One missed session becomes three
A patient misses week two. Nobody calls, and the plan that depends on weekly progression quietly stops.
See the attendance dataCet exemple est en cours de mise à jour. Le texte ci-dessous est encore en anglais.
Example · Physiotherapy and therapy clinicsRebooking and adherence agent
The course of treatment that quietly stops
An agent that reminds the patient, rebooks the session, checks in between visits and flags a drop-off to the clinician — without ever advising on exercise, pain or progress.
Illustrative scenario — not a real client result
Course tracker · 16:20
- Answered
18 reminders sent
16:21 · Next session, time, what to bring
- Answered
4 sessions rebooked
16:24 · Same clinician, inside the plan's window
- Person
“The pain is worse this week”
16:26 · Clinical · with the physiotherapist
No exercise or pain advice, ever
Rebooking and adherence agent · Physiotherapy and therapy clinics
- Sourced facts
- A clinician decides
- Drop-offs are flagged
01 — A typical day
Three small failures that add up.
What physiotherapy and therapy clinics owners tell us goes wrong in an ordinary week.
A booking line that cannot be reached
Patients who want to change an appointment cannot get through, so they simply do not come.
See the clinic studyA pain question in a reminder thread
“Should I keep doing the exercises?” is a clinical question, and a friendly answer from an assistant is a risk.
See the boundary01 — A typical day · the evidence
What the numbers actually say.
Each figure opens its source, year, sample and limits. Click a badge to check it.
01
Source
PLOS ONE, missed appointments across US outpatient physiotherapy
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the source73%
of patients missed at least one appointment in a course of physiotherapy
Retrospective cohort of 444,995 patients across 697 US clinics, records from 2016–17. Share of patients, not of appointments.
PLOS ONE · 202102
Source
International Journal of Physiotherapy, no-shows at a private clinic
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the source20.6%
of appointments were no-shows or cancellations at one clinic
6,162 appointments at a Calgary clinic, 2017 records. Combined figure, not no-shows alone.
International Journal of Physiotherapy · 202103
Source
International Journal of Physiotherapy, no-shows at a private clinic
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the sourceC$114,506
estimated annual cost of those missed appointments
The same single-clinic study. An estimate for one clinic, not a sector figure.
International Journal of Physiotherapy · 202102 — What the helper does
From your records to a decision you own.
The agent works from the plan the clinician wrote: how many sessions, how far apart, and which one is next. It reminders the patient, rebooks within that window, and keeps the record current.
Between sessions it sends the check-in the clinic has approved — a short question about attendance, not about symptoms — and passes any answer that mentions pain, swelling or a change in condition straight to the clinician.
It never prescribes, progresses or adjusts an exercise, never says a symptom is normal, and never discharges a patient from a plan.
6 steps · 2 decisions you own
Reads from
- Practice system
- SMS
- Phone notes
Text version of the flow
- 1. Read the plan — Sessions left, spacing.
- 2. Remind and rebook — Same clinician, same window.
- 3. Check in between — Attendance, not symptoms. Human checkpoint: Two misses reaches a person.
- 4. Flag the drop-off — Two missed, one message. Human checkpoint: A clinician owns the plan.
- 5. Route anything clinical — Pain, swelling, new symptoms.
- 6. Close the plan — Completed or discharged.
02 — What the helper does · a simulated example
One simulated example, step by step.
Use the buttons or the left and right arrow keys. Nothing here is a real customer.
Simulated example
North Quay Physio, five clinicians
SMS · 16:20
A five-clinician outpatient clinic. The agent manages reminders and rebooking for active plans. Every message is simulated; no real patient data is used.
North Quay Physio's assistant. I can confirm or rebook your session and pass messages to your physiotherapist. I can't advise on exercises or symptoms. Reply HUMAN for a person.
03 — What you decide
The helper prepares. You decide.
The agent keeps the appointments. The clinician owns the treatment.
The plan is read-only
Session count, interval and exercises come from the clinician's record; the agent cannot change any of them.
Symptoms stop the script
Pain, swelling or a change in condition goes to the clinician with the plan, and the patient is told who will reply.
Drop-offs are clinical events
Two consecutive misses flag the plan instead of generating another reminder.
You can pause it
Pause for a clinician, a patient or the whole clinic; messages fall back to reception.
Without your approval · No exercise prescription, no progression, no reassurance about pain, and no discharge. Two missed sessions always reach a person.
04 — What changes when a safeguard is missing
Documented cases, not scare stories.
Three documented cases with their sources: a booking system that patients could not use, a falsified timesheet, and a fraud that relied on unchecked records.
Letters late, phone line busy, patients absent
A quality-improvement review found patients complaining that appointment letters arrived too late and that a busy reception line stopped them changing appointments. Baseline DNA was 23.76% for new referrals and 23.74% for follow-ups; after booking changes and SMS reminders, 13.46% and 13.26%.
