Someone whose back has just gone searches for “physio near me”, finds your clinic and rings. One ring, two, three. Nobody picks up. They hang up and try the next clinic on the list.
None of that shows up in a report. You never see the patient who didn’t come, only a missed call in the log, if you look at it at all. This article covers how many calls tend to slip through, how to work out what they cost using your own numbers, what happens out of hours and what you can do about it. At the end we look at WhatsApp, which has the same problem.
How many calls go unanswered
We haven’t found a reliable public study on how many calls physio, chiropractic or osteopathy clinics miss. The most solid data we’ve found is broader.
The Invoca Lead Conversion Benchmarks Report 2026 looks at more than 70 million calls to businesses in ten sectors. Only 56% of callers got to speak to a person, so 44% didn’t. In healthcare, 54% spoke to someone. Leave out calls shorter than 15 seconds (wrong numbers, quick hang-ups) and the overall figure rises to 65%.
These are figures from Invoca’s customers. Invoca is an American call analytics company, and this isn’t data from clinics like yours. It gives you a sense of scale. Your own figure could be better or worse, and further down you’ll see how to measure it.
So what do people do when nobody answers? In a 2025 CallRail survey of 1,000 US consumers, 42% said they leave a voicemail and 21% ring another business straight away.
What a missed call costs: the sum with your own numbers
Not every missed call is worth the same. An existing patient checking Thursday’s appointment time will probably ring back. The damage comes from the new patient who calls once, gets no answer and books somewhere else.
So the sum works in steps. The numbers in the table are a made-up example: swap them for yours.
| Figure | Example | Your clinic |
|---|---|---|
| Missed calls per month | 60 | |
| New patients wanting an appointment | 1 in 3, so 20 | |
| Those who would have booked | half, so 10 | |
| Visits per new patient | 6 | |
| Average session price | £50 | |
| Value of a new patient | 6 × £50 = £300 | |
| Revenue lost per month | 10 × £300 = £3,000 |
On these assumptions, that’s £3,000 a month and £36,000 a year. Sixty missed calls a month is about three per working day, which is fairly normal for a clinic with one person on reception.
The sum also leaves two things out. It doesn’t count the referrals that patient would have brought you. And it doesn’t count existing patients who rang to move an appointment, couldn’t get through and ended up not turning up.
If you’d rather not do it by hand, put your numbers into the calculator on the home page.
Why calls get missed even when your team is doing a good job
It’s almost never about attitude. The problem is capacity.
Your receptionist can only take one call at a time; while they’re talking to someone, the next call keeps ringing. And the patient at the desk comes first: taking payment, booking the next session or answering a question at the front desk takes the phone out of their hands for a few minutes.
Peak times also pile up. First thing, late morning and the end of the working day bring in more calls just when reception is busiest. When your receptionist is off sick or on holiday, whoever is free answers the phone between patients.
In a small clinic it’s even starker. If you’re the one treating and the one answering, you won’t pick up mid-session. Nor should you.
Out of hours: the times that cost you most
If your clinic is open 50 hours a week, the phone goes unanswered for the other 118. Those hours don’t all count the same, though. It helps to split them into four:
- Lunchtime, which often lines up with the moment your patients step out of work and use their break to call.
- Before you open and just after you close. Plenty of people ring on the way to work or as they leave in the evening.
- Evenings and nights. Fewer people call, but the ones who do are usually after an appointment for the next day.
- Weekends and bank holidays. If you’re closed on Saturday, those calls go to another clinic.
Acute pain is the clearest case: low back pain, sciatica or a sports injury. That person wants an appointment now and won’t wait for you to ring back tomorrow.
There’s one more thing. If you pay for Google or social media ads, every out-of-hours call that goes unanswered is ad spend that turns into nothing.
Voicemail, an answering service or an AI assistant: your options
There are three usual ways to cover the calls your team can’t take.
| Option | What it does well | What it lacks |
|---|---|---|
| Voicemail | Comes with your phone system and costs next to nothing | Many new patients hang up without leaving a message, and you ring back hours later |
| Outsourced answering service | A person answers | Often just takes a message and can’t book into your diary |
| AI voice assistant | Answers at any hour and can book into your diary during the call | Needs setting up properly at the start, and doesn’t replace face-to-face care |
With voicemail, timing is the problem. By the time you listen to the message the next morning, the patient may already have booked elsewhere. An answering service solves the “someone picks up” part. But if it can’t see your diary, the patient still hangs up without an appointment and your team has to call them back.
