Explorez tous les épisodes du podcast The Business of a Clinic (BOAC)

In this episode of The Business of a Clinic, Jared Aron speaks with Dr. Geoff Gamble, chiropractor and co-founder of Niagara Health Rehab Center, a large multidisciplinary rehab clinic in Canada.

Geoff shares the honest story of how NHRC grew from four practitioners and 4,000 square feet into a much larger clinic team — but not in a straight line.

After several years of organic growth, the clinic hit a difficult breaking point. Staff turnover reached 85%, growth flatlined, the business started to regress, and Geoff and his team were even considering closing the clinic.

What changed was the way they looked at the business.

Geoff talks about the transition from clinician to clinic entrepreneur, the mistake of assuming the clinic would “run itself,” and the importance of learning business fundamentals: P&Ls, metrics, utilization, hiring, culture, and patient reactivation.

He also shares how the pandemic became an unexpected reset point for NHRC, helping the team rebuild operations, rethink staffing, and create a more scalable business. Since then, the clinic has quadrupled gross revenue and significantly expanded its team.

This conversation is especially relevant for clinic owners, MSK leaders, chiropractors, physiotherapists, and healthcare entrepreneurs who are trying to move from being the main practitioner in the business to becoming the leader of a clinic that can grow without depending entirely on them.

In this episode, Jared and Geoff discuss:

• Why early clinic growth can hide weak business foundations
• The reality of going from clinician to entrepreneur
• How 85% staff turnover forced NHRC to rethink the business
• Why Geoff nearly burned out as the main revenue driver
• The danger of building a clinic that depends too heavily on the owner
• What clinic owners need to understand about P&Ls, metrics and utilization
• Why culture, hiring and communication became central to the turnaround
• What should stay in-house versus what can be outsourced
• Why patient reactivation is both a revenue problem and a care problem
• How NHRC approached a cold list of around 18,000 patients
• Why “having a process” does not always mean the process is working
• The challenge of letting go of control as a clinic owner
• What Geoff wants to improve next as NHRC continues to grow

This episode is a practical look at what it really takes to rebuild a clinic business: not just better marketing or more practitioners, but better systems, stronger leadership, clearer metrics, and a deeper understanding of the patient journey.

Guest: Dr. Geoff Gamble, Niagara Health Rehab Center
Host: Jared Aron, Founder of Coherent

The Business of a Clinic is a podcast about the business, operations, growth, and patient experience side of running modern private healthcare clinics.

In this episode of The Business of a Clinic, Jared speaks with Rachna Murthy and Jonathan, two consultant ophthalmologists and oculoplastic surgeons building a highly personal private clinic across London, Jersey, and soon Bermuda and the Cayman Islands. 

Rachna and Jonathan share how they moved from NHS backgrounds into private practice, and why building a successful clinic is not only about clinical skill. It is about trust, teamwork, patient obsession, communication, and creating a level of care that feels deeply human. 

They discuss why they operate as a two-surgeon team, how that improves speed, safety, and decision-making, and why ego can be both necessary and dangerous in surgery. They also explore what “five-star medicine” really means: treating patients like people, not transactions; building long-term relationships; offering direct access through WhatsApp; and making every part of the patient journey feel considered. 

The conversation also covers AI, wellness, longevity, aesthetics, body dysmorphia, holistic care, gut health, skin health, and why private medicine will always remain a “feeling business.” Technology can improve efficiency, but the future of great clinics will still depend on human trust, clinical judgement, and keeping the patient relationship at the center. 

Rachna and Jonathan also reflect on the realities of becoming clinician entrepreneurs: starting without much capital, building through word of mouth, acquiring a clinic in Jersey, hiring around values, expanding internationally, and learning how important self-care, outsourcing, and operational discipline become when running and growing a clinic. 

In this episode 

•  Why business matters in medicine 
•  How to build a clinic around patient trust 
•  Why clinical skill alone is not enough 
•  The benefits of a two-surgeon team 
•  Ego, confidence, and surgical improvement 
•  What five-star care means in private clinics 
•  Why direct communication changes the patient experience 
•  How WhatsApp groups support long-term patient relationships 
•  Body dysmorphia, expectations, and knowing when not to operate 
•  AI, empathy, hallucinations, and the limits of automation 
•  Wellness, longevity, microbiome health, and holistic care 
•  Why medicine is still a feeling business 
•  Lessons from leaving the NHS and building a private practice 
•  Hiring around values and learning to let people go 
•  Scaling a clinic across London, Jersey, Bermuda, and the Cayman Islands 
•  Why self-care matters for clinician entrepreneurs 

Key idea
 
Great clinics are not built on clinical skill alone. They are built on trust, team, process, communication, and the feeling patients have that someone genuinely knows them, cares about them, and is looking after them.

