Ninety days at a three-operatory general practice
The same engagement every practice gets, written out in order so you can see where the time goes and what actually gets measured. The practice below is a composite drawn from the audits we run: the shape of the problem is the one we find almost every time.
- Practice
- General and cosmetic, one location
- Operatories
- 3
- Front desk
- 2 staff, no evening cover
- Before
- Template site, phone and a contact form
What the audit found
We called at 11:40 on a Tuesday
Five rings, then voicemail. The call was returned at 09:15 the next morning — twenty-one hours later, by which point a patient in pain has called someone else.
We submitted their own web form at 19:12
The first human reply arrived at 14:00 the following day. Nothing acknowledged the form in the meantime, so the patient had no way of knowing it had been received.
Their inbox told the real story
Of the last sixty form submissions, thirty-eight had arrived outside opening hours. Every one of them waited until morning, and nobody in the practice had ever counted them.
The site took 4.8 seconds to paint on a mid-range phone
The insurance page named no plans, and there was no page for a single procedure the practice wanted more of. Search had nothing to rank.
Day 0
The audit, before any money changed hands
We test the practice the way a new patient would, then write down what we found and hand it over. At this point the practice is free to take the document and fix it themselves.
- Four channels timed: phone, web form, WhatsApp, email
- The site opened on a real mid-range Android handset, not a simulator
- The three fixes with the best return, ranked
Weeks 1–4
The build
Fixed scope, fixed price. The site is rebuilt around the three questions that decide whether someone contacts a practice, and the booking form becomes the thing every page points at.
- New site: procedure pages, an insurance page listing the actual plans
- Online booking wired to the practice's own calendar rules
- Knowledge base written from their policies, then checked line by line by the office manager
Week 5
Launch, with the front desk watching
The assistant goes live answering on the site, WhatsApp and email. For the first fortnight every reply it sends is copied to the office manager, so the practice can see what it says before it trusts it unattended.
- Handover rules agreed: clinical questions and anything about pain go to a human
- Out-of-hours replies acknowledge, answer and offer a slot
- Accounts, domain and code in the practice's name from day one
Week 12
The first quarterly read
Ninety days of the monthly report, against the numbers taken at the audit. The comparison below is the whole of it — the same six measures, before and after, with no line added because it happened to look good.
- Every figure traceable to a log the practice can open itself
- Reply times measured per channel, not averaged into one number
- The front-desk hours line re-estimated with the office manager, and labelled as an estimate
| Measure | At the audit | Day 90 |
|---|---|---|
| Median time to first reply, web formMeasured from submission to the patient receiving an answer, not to a staff member seeing it. | At the audit19 h | Day 9040 s |
| Inquiries answered outside opening hoursPreviously these waited for the next working morning. | At the audit0 | Day 9034 / month |
| New-patient bookings made without a phone call | At the audit0% | Day 9036% |
| Questions the assistant closed on its ownThe remaining 29% were handed to a human, which is the behaviour we want. | At the audit— | Day 9071% |
| Started bookings finished after a follow-upPeople who stalled part-way through the form. Before the system existed, nobody knew they were there. | At the audit— | Day 909 / month |
| Front-desk time on the phone, per dayThe least precise figure here, estimated with the office manager at both ends and labelled as an estimate in the report. | At the audit≈5.5 h | Day 90≈3.5 h |