A full schedule without another hire.
Most independent practices don't lose patients in the exam room. They lose them on hold, in the waiting room and at checkout. This sample project shows how we work on that with a practice like Linden Row. The same approach fits dental, physical therapy, chiropractic and dermatology offices.
The problem
About 140 calls a day, and nearly 1 in 5 went unanswered during the morning rush. About 1 in 9 patients didn't show up, and follow-up visits were rarely booked before patients left. The owner's plan was to hire another front-desk person.
The goal
Answer more calls, cut no-shows roughly in half and bring overdue patients back, with the staff the practice already had. Most of the changes use tools the practice was already paying for.
Pick your kind of practice. The same three problems show up, under different names.
Does this sound like your practice?
If three or more of these apply to you, the rest of this page is worth a read.
- Tap any that apply.
Where a patient goes, before and after.
In the old layout, the phones rang at the check-in counter. Every call pulled someone away from the patient standing in front of them.
Example model for a three-provider practice seeing about 1,200 visits a month. The math is in section 08, and you can run your own numbers in section 12.
We tried to book as a new patient.
We start every project by going through the practice the way a new patient would. At Linden Row that meant a secret-shopper visit, from the first phone call through the following three weeks, and a walk-through of both offices with the owner.
8:12
8:40
10:05
8:45
3 weeks
"We need to hire another front-desk person."
The desk had enough people. They were answering phones and checking patients in at the same time.
Most missed calls happen before 10am.
We pulled two weeks of phone records. The morning rush, when patients are also arriving, accounts for most of the calls that go to voicemail.
Before: 25 missed calls a day (18%). After: 7 (5%). The difference is mostly the 8 and 9am hours.
"I called three times before work. I gave up and booked somewhere with online scheduling."
Patient, 41 ยท switched practices"I'm checking someone in, the phone rings, and I have to choose. Either way somebody's unhappy."
Front-desk coordinator, 9 yearsThe visit from the patient's side.
We mapped how a patient feels at each step. The care itself scored well. The worst moments were getting through on the phone, the paperwork and leaving without a next appointment.
A visit went from 66 minutes to 40.
The service blueprint lays out what the patient sees, what staff do out of sight and the software behind both. New or changed steps are highlighted.
Time with the provider stays the same. The 26 minutes come out of paperwork done at home and a front desk that isn't also answering phones.
Three small changes to the office.
None of this needed construction. We moved the phones, added a tablet and a few signs, and changed what the checkout desk is for. See the plan โ
โ Check-in at the door
A tablet on a stand by the entrance. Most patients have already done their forms at home, so it takes about four minutes.
โก Call pod in the back office
Two headsets at the empty back desk. Phones no longer ring at the counter, and one person owns the phones during the morning rush.
โข Checkout & scheduling
The desk near the exit books the follow-up before the patient leaves, with the provider's note already on screen.
Fewer phone calls, more texts.
Patients can handle most things from their phone: book after a missed call, fill out forms before the visit and confirm or move an appointment. The practice's existing software did most of this. It just wasn't set up.
Sorry we missed your call.
Add your insurance card
Take a photo of the front
See you Thursday at 9:30
9:30Mon
2:15Tue
8:45
Wait for a call, miss it, call back, hold, pick a time, get no confirmation.
Booked at checkout before leaving. The reminder text handles any changes.
Most of the fixes cost nothing.
We didn't hire anyone or sign up for new software. Four of the seven changes were features in the phone system and patient software the practice already paid for.
The impact bars are our estimate of how much each change helps. We expect the free changes to make the biggest difference.
Where the money comes from.
Three things add revenue: new patients who used to hang up, visits that used to be no-shows, and overdue patients who come back. The math is below so the owner can check it.
Missed calls
6 more new patients a month ร $1,000 in first-year visits.
No-shows
60 more kept visits a month ร $120 average visit.
Overdue patients
225 overdue patients back in ร $120, once a year.
| Calls a day, missed 18% โ 5% | 18 more answered / day |
| New patients who used to hang up | 6 / mo ร $1,000 |
| Visits a month, no-shows 11% โ 6% | 60 more kept ร $120 |
| Overdue patients brought back | 225 / yr ร $120 |
| Cost: example engagement + materials | $20,000 + $1,400 |
| First-year cash while ramping | $166,800 |
| Yearly run-rate | $185,400 / yr |
About four hours a day. That covers much of the work the owner was planning to hire for.
Bringing back patients you already have.
Before spending on ads, we contacted patients who hadn't been in for more than a year. They already know the practice and its providers.
The campaign runs once a year. Most returns come in months 3 to 7, then taper off.
Twelve weeks to set up, then we keep it running.
The phone changes go first because they pay back fastest. The second office follows once the numbers hold for a month. The red diamonds are milestones.
What the owner checks every Monday.
The owner gets these four numbers by text every Monday. When one drops, it shows which part of the visit needs attention.
Targets for this sample engagement. On your engagement, the scorecard reports your measured numbers every week.
Try it with your own numbers.
This uses the same assumptions as the Linden Row example. Missed calls drop from 18% to 5%, no-shows fall by about 45%, and about 1 in 5 of your monthly visit count comes back from the overdue list each year.
Estimate only. We check it against your phone and scheduling data in the first two weeks.
One team covered all eight parts of the job.
A project like this usually means hiring a practice consultant, a designer, a developer, a phone-system vendor and someone to build the financial model. With Osnova it's one team and one monthly invoice.
UX Research
Find out where patients get stuck.
- Secret-shopper visit
- Walk-through of both offices
- Phone and schedule data
Service Design
Plan the visit step by step.
- Journey map
- Service blueprint
- Checkout script
UX/UI & Web
Let patients do more by text.
- Missed-call text-back
- Online forms
- Reminder and reschedule flow
Brand & Space
Change the office without construction.
- Floor plan
- Check-in and call pod
- Signs and directions
Operations & Process
Take 26 minutes out of a visit.
- Phone routing
- No-show follow-up
- Staff training
Finance & Pricing
Show where the money comes from.
- Revenue model
- Payback analysis
- Staffing math
Marketing & Growth
Bring back patients you already have.
- Recall campaign
- Review requests
- Website updates
Data & Reporting
Report results every week.
- 4-number scorecard
- Weekly text report
- Quarterly review
If this sounds like your practice, give us a call.
We start with a secret-shopper visit and a walk-through. You get our notes and a priced plan before you decide on anything else.