IS AI TELEPHONE TECHNOLOGY READY

Why intelligent chiropractors make illogical decisions about AI reception technology when presented with data that disrupt their established systems

Author: Dr. Ryan Rieder
Date: October 2025

The Backstory: “Weird Wendy” – My First Telephone Hesitancy Story!

Back when I operated eight practices during online marketing’s early days, Facebook leads were remarkably inexpensive. Today’s costs seem astronomical by comparison, but even then, converting those leads into patient appointments required diligent, consistent follow-up.

Wendy was among the multiple team members managing our telephone follow-ups. She was … difficult—the type of person who could suck the energy out of the room simply by showing up. And her work? It reflected that same carelessness. Wrong practice locations, garbled patient information, completely inappropriate time slots. The pattern was undeniable.

She had one undeniable talent, though: her booking rate demolished everyone else’s numbers. She converted leads at percentages we’d never seen before. And in lead follow-up, that skill trumped everything else. Other hires? They either walked out or failed to produce. Unsurprisingly, Wendy’s screw-ups frustrated leadership. They were livid in ways I’d never seen. But the outrage seemed excessive for the actual problem. Sure, someone had to fix her booking errors and correct patient details. Annoying? Absolutely. But we were booking new patients at unprecedented rates across all eight practices, and Wendy was single-handedly responsible for most of it.

Yet in each leadership meeting, I faced near-mutiny over Wendy. The consensus was unanimous: she had to go.

My answer never changed: “Find me someone who can book like she does, and I’ll let her go.” It had taken us nearly a year to find Wendy. Good luck replacing those numbers quickly.

Here’s the pattern you’ll see throughout this story: everyone excessively scrutinized her telephone imperfections while completely ignoring the obvious reality—without her calls, we’d have zero new patient bookings.

No matter how I tried to refocus my team, Wendy’s mistakes consumed too much of my team’s mental energy. Eventually, I gave in. I gave them the green light to fire her.

I regretted it almost immediately.

Idiot. Absolute fool.

Four months later, we’d blown through tens of thousands of dollars in missed bookings. The number grew uglier by the week. Everything happened exactly as I’d predicted.

Total imbecile.

Since then, I’ve seen this pattern repeat itself over and over. Practice owners ignore the booking rates and answer percentages, instead falling into severe confirmation bias. They cherry-pick information that supports what they already believe and completely disregard any hard data that contradict it.

The frustrations I experienced running eight practices aren’t unique: most practice owners face identical challenges. Now that I work with hundreds of practices, I see the same two problems destroying new patient growth everywhere:

Inadequate (or completely absent) lead follow-up

Front desk calls remaining unanswered

Chiropractic practices bleed money from slow lead follow-up and unanswered phones. How do I know? I previously ran a concierge telemarketing operation handling around 10,000 calls per week. I currently run an online marketing agency generating more than 10,000 chiropractor leads monthly. And I’ve performed secret shopping at 60 practices to analyze exactly what happens when leads come in.

OUR AI JOURNEY!

During the last 60 days, we rolled out our AI reception answering and calling service (https://receptionai.net/) across more than 20 beta practices. Development required 10 months of rigorous testing and problem-solving. Every challenging moment proved worthwhile given our final product. The results are remarkable—I’ll reveal the statistics shortly.

Yet I’ve observed remarkably strange choices during this rollout—stranger than almost any other practice management scenario I’ve encountered. Clear proof demonstrates that AI outperforms humans across nearly every measurable metric, yet curious reluctance persists.

It’s like I’m facing that anti-Wendy rebellion again, although now, the technology being fought costs merely $200 per week ($1-$1.79 per hour) compared with $100k-$200k-plus in yearly team salaries.

Why such pushback? This article explores possible answers. Hold tight.

Let’s begin by diving into the findings from our covert shopper study spanning 60 practices. We enrolled in their lead generation programs, tracked response timing, then randomly phoned each location both during business hours and after hours.

