Medical practice: organising the team for the Monday morning call peak

A “Monday morning rush” is a hypothesis to check: the shape of any peak depends on the specialty, the patient base, whether or not there is a secretariat, and the opening days. Before reorganising the team, measure what happens at your practice.

Over a few weeks, note from the phone’s call log the time slots when calls pile up, the number of unanswered calls and the time callbacks take. Also note the recurring reasons: appointment booking, cancellation, a question about hours, an administrative request, a result to collect. This map will tell you where to act.

Distinguish the volume peak from the difficulty peak. The same number of calls weighs differently depending on whether they are simple appointments or requests that call for a check, a hand-off to the practitioner or a callback after looking at the file. This distinction guides the choices: simple requests can be moved online, more complex ones deserve a dedicated callback slot.

Define who answers during the peak period, who greets the patients who are present, who makes the callbacks and who can step in as backup. Plan a stand-in for each role, so that one person’s absence does not disrupt the start of the week. A short meeting, once a week, lets you adjust.

According to the Assurance Maladie (France’s national health insurance), the administrative duties of a medical assistant (assistant médical, a role supported by a French health insurance funding scheme) include in particular welcoming the patient, creating and managing their file and billing the consultation. If your practice employs a medical assistant, clarify what falls to them (appointment booking, callbacks) and what remains with the care team, rather than letting the split happen as you go along.

Document how the peak works on a one-page sheet: who does what at what time, what to tell the patients who are present when the lines are saturated, how to ask for backup. A short sheet, displayed at reception, is easier to read and update than a long protocol, and makes it easier to bring in a stand-in or a new recruit.

Two levers lighten the phone load. The first is slot management: reserving part of the diary for unscheduled requests, spreading follow-up appointments across the week, and telling patients when the practice is more available. The second is online appointment booking: patients who wish to can book without calling, which frees up reception for requests that need a conversation.

The Assurance Maladie also mentions it in the funding scheme for employing a medical assistant: when a medical secretary becomes a medical assistant, payment of the aid is conditional on hiring a new secretary or using another medical secretarial arrangement, an appointment-booking platform included. Decide with the team which types of consultation can be booked online and which require a call, and state it clearly on the website and in the greeting message.

Reception must not give medical advice. Write with the practitioners a short, dated protocol: practical information that can be given (hours, appointment arrangements, administrative procedures), questions not to be settled at reception, the route for passing things on to the practitioner. For emergencies, direct callers to 15, the Samu number for medical emergencies according to Service-Public.gouv.fr (France’s official administrative information portal), and to 112 if needed; the article on safety instructions details this referral.

Also invite patients not to describe their symptoms in a voicemail: “leave your name, your number and the reason for your call, and we will call you back”. For the periods when the practice is closed, the French Public Health Code (Code de la santé publique) provides for out-of-hours care (the “permanence des soins”), whose organisational principles are set by a regional specification issued by the director general of the regional health agency, and in which access to the doctor is subject to prior telephone medical regulation (116 117 or 15, depending on the region); the subject is covered in a separate article.

If a provider or a tool keeps, on the practice’s behalf, recordings, transcripts or summaries of patient calls, check with your data protection officer whether they may contain health data: Article L1111-8 of the Public Health Code makes the hosting of health data collected in the course of prevention, diagnosis or care activities subject to certification, where it is carried out on behalf of the person who produced or collected them, for example a practice.

Also plan for what is out of the ordinary: a practitioner’s absence, a delay, a public holiday. A message updated on the line and on the website, validated by the practitioners, stops reception answering the same questions case by case.

Once the peak has passed, handle callbacks in an agreed order (for example by time of call or the degree of urgency expressed by the patient), and close out each request in a shared tool. Do a weekly review of a few minutes: how many callbacks are pending, which reasons dominated, what could be moved online.

Alyas, an AI voice agent, can take the calls the team cannot answer: it answers using the information you give it, announces at the start of the call that it is an AI and that the call is recorded, captures the contact details and leaves the transcript and summary in your workspace. It books appointments if Google Calendar or Cal.com is connected; for other practice software, a compatibility check is needed. If it does not know, it says so and offers to pass the request on. The trial is free for 10 days, with no card required.