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Why Do Practices Struggle to Eliminate Patient Hold Times
Key Takeaways:
Patient hold times persist because call demand, administrative complexity, and front-desk turnover all compete for the same limited phone capacity, making it difficult for practices to eliminate patient hold times through staffing or call routing alone.
Most practice leaders already recognize that phone access is a persistent weak point in patient experience. So, new hires get trained, phone trees get rebuilt, and callback options get added. Yet the queue returns as soon as call volume rises again, raising a harder question:
Why do the efforts to eliminate patient hold times seldom produce lasting results?
This recurring fix-and-relapse cycle is common across the industry. In a December 2025 MGMA Stat poll, 22% of medical group leaders named phone access as their top patient access focus for 2026, and another 21% named wait times. These responses already came from medical practices with dedicated teams for operations, budgets, and reporting oversight; however, the issue still remains a priority.
This article looks at the structural reasons hold times persist and where common fixes fall short. It is written for all operations leaders who want a clear view of the problem before they decide how to address it.
Why Practices Struggle to Eliminate Patient Hold Times
Hold times affect more than patient convenience. A 2019 study in The American Journal of Managed Care of 252,145 Veterans Health Administration patients found that longer average speed to answer was associated with lower patient ratings of timely access to urgent care. Some of those patients may even book elsewhere or delay seeking care.
Hold times are rarely caused by a single failure. They result from several overlapping conditions at the front desk, and addressing one often leaves the others unresolved.
Call volume peaks exceed front desk capacity
A receptionist can handle one call at a time. Hence, when five patients call within the same few minutes, four of them wait, regardless of how efficient the team is. Staffing models are usually built around average volume, so the busiest hours of the day are also the hours with the least spare capacity. MGMA also lists adding staff during peak periods among the steps practices take to reduce hold times and dropped calls, which reflects how closely the problem tracks call timing.
Phone calls and person check-ins compete for the same staff
In many practices, the same staff responsible for patient check-in also manage incoming calls. When both demands arise at once, in-person patients typically take priority and callers are placed on hold while staff assist patients at the desk. MGMA links thin support teams to slower check-in and higher call abandonment, which shows how closely the two workloads are tied.
Long and complex calls extend average handling time
Call length affects hold times as much as call volume. In a March 2026 MGMA Stat poll of 294 practice leaders, 45% said eligibility and prior authorization tasks take the most staff time on the phone, followed by scheduling at 31%. The broader prior authorization workload is substantial. A late 2024 AMA survey of 1,000 physicians found that practices complete an average of 39 prior authorization requests per physician each week, and physicians and their staff spend about 13 hours a week on them. In practices where front desk staff also handle these requests, those hours come directly out of the time available to answer patient calls.
Frequent front desk turnover and vacancies
In a May 2026 MGMA Stat poll of 303 medical group leaders, 28% reported higher staff turnover than in 2025. Respondents frequently cited front desk and administrative roles as common churn points, relating front desk turnover to rising call abandonment and lower scheduling accuracy.also the hours with the least spare capacity.
MGMA also identifies medical receptionists as among the hardest support roles to keep filled, since practices compete with retail, hospitality, and call centers for the same workers. The U.S. Bureau of Labor Statistics projects about 105,100 receptionist openings each year from 2025 to 2035, all from replacing workers who leave the occupation or the labor force. Each vacancy and each new hire that is still learning scheduling rules eventually reduces the number of calls a medical practice’s front desk can answer.
Voicemail and callbacks delay the response
Voicemail and callback queues reduce the time patients spend on hold, but they do not shorten the time it takes to resolve the request. Messages accumulate in a queue that staff address between other responsibilities, which can delay responses by several hours. For clinical messages, that delay may carry questions into the next business day and prompt repeat calls from patients awaiting a reply.
Phone performance targets are difficult to track
Phone performance is difficult to improve when it is not fully tracked. A VA Office of Inspector General review found that 13 of 15 Veterans Health Administration (VHA) facilities it examined lacked essential call data, and nearly 1 million of 2.1 million call attempts between August 2024 and July 2025 were missing critical information.
Even facilities that track phone performance can fall well short of their standards. A January 2025 OIG report on the Atlanta VA medical center's call center found that 30% of callers abandoned their calls (against a VHA standard of 5%), and only 22% of answered calls were picked up within 30 seconds (against a standard of 80)%. The OIG attributed the shortfall to staffing shortages, with the center averaging 29 staff, while VHA's own model called for 53 staff to handle 135,600 calls.
Common Hold Time Fixes and Their Limitations
Practices are not short on options. MGMA reports that groups focused on phone access are adding callback and queuing options, IVR, texting, extra staff during peak periods, centralized call centers, and upgraded VoIP systems with better analytics.
Each of these helps, but each has its own limits when the goal is to eliminate patient hold times.
Most of these options either redirect calls or depend on staff availability during peak hours. When several patients call at once, the front desk can still only answer as many calls as it has people free to take them.
Moving Toward Shorter Patient Hold Times
Patient hold times say less about how hard a front desk works and more about how phone access is designed. Call demand, administrative complexity, and workforce turnover all converge on the same point of contact, and each one shifts independently of the others.
For practice leaders, a more useful question may be how the practice responds in the moments when call demand exceeds the number of people available to answer. Framing efforts to eliminate patient hold times around those peak moments gives operations teams a clearer view of where pressure builds and what kind of support the front desk needs to absorb it.
Aidion Health offers a HIPAA-compliant Voice AI platform built by healthcare professionals for healthcare professionals. Its AI agent handles multiple patient calls simultaneously, books and reschedules appointments, and syncs call details to your EHR. Your team sets the rules for which calls go to staff, so the platform adds capacity during peak hours and works alongside your front desk.
Visit Aidion Health to learn how its Voice AI supports your front desk, or book a demo to see how it handles your practice’s call volume.
Frequently Asked Questions (FAQs)
1. What is an acceptable hold time for a medical office?
There is no single industry standard for medical practices. As a reference point, the Veterans Health Administration (VHA) sets standards of answering 80% of calls within 30 seconds and keeping abandonment at 5% or less, according to a January 2025 VA Office of Inspector General report.
2. Why do patients hang up while on hold?
Patients hang up when the wait outlasts their patience or their schedule. Many call during work breaks or between other obligations. Longer waits increase the chance they will abandon the call and try again later or seek care elsewhere.
3. Can hiring more front desk staff eliminate patient hold times?
Additional staff can only shorten hold times during their working hours. It is difficult to eliminate patient hold times through hiring alone, because peaks are short and unpredictable, and receptionist roles turn over steadily. Many practices combine staffing with technology capable of handling multiple calls simultaneously.