Secret Shopper Discoveries:

Inbound Calls (We Contacted Practices During and After Business Hours)

44% of phone calls went unanswered during business hours.
95% of after-hours and weekend calls went unanswered.
91% of unanswered calls were directed to voicemail.
83% of voicemail messages received no response within 24 hours.
60% of voicemails were never returned (tracked for seven days).

Outbound Calls (We Enrolled in Lead Gen Campaigns, Like Facebook Ads)

82% failed to return calls with one hour.
62% failed to return calls in 24 hours.
57% never returned calls after seven days.
Among those who called back, 94% made only one attempt.

I conducted this study out of pure frustration. Client after client claimed they answered 90% of phone calls, had follow-up mastered, and booked 50% of leads. I couldn’t bluntly say they were full of, well … you know. But I knew one thing for certain: Either their team was lying or they were lying to themselves. With access to both digital marketing and EHR data across most practices, I saw reality: booking rates nowhere near their claims, and follow-up not happening in the reported timeframes.

Reporting these facts to them triggered Wendy-level skepticism. I needed hard evidence to demolish the “I book 50% myself” fantasy. The data were damning: 57% never followed up at all—not once in 7 days. Even when reading this, I’m certain that most think “not me”, and you would be dead wrong! Yes, you too!. Now contrast those dismal numbers with two actual ReceptionAI beta practices. Both implemented complete AI coverage for inbound and outbound during the past 60 days.

One important point: I believe in making it easy for a new patient to phone anytime (even at 9pm) and book, but I’m still not certain about making it equally easy for existing patients to reschedule or cancel. Allowing established patients to freely reschedule and cancel online without intervention has always struck me as problematic.

Our launch group reflects this thinking. New patients book directly with the AI voice agent, but existing patients requesting schedule changes trigger a different response: the AI takes their message and creates a follow-up task for the team.

This protocol may evolve, but it serves as a protective measure: Chiropractor assistants (CAs) can work to reschedule patients within the same week (keeping care plans on track) or convert cancellations into doctor checkups to reduce attrition. It’s a thoughtful balance between automation and human touch—designed to protect continuity of care while maximizing practice efficiency.

Inbound AI Telephone Performance Snapshot:

Note: With our launch group we initially recommend starting with after-hours and weekend coverage, although many practices launched 24/7. These results reflect stats when practices opted for 24/7 inbound answering.

Answer percentage: 100% (lowest recorded: 97%)
54% of business-hour calls involve existing patients.
AI takes messages and creates front desk tasks, acting as a concierge of sorts.
72% booking rate for new patient appointment requests through AI-answered phone calls

Outbound AI Telephone Performance Snapshot (Across 10,000 Calls):

98% of leads contacted within 60 seconds of submission
40-45% reach voicemail despite sub-60-second response times
35-45% book appointments when answering live (roughly one in two to one in three)
20-30% overall conversion from cold leads like Facebook campaigns (typically around 25%)

Practice 1

AI TELEPHONE INBOUND RESULTS:

Answer rate: 99% across all hours (business and after-hours)
Total calls managed: 244
Messages requiring follow-up: 55%
New patients booked: 61
Combined call duration: 12 hours 20 minutes
Booking conversation time: 6 hours 43 minutes
Average duration per call: 3 minutes

AI TELEPHONE OUTBOUND RESULTS:

Total leads: 202
Appointments booked: 41
Overall rate of booking: 20.2%
Attempts made: 646
Contacted under 60 seconds: 97%
Voicemails delivered: 333
Text messages sent: 110
Conversion when reached: 53.2%
Combined talk time: 7 hours 22 minutes
Total booking talk time with patients: 3 hours 15 minutes

Practice 2

AI TELEPHONE INBOUND RESULTS

Answer rate: 98% across all hours (business and after-hours)
Total calls handled: 111
Messages requiring follow-up: 58%
New patients booked: 33
Combined call duration: 8 hours 57 minutes (front desk time saved)
Booking conversation time: 4 hours 42 minutes
Average duration per call: 8 minutes 54 seconds

