It's not yet 8 a.m. when the calls begin and the patients start arriving. Family physician Christopher Crow has just stepped out of his office on his way to see the morning's first patient when the buzzing of his intercom stops him. A woman called, he's told, to inform the practice — not to ask, to inform — that she'd be bringing her husband, just released from the hospital after a weekend motorcycle accident, in for an examination.

Oh, and she has no money to pay, by the way.

"OK, that's fine," Crow, after a brief resistance, says resignedly. "That's a little annoying," he tells me, after some prodding, "for her to just assume we'll take care of him. But we will." They can afford the motorcycle, I note. Yes, Crow replies, wordlessly. Exactly.

Welcome to Monday morning at America's best-run practice, Family Medical Specialists of Texas (FMST). The three-physician group in Plano, a Dallas suburb, is our 2006 Physicians Practice of the Year. Yes, it still has its share of headaches, like pushy Mrs. Knievel, but everything here works so well that such minor irritations barely register.

What's so terrific about this group of three 30-something physicians?

Let's find out.

It wasn't long into my day with Crow and his colleagues, family physicians Matthew Weyenberg and Sander Gothard, that it started becoming clear why our judges chose their group to be our practice of the year. For one thing, this group's Monday morning, while busy, is not chaotic, as it is in many other primary-care offices.

That's in part due to FMST's same-day scheduling. Though not revolutionary, it is one small example of the group's forward-thinking patient-first philosophy.

Crow says he's baffled by practices that haven't adopted same-day scheduling, a relatively simple innovation to implement. How, he wonders, can a service business like a primary-care medical practice be so insensitive to things that make patients happy, such as convenient access? Patients are the customers, after all; taking care of them is how practices stay in business. What other business would erect barriers to customer access?

"You call a practice up for an appointment and they say, 'OK, we'll see you next Tuesday.' But I'm sick today," he says. "I don't understand that. It's like going into Burger King and ordering a cheeseburger and they say, 'OK, come back later, and we'll feed you.' But I'm hungry now."

FMST believes that everyone wins when patients can see their physician when they want. Patients are happier and healthier, and the practice is more successful.

It's one of the many ways that this group connects good practice management with good patient care. FMST didn't win our Practice of the Year competition because of its days-in-accounts-receivable data, or because of its EMR, or because the doctors make more money than most — although it does have enviable collections, it does make full use of an EMR and other technologies, and, yup, the docs are doing quite nicely, thank you.

Rather, FMST won this contest because its physicians understand that running a more efficient office tends to make them better doctors. And it makes for happier patients.

Young guns

Spend a day with this group, and you'll discover how practices should be run and how the successful ones will be run in 10 years, maybe five. FMST seems to ooze newness — even the physicians themselves, who range in age from 31 to 37.

"Here, we embrace change," Gothard says. "Embrace it. And that's how we've been successful. Everything we do is about change. ... We don't sit around and wait until we have to do things. We're proactive with change."