About the show
 
The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.
 

In this episode of The Business of a Clinic, Jared speaks with Cyrus, an investor focused on traditional services, AI-enabled businesses, and small business growth.

Cyrus brings a different perspective to the podcast: not as a clinic operator, but as someone thinking deeply about how traditional businesses are bought, scaled, modernized, and supported. The conversation explores the “real economy” — the clinics, service businesses, local operators, and offline companies that underpin daily life — and why healthcare sits at the center of that opportunity.

Jared and Cyrus discuss how investors think about clinic acquisitions, the difference between strategic and financial buyers, and why consolidation is not just an acquisition game. It is an integration game. They explore why acquirers need to understand the day-to-day work inside each clinic, why transformation should start from the unit level, and why patient relationships, team culture, and operational detail matter as much as the financial model.

They also go deep on AI in healthcare: where it can create real efficiency, where the hype gets ahead of reality, and why AI receptionists are more complicated than simply “answering the phone.” The question is not just whether AI can do a task, but what happens next — and whether the workflow actually works in the real world of patient care.

The episode closes with reflections on VC, private equity, entrepreneurship through acquisition, the importance of small operational details, and why, even in a world of automation, business is still ultimately about people.

In this episode

•  What investors mean by the “traditional economy” 
•  Why healthcare is a major opportunity for modernization 
•  Strategic buyers vs financial buyers 
•  Why clinic rollups are really integration businesses 
•  How acquirers think about unit-level value creation 
•  Why bottom-up thinking beats top-down transformation 
•  The importance of integrating people, culture, and patient books 
•  Why patient relationships create value for clinics and groups 
•  How to think about AI ROI in healthcare 
•  Why AI receptionists are harder than they sound 
•  The “then what?” problem in clinic automation 
•  Why process foundations matter before AI 
•  What changes when moving from VC to private equity 
•  Why small operational details can become big problems 
•  Why buying or selling a clinic still comes down to people, trust, and legacy 

Key idea

AI and capital can help clinics grow, but the real value is created in the details: the people, the workflows, the patient relationships, and the ability to integrate a clinic without losing what made it valuable in the first place. 

About the show

The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

Joshua Catlett bought his first private healthcare practice at around 22 years old.

He started at the front desk, answering phones, making tea, fixing the website, managing the diary and learning how a clinic actually works from the inside. That first practice eventually became the foundation for BodySet, a 36-site healthcare group that went on to take private equity investment.

Today, Joshua is the Founder and Managing Director of Verilo, a specialist healthcare business brokerage and advisory firm supporting clinic owners through valuation, sale, acquisition and exit planning.

In this episode, Jared Aron speaks with Joshua about the real business of buying, selling and scaling healthcare clinics.

They cover what buyers actually look for, why concentration risk can reduce valuation, how maintainable EBITDA is assessed, what makes a clinic genuinely exit ready, and why many owners only discover operational weaknesses when they enter a sale process.

Joshua also shares stories from his own acquisition journey, including how he structured early deals, what he learned from sitting on reception, why the front desk gives you one of the clearest views of the business, and how small details such as insurance, lease terms or poor financial visibility can put an entire transaction at risk.

Later in the conversation, Jared and Joshua discuss technology adoption in healthcare, the rise of AI, the pressure on clinics to become more efficient, and why online booking is still far more difficult than it should be for patients.

In this episode, they discuss:

• Buying a private practice at 22
• Building BodySet into a 36-site clinic group
• Selling into private equity
• What Verilo does for clinic owners
• Why selling a clinic is not just about finding a buyer
• The emotional side of healthcare M&A
• Concentration risk and owner dependency
• Lease security and premises risk
• Maintainable EBITDA and clinic valuation
• Why buyers care about data quality
• The importance of understanding the patient body
• Why many clinic owners do not know their numbers
• AI, workforce transformation and operational efficiency
• Why clinics need to make booking easier for patients
• What it means to build an exit-ready clinic

This episode is especially relevant for clinic owners, founders, healthcare operators, MSK clinic leaders, aesthetics clinic owners, dental practice owners, buyers, sellers and anyone thinking about the future value of their healthcare business.