AI TELEPHONE OUTBOUND RESULTS:

Total leads: 26
Appointments booked: 7
Overall booking rate: 26.92%
Attempts made: 87
Contacted under 60 seconds: 96%
Voicemail rate: 42% unreachable
Voicemails delivered: 59
Text messages sent: 16
Conversion when reached: 62.5%
Combined talk time: 4 hours 42 minutes
Booking conversation duration: 4 hours 42 minutes

Inbound Cost Savings & Operational Impact

For every hundred inbound calls, AI automation delivers:

Call cadence: Immediate contact, then twice daily for seven days
400+ attempts placed automatically
230+ voicemails delivered systematically
250+ texts and follow-up messages
5+ hours of conversation time
Equivalent workload: Two front desk staff, full-time
AI Cost Benchmark: $200 weekly ($1-$1.75 hourly) versus $150,000+ annually for human coverage

Outbound AI Telephony Case Study (Actual Results ):

180 leads processed → 41 appointments secured (22.8%)
720 attempts completed
34.7% converted after live connection
9h 30m 50s combined talk time
Weekly cost: $200

Inbound Cost Savings & Operational Impact

Per 100 inbound calls, AI delivers:
99% answered within seconds—zero missed opportunities, no voicemail pile-up
6+ hours managed autonomously
Average duration: 3-6 minutes each
55% categorized and assigned for clinic follow-up (existing patient inquiries)

Part II – Three Major Hesitation Areas

The “Weird” Objections: Despite Overwhelming Evidence

1. Voice anxiety: “The voice will turn people away”

Note: Pronunciation is weighted more highly than performance.

Counterintuitively, it seems that a perfectly pronounced non-booking is more valued than an imperfectly booked patient.

2. Self-appraisal performance delusion: ”Our team converts 25% already and rarely misses calls.”

3. Workload Miscalculation:

“I’’m not sure it freed up much time for us .”

Real life Example – Voice Anxiety

What occurred: The AI handled a 9:30 p.m. call. It stumbled over a challenging surname but booked the appointment anyway.

Practice owner: “So cringeworthy. Is this thing really ‘ready’ yet?”

Our audit (performed the following day): Made 10 manual secret-shopper calls to their office → 0 picked up → 0 patients booked.

Food for Thought:

After nearly 12 months developing this product, the voice quality has improved exponentially. While it seems obvious that securing the booking is more important than having a CA who pronounces the surname correctly but never answers the call, the persistent question remains: “Will prospects detect they’re talking to AI?”

Several considerations before answering:

Does it matter? Within 6-12 months, I predict the conversation will shift to: “Unbelievable that in today’s AI-driven world, practices still can’t handle appointment booking at 8 p.m. Saturdays.”

Doesn’t the booked appointment matter more than minor pronunciation errors?

Wouldn’t humans equally struggle with such a complex surname?

The irony here: The practice owner meticulously reviewed the AI recordings while confessing they’d never listened to their staff’s calls (not even once).

Here’s the reality: imperfect bookings outperform perfectly articulated missed opportunities. AI NEVER ignores calls, and actual revenue should outweigh hypothetical claims about “superior human performance.”

Think about this scenario:

Suppose a receptionist independently answered a 9 p.m. call, successfully scheduled the appointment, BUT butchered the surname pronunciation. Grounds for dismissal? Obviously not.

And if that receptionist received $1-$1.50 hourly while delivering exceptional performance aside from one mispronounced word, would anyone deem her “substandard”? No way.

Somehow AI endures relentless scrutiny while humans escape judgment, despite delivering performance hundreds of percentiles inferior to the technology.

Another real life example

”Here’s another instance of my newly coined “pronunciation beats performance” bias. A customer began our consulting call with: “Not sure if AI is actually working here.”

I was naturally concerned since my team reported outstanding results. What had I missed?

Reviewing her AI metrics together confirmed my initial understanding: outbound bookings around 25%, almost 50% conversion after live conversations, and 67% inbound booking success (PHENOMENAL!) She still seemed unconvinced.

