TL;DR: A 14-person dental practice in Cardiff has 4,800 registered patients and roughly 720 overdue for recall at any given time. The recall process: one receptionist calling from a printed list on Monday mornings. She reaches 40% of patients (the rest are at work, screening unknown numbers). Of those she reaches, 55% rebook. Effective recall rate: 22%. The other 78% go back into the pile. The list never shrinks. Estimated annual revenue sitting in overdue recalls: £38,000-£52,000. We designed a four-stage agent that monitors recall dates daily, runs an automated SMS and email outreach sequence with online booking links, flags non-responders for phone calls with full context, and dashboards the results. Patients book at 10pm on a Tuesday without Helen being involved. Helen's phone list shrinks to the 15-20 patients who genuinely need a call. Running cost: £38-£65 per month.
Monday Morning, 9am, Reception
Helen pulls up last week's recall report from Dentally. Forty-seven patients overdue. She prints it. She starts calling.
First call: voicemail. Second: voicemail. Third: answers, books a hygienist appointment for next Thursday. Fourth: voicemail. Fifth: "I'll call you back." She won't. Sixth: number disconnected.
By 11:30, Helen has called 47 patients. Reached 19 of them. Booked 11 appointments. The other 36 go back into the pile.
Next Monday, the report shows 52 overdue patients. Some are new (recall dates expired this week). Some are the same 36 from last week. Helen calls again. Reaches a different subset. Books a few more. The list has grown by 5.
The week after: 56. Then 49 (a good Monday). Then 58. The list never shrinks. It grows slowly, punctuated by Monday morning dents that don't keep pace with the new overdue patients accumulating between calls.
Helen is also answering incoming calls, greeting patients arriving for appointments, processing payments, and managing the appointment book. Recall calling is the task that gets squeezed when everything else is busy. Which, in a dental practice on a Monday morning, is always.
The practice has 720 patients who should have been seen within the last six months and haven't. That's 15% of the register. At average appointment values (£65 for check-ups, £55 for hygienist, £120 for follow-up treatments), those overdue recalls represent £38,000 to £52,000 in annual revenue sitting in a spreadsheet that someone calls through on Monday mornings when she has time. She rarely has enough time.
The Practice
Private dental practice in Cardiff. Fourteen employees: three dentists, two hygienists, four dental nurses, one practice manager (Megan), two receptionists (Helen and one colleague), one admin, one office manager. £1.4M annual revenue. Roughly 4,800 registered patients.
Helen's loaded cost: approximately £16 per hour. She spends 2-3 hours per week on recall calling: 104-156 hours per year. Annual cost: £1,664 to £2,496. Modest. The problem isn't the cost of making calls. It's the cost of the calls that don't connect.
Contact rate on Monday morning calls: 40%. Patients are at work. They don't answer unknown numbers. They see "Cardiff" on their screen and decline because they're in a meeting, or because they suspect (correctly) that it's their dentist reminding them of something they've been meaning to do but haven't.
Of the 40% Helen reaches, 55% rebook. Effective recall rate: 22%. For every 100 overdue patients on the list, 22 end up back in the chair. The remaining 78 cycle back into the pile, where they stay until the list rolls around again (4-8 weeks, depending on volume).
Patient attrition attributable to recall gaps (patients who eventually deregister or move to another practice): estimated 3-5% of the register annually. At an average lifetime patient value of £1,200-£2,000, that's £172,800 to £480,000 in long-term value at risk from patients who drifted away because nobody reached them at the right time through the right channel.
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