Episode 24 · With John Chinegwundoh · 15 Mar 2026 · 34 min

    The Patients You Never Hear From

    The real limit on patient follow-up is not care but capacity, and closing that gap means partnering rather than trying to do it all yourself.

    Featured guest

    John Chinegwundoh

    Respiratory physician in private practice
    A respiratory physician who has spent more than 20 years (22 by his own count) in UK private practice, seeing roughly 1,500 patients a year and working across several private hospitals. He has adopted AI scribes in his own clinics and works closely with conditions such as asthma and smoking-related lung disease.

    Show notes

    John Chinegwundoh has spent more than two decades in private practice as a respiratory physician. He sees around 1,500 patients a year, and the caseload he carries in his head keeps climbing. In this conversation with Jared, he describes the quiet inefficiency every clinic owner recognises: the white space in the diary, the patients who cannot get a slot one week and the empty afternoons the next, and the ones who cancel, mean to rebook, and simply forget.

    His experienced PA keeps the practice running, but she cannot be replicated five times over. So the follow-up that matters most, checking in on a patient with asthma before the spring pollen arrives, or flagging new tests to someone seen years ago, tends to fall away. John's point is not that clinicians stop caring. It is that good intentions run into a hard ceiling of hours and capacity, and most patients only act once symptoms return.

    The back half of the conversation turns to what changes the maths. John has adopted AI scribes and still reads every letter as the final arbiter of accuracy. He talks about a more competitive private market where trust and visibility decide who patients choose, about patients who now prefer a WhatsApp reply to an email, and about why he expects to need a tech partner as much as a PA. His closing thought: the clinicians who pull ahead are the curious ones who know their own limits and choose carefully who they lean on.

    Key takeaways

    • A reactive, wait-for-the-patient-to-call system means many past patients quietly drop off the pathway, and the practice rarely has capacity to chase them.
    • Seasonal and condition-specific nudges, like an asthma review before spring pollen or a check-in on a smoking-related risk, are high-value follow-ups that usually go undone.
    • John treats AI scribes as a time-saver, not an authority: the clinician stays the final arbiter of accuracy on every letter before it reaches the patient.
    • In a more competitive private market, visibility and trust (starting with the website) shape both whether patients book and how readily they follow the plan.
    • Patients increasingly expect instant, informal channels such as WhatsApp, and practitioners have to match that responsiveness or lose the thread once the appointment ends.
    • Staying current is impossible to do alone, so John argues clinicians should ally with a tech partner and stay curious rather than try to master every new tool themselves.
    The people who are achieving the most are those that are aware of their own limitations. But most importantly, they're the people who are the most curious.
    John Chinegwundoh
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