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Case study · First-party data
A one-doctor medical practice in New Jersey put Lydoh on its main phone line on October 3, 2026. This is everything it did in the first four and a half weeks, from Lydoh's own records, including the day it turned patients away.
By Sohel Siddique, who builds Lydoh and VoiceboxMD · Updated November 4, 2026 · Data: October 3 to November 4, 2026
The short version
Lydoh answered 2,151 calls, about 470 a week. 75% were resolved on the call, a third were passed to the front desk on purpose, and 18% came when the office was closed. Staff marked 89% of the 843 requests Lydoh wrote up for them as handled. The worst day was caused by our own fraud guardrail, not by the AI, and we explain it below.
Our stake.We make Lydoh, so read this as a vendor's account. The counts come from Lydoh's records, not an independent audit. The practice is also close to our team: its doctor reviews our guides on AI in practice. We have published the failure alongside the good numbers, and left out what we did not measure: we make no claim about staff hours saved or revenue, and we quote no one.
The practice
The practice is a one-doctor medical office in New Jersey. It forwards its existing practice line to Lydoh, so Lydoh answers every call, day and night, and transfers callers to the front desk when they need a person.
After hours, a caller with an urgent problem is put through to the doctor: Lydoh tries the doctor twice and, if neither attempt connects, gives the caller a fallback message. This is the after-hours answering setup. Patients also get appointment reminder texts.
| Monday | 10 AM to 6 PM |
| Tuesday | 10 AM to 7 PM |
| Wednesday | 9 AM to 5 PM |
| Thursday | 10 AM to 6 PM |
| Friday | Closed |
| Saturday | 10 AM to 3 PM |
| Sunday | Closed |
The numbers
About four and a half weeks, counted from Lydoh's records for the practice.
2,151
calls answered, about 470 a week, from 727 different numbers
35 sec
median call length
18%
of calls came outside office hours (384), 131 of them on the closed Friday
75%
resolved on the call (1,611)
33%
forwarded to the front desk by design (706)
843
requests written up for staff: 809 appointment, 34 prescription refill
89%
of those requests marked handled by staff (751)
6 of 12
urgent after-hours calls connected live to the doctor
Where calls ended
Appointment requests (booking, rescheduling, checkups and physicals) made up 809 of the 843 requests; the other 34 were prescription refill requests. Lydoh takes the request and staff confirm it. Among the requests, 298 were callbacks for callers who hung up before they finished, so the front desk could ring them back.
Lydoh also sorted callers automatically: 538 were identified as patients, 33 were pharmacy calls (refill authorizations and callbacks), 8 were sales reps, and 9solicitation or spam calls were kept off the staff's plate.
On texts, Lydoh sent 473 appointment reminders, 201 callback texts and 48 confirmations, and patients sent 191 texts back.
When the phone rang
10 AM took 308 calls, more than any other hour, and the line stays busy until about 4 PM. Calls keep coming after the office closes, and a few arrive in the middle of the night.
| Hour | Calls |
|---|---|
| 2 AM | 12 |
| 3 AM | 1 |
| 8 AM | 39 |
| 9 AM | 137 |
| 10 AM | 308 |
| 11 AM | 251 |
| 12 PM | 234 |
| 1 PM | 276 |
| 2 PM | 268 |
| 3 PM | 230 |
| 4 PM | 177 |
| 5 PM | 112 |
| 6 PM | 64 |
| 7 PM | 30 |
| 8 PM | 5 |
| 9 PM | 7 |
| All other hours | 0 |
After hours
Over the month, 12 urgent after-hours calls were escalated to the doctor. 6 were connected live, with a median of 45 seconds from the escalation to the doctor on the line. The other 6 went unanswered after two attempts and were handled by the fallback message. Lydoh never gives medical advice; it puts the caller in touch with the doctor or takes the message.
What went wrong
On the first full day, Monday, October 6, a limit we had built against phone fraud cut in at 1:15 PM. New trial accounts were capped at 60 answered minutes a day, and this practice hit the cap by early afternoon. From then until the next morning, 132 patient calls were turned awaywith a "daily limit" message.
By 9:34 AM the next day it was fixed in two ways. Trusted practices are now exempt from the cap, and a red "Lydoh missed" badge flags any call Lydoh failed to answer, so staff can call the patient back.
Since October 8, 7 of about 1,840 calls (0.4%) ended in an error, and each was flagged for a callback.
We publish this because it is the point. The AI was not the part that failed; a guardrail was. Any practice adopting AI should ask its vendor what limits sit around the system, what happens to a patient when one trips, and who finds out.
Lessons
The AI did not cause the worst day of the month; a safety rule did. A guardrail is software too. Give it the same alerts and review you give the AI, and make sure someone hears about it when it blocks a patient.
"Calls handled" flatters any system. The numbers we watch are the 843 requests written up for staff and the 89% they marked handled, plus every call that ended unresolved or in an error, each of which now gets a visible flag.
18% of calls came when nobody was in the office, 131 of them on the closed Friday. Staff cannot pick those up anyway, so they are the lowest-risk place to start and the easiest to measure.
A third of calls went to the front desk, by design, and urgent calls at night went to the doctor. An AI receptionist should make the staff easier to reach, not harder.
If you are weighing an AI medical receptionist against a live service, our AI receptionist vs. answering service comparison sets out the trade-offs, and the HIPAA guide lists what to ask any vendor before it takes a patient call.
Method
Questions
In this practice, about 470 a week: 2,151 calls from 727 different phone numbers in about four and a half weeks. Most calls were short; the median was 35 seconds. Call volume varies a lot by specialty and patient base, so treat this as one real example, not a benchmark.
18% of this practice's calls (384 of 2,151) came outside office hours, including 131 on Fridays, when the office is closed all day.
No, and it should not try. A third of this practice's calls (706) were forwarded to the front desk by design. Of all calls, 75% were resolved on the call, 364 needed staff follow-up and 176 ended unresolved.
They go to the doctor. Over the month, 12 urgent after-hours calls were escalated: 6 reached the doctor live, with a median of 45 seconds from escalation to the doctor on the line, and 6 went unanswered after two attempts and were handled by the fallback message. Lydoh never gives medical advice.
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