Planning for Peak Stone Months in a Urology Practice

Ask any urology front desk which month is the worst, and they'll tell you without looking at anything. "May-June mein phone band hi nahi hota." Then ask when the staff take leave, when the OT is booked for maintenance, and when the ad budget goes up. Often the answer is: whenever someone asked, whenever the vendor came, and the same every month.

A practice that knows its busy season and doesn't plan for it ends up with a full emergency room, an empty OT schedule, two receptionists on leave and an ad budget spent in February. Let's fix that with your own numbers.

Does your practice really have a stone season?

Many urologists tell me they see more stone pain in the hotter months. Don't take that, or my word, as your plan. Check your own data, because your city, your patient mix and your referral sources shape it.

Pull these numbers by month for the last two or three years:

1. Stone-related enquiries: calls, WhatsApps and form fills.
2. Emergency or after-hours stone calls.
3. Stone consultations.
4. Stone procedures.
5. Ad spend, and cost per stone enquiry.

Put them in one table, one row per month. If your CRM tags enquiries by condition, this takes an hour. If it doesn't, start tagging today, and use OT registers and billing for the past.

Once the table is ready, look for three things:

• Peak months: where enquiries and procedures are clearly above your average.
• The lag: do procedures peak in the same month as enquiries, or a few weeks later? Many patients have pain, settle, and come for the procedure later.
• Quiet months: where everything dips.

Example: say your numbers average 80 stone enquiries a month, but April to July run at 110 to 130, and November to January sit at 55 to 60. Procedures follow the same shape about three weeks later. That's your season: April to July for enquiries, May to August for procedures. Your numbers will look different. The method is the same.

How should you plan OT slots and on-call for the peak?

Once you know your peak, book capacity before you need it.

The single biggest mistake I see is maintenance done in the peak because "the machine was due". Move the due date.

What about staff leave and front desk hours?

Your front desk is the first thing to break in the peak. If enquiries go up by half and staff stay the same, answer rate falls, and every missed call in stone season is a patient in pain calling the next number.

• Block leave for front desk and coordinators in your peak months. Tell the team in January, so they plan family events around it.
• Extend phone hours during the peak, or add an evening shift. Stone pain doesn't keep OPD timings.
• Set up an instant WhatsApp reply that acknowledges every message and tells the patient what happens next, with clear emergency guidance your doctors have written.
• Train a backup person on stone calls before the season, not during it.

Watch two numbers weekly in the peak: answer rate, which should stay at 95% or above, and speed to first contact, which should stay under five minutes.

How should ad budgets follow the season?

If you run Google ads for stone searches, more people search when more people are in pain. So shift budget towards your peak, rather than spending evenly all year.

Example: say your annual Google budget for stone keywords is ₹6 lakh. Spending ₹50,000 every month treats February like June. Instead, say you put ₹70,000 a month into April to July, and ₹40,000 a month across the other eight months. Same ₹6 lakh. More of it lands when searches and your own past enquiries show demand is highest. Watch cost per new patient by month and adjust next year.

Keep ads educational and factual, and read the current NMC guidelines on advertising yourself before you write any copy.

What should you do in the quiet months?

The quiet months are where next year's peak is won.

• Train the team. Role-play stone calls, the cancellation conversation and the cashless explanation.
• Service equipment and fix anything that slowed you down last peak.
• Teach. Run your GP and physician CMEs on stones before the season, so referrers think of you when it starts.
• Contact past stone patients about their planned prevention follow-ups, through private messages, as part of their care. Their own anniversaries are a natural time.
• Build content. Record a batch of educational videos on stones in the quiet months, ready to publish through the peak.

What does a peak week look like when it's planned?

Here's the difference planning makes, on an ordinary Tuesday in June.

Unplanned: two calls missed before 10 am because one receptionist is on leave. A stone patient in pain waits 40 minutes for a callback and goes to the emergency room of a hospital where you don't operate. The OT has one slot free on Thursday because you didn't ask for more. The laser is out for servicing.

Planned: both front desk staff are in, plus the backup on the evening shift. Every WhatsApp gets an instant acknowledgement and a human reply within minutes. Three extra OT slots were requested in March and are confirmed. The laser was serviced in December. Your on-call colleague covers Tuesday night, as agreed in the rota.

Same demand. Very different month.

How do you turn this into one calendar?

Make a one-page, 12-month plan and put it on the wall: peak months shaded, leave blocked, OT slots requested, servicing scheduled, CMEs booked, ad budget per month written in. Review it every quarter against the real numbers.

This is the "know your numbers" idea from Good Doctors Go Broke, applied to the calendar. If you want help pulling the data and building the plan, our growth consulting team does this with practice owners, and our patient acquisition team plans the budget shifts. More on our urology page.

The short version

• Don't assume a stone season. Pull two or three years of your own enquiries and procedures by month.
• Find your peak months, the lag between enquiries and procedures, and your quiet months.
• Book OT slots, on-call cover and consumables ahead, and move equipment servicing out of the peak.
• Block front desk leave and extend phone hours in the peak, and watch answer rate weekly.
• Shift ad budget towards the peak, and use quiet months for training, CMEs, content and prevention follow-ups.