The phone call is the most expensive thing my clinic does

I used to think a missed call was just a missed call. The line was busy, the front desk was slammed and the caller would try again later. No harm done. Every clinic I’ve worked in treated the phone this way, so I never questioned it.Then I started paying attention to who was actually on the other end of the calls we didn’t answer. It changed how I run my practice, and I want to make the case that it should change how you look at yours.Who hangs up after the third ringHere’s what I found when I finally looked. The missed calls weren't random noise. They were patients with a reason to call right now.The patient needed a refill and had two pills left. The patient who’d been sitting on a symptom for a week finally worked up the nerve to phone. The patient, trying to book a follow-up, I’d told her was important, got voicemail twice and quietly decided it could wait. Some of them called back. Plenty didn’t. A few of the ones who didn’t turn up months later, further along in whatever we could have caught earlier.None of this showed up in any report. A missed call leaves no chart entry, no complaint, no record at all. That’s exactly why it took me years to see it. The costs of an unanswered phone are real, but they land silently: on the patient first, and on the clinic later.(The patients described above are composites of the kinds of patients I see, not specific individuals.)We chose this, we just stopped noticingThe comfortable story is that busy phones are a staffing problem. Front desks are stretched everywhere, and mine is no exception. When patients complained they couldn't get through, I’d nod and say what every clinic owner says: we’re doing our best, it’s hard to find staff, please keep trying.But that story let me off the hook too easily. The truth is that unanswered calls are the result of decisions I made and stopped questioning. I decided the phone gets answered only when someone happens to be free. I decided lunch hour means the line rings out, even though lunch hour is exactly when working patients can call. I decided that a person standing at the counter always outranks a person on the phone, without ever asking whether that’s right. No one imposed those rules on my clinic. They were defaults I inherited and never examined.Once I framed it that way, the phone stopped looking like a nuisance and started looking like what it actually is: my front door. Most patients never see my waiting room until they’ve gotten through on the phone first. If the door doesn’t open, nothing else about the clinic matters. The care I’m proud of, the team I’ve built, the appointments I hold, all of it sits behind a door that was closed more often than I wanted to admit.Counting what the phone actually costsDoctors are trained to think in clinical costs, so let me put it in those terms and in business terms at once.Clinically, a missed call can be a delayed diagnosis, a lapsed medication, a follow-up that never happens. The patient who gives up on the phone doesn’t stop being sick. She either waits, goes to a walk-in or lands in an emergency department for something my clinic could have handled on a Tuesday afternoon.Operationally, the arithmetic is blunt. Every unanswered call is potentially a booking that didn’t happen. A modest number of lost bookings a week, carried across a year, is a serious amount of care not delivered and revenue not earned, all while my schedule showed open slots I assumed nobody wanted. The slots weren’t unwanted. They were unreachable.That’s why I’ve come to say the phone call is the most expensive thing my clinic does. Not because answering it costs a lot, but because failing to answer it does, and that expense never appears on any statement where I’d be forced to look at it.What I’d ask a colleague to doI’m not going to pretend the fix is simply “answer every call,” because no front desk can, and mine can’t either. What I’d ask instead is this: measure it. Find out how many calls your clinic misses in a normal week, and at what times. Most phone systems can tell you, and most of us have never asked. My own number embarrassed me.Then treat the answer as a design problem, not a staffing complaint. Decide, deliberately, what happens when a call can’t be answered live. Does the patient reach a dead voicemail or something that responds? Does anyone follow up on missed calls the same day? Is there a way to book or ask a question that doesn’t depend on winning the phone lottery at 9 a.m.? Different clinics will answer differently, and I’ll disclose that I now work with a company that builds tools in exactly this space, so weigh my enthusiasm accordingly. But the argument stands apart from any tool: access is part of care and the phone is where access lives or dies.I undervalued mine for years because the patient who hung up after the third ring was invisible to me. She isn’t anymore. I believe the phone deserves the same seriousness we give the exam room, because for the patient, it comes first.Dr. Varun Bajaj is a practicing physician based in Abbotsford, B.C., who manages a high-volume practice across in-person and telemedicine settings. He is a co-founder of HiClinic, a Canadian clinic management and healthcare CRM platform he built with Danish Wadhwa to help clinics automate patient communication, recover missed calls, increase reviews, and improve patient retention.

The phone call is the most expensive thing my clinic does

Register for free access or login.

Related Topics