Research
One million consults: the five things that surprised us
When you do enough consults, patterns emerge that no individual clinician could see. Here are five we didn't expect when we started in 2021.
In June 2021 we did our first consult. In April 2026 we did our millionth. That’s a number worth being slightly suspicious of, the way you’d be suspicious of any company that name-checks “millions” of anything. But it lets us look at patterns no single clinician sees in a career. Five of them surprised us.
1. The single biggest predictor of a good outcome is whether the patient comes back
Not the medication. Not the diagnosis. Not the demographics. Whether they return for a planned second appointment is the strongest signal we have for adherence, clinical resolution, and patient satisfaction at twelve months. This sounds obvious in retrospect. Operationally, it means we’ve reorganised everything around making the second appointment frictionless, rather than optimising the first.
2. After-hours demand is not what we thought it was
We assumed after-hours telehealth would be dominated by urgent issues: chest pain, kids’ fevers, emergency contraception. It’s not. The single biggest after-hours category is script renewals for chronic conditions — patients catching up on care they meant to do during business hours but didn’t. This changed our staffing model. We need fewer urgent-care clinicians at 9pm and more prescribers who can do thoughtful refills.
3. Patients overestimate the embarrassment of telehealth and underestimate the embarrassment of in-person
In post-consult surveys, patients who chose telehealth said the most common reason was “convenience.” But when asked what would have stopped them from going in-person for the same issue, 47% named a non-convenience reason: embarrassment, prior bad experience, or “I didn’t want to talk about it face-to-face.” That’s a different value proposition from “saves you a trip.”
4. Bulk billing rules are a public-health policy with side effects
Changes to Medicare bulk-billing eligibility in late 2025 had a non-obvious effect on our case mix. The volume of low-complexity consults dropped, which we expected. The volume of moderate-complexity consults dropped too, which we didn’t, because patients deferred. That deferral showed up as more presentations 3–6 weeks later that were harder to manage. Policy ripples.
5. The longest stretch a patient will wait for a callback before disengaging is 14 minutes
Across our brands, we observed that if a patient submits an enquiry and we haven’t responded within 14 minutes, the chance they complete the journey halves. After 30 minutes it’s a third. After an hour it’s effectively gone. This shaped our staffing model more than any other metric: shifts are sized to keep the response time at or below 14 minutes during opening hours, even at the cost of unused capacity overnight.
What it adds up to
Most of healthcare data is interesting in theory and unactionable in practice. The above five all changed something concrete in how we operate. That’s the only kind of data we still bother chasing.
Deeper dives on two of these: the 14-minute response window (point 5), and bulk billing changes for telehealth: what’s actually different (point 4).