The patient engagement gap: Clinekt's 2026 research report

Clinekt's 2026 research report, The patient engagement gap, puts a number on the revenue a practice loses to patients it never sees: about $107,000 per physician a year, 7.7% of practice revenue, and about $45 billion a year across twelve specialties and primary care. The model is built from 28 public sources, including MGMA, AAMC, AHRQ, CMS and peer-reviewed studies of referrals, no-shows and follow-up, and every estimate in it is set low on purpose. Read the full report, with the method and a calculator for your own practice, at clinekthealth.com/patient-engagement-statistics, or download the twelve page PDF.

Key takeaways

• The gap is $107,000 per physician a year in the base case. Halve every estimate in the model and it is still $54,000.
• It comes from four places: new patients who never book, referrals that never schedule, visits that never happen, and patients who never come back.
• Primary care carries the largest share at about $23 billion a year, followed by pediatrics, OB/GYN, cardiology and orthopedics. Every specialty in the report loses between 5 and 13 visits per physician every week.
• None of it shows up on the P&L. From the inside it looks like an open slot.

Where the revenue leaves

The report follows a patient through the four moments a practice loses them, and sizes each one against the MGMA median of $1.39 million in revenue per full time physician.

• New patients who never book. 29% of healthcare calls go unanswered or to voicemail, and 43% of online bookings happen outside 8am to 5pm. About $32,000 per physician a year.
• Referrals that never schedule. About half of specialty referrals for adults 65 and over are never completed. About $26,000 per physician a year.
• Visits that never happen. Single specialty practices report a median no-show rate of 6.8%, and half of missed visits are never rebooked. About $17,000 per physician a year.
• Patients who never come back. In one pediatric cardiology clinic, 45.9% of patients told to return were lost to follow-up. About $31,000 per physician a year.

Why it matters more in 2026

Operating cost per physician rose 71.6% from 2011 to 2024, against 39.5% consumer inflation, and Medicare physician pay is down 33% since 2001 once practice cost inflation is counted. 70% of practice leaders report front office staffing instability. A practice cannot hire its way out of a gap that opens at 7pm, in the fax queue, and in the recall list, which is why the report ends with what an always-on layer of patient engagement recovers in each of the four places.

What is in the full report

• The twelve specialty table: physicians in direct patient care, revenue per visit, and the annual gap for orthopedics, dermatology, ophthalmology, urology, cardiology, rheumatology, gastroenterology, otolaryngology, pain medicine, OB/GYN, primary care and pediatrics.
• A calculator that sizes the gap for your own provider count and revenue.
• The method, the sensitivity scenarios, and all 28 numbered sources with links.

Read it at clinekthealth.com/patient-engagement-statistics. To cite it: Clinekt Health (2026). The patient engagement gap: what US specialty and primary care practices lose to patients they never see. October 2026.

Where Clinekt fits

Clinekt is patient engagement software: AI agents that engage new patients the moment they reach the practice, bring back overdue patients from the EHR, and keep every scheduled visit on the calendar, with nothing landing on your staff. The Inbound Agent covers the first two places revenue leaves, the Recall Agent covers the fourth, and the Care Agent covers the third. Size your own gap with the patient leakage calculator, or book a 15 minute demo.

Read the full report, with the method, the specialty table and the calculator, at clinekthealth.com/patient-engagement-statistics. See what the gap looks like for your own practice with the patient leakage calculator, or book a demo.