The Business of a Clinic is hosted by Jared Aron, founder of Coherent. The podcast explores how private healthcare clinics can grow by improving the business and operational side of care, including patient engagement, follow-up, retention, technology, clinic operations and the overall patient experience.

In this episode of The Business of a Clinic, Jared speaks with Oli, Director of M&A at Kinetico Health, about what makes a private healthcare clinic valuable, scalable, and ready for acquisition.

Oli shares his journey from dental M&A into MSK, what he learned from the consolidation of the dental market, and why MSK is now entering a new phase of professionalisation, partnership, and group-building.

The conversation explores the full M&A process: origination, heads of terms, due diligence, commercial review, legal challenges, partner onboarding, and integration. Jared and Oli discuss what acquirers actually look for in a clinic, why culture is one of the most important signals, how founder reliance affects valuation, and why recurring patient revenue matters more than new patient volume alone.

They also go deep on the economics of MSK clinics: insurance vs self-pay, practitioner capacity, margin, overheads, cancellation rebooking, first-visit integrity, and why patient retention is central to organic growth.

The episode closes with a comparison between dentistry and MSK: what MSK clinic owners can learn from dental practice owners about preparing for sale, and what dentists can learn from MSK operators about reducing reliance on the principal practitioner.

Chapters

0:00 Introduction
1:00 Oli’s role at Kinetico Health
1:45 Finding and onboarding MSK clinics
2:30 From law to dental M&A
3:40 Why working with clinic owners matters
4:25 What happens after heads of terms
5:00 Financial and commercial due diligence
6:05 The legal process and lease issues
7:20 Why M&A should not feel adversarial
8:10 How clinic owners can prepare for acquisition
9:05 What acquirers look for beneath revenue
10:00 Why the clinic owner matters first
10:45 Culture, team loyalty, and principal retention
11:30 Key person reliance and founder concentration
12:20 Succession planning inside the clinic
13:15 The “who” behind a valuable clinic
14:05 Patient body, recurring revenue, and data quality
15:00 Insurance, NHS contracts, and payer mix
16:20 Stroke-of-the-pen risk in healthcare revenue
17:15 Insurance provider rates and profitability
18:00 MSK economics vs aesthetics and dermatology
19:10 Margin improvement through revenue growth
20:15 Private equity stereotypes and cost-cutting
21:15 Revenue growth in MSK clinics
22:10 Returning patient mix and clinic performance
23:05 When low retention is fixable
24:00 Practitioners, treatment plans, and “sales” discomfort
25:00 Helping patients commit to the right care journey
26:05 The practitioner as guide, not salesperson
27:15 Who owns follow-up after the patient leaves?
28:25 Practitioner responsibility vs front desk responsibility
29:10 Booking the next appointment before exit
30:10 Patient leakage and why patients drift
31:10 First-visit integrity and cancellation management
32:15 Building a pipeline to backfill cancellations
33:10 Same-day cancellations vs seven-day cancellations
34:05 Cancellation fees, friction, and reputation
34:50 Reading culture inside a live clinic
36:10 Why Oli moved from dental to MSK
37:15 Dental consolidation and market maturity
38:20 Emotional investment in clinic partnerships
39:30 Why mature M&A markets feel different
40:20 Building an organic acquisition pipeline
41:15 Why corporates get a bad reputation
42:10 Why MSK is an exciting consolidation market
43:10 Building a group from a less mature market
44:00 Entrepreneur by accident: the clinic owner journey
45:00 Helping practitioners get back to patients
46:00 What dentistry and MSK can learn from each other
47:00 How dental owners prepare for sale
48:00 Getting accounts and operations exit-ready
49:00 Why sellers should speak to other partners
50:05 What dentists can learn from MSK owners
51:00 Reducing reliance on the principal practitioner
52:05 The next phase of Kinetico Health
53:00 Greenfield sites, acquisitions, and group growth
54:05 Integration as the foundation for growth
55:00 Building systems so clinicians can focus on care
55:40 Closing thoughts

The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

What if your clinic’s biggest growth problem is not a lack of new patients — but the patients you already paid to acquire, consulted, and then quietly lost?

