I have been using GotVMail virtual answering system (learned about it in PC Magazine). It costs me about $15/month. After hours we transfer main line to our GotVMail number. Patients get the message: if if not urgent, press #1 and we'll return call tomorrow (phone is transferred to one mail box for nurses to check next day), if urgent press #2 and we'll transfer to dr.on call (if I am on call - patient leaves a message to another mailbox and I get notification on my call phone)(If another doctor is on call - call gets forwarded to another doctor's office) Every day receptionist goes online and changes the "on-call" phone number to which urgent calls get transferred