Hi Reader

A lot of the providers I talk to are thinking about growth right now — more patients, maybe a second provider, maybe expanding into new states. All good instincts.

But here's what I've seen trip up more practices than anything else: growth doesn't fix friction, it multiplies it. If something's costing you a few patients a month at your current volume, it costs you a lot more once you've doubled your patient count or added providers who didn't build the workflow themselves.

So before you spend a dollar on growth, here are five things worth locking down first — the stuff that gets exponentially more expensive to fix once you've scaled past it.

1. The 3-click rule. Time yourself joining your own virtual visit from a phone — not your work laptop, an actual patient's phone. If it takes more than 3 taps from the confirmation message to actually being in the visit, that's friction. Fine to absorb at low volume. Expensive once marketing or referrals start sending you more patients through that same broken link.

2. Dead air in the waiting room. Silence before a visit starts reads as uncertainty, especially to a new patient who doesn't know you yet. That's a small trust tax now. Ask me about personalized waiting room messages or even adding your logo and contact info to the waiting room, even in Zoom! Once you're bringing on new patients faster, or a new provider whose patients don't have the benefit of an existing relationship, they could lose trust.

3. Whether your platform actually works on mobile. Most new patients join from a phone, not a desktop. If your platform or your instructions were only ever tested on your own setup, you don't know if it holds up for the next hundred patients you bring in. This is exactly the kind of thing that can cause problems as you're growing.

4. One reminder isn't enough. A single day-before reminder is what most practices default to. Two or three — 24 hours out and 1 hour out, both with the direct link — measurably cuts no-shows. That gap matters more with volume: a no-show rate that's a minor annoyance today becomes real lost revenue once you're seeing more patients or paying another provider by the hour.

5. A workflow that only works because you're the one running it. This is the one that actually blocks growth outright. If your intake-to-follow-up process lives in your head instead of on paper, you can't hand it to a new provider or a new staff member without it breaking. Write it down. One page. Or better yet, screen record it for others to see. It's the difference between a workflow and a bottleneck.

None of these require new software or a new hire. They're a few afternoons of tightening up — and they're the difference between growth that compounds and growth that just multiplies your existing problems.

This week's action item: pick the one on this list you're least confident about, and actually check it before you take your next step toward growing.

If you're seriously thinking about scaling and want an outside read on whether your foundation can handle it, that's exactly what my free 15-minute audits are for — no pitch, just an honest look.

Connect with me on LinkedIn for more Telehealth tips all week long

Thanks for reading,

— Dan

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P.S. that feeling when you realize the bottleneck was never the patients, it was the workflow​

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Also: Want to go back and look at our previous Telehealth Tips? Click Here​