No. 004 · Sunday
THE MEMO
I run a part-time clinic now. Two days a week, by design. Which sets up an obvious question: who answers the phone the other five days?
Nobody. The phone gets answered anyway.
Since 2025, the first voice a patient hears when they call United Foot & Ankle is an AI agent. Not a robot voice telling people to press one. A natural conversation. She picks up, answers the ordinary questions (do we take Blue Cross, is there parking, do I treat this condition), texts the patient our booking link, and gets them scheduled. Evenings, weekends, holidays, 2 AM. Then she notifies my team, so a human still reaches out when we're back in.
Here's the part that matters. As far as the patient is concerned, the call never goes to voicemail. They talked to the practice. Patients don't wait for callbacks anymore; they call the next doctor down the street. Mine don't have to.
What it cost. About $30 a month. That's the phone bill and the AI usage. The comparison that matters is the human one: a part-time front desk covering even a slice of those hours runs $1,500 to $2,000 a month, and no human covers 2 AM and weekends. My voice AI agent never sleeps.
What it returned. She answers 30 to 40 calls a week. My team gets notified, we call each one back, and we convert about eight of them into booked patients. Every week. At a clinic that is physically open two days.
And the thing I didn't fully appreciate until I lived it: I don't need a physical employee sitting in the office on days I'm not there. That is what makes a two-day clinic viable at all. The phone coverage isn't a convenience. It's the load-bearing wall of the lifestyle.
I've been helping other practices set this up too, and I've noticed something. Once an owner understands the workflow, they never go back. Because voicemail, once you've seen the alternative, looks like a hole in the side of the building.
TJ
THE SIGNAL
Three things worth your attention this week.
72% of Americans say it's important that a provider tell them when AI is being used in their care. That's Pew Research Center, from a survey of 3,488 US adults fielded in June. The demand for disclosure is highest on clinical work (81% for reading a scan) and lowest on admin, but even scheduling an appointment sits at 56%. The lesson isn't to hide the AI. It's the opposite: patients are fine with it, as long as you're the one who tells them.
The share of physicians in private practice has fallen to 42.2%, down from 60.1% in 2012. That's the AMA's Physician Practice Benchmark Survey, an 18-point drop in twelve years, with low payment, high costs, and administrative burden named as the drivers. The overhead that pushes doctors to sell is exactly the overhead a leaner practice can now automate.
84% of medical groups say their operating costs are higher than a year ago, and the average increase is about 11%. That's the MGMA's August poll of 251 practices, which names labor first among the drivers: wages, benefits, and staffing shortages. The single biggest line item in most practices is the one climbing fastest.
WHERE I’LL BE
MIS Intensive Private Cadaver Lab
September 25-26, 2026 · Glenview, IL · CME Dynamics HQ
misintensivelab.com
Private Practice Profits Workshop, In Person
October 23-24, 2026 · Glenview, IL
privatepracticeaiworkshop.com
