Field study 07

How small clinics actually schedule a follow-up

Eleven practices, three cities, six weeks of shadowing and 34 recorded calls.

March – May 2026Research team of threeSample report

The question we kept coming back to: who decides the date — the clinician or the front desk?

Method

Shadowing first, interviews second.

Two researchers sat at the front desk of eleven practices for a half day each, logging every scheduling event on paper. Interviews came afterwards so that what people said could be checked against what we had already watched them do.

InstrumentCountHours
Front-desk observation1144
Recorded calls, with consent346
Clinician interviews911
Patient intercepts225

What this cannot see: anything that happens after the patient leaves the building.

Finding 01

The date is chosen in the corridor, not at the desk.

In 29 of 44 observed follow-ups, the clinician named a rough interval while walking the patient out. The desk then worked backwards to fit that interval into the diary, and only moved it when nothing was free.

  • The interval was spoken as a range ("four to six weeks") in 24 of those 29 cases.
  • The desk treated the lower bound as the target in almost every case.
  • Nobody wrote the interval down before it reached the booking screen.

Spoken, never written. Everything downstream is a reconstruction.

I say six weeks and I mean "before this gets worse". The desk hears a number.

Clinician, practice 4 — April 2026

Finding 02

Rebooking clusters on two days of the week.

Follow-ups landed on Tuesday and Thursday far more often than the diary's own capacity would explain. Both are the days the practices run their longest clinics, and the desk fills them first.

MONTUEWEDTHUFRI

Capacity is flat across the week. The clustering is a habit, not a constraint.

Finding 03

Reminders work; confirmations do not.

PromptSentAttendedRate
No prompt966164%
Reminder, 48 h before1048986%
Confirmation request at booking885866%
Both726388%

Asking people to confirm at the moment of booking added nothing; the reminder did the work. Sample data.

Two prompts cost twice as much and bought two points.

If I confirm when I book it, I have already decided. The text two days before is the one that changes my morning.

Patient intercept, practice 9 — May 2026

Pattern

Three groups, one overlap that nobody owns.

Clinical intentDiary capacityPatient week the gap

Nobody is accountable for the middle, so it defaults to whoever is at the desk.

Counter-evidence

Two practices did not behave this way.

In practices 2 and 10 the clinician entered the interval directly into the record before the patient reached the desk. Both had a nurse-led triage step the others did not, which is as likely an explanation as the booking habit.

We are not able to separate the two with eleven sites. Treat the pattern as a hypothesis for a larger sample, not a finding.

Say the thing that weakens your own story, before someone else does.

Limits

Four things this study cannot tell you.

  • Eleven practices in three cities, all urban. Rural scheduling was not observed at all.
  • Observation changes the desk. Two front-desk staff said so directly.
  • Attendance figures come from the practices' own systems, which count a late arrival differently in two of them.
  • Six weeks covers one season. Nothing here speaks to winter load.

Limits first, before the recommendations. They set the price of each one.

Next

Three things worth doing next.

All names, practices and figures in this sample deck are invented.

FIELDNOTE 1 / 11