What the helper would do differently
Rebooking is self-service and always reachable, and the reminder carries the change route in the same message. The clinic measures its own DNA rate before and after rather than assuming the effect.
23.8%
DNA rate for new referrals at baseline
Timesheets signed for hours not worked
A physiotherapist repeatedly claimed pay for hours not worked, submitted timesheets purporting to carry a colleague's signature, and claimed travel expenses improperly, including after leaving employment. The panel found misconduct and imposed a striking-off order.
What the helper would do differently
Session attendance and completion come from the clinic's own record, never from a self-report the agent collects. What the agent records is evidence, not an approval.
Struck off
misconduct found by the regulator
Treatment recorded for therapists who were not there
A clinic office manager falsified medical records to say physical therapists who were not at the clinic had treated patients; Medicare paid the clinics more than $8 million over 2018–2020. A federal jury convicted her of health-care fraud and false statements.
What the helper would do differently
The agent cannot mark a session as delivered. Attendance is matched to the clinician's identity and the appointment record, and an anomaly is investigated rather than absorbed.
$8M
Medicare paid to the clinics in the scheme
04 — What changes · the evidence
The rest of the evidence.
Every figure resolves to a source with its sample and limits. No figure without one.
73%
of patients missed at least one physiotherapy appointment
444,995 patients, 697 US clinics, 2016–17 records. Share of patients, not appointments.
Source
PLOS ONE, missed appointments across US outpatient physiotherapy
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the source20.6%
no-shows and cancellations at one outpatient clinic
6,162 appointments, Calgary, 2017. Combined figure; single clinic.
Source
International Journal of Physiotherapy, no-shows at a private clinic
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the sourceC$114,506
estimated annual cost of missed appointments at that clinic
The study's own estimate for one clinic. Not a sector-wide cost.
Source
International Journal of Physiotherapy, no-shows at a private clinic
2021
Method and sample are recorded in the source registry.
Read the source for its scope and limits.
Open the source
04 — What changes · your week
The same week, two ways.
Drag the handle, or use the left and right arrow keys when it is focused.
Typical week, beforeTypical week, after
Mon
Two patients miss their session; nobody calls them.
Tue
A patient cannot reach reception to move an appointment, so does not attend.
Wed
A pain question is answered by whoever picks up the phone.
Thu
A plan stalls at session three and stays on the books.
Mon 16:21
Reminders sent; changes handled in the same thread.
Tue
Sessions rebooked inside the plan's window, with the same clinician.
Wed
Pain reports reach the clinician the same day.
Thu
Two consecutive misses flag the plan for clinical review.
Illustrative example · not a measured result
05 — Your version
Four questions about your own week.
Keep your answers. They are the brief for the first version we would build for you.
How many sessions does the clinic run in a week, and how many are missed?
How often should a check-in happen between visits?
What counts as a drop-off that a clinician should hear about?
Which questions must never be answered by an agent: exercise, pain, progress?
Next
Put your own figures into the calculator below. It runs in your browser, and nothing is sent or stored.
Put your week into the calculatorBring the four answers to the free one-hour call. We will use them to sketch the first version, and you keep the written plan either way.
Talk about your business05 — Your version · your numbers
Put your own week into it.
An estimate, not a promise. The model and its assumptions are printed below.
Your inputs
All clinicians.
count
Reminders, changes, call-backs.
min
Your own no-show and late-cancel rate.
%
What a missed session costs you.
per hour
Reception time.
per hour
Example defaults are typical for a small business. Replace them with yours. Nothing is stored, sent or shared.
Estimated result
IllustrativeReception hours back each month
0–0
- Time released at your rate
- £0–£0
- Reminders sent after hours
- 0–0%
- Time to a rebooked session
- Already immediate
How we calculated this
Routine work handled by the helper: 70% of the share you marked routine.
Time saved per item: 80% of the minutes you entered.
Monthly volume: weekly figures × 4.33; monthly figures used as entered.
Cost: hours saved × your staff cost per hour, in pounds as an illustration.
Reply time: routine items move within the hour while the helper runs. Complex work still waits for a person.
Questions
The things people ask next.
No. Exercises, progression, frequency and stopping are the clinician's decisions. The agent routes any such question with the plan attached.
It goes to the clinician the same day, with the plan and the patient's own words. The agent does not say whether that is normal.
It offers to rebook inside the plan's window. Two consecutive misses flag the plan for clinical review instead of another automated reminder.
No. Only the clinician discharges a patient. The agent can report that all sessions were attended and is waiting for a discharge note.
Attendance comes from the clinic's appointment record, matched to the clinician. The agent cannot mark a session as delivered.
It stays in the clinic system, is encrypted, and is retained on the clinic's schedule. Clinical notes are not ingested.
Two to three weeks: plan structures, your check-in wording, escalation rules and a parallel run with reception.
Start here
Show us a month of missed sessions.
One hour with your attendance data and one treatment plan. We will show you where the course stalls, and what the agent would send — and never send.