In this episode of The Business of a Clinic, Sean and Jared Aron explore the hidden revenue leaks inside private healthcare clinics: failed consult progression, unrecovered cancellations, lapsed patients, weak lead follow-up, disconnected CRM/PMS data, and the temptation to “just put AI on it.”

Jared explains why cost-per-lead can be a misleading metric, why consult leakage is often more expensive than billing leakage, and why patient operations teams rarely scale at the same pace as patient volume. The conversation also looks at AI receptionists, WhatsApp at scale, human-supervised patient engagement, and why clinics need to treat retention as a revenue function — not an admin task.

This episode is especially relevant for clinic owners, operators, and healthcare leaders thinking about growth, patient recall, front-desk capacity, AI adoption, and how to build a more commercially resilient clinic.

In this episode:

• Why recovering lapsed patients can beat spending more on ads
• Why consult leakage is one of the most expensive problems in a clinic
• Why cost-per-lead does not tell the full story
• Why patient volume scales but patient operations teams do not
• The limits of AI receptionists in healthcare
• Why WhatsApp becomes a technology problem at scale
• How clinics confuse marketing communication with patient engagement
• Why patient recall needs ownership, data, and dedicated horsepower
• Why existing patients often re-enter the funnel as “new leads”
• Why CRM, PMS, and marketing data need to connect across the patient journey

Key idea:

The clinic growth problem is not just acquisition. It is what happens after a patient enters the journey — whether they book, attend, progress, return, pay, and stay connected to the clinic over time.

The Business of a Clinic is a podcast about the operational, commercial, and human realities of building better private healthcare clinics.

Hosted by Jared Aron, founder of Coherent.

In this episode of The Business of a Clinic, Jared speaks with Janine from the Dental Recruit Network about dentistry, recruitment, staff turnover, treatment coordinators, patient recall, AI, and why dental practices lose patients they already worked so hard to acquire.

Janine shares how her team achieves a 95% permanent recruitment success rate, why matching candidates to the culture of a practice matters as much as technical skill, and why the modern dental front desk has become one of the most overloaded roles in private healthcare.

The conversation explores the changing role of reception, the rise of the treatment coordinator, why “sales” is still an uncomfortable word in dentistry, and why treatment plans often fail to convert when patients are not properly guided through their options.

They also discuss one of the biggest hidden problems in dental practices: patients who disappear from recall. Janine shares her own experience of being “lost” as a dental patient for three years despite working in dentistry, regularly attending hygiene appointments, and being physically present in the practice. It becomes a real-world example of how patients slip through even when reminders are technically being sent.

The episode closes with a discussion on AI in dentistry: why adoption is still early, why practices feel overwhelmed by choice, and why the right AI systems can reduce admin, protect patient relationships, and free teams to deliver better care.

Chapters

0:00 Janine’s lost patient story
0:37 Janine and the Dental Recruit Network
1:12 95% recruitment success rate
1:45 Matching candidates to dental practices
3:10 Culture, personality, and practice fit
4:15 Competition between dental practices
5:18 What “good” really means in dental staff
6:05 Reception, recalls, and the overloaded front desk
7:00 Treatment coordinators and patient follow-up
8:20 Technical skill vs customer service
9:20 How the front desk has changed
10:00 Why “sales” feels uncomfortable in dentistry
10:45 The rise of the treatment coordinator
12:10 Patients using ChatGPT before appointments
13:20 Small practices, corporates, and high-end clinics
13:45 Why small practices remember patients better
15:00 When the patient body outgrows the team
16:15 Hiring for patient communication and retention
17:00 Working backwards from the real staffing problem
17:40 Treatment coordination as soft selling
18:45 Why one person cannot own every patient process
20:05 Dentistry’s treatment coordinator advantage
21:05 Why other healthcare sectors lack a TCO role
22:00 Archived patients and hidden recall opportunity
23:20 Why practices lose focus after consultation
24:05 Process gaps, follow-up, and staff turnover
25:10 Why every practice works differently
26:10 When key staff leave, the process leaves with them
27:25 Patient management as a talent problem
28:05 Referral dentistry and specialist follow-up
29:00 Who owns the patient one year later?
30:00 Why existing patients are easier to reactivate
31:15 Patient feedback practices never hear
32:10 Janine’s own recall failure as a dental patient
33:20 Hygiene booked, dentist forgotten
34:10 Why SMS and email reminders were not enough
35:20 The friction of seeing a new dentist
36:10 How the practice lost Janine as a patient
37:10 Lost checkups, missed revenue, and missed care
38:15 Why patients need repeated human follow-up
39:05 Staff turnover and broken recall processes
40:00 The 10% monthly patient leak
41:00 109% increase in recalls
41:45 Why patients don’t know they’ve disappeared
42:30 Why dentists cannot remember every patient
43:25 Nine surgeries and traffic control
44:30 AI in dentistry: hype vs reality
45:20 Admin, treatment plans, payments, calls, and notes
46:20 Why AI adoption is still early
47:05 AI as a must-have for dental practices
48:10 Why practices are overwhelmed by AI tools
49:00 Talent as the unlock for clinic growth

