Turn cost containment into a staff project. If practice overhead is higher than 42% of total revenue, there are almost certainly areas where costs can be reduced without negative consequences. The best approach to finding places to cut is to involve the whole team. Introduce this project at a monthly meeting, asking everyone to come to the next meeting with at least 5 specific cost-cutting ideas to present to the group for discussion. Encourage participation with a lunchtime pizza party or other not-too-extravagant reward.