There are 168 hours in a week. A clinic that opens nine to five, five days a week, answers the phone for 45 of them, and not really even then, because for most of those 45 you are treating someone. Your Google Ads do not keep those hours. They run through the evening, through Sunday, through the exact hours when someone sits on the sofa noticing their foot hurts and decides to do something about it. You are paying, at full price, for clicks that arrive when nobody can pick up.
Size it before you fix it
Do not take our word for the size of this. Your ad account already knows.
Open Google Ads, look at your campaign report and break it down by hour of day and by day of week. It is a standard report and it takes about two minutes. What you are looking for is the share of your clicks that land outside the hours you genuinely answer the phone. Most clinics have never looked, and are surprised.
Then work out what those clicks did. If your booking runs through your website you may be able to see it directly. If it runs through a phone call, your call log tells you: count the calls that rang out, went to voicemail, or lasted eleven seconds.
Here is the sum, with placeholder numbers. Swap in your own, because ours are made up to show the shape.
Say you spend £600 a month on ads. Say 40% of your clicks land outside answered hours, which is common for a business whose customers are at work during your opening times. That is £240 a month arriving at a closed door. Say you currently win none of those, because nothing answers. That is roughly £2,880 a year of spend that bought a ring-out.
Why that number matters more than it looks: it is not potential revenue you failed to chase. It is money that has already left your account. The clicks are bought and paid for. The only remaining question is whether anything is there to collect them.
Why after-hours callers are worth more, not less
It is tempting to assume the evening caller is a time-waster who will ring back tomorrow. The opposite is usually true, for two reasons.
First, they went out of their way. Nobody idly researches podiatry at 9pm. They are doing it because something hurts enough to interrupt their evening, and pain that interrupts an evening is pain that books an appointment.
Second, they are shopping in exactly the moment when you are least protected. At 9pm they are not ringing you and then waiting. They have three clinics open in three tabs and they are ringing all of them. Whoever answers gets the patient. Ringing back at half nine the next morning is not competing for that person, it is asking them to change a decision they already made.
Three honest ways to close the gap
Option one: stop paying for the hours you cannot serve. Ad schedules are free. You can tell Google to run your ads only during hours you answer, and stop buying the clicks that ring out. Where this genuinely wins: it is free, it takes ten minutes, and it immediately stops the bleeding. If money is tight, do this today. Where it falls down: you have not won those patients, you have surrendered them. Your competitors keep bidding at 9pm, and the pain that starts on a Sunday does not wait for your Monday. You have made your ad account look tidier while the demand goes elsewhere.
Option two: a medical answering service takes messages out of hours. A human answers in your clinic's name and takes a name and number. Where this genuinely wins: a real voice beats voicemail every time, people leave proper details for a person, and for a clinic that mainly needs after-hours cover for the rare urgent call, it does the job. Where it falls down: a message is not a booking. They cannot see your diary, so the caller is told someone will ring back. The ringing back lands on you between patients, which is the problem you were paying to remove, and by then she has booked the clinic that could actually give her Thursday at two.
Option three: a voice agent connected to your real diary. Software answers in seconds, at any hour, checks genuine availability in Cliniko, and creates the appointment while the caller is still on the phone. Anything clinical is never answered by it and goes straight to you. Where this genuinely wins: it is the only one of the three where the 9pm call ends in a booked slot with nobody working the evening. Where it falls down: setup is real work, it costs more than an ad schedule, and if your after-hours click volume is genuinely small it will not earn its keep. This is what we build and sell, so weigh it knowing whose article you are reading.
The recommendation. Run the hour-of-day report first, because it decides everything. If the after-hours share of your spend is small, set an ad schedule this afternoon and keep your money; that is a real answer and it costs nothing. If the report says a meaningful slice of your budget is arriving at a closed door every month, an answering service will capture the messages and a voice agent on your diary will capture the bookings, and only one of those two is competing with the clinic she is ringing next.
What this looks like when it is running
We built Thameside Podiatry's website and its Cliniko booking flow, live since July 2026: real appointment types, live availability, appointments created straight in the clinic's own diary. We then put a voice agent on the phone line that answers, works out what kind of appointment is being described, checks what Cliniko genuinely has free, and books it while the caller is still talking. It books into the clinic's real diary today, in a supervised pilot with the owner, before full go-live.
What we are not claiming: we are not telling you it has produced a measured pile of extra patients, because it has not been running long enough to say that honestly. What we can say is that the mechanism works on a real clinic's real diary, which is more than a demo and less than a case study.
Do this today, for nothing
Open your ad account and pull the hour-of-day report. Then look at your call log for the same period and count the calls under fifteen seconds. Put those two numbers side by side.
That pair of numbers is the entire argument, and you now own it. Whatever you decide next, never let anyone sell you a fix for this without seeing it first, including us.
Bring last month's ad spend and that call log. Twenty minutes and you will leave knowing what your after-hours clicks are costing, and whether the answer is a free ad schedule or something we build.
