Are there economies of scale in the employment of administrative and reception staff?

In most fields of activity there are economies of scale as organi­ sations get larger, though this is perhaps less true in service activities than in production. In general practice we might expect that the supporting administrative activities would provide more potential for such economies than the one-to-one contact of the consultation. In particular, since a hypothetical single-handed GP with only 100 patients would still need to employ a receptionist for much of the week, as well as some secretarial and administrative back-up, we intuitively expected some advantages to accrue with greater list size.