After previously operating my own concierge scheduling service for chiropractors and knowing what top human-staffed booking companies deliver globally (frequently just 5%), her skepticism baffled me.

Eventually, after additional questioning, she confessed:

Their own booking percentages were below 10%.

She ultimately acknowledged that after reviewing many AI call recordings she thought that at times the AI sounded “strange.”

Remember the context here: AI delivered verifiable 150% performance gains while providing 200%-plus in cost reductions. These numbers alone demonstrate that occasionally awkward phrasing doesn’t diminish results. Quite the contrary: all metrics improved significantly, plus the likely thousands of hours saved annually (I’ll circle back to that later).

Additionally, when I asked, “Ever recorded and reviewed your CA’s call recordings?” she acknowledged never having listened to a single one. Meaning nobody knows whether her staff makes similar pronunciation blunders and miscues.

It’s almost like having data “immediately available” and recordings “easily accessible” through AI platforms (truly remarkable) has spawned unusual excessive scrutiny while apparently giving the highest overhead item—payroll—total immunity regarding practically everything.

Throughout these stories, “Wendy” and “AI voice agent” become nearly interchangeable. Both situations baffle me yet seem to originate from two immovable convictions: 1) my reception staff sounds better, even without hearing one actual call, and 2) my team would’ve answered that phone, despite statistics revealing that 44% of calls are missed during operating hours and 98% outside them.

Beggars belief, I tell ya.

Self-appraisal performance delusion

What teams thinks

“Our team achieves 25% bookings and answers most incoming calls.”

False.

Remember the secret shopping results across 60 practices? Let me refresh your memory:

82% failed returning calls within one hour.

62% never called back in 24 hours.

57% hadn’t responded after seven days.

Of the ones who called, 94% made just one attempt.

These statistics aren’t surprising. Independent research from Leads360 (Velocify) found you’re 391% more likely converting leads when calling within 60 seconds (which our AI accomplishes).

Other data sources suggest leads require 6-10 call attempts before converting, yet 50% never receive a second call, regardless of industry.

Given this evidence and our secret shopper findings, achieving 25% overall booking rates without AI-assisted speed-to-call and sequencing is statistically improbable.

We’ve worked with more than 700 practices on lead generation and Facebook advertising. There are always outliers who somehow nail this and achieve 40% booking rates—generally in rural areas—but this represents roughly 0.2% of practices.

To demonstrate this point, I asked ChatGPT to determine the statistical chance of practices booking 25% of Facebook leads, based on median response times exceeding 60 minutes (true for most practices) and fewer than three attempts (true for all practices), mentioning that current “to voicemail” rates hit 45% even with 60-second callbacks.

The response: Statistically, chances of booking 25% of all leads hover around 0.2-0.5% based solely on those metrics. Yet practice owners will insist until they’re blue in the face that they book nearly 50% in some cases.

Inbound Answering Resistance (“Voicemail Will Handle It”)

When we initially launched our AI reception service, our focus targeted what I considered the industry’s biggest problem: minimal, absent, or extremely delayed lead follow-up. That was problematic and remains so, but I didn’t fully recognize that the “inbound” call problem proved equally bad—possibly worse in both inefficiency and almost certainly in lost revenue.

Our own secret shopper statistics revealed:

44% of calls went unanswered during business hours

95% of calls went unanswered after-hours and weekends

91% of unanswered calls were directed to voicemail

83% of voicemail messages received no response within 24 hours

60% of voicemails were never returned (tracked for seven days)

Independent healthcare research showed that 29% of calls go unanswered, while dentistry saw 37% of calls going unanswered (one in three). The American Chiropractic Association published estimates that 30% of all chiropractic office calls during business hours go unanswered.

Missed inbound calls are far more costly to practices than weak follow-up—and the data prove it. Inbound callers consistently rank among the highest-value prospects. In fact, 84% of marketers report that phone calls convert 30% better than web leads and generate higher average order values than any other engagement channel. Yet despite their value, 40% of these calls go unanswered.

