There is a growing number of practitioners who find that the busier they get, the less successful they are. They report that they are working harder, seeing more patients, and taking home less money. They have minimal connection with their fellow clinicians, staff members, or patients. They are unfulfilled and even disillusioned. Physicians aren’t the only ones who are complaining— patient satisfaction and loyalty are decreasing, and staff members are holding negativity sessions in the parking lot. The solution is to exact a culture change by implementing a strategic operational plan in which your large practice is managed as if it were a small one.