaranteed productivity.
The better question is whether the practice has clearly defined what success looks like.
Remote work can expose weaknesses in accountability because leaders can no longer rely on simply seeing someone at a desk. Responsibilities need defined outcomes, measurable expectations, and regular communication.
That is a good discipline for every position in the practice.
If a leader cannot explain what someone owns, what results are expected, and how performance will be evaluated, the problem is not necessarily remote work.
It may be role clarity.
Create clear responsibilities. Establish measurable expectations. Decide how frequently progress will be reviewed. Then evaluate performance based on results rather than visibility.
Artificial intelligence adds another layer to the conversation about capacity.
Amanda expects AI to increasingly handle basic administrative and repetitive tasks, changing what both remote and in-office team members spend their time doing.
That does not necessarily mean people disappear from the practice.
Their work changes.
If technology can handle a repetitive process faster or reduce the amount of manual work involved, team members can spend more time on responsibilities that require judgment, communication, problem-solving, and relationships.
That is where the opportunity becomes particularly interesting for orthodontic practices.
Instead of asking whether AI will replace employees, leaders can ask:
What work should technology handle so our people can spend more time doing what people do best?
AI can potentially create efficiency, but human connection remains a critical part of healthcare.
Patients still need reassurance. Team members still need leadership. Difficult conversations still require empathy and judgment. Relationships still matter.
The future is likely less about choosing between people and technology and more about determining how the two can work together.
Remote staffing can create capacity, but it cannot fix a process that was never clearly defined.
Before handing a responsibility to someone outside the office, make sure the practice understands how that responsibility should be completed.
Document the workflow.
Define who owns each step.
Clarify when something should be escalated.
Determine what information the remote team member needs.
Establish how the practice will measure whether the process is working.
If the existing workflow is inconsistent, adding another person can simply spread that inconsistency to another location.
This is why systems matter so much.
A well-defined process can be trained, measured, improved, and eventually scaled.
A process that lives entirely inside one employee's head cannot.
Remote staffing in healthcare requires additional consideration because team members may interact with sensitive patient information.
HIPAA compliance, data security, access controls, training, and technology protocols should all be evaluated before moving responsibilities outside the physical practice.
Amanda emphasizes the importance of working with organizations that have appropriate training and systems in place.
Practice owners should understand how patient information will be accessed, what security measures are being used, how remote team members are trained, and what responsibilities remain with the practice.
Convenience should never come before protecting patient information.
The goal is to create efficiency while maintaining the same standards of professionalism and security expected inside the office.
Outsourcing should not be viewed only as a way to reduce staffing costs.
One of its greatest potential benefits is giving the existing team more capacity to focus on higher-value work.
Consider a front desk team member who spends hours completing administrative tasks while simultaneously answering phones and greeting patients.
Removing some of that back-office workload may allow that person to be more present with the patient standing in front of them.
The same principle applies throughout the practice.
When repetitive or administrative responsibilities are assigned appropriately, in-office team members can spend more time on work that benefits from their physical presence, expertise, and relationships.
The goal is not simply fewer people.
It is better allocation of people.
Orthodontic practices will continue to change.
Technology will become more capable. Remote work will become more familiar. Some tasks that currently require significant human effort may eventually become automated.
That means practice leaders should be careful about building tomorrow's team around yesterday's job descriptions.
Instead, continually evaluate the work.
What needs to happen inside the office?
What can happen remotely?
What can technology support?
What requires human judgment?
Where does personal connection create the most value?
Those questions can help practices build teams that are more flexible and scalable as the business grows.
The practices that adapt successfully will not necessarily be those with the smallest teams or the most technology.
They will be the practices that become increasingly intentional about where people spend their time.
Remote staffing involves having team members complete certain practice responsibilities from outside the physical office. Depending on the practice, remote staff may support administrative, scheduling, insurance, follow-up, data entry, or other back-office functions that do not require an in-person presence.
The appropriate tasks depend on the practice, but leaders can begin by evaluating repetitive administrative responsibilities that do not require physical presence. The process should be clearly documented, trainable, measurable, and appropriate for remote access.
Practices can integrate remote team members into the culture through regular communication, clear expectations, feedback, accountability, and inclusion in relevant team activities. Culture is reinforced through consistent behaviors and leadership, not simply physical proximity.
Remote employees should be evaluated using clearly defined responsibilities and measurable outcomes. Practices should establish performance expectations, reporting methods, communication rhythms, and regular reviews rather than relying on physical visibility as a measure of productivity.
AI can potentially handle or simplify repetitive administrative work while remote and in-office team members focus on tasks requiring communication, judgment, problem-solving, and human interaction. The goal is to assign each type of work to the resource best equipped to handle it.
Practices should evaluate which responsibilities can be performed remotely, whether workflows are documented, how performance will be measured, how remote team members will communicate with the in-office team, and what HIPAA, security, training, and access requirements apply.
Practice growth does not have to mean adding more people to the building every time the workload increases.
Sometimes the better solution is redesigning the work.
Remote staffing, AI, and automation are giving orthodontic practices more options for deciding where work happens and who, or what, should handle it.
But the fundamentals have not changed.
You still need clear systems. You still need accountability. You still need strong communication. And you still need people who understand the culture and expectations of the practice.
The opportunity is not to replace your team.
It is to build a smarter structure around them so the right people can spend more time doing the work where they create the most value.