Medical practice org chart example
A physician-owned group practice with two lines under one roof: the clinical line, where providers answer to a medical director, and the business line, where everything from the front desk to billing answers to a practice administrator. Where the two meet — nursing — is a dotted line.
How a medical practice is usually structured
Almost every medical practice, from a three-provider clinic to a hospital, has the same two lines. Clinical: physicians, nurse practitioners and physician assistants, who report to a medical director for credentialing, quality and clinical decisions. Business: front office, billing, IT, compliance and HR, which report to a practice administrator (in a hospital, a COO). At the top, in a physician-owned group, sits a managing partner; in a corporate-owned practice, a regional director.
Nursing is where the lines cross. Nurses and medical assistants are employed and scheduled by the practice — solid line to the administrator through a nurse manager — but their clinical work is supervised by providers. That is a dotted line to the medical director, and it's not optional: clinical supervision is a legal relationship, and the chart should show who holds it.
Compliance and privacy report to the administrator day to day, with a dotted line to the top, because the officer sometimes has to say no to the administrator. Billing is its own department the moment the practice has more than one biller, because revenue cycle is a specialty and the person who codes shouldn't also be the person who books.
Typical titles by level
The vocabulary these charts use, from the top down. Titles vary by country and by company; the levels don't.
| Level | Titles you'll see |
|---|---|
| Leadership | Managing Partner or Practice Owner, Medical Director, Practice Administrator (CEO or COO in larger groups), Chief Nursing Officer (hospitals) |
| Providers | Physician, Nurse Practitioner, Physician Assistant, Locum (as a contractor) |
| Managers | Nurse Manager, Front Office Manager, Billing (Revenue Cycle) Manager, Clinical Supervisor, Lab Supervisor, Compliance & Privacy Officer, Practice Manager (per site) |
| Staff | Registered Nurse, Licensed Practical Nurse, Medical Assistant, Patient Services Representative, Scheduler, Referral Coordinator, Billing Specialist, Medical Coder, Lab Technician, EHR & IT Coordinator |
Where these charts go wrong
The practice chart goes wrong when the nurse manager is drawn with one line (whichever is chosen, someone is now technically unsupervised), when partners are left off because 'they're owners', when compliance reports to billing, and when the practice administrator has fourteen direct reports because nobody wanted to promote a front office manager.
Questions people ask
- Who does the nurse manager report to?
- Two people, honestly. Solid line to the practice administrator for employment, scheduling and pay; dotted line to the medical director for clinical supervision. Draw both. A chart with only one line hides a relationship that regulators and malpractice insurers will ask about.
- Where does the compliance officer go?
- Under the practice administrator for day-to-day work, with a dotted line to the owner, managing partner or board. The officer needs a route around the administrator, because some of what compliance flags is the administrator's.
- How do you show physician owners on the chart?
- As providers, under the medical director, like everyone who sees patients. Ownership isn't a reporting line. If it matters to the reader, note 'Partner' in the title.
- Does a hospital org chart look the same?
- Same two lines, more layers. A hospital adds a CEO at the top, a chief medical officer above the medical directors, a chief nursing officer above the nurse managers, and a COO for operations; departments (radiology, lab, pharmacy) each get a director. Start from this chart and add the layer you need.
Other industries
- ManufacturingTwo shifts, and quality kept out of production's line.
- LogisticsDispatch runs the day; supervisors run the people.
- ConstructionOffice and field, meeting on every project.
- Software startupSquads under a CTO; product managers on a dotted line.
- NonprofitThe board on top, programs beside the money.
- SchoolDepartments led by teachers who also manage.
- HotelSix divisions around one general manager.
- Marketing agencyDisciplines own people; pods own the work.
- Security & facilities servicesSites stacked under supervisors; a 24-hour control room.
- Sales teamRegions for closers, a team for openers, RevOps beside them.
- Accounting firmA partner pyramid, three service lines.
- Law firmPractice groups, and the business side that runs the firm.
- ChurchA board that governs, a pastor who leads, ministries below.
- RestaurantFront of house and back of house, meeting at the pass.
- IT departmentRun, build and secure, under one director.
- HR departmentPartners, specialists and operations: the three legs.
- Local governmentElected above appointed, and two officers who answer to the council.
- Utility companyField crews, a 24-hour control center, and a regulator in the room.
- BankThree lines of defense, drawn as lines.
- Staffing agencySales desks, recruiting desks, and a back office that pays two thousand people.
- HospitalTwo hierarchies that meet at the bedside.
- Retail chainHead office, the field, and a store drawn once.
- Small businessOne owner, two managers, and the jobs the owner still does.
- Finance departmentAccounting closes the books; FP&A says what they mean.
- Marketing departmentDemand, product, brand, and the operations under all three.
- Customer service departmentTeams on the floor; quality, training and scheduling beside them.
- Engineering departmentProduct teams under a VP of engineering; platform, data and security under the CTO.
- Operations departmentSupply chain, fulfillment and the functions that keep both honest.
- Product departmentProduct, design, research and the operations that measure them.
- Consulting firmThree practices, one firm behind them, and no engagement on the chart.
- Real estate brokerageAgents who are not employees, on the chart anyway.
- Insurance agencySales on one side, service on the other, and the lines where they meet.
- Dental practiceA clinical line the law draws, and a business line the office manager runs.
- UniversityAn academic line and an administrative line, and governance kept off the chart.
- E-commerce companyThe site is the store, the warehouse is a contractor, and the lines between them are drawn.
- Veterinary clinicThe doctors own the medicine, the manager owns the day, and the technicians answer to both.
- Auto dealershipThe front end sells the cars; the back end pays the bills; the chart shows where they meet.
- School districtSchools on one line, the money on another, and a board that governs from a second chart.
- Police departmentPatrol takes the calls, investigations takes the cases, and professional standards answers to the chief alone.
- Nursing homeThe administrator holds the license, the director of nursing holds the building, and the survey reads both lines.
- Property management companyThe owners and the boards are clients, the site staff are employees, and the chart is where the two facts meet.
Or start from a structure — functional, divisional, matrix or flat — or from your own spreadsheet. The guides cover a reorg, a merger, an assistant's chart and a consultant's deliverable.
Make it yours
Download the spreadsheet, replace the names, import it — the chart redraws itself. Or start empty and drag people until it's true. Building is free at any size.