The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

In this episode of The Business of a Clinic, Jared speaks with Dr Krista, a consultant neurologist and member of Coherent’s Medical Advisory Board, about what patient experience really means when you look beyond the consultation room.

They discuss the day-to-day work of a neurologist, the hidden administrative machinery behind clinical care, why communication is often the biggest source of patient frustration, and why something as simple as booking an appointment can still involve days of back-and-forth emails.

The conversation explores the tension between healthcare and technology: why patients want one-click access, why doctors are cautious about new tools, why patient safety slows adoption for good reason, and how AI, automation, triage, and ambient voice technology may reshape the future of care.

They also discuss private practice, the non-clinical burden of running a healthcare business, why that burden may disproportionately affect female clinicians, and how hospitality, customer service, and relationship-building fit into modern healthcare.

Chapters

0:00 Pre-roll and setup
1:20 Dr Krista’s background
2:00 What a neurologist actually does
5:31 The operational machinery behind clinical care
7:20 Why admin is part of the standard of care
8:07 Patient access, referrals, and knowing who to see
10:00 Clinical care vs operational support
12:35 How patient experience has changed
14:50 Communication as the biggest source of complaints
16:25 The one patient experience problem worth fixing
17:11 One-click booking: click, booked, done
18:51 The “to-and-fro” problem in healthcare booking
20:45 Why healthcare still cannot book like e-commerce
21:50 Referral triage, automation, and seeing the right doctor
23:15 Cultural change in medicine
25:41 Patient safety, skepticism, and why doctors move slowly
27:16 Clinical habits, routines, and medical training
28:25 Ambient voice technology and clinician identity
30:10 The business side of private practice
31:35 Why private practice can be harder for female clinicians
34:38 The non-care parts of healthcare
36:30 Hospitality and healthcare
38:20 Feeling welcomed, looked after, and known
39:12 Customer service, airlines, and healthcare logistics
41:10 Safety as the baseline of care
43:22 Restaurants, healthcare, and the experience around the core service
44:55 When admin failures damage clinical care
46:28 Who owns follow-up after the consultation?
48:00 Patient responsibility, clinician responsibility, and systems
49:55 Closing thoughts

The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

In this episode of The Business of a Clinic, Jared Aron and Sean explore why the next wave of clinic growth will not come from more software, more front-desk hires, or reactive patient communication.

The conversation starts with Jared’s path from teaching high school to building in healthcare, and moves into the deeper operating problem inside modern clinics: patients fall off track because nobody owns the relationship once they leave the room.

Jared explains why “proactive patient engagement” is becoming a category, why clinicians rarely have the time or structure to manage follow-up properly, and why clinics need to move from reactive front-office operations to active patient management.

They also discuss AI receptionists, the verification tax, broken PMS and CRM workflows, data quality, first visit integrity, benchmarking, appointment-book hardening, and why clinics need transformation partners rather than another point solution.

