I have a new office with two employees. We are seeing about 13 people per day, which puts us close to breaking even for the day. Is there a practical reference that will help me to decide at what point it is best to add another employee?

There is no hard and fast rule, although I’d say you’ll want at least 30 patients a day. You want to know that you’ll be profitable enough to cover the expense and still pay yourself. 

I seem to be talking to more and more physicians who are purposefully keeping staffing (and patient panels) low. They prefer low overhead even if it also means less revenue. They make less, but keep more of it. 

Run some models for your practice. If you added another staffer, how many more patients would you be able to see? Up to 40 or even more per day per physician is increasingly common. If you saw that many, what would your revenue be? Would it cover the additional costs? Barely? Or well enough to make the aggravation worth it?