Lead to surgery: the seven handoffs where clinics lose patients

01

1. Enquiry to first human contact

A form is submitted at 9.40pm. Somebody sees it at 11am the next day. In between, the patient has filled in three more forms on three other sites, and two of those clinics called back first.

What fails: no acknowledgement, so the patient assumes nothing is happening. Response is measured as an average, which hides the enquiry that waited eleven hours.

I would require an acknowledgement that identifies the responsible coordinator and an agreed callback window. Review both the response distribution and the longest unresolved waits. An average alone can hide the patient still waiting for an answer.

02

2. First contact to qualified conversation

The call connects. The agent takes a name, a city and a budget, and books a consultation. Nobody asks what the patient has already tried, what medication they take, what they think is going to happen, or why now.

What fails: the consultation then starts from zero, which wastes the most expensive fifteen minutes in the business.

What fixes it: a short set of questions the agent must complete before booking, and the rule that the answers travel with the patient. Five or six questions, no more. If your agents cannot fill them in without reading a script aloud, the questions are wrong, not the agents.

03

3. Booking to attendance

Between booking and the appointment sits a gap of days. In that gap the patient tells a partner, reads a forum, finds a cheaper option and thinks about whether they really want to do this.

What fails: the clinic goes silent, and silence is where doubt grows.

What fixes it: two or three contacts in the gap that give rather than ask. What to expect at the consultation, how long it takes, what to bring, whether anyone will see them arrive. Reminder messages that only confirm a time are a wasted contact.

04

4. Phone team to clinical consultation

This is the expensive one. The patient arrives having had one relationship, with the person on the phone, and is handed to a clinician who has not read the file.

What fails: the patient repeats themselves, which reads as disorganisation. Worse, expectations set on the phone go unexamined in the room. A patient who was told what they wanted to hear now hears something different and does not know which version is true.

What fixes it: the clinician opens the file before the patient sits down, and opens the conversation by referring to something the patient said on the phone. Thirty seconds of preparation. It changes the room. And the phone team must know that setting an expectation the clinic cannot meet is not a sale, it is a future complaint with a deposit attached.

05

5. Consultation to decision

The consultation ends well. The patient says they will think about it. Nothing is scheduled.

What fails: "think about it" is treated as an outcome rather than a stage. There is no owner and no date, so the follow-up depends on whoever remembers.

What fixes it: never end a consultation without a next event. A call at a stated time, a second opinion, a plan sent by a stated day. And the follow-up should carry something new, a plan document or an answer to the specific worry raised, not a request for a decision.

The rebuttal point sits here too. Handling an objection is not talking someone past their own hesitation. It is finding out what the hesitation actually is, because most of the time the stated objection is price and the real one is fear of the result, or of what people will say. Argue with the stated one and you lose both.

06

6. Decision to surgery day

The patient says yes. Now the pre-operative sequence has to run: tests, instructions, medication holds, arrival time, what to bring, who takes them home.

What fails: instructions arrive as one long message a day before. Blood tests get treated as a formality rather than a gate.

What fixes it: a countdown, with each instruction arriving when it is actionable. Fourteen days, seven days, one day. Hard gates that stop the schedule, not warnings that get waved through. If a required test is missing, the case moves. That rule is easier to write than to hold, and holding it once in front of the whole team is what makes it real.

07

7. Surgery to the long follow-up

The procedure goes well. The patient leaves. Then the clinic's attention moves to the next case, and the patient's own eighteen months of anxiety begins.

What fails: follow-up is treated as care rather than as operations, so it depends on individual conscientiousness. Month six, when the result is genuinely at its most disheartening for the patient, is exactly when the messages have usually stopped.

What fixes it: a scheduled sequence with named milestones, out to eighteen months, that runs whether or not anyone remembers. First wash, month two, month six, month nine, month twelve, month eighteen. The month six contact is the most valuable message the clinic will ever send, because it is the one that prevents a bad review written in a bad week.

08

The rule underneath all seven

At every handoff, three things must move with the patient: who owns them now, what has already been said to them, and what happens next. If any of the three is missing, the handoff is where you will find your losses.