A new primary care patient is worth a decade, not a visit.

A patient who chooses a primary care practice may come back several times a year for many years: annual checks, chronic care, the occasional acute visit.

Judged on the first appointment, every source looks similar, because a first visit is a first visit. Judged on the following two years, they separate.

Grouping collections under each patient's first visit and following them over a long window gives the number that matters: what each source added to the panel.

It also shows which sources produce patients who stay, which is a better guide to where to spend than cost per new-patient appointment.

The report shows the count of patients each figure rests on, because a small practice's two-year cohort can be small enough to mislead on its own.

Urgent and same-day visits are usually driven by proximity: somebody searches for care near them now and goes to the nearest option with a good rating.

Most of those patients call or walk in, so without a tracked number on the map listing they arrive with no source at all.

A distinct number on each location's listing turns that channel into a lead file, and a year later the practice knows what the listing produced.

It also shows how many urgent-visit patients became regular patients, which is often the most valuable thing an urgent-care line does for a practice.

A practice offering virtual visits can see patients who would never travel to its offices, and those patients arrive through different searches and different sources.

They often behave differently too: more one-off visits, fewer long relationships, sometimes a different payer mix.

Where the export marks the visit type, the report splits virtual-first patients from office-first patients, so each gets its own ranking.

Pooled together, a virtual channel that produces many single visits can look better or worse than it is, depending on which side of the average it sits.

Where a practice takes part in value-based arrangements, some of the revenue a patient produces arrives as programme payments rather than as a fee per visit.

A report built only on visit collections undercounts the patients those programmes reward, and the undercount is not spread evenly across sources.

The report ranks on the collections in the file and says so. Where programme revenue can be attributed to a patient, adding it to the export makes the ranking complete.

Stating the basis matters here more than most places, because the same patient can be worth very different amounts depending on which revenue is counted.

It also changes what a source is worth. A channel that brings in patients with ongoing care needs can look ordinary on visit fees and very good once programme revenue is included, and the practice should know which view its budget is being set on.