Phone callers convert 30% more quickly than web leads. Before assuming patients prefer booking online, healthcare statistics say otherwise: phone remains the top choice for 68% of people when contacting businesses.

With most patients unwilling to hold longer than a minute—and 85% unlikely to call back—every missed ring risks lost revenue.

In our initial 60-day rollout, no practice ever dropped below a 97% answer rate. Last week, across 20 practices, we achieved a flawless 100%. Just think about that for a second. That’s not just impressive—it’s transformative.

As I’ve mentioned before, I spent 10 relentless months testing solutions to improve outbound lead follow-up. But in the process, I uncovered something even more critical. Initially, I advocated for using our reception AI only after hours. It seemed like a reasonable boundary. But the data told a different story—and it hit hard.

Practices that limited AI coverage still missed 30–40% of their calls, simply because, even though out-of-hours calls were handled by AI, they still weren’t answering the phone during working hours. That’s a tough pill to swallow—I struggled with it myself. But the numbers don’t lie. This isn’t just an optimization opportunity; it’s a hidden gap in your revenue stream.

We’ve consistently maintained near-perfect answer rates—24/7—without the need for hiring, training, managing turnover, covering sick days, or paying overtime for after-hours support. Our AI reception system runs nonstop.

Even in cases where we demonstrated 25% booking rates and performance gains between 100% and 400%, many practice owners still felt uneasy about adopting what they perceived as “new” technology.

Unbelievable.

This represents a combination of survivorship bias, sunk-cost fallacy, availability bias, and status-quo bias—which I’ll define shortly!

Truth Test: Pull your time-to-first-call data and attempts-per-lead metrics from the last month. If median response time exceeds one hour or median attempts remain below three, your claimed 25% is nonsense. Statistically improbable.

Add up the missed calls across every time slot—morning, midday, evenings, weekends. Now picture this: 10% to 40% of those could be new patients. Not inquiries. Not tire-kickers. Real, revenue-generating opportunities. And they’re slipping away.

Time Savings Blindness

One practice generated 120 leads during 60 days. AI booked 41 from 140 total leads (29%) straight into the calendar without any human involvement needed. This encompassed all appointment reminders, schedule updates, and confirmations.

A second practice fielded 244 inbound calls. The AI reception system booked 61 new patient appointments, accumulating 12 hours 20 minutes of total conversation time across all incoming calls.

Owner Response: Not convinced it actually saved us much time.
Human hours required to “replicate” AI results (per 100 leads outbound, rounded figures, assuming near-perfect efficiency)
Conversation time: 5.0 hours total
Voicemail messages: 2.5 hours (230 messages × 0.6 minutes with rings & drop)
Unanswered attempts (no voicemail): 1.0 hour (100-120 calls × 0.5 minutes with rings)
Manual dialing & setup: 10-13 hours (400 attempts at 30-40 dials hourly)
Text messages/follow-ups: 2.0 hours (250 messages × 0.5 minutes to craft/send/log)
CRM updates & scheduling: 1.0 hour (400 entries × 0.15 minutes each)
Subtotal: 22-25 hours

Actual overhead (breaks, context changes, transitions, meetings, mistakes/corrections): +40-60% → 9-15 additional hours for 100 leads

Final time: 31-40 hours for 100 leads

In one case, a practice fully committed to AI, enabling our system to contact all outbound leads and field all inbound calls during business hours and beyond them. Currently, the majority of practice owners selected our voice AI handling inbound calls ‘outside business hours,’ which we endorse.

Yet the results of this total commitment approach completely blew my mind!

Inbound Results (30 Days)

Total calls: 111, mixture of new patient bookings, rescheduling requests, plus other general patient inquiries
New bookings: 33
Talk duration: 7 hours 34 minutes
Average per booking: 8 min 54 sec

How do you quantify ROI from 40 hours saved via AI-managed lead follow-up and 8 hours reduced phone time while patients stand before CAs?