If you want to know exactly what a voice assistant is, there’s a short explanation in what an AI voice agent is. And if you’re weighing up another hire against an assistant, the comparison is in AI receptionist vs human receptionist.
How to measure your missed calls before you decide
Measure before you buy anything. A week or two of data is enough.
- Log into your phone provider’s portal. BT, Vodafone and most other providers give you inbound call statistics. Look for total calls, answered and unanswered calls, and the time each one came in.
- Separate the out-of-hours calls. Count lunchtime, before opening, after closing and weekend calls on their own.
- Check who was calling. Compare the missed numbers with your patient list. Numbers you don’t recognise are almost always new patients.
- Run the sum. Use the table above or the calculator.
Treat the result as a floor. It doesn’t count the people who saw your opening hours on Google and never rang.
How CAi helps you stop missing calls
CAi is HeyCAi’s voice assistant. It answers your clinic’s phone when your team can’t, and introduces itself as your clinic’s assistant.
If you’d rather see it working than read about it, the after-hours calls page shows what CAi does with each call your team can’t pick up.
It picks up in under 2 rings. Mornings, lunchtimes, nights and bank holidays. Several calls at once, no waiting and no voicemail.
You decide when it steps in. Keep your number: calls go to CAi when you can’t answer, out of hours or always. You choose.
What matters is that the call ends in an appointment, booked while the patient is still on the line:
- Books directly into PracticeHub and QuiroHiro, and into any diary with an API, such as Cliniko or Google Calendar.
- If you use a different diary, we’ll look at it on the video call.
- Once booked, the patient gets a confirmation on WhatsApp.
And it knows when to stop. If something falls outside what it knows, it puts the call through to you or an on-call number, or takes a message and alerts your team on WhatsApp. You choose.
A few more details:
- Answers in Spanish and English.
- Reminder calls 24 hours and 2 hours before the appointment, with the option to reschedule there and then.
- After every call you get a summary, the transcript and a WhatsApp alert.
For the full picture of what an assistant like this does, read what an AI assistant for clinics is.
To be fair, it isn’t always worth it. If you get fewer than 10 enquiries a day and hardly miss any, you may not need it. And if your diary is on paper or in a spreadsheet, you’ll need to move to a digital diary first, because CAi can’t book without one.
And then there’s WhatsApp
Your patients don’t only ring. They message too. WhatsApp has the same problem as the phone, it’s just less visible: the message arrives at 9.30pm, nobody sees it until the next day, and by then that person has messaged two other clinics.
To see where you stand, open the clinic’s WhatsApp and compare the time of each message from a new patient with the time of your first reply. If the gap is measured in hours, you’re losing patients in writing just as you are on the phone.
CAi answers your clinic’s WhatsApp too, just like the phone: it replies straight away, offers real slots and books, moves or cancels appointments in your software. It works from the same diary, so there are no double bookings. We use the official WhatsApp Business API.
WhatsApp is also useful after the booking: confirming the appointment and reminding the patient. We cover that in clinic WhatsApp reminders that cut no-shows and how to cut no-shows with WhatsApp and AI.
Frequently asked questions
How many calls does a clinic miss on average?
We haven’t found a reliable figure for physio, chiropractic or osteopathy clinics. The Invoca report for 2026, covering more than 70 million calls to businesses, finds that 44% of callers never speak to a person, and 46% in healthcare. The best figure is your own: pull it from your phone provider’s portal over a week or two.
Isn’t voicemail enough?
It does little for new patients. In the 2025 CallRail survey, only 42% said they leave a message and 21% ring another business straight away. And by the time you listen to the message and call back, hours may have passed and the patient may already have booked elsewhere.
Can I keep my phone number?
Yes. Keep your number: calls go to CAi when you can’t answer, out of hours or always. You choose. You can start with just the calls you miss and widen it later.
What happens if someone wants to speak to a person?
If something falls outside what it knows, it puts the call through to you or an on-call number, or takes a message and alerts your team on WhatsApp. You choose. CAi doesn’t give clinical advice.
Does CAi answer WhatsApp as well?
Yes, just like the phone and from the same diary, so there are no double bookings. You can start with WhatsApp only and add voice later.
Want to hear how CAi would answer at your clinic? Ask for a demo call: CAi reads your clinic’s website and calls you: your phone rings in about 30 seconds. If you’d rather talk it through, get in touch and we’ll go over it on a video call.