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A caller who leaves no message leaves no record that they rang.

Last reviewed September 2026

Voicemail is not a decision most clinics made. It is what the phone does when everyone is with a patient. This page compares leaving things as they are against putting an AI front desk on the line — what the caller actually experiences, and what each costs when you build the numbers in the open.

Voicemail is a default, not a decision. Nobody in a small clinic sat down and concluded that the best thing to do with an unanswered call was record it and ring the person back later. It is simply what the phone does when three people are running a practice and all three of them are with patients. So this page is not going to tell you off. It is going to describe what happens at the other end of a voicemail greeting, what each option costs, and how to work out what answering every call is worth to you.

First, a practical aside, because a fair share of people searching this are dealing with something else entirely. If calls are going to voicemail during your opening hours, when someone is actually at the desk, that is usually a routing fault rather than a staffing one. Do Not Disturb left on a handset. A forwarding rule that survived a staff change. A VoIP schedule still set to last year's holiday hours. A hunt group that ends at a phone nobody sits at any more. Check all of that first — it is quick to fix and costs nothing.

Now, the caller. You will find a great many pages in this category asserting that some precise percentage of people hang up rather than leave a message. We went looking for where that number comes from, and we will tell you what we found. The most-repeated version — 80 per cent of callers sent to voicemail leave no message — traces back to a single paragraph in a 2014 CRM Magazine piece attributing it to Forbes. There is no published study underneath it. The same article quotes a call-centre executive putting the range at 50 to 75 per cent, depending on the business. Treat all of it as folklore: directionally believable, evidentially thin. Anybody presenting one of those numbers to you as hard data is selling something — and that includes us, if we ever do it.

What holds up without a statistic is something you already know from your own life. Think about the last time you rang a business, got a mailbox, and had a second option in the search results. The split most clinics recognise — and the one worth checking against your own call records rather than taking from us — is between the patient who has a relationship with you and a reason to wait, and the person who has never been in. The one with a sore back who found you at 8pm on a Tuesday and is looking at four clinics in the same postcode is not invested in you yet. That caller is the one voicemail loses, and they are also the one worth the most, because they are the start of a course of treatment rather than a single visit. Voicemail's real problem is not that it is unpopular. It is that it fails invisibly, and it fails hardest on exactly the calls you would most want.

There is a second cost, and it lands on your staff. A mailbox does not resolve anything, it defers it. Every message becomes a callback, and callbacks are the least efficient minutes in a clinic day: a queue of return calls, a share of which go to voicemail themselves, worked by the same person who is trying to check patients in. The phone tag is the tax.

gema is the other side of this. It answers inbound calls on the first ring, at any hour, and it books, cancels and reschedules the appointment during the call rather than taking a message about one. It does the same over SMS, web chat and email. It owns the calendar — it is the booking system, not a script sitting on top of one — which is why it can commit to a time on the phone instead of promising someone will confirm. Bookings then sync straight into Aspire, Cliniko, Juvonno, IntakeQ/PracticeQ or Practice Better. When a caller wants a person, it puts them through to your office line during your open hours and flags the call for your team after hours, and the whole exchange sits in one cross-channel log you can read afterwards.

The arithmetic is the part worth doing slowly, and worth doing in the open rather than taking anyone's headline number. gema Front Desk is $299 CAD a month per clinic location, with $0 setup, no booking commission and no per-practitioner fee. The thing people want to compare that against is a person, so here is that figure built up rather than asserted, with the assumptions stated so you can redo it with your own.

Job Bank puts the median wage for a medical receptionist in Ontario at $20.50 an hour, on a range of $17.60 to $28.00. Take twenty-five hours a week — one part-time person covering the desk, not full-time cover. That is 1,300 hours a year, about $26,650 in wages, or roughly $2,220 a month. On top of the wage an employer pays CPP at 5.95 per cent of pensionable earnings above the $3,500 basic exemption, which is about $115 a month; EI at 1.4 times the employee rate of 1.63 per cent, so 2.282 per cent, about $51 a month; and Ontario vacation pay of at least 4 per cent of gross wages, about $89 a month. On those assumptions the total lands near $2,475 a month. Change an assumption and the answer changes: at fifteen hours a week it is considerably less, and if the role is really a medical administrative assistant — Job Bank's Ontario median for that is $25.00 an hour — it is more. The build-up also leaves out recruiting, training, and covering the weeks that person is away or ill, and what it buys you is their hours, not twenty-four of them. Run your own numbers through it. That is the point of showing the working.

Answering services sit between the two, and the honest thing to say about them is structural rather than numerical, because it is the part that does not depend on whose brochure you read. They bill by the minute, by the call, or by a monthly bundle with a minute allowance you can exceed — Direct Line Answers' published pricing describes per-minute billing in the region of $0.70 to $1.20 along with tiered monthly plans, and Answer United's published 2026 figures describe per-minute, per-call and monthly-tier models. Those are two vendors' own published plans, not a market rate, and we are not going to pretend we have surveyed the market. What matters for your decision is the shape: on that model, a busy month costs more than a quiet one, which is to say the bill rises exactly when the phone is doing its job. gema is priced per location, with a pool of credits included every month and only usage past that pool metered, monthly. Which structure suits you depends on your own volume.

Here is what gema actually handles: booking, cancelling and rescheduling on the call, plus SMS, web chat and email — the front-desk conversation, not the billing side of the practice. Claims and coverage work stay with your billing team and your practice-management system exactly as they do now.

On privacy: gema is built for PHIPA and PIPEDA, and records are stored in Canada. Note the wording, because the wording matters. Under Ontario's PHIPA your clinic is the health information custodian; a vendor like us acts as your agent. That responsibility does not transfer to us when you sign up, which is why no vendor can hand you compliance in a box. There is no government certification scheme for PIPEDA — the Privacy Commissioner's own guidance is about building a privacy management programme, not about earning a seal — so if a competitor tells you they are "PIPEDA certified", they are describing something that does not exist. Ask instead where records are held, what is encrypted in transit and at rest, who can see what, and what the audit trail looks like.

How to decide, in one line: divide $299 by what your average visit is worth. That is how many bookings a month gema needs to rescue from voicemail to pay for itself — then look at your own call records and count the callers who never left a message.