8 jobs in your practice only one person knows how to do

Every practice has a Donna. She’s been there 11 years, she’s the only one who knows how to do four or five things, and none of those processes are written down because it’s never been needed.

And that arrangement works fine, right up until the morning it doesn’t. A resignation, a medical leave or a two-week vacation that happens to land in the same week as a revalidation deadline.

The timing to fix it is unusually good. A May 26 Stat poll from the Medical Group Management Association (MGMA) found 69% of medical group leaders reporting turnover about the same or lower than 2025, with 28% still reporting increases. MGMA's read was that the calmer environment gives leaders a window to strengthen retention systems before the next churn cycle. The same window applies to continuity.

Above are eight jobs that tend to live with exactly one person. The fix is the same shape every time: a written procedure, a named backup and a credential that does not belong to an individual.