Additionally, zero inbound calls went missed. Let that sink in. Regarding the 33 new patients booked, practice owners incorrectly assume these outcomes would’ve occurred “regardless.”

That’s textbook confirmation bias. But you can’t prove it except by secretly shopping your practice, as I did. Yet confirmation bias leads practice owners to create justifications for why humans are superior to AI, despite the cold, hard facts in front of them.

Notably, both practice owners in this scenario experienced record months yet almost certainly never attributed success to AI managing all telephone calls initially.

Back Part III: Six Biases Blocking Chiropractic Growth

When practice owners encounter data-backed evidence showing AI systems generating 100-400% improvements yet still hesitate or resist implementation, they’re not responding purely rationally. They’re reacting through several overlapping psychological biases.

1. Status Quo Bias
Definition: The tendency to prefer things to stay the same, even when change offers clear advantages.Preferring things remaining unchanged, even when transformation offers obvious benefits. Application: Many chiropractors achieved success via human connections—receptionists, CAs, manual processes—so substituting that with ‘machines’ feels like betraying what worked. Emotionally, preserving existing workflows feels safer, despite contradictory evidence.

2. Confirmation Bias
Definition: Pursuing information validating current beliefs while rejecting contradictory evidence.

Application: When practice owners believe “humans build better rapport” or “AI lacks empathy,” they subconsciously dismiss outlier successes as anomalies. Despite viewing comprehensive performance metrics, they fixate on possible drawbacks (“What if it sounds unnatural?”).

3. Loss Aversion

Definition: Humans experience losses approximately twice as intensely as comparable gains..

Application: Although AI provides superior returns, the imagined risk of losing patients due to miscommunication overshadows the tangible benefit of securing hundreds of additional bookings. Humans fixate on hypothetical disasters rather than probable successes.

4. Control Illusion Bias

Definition: Believing we possess greater influence over results than reality permits. Application: Owners believe their human teams “understand patient communication” or “manage leads more effectively,” contradicting objective evidence revealing inconsistent follow-through and availability. Allowing AI autonomy feels like surrendering authority, though such authority was predominantly imaginary.

5. Sunk Cost Fallacy

Definition: Persisting with investments due to previous expenditures of time, resources, or energy, despite superior alternatives existing.

Application:Practices investing years developing staff training, crafting scripts, or contracting external services resist abandoning those investments. Embracing AI requires acknowledging such efforts were replaceable or improvable—psychologically challenging.

6. Novelty Aversion (Technophobia)

Definition:.Avoiding new technological adoption from uncertainty fears.

Application: Despite ubiquitous smartphone usage and automation acceptance, many characterize AI as “unproven.” Within healthcare, where credibility and standing matter critically, this apprehension intensifies, regardless of demonstrated dependability .

Conclusion: Transform and Flourish with AI Reception

Across human history, technology and innovations have faced fear and resistance, from Galileo’s understanding of our solar system to the widespread rise of the Internet. It’s understandable wanting to stay within a familiar comfort zone. But I wouldn’t be doing you any favors by encouraging you to remain there. Growth doesn’t happen in comfort—it happens in courage.

Just like chiropractic requires balancing science, art, and philosophy, business decisions need to incorporate data, research, and measurable results you can track—not just individual preferences or guesswork. When you lead with data, results follow.

As with any tool, picking a top-tier AI solution and using it wisely is critical. Our data clearly show that an AI-powered reception service—handling both inbound and outbound calls—offers a highly efficient way for potential patients to book appointments. It’s not just about convenience; it’s about driving measurable impact and revenue growth. To truly understand how seamless the experience is, we encourage you to listen to actual call recordings and hear firsthand how the system enhances patient interactions.

Don’t let outdated assumptions stand in the way of progress. Waiting to adopt AI until your systems are obsolete only delays growth and compounds missed opportunities. Instead, lean into evidence-based decision-making and take action now. This technology is already transforming practices—and yours could be next. Visit www.receptionai.net to learn more and book a consultation with my team.

Let’s explore how AI can elevate your practice, starting today.

Dr Ryan Rieder