The call center at Thomas Dermatology didn't have a Monday morning problem. It had a Sunday night problem.
Patients spending the weekend thinking about appointments they needed to book, spots they wanted checked, Botox treatments they'd been putting off. No way to book after hours. Just a mental note to call first thing Monday.
And they did. All of them. At once.
Chris Fredericksen, the practice's COO, could see it in the data: "From all the analytics we ran," he said, "Mondays were the heaviest traffic call day and wait times were up." The pattern repeated every week, without exception.
The real problem driving the Monday chaos wasn't staffing; it was a patient experience problem with real revenue attached to it.
Patients on hold aren't just inconvenienced. They're making decisions. A medical patient waiting for a referral will stay on hold because they have to. A patient thinking about booking a cosmetic appointment, spending their own money on a discretionary service, is doing a quieter calculation: Is this worth it? Every minute on hold nudges the patient away from your practice.
Five years ago, Fredericksen wanted to solve both of these problems at once. Fewer calls on Monday mornings. Better access for patients wanting to book outside business hours. And he wanted to do it without adding on a separate system that didn't talk to the rest of the practice’s workflows.
"I wanted to look into scheduling software, but real-time scheduling software," he clarified, and the emphasis on real-time mattered. A booking tool that didn't sync live with their EHR would create different problems — double-entry, scheduling errors, staff cleaning up after the system instead of being freed by it.
Thomas Dermatology implemented online scheduling through NextPatient, integrated directly with their existing ModMed EHR. No parallel system. No manual reconciliation. Appointment times live and accurate in real-time.
The results showed up in the data quickly — and continued to compound.
Last year alone, 23,000 appointments were booked through NextPatient, out of roughly 150,000 total. That's about 20% of all appointments. Significant on its own, but the number that mattered most to Fredericksen was the one underneath it: 47% of those bookings came after hours.
"That’s exactly what I wanted," said Fredericksen, regarding nearly half of all online appointments happening when the phones are closed — evenings, weekends, the exact window where patients had been stranded before. The Monday morning queue didn't disappear, but it thinned because the pressure valve had somewhere to release.
The operational shift went deeper than call volume. With online booking absorbing a meaningful share of appointment traffic, the practice didn't need the same concentration of staff hours on the phones. But rather than reducing headcount, Thomas Dermatology did something more deliberate: They redistributed staff time.
"Overall, we need less staff hours on the phones," Fredericksen said. "We've repurposed some of the call center people to other tasks, so there's definitely been an ROI on that."
And there’s also the quieter ROI of staff who enjoy what they do. As Fredericksen plainly put it: "A call center can be a tough job." It’s call after call, patients frustrated by hold times, staff navigating complex charts under pressure with someone waiting on the line.
The system didn't eliminate that work entirely — patients booking online still need insurance verified, charts reviewed, and eligibility confirmed — but it changed the ratio. Staff spend less time fielding inbound call volume and more time on work that values careful judgment and attention, which is a more fulfilling job to clock in for every Monday.
Five years on, the Monday morning chaos — caused by patients with no after-hours booking option — has calmed.
23,000 appointments booked online. 47% booked after hours. Call volume down. Staff repurposed into work that better fits them.
None of it required a rip-and-replace of how the practice operated. NextPatient lives inside the EHR environment Thomas Dermatology already uses. The staff changes were additive, and patients didn't need to be taught a new behavior. Patients wanted to book after hours all along — Thomas Dermatology just finally gave them a way to do it.
See the full picture of how Thomas Dermatology modernized their scheduling — from Monday morning call chaos to 23,000 online bookings a year. Read the full case study →