Chapters

0:00 Teaching, authority, and human behaviour
 1:40 How Jared got into healthcare
 2:45 From classroom to private clinic
 3:19 Love, autonomy, and boundaries
 4:23 Why teenagers are different
 6:38 What changed in healthcare this week
 6:45 Proactive patient engagement
 8:14 Why practitioners do not own follow-up
 9:14 One-to-one support for every patient
 10:07 The orphaned patient
 10:56 Patient engagement as infrastructure
 11:26 Why the patient journey breaks at scale
 12:37 Appointment uplift and workforce transformation
 13:53 The old healthcare operating model is breaking
 14:27 Technology across the healthcare assembly line
 15:03 Frankenstein teams and software bloat
 16:02 Why clinics need deeper operational change
 16:16 Healthcare transformation risk
 17:35 Clinical care vs patient experience
 18:07 Software, headcount, and redesign
 19:46 AI, services, and the P&L mandate
 20:34 The AI receptionist question
 21:14 The verification tax
 21:51 Less software, fewer people, better outcomes
 22:26 Patient operations as a medical device
 23:06 What healthcare can learn from fintech
 24:25 Why healthcare has not had its Revolut moment
 25:28 PMS, EMR, EHR, and patient support
 26:36 Buying AI without getting burned
 27:47 What AI receptionists actually do
 28:32 Reactive front office vs proactive patient operations
 30:02 Who is off track right now?
 31:21 When AI cannot fix broken plumbing
 32:47 Why complexity explodes in larger groups
 33:23 Start with an audit
 33:39 First visit integrity
 34:49 Data quality foundations
 35:30 Patient journey visibility
 36:04 Benchmarking the patient book
 36:53 Transformation partner vs point solution
 37:23 AI FOMO in clinic operations
 37:59 Revenue uplift, cost reduction, workforce redesign
 38:38 Book hardening
 39:20 Patient experience under automation
 39:49 Workforce transformation
 40:05 Band-aids vs transformation
 41:01 Why incremental change is not enough
 41:20 Discovery before problem-solving

About the show

The Business of a Clinic explores how private healthcare clinics can grow by improving the business and operational side of care.

Hosted by Jared Aron, founder of Coherent, the podcast covers patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

In this episode of Business of a Clinic, Jared sits down with Shaima, a private GP with more than 20 years of experience in private general practice and co-founding director of Chelsea Medics.

They explore how private GP practice has changed over the last two decades, from the increasing demand for private appointments to the rise of more informed patients using Google, ChatGPT and online health information before they ever enter the clinic room.

Shaima shares how this has changed the role of the doctor. Patients now arrive with more questions, more expectations and often more anxiety. For clinicians, the job is no longer just to diagnose and treat. It is also to guide, clarify and help patients make sense of the information they already have.

The conversation also covers the reality of running a private clinic: the business education doctors rarely receive, the operational shock of COVID, the sudden shift to virtual practice, the growing expectation of communication between appointments, and why recruitment is one of the most difficult parts of clinic ownership.

This episode is a thoughtful look at the future of private GP medicine and why clinic leaders need to keep adapting as patient expectations, technology and healthcare delivery continue to change.

In this episode, we cover:

•  Why more patients are turning to private GP care 
•  How NHS access challenges are changing patient behaviour 
•  The impact of Google, ChatGPT and online health information 
•  Why the doctor’s role is becoming more like a guide 
•  What clinicians are not taught about running a business 
•  The business lessons Shaima wishes she had learned earlier 
•  How COVID forced private clinics to adapt overnight 
•  Why communication between appointments now matters more 
•  What makes recruitment so difficult in private practice 
•  Why the future of private GP requires technology adoption

Joëlle Rotsaert, founder of Injectual, joins us to talk about what it really takes to build a modern aesthetics brand.

We cover Joëlle’s journey from fashion into aesthetics, the personal experiences that shaped her view of the industry, and why she believed there was room for a more focused, more design-led, more culturally relevant injectables brand. We also discuss why many clinics weaken themselves by offering too much, how Injectual built around a clear specialty, and why Joëlle sees injectables as something that can be safe, premium, and still feel accessible.

The conversation also goes deep on clinic growth: bookings, sales, front of house, aftercare, memberships, operational strain, HR, and what starts to break when a founder-led clinic becomes a multi-site business. Joëlle also shares her longer-term vision for international growth and for building a dedicated offering around gender-affirming care.

In this episode:

•  Joëlle’s route from fashion into aesthetics 
•  Lessons from Harley Academy and Cavendish Clinic 
•  Why focus matters in clinic branding 
•  Building Injectual around injectables 
•  “Approachable luxury” and hospitality-led healthcare 
•  Organic content, influencers, memes, and authenticity 
•  Why front of house is not the same as sales 
•  Specialist bookings and conversion systems 
•  Scaling pains: memberships, systems, inventory, and HR 
•  Growing internationally without losing the brand’s DNA 
•  The long-term vision behind Transect

What do private equity-backed clinic groups understand about growth that many clinician-led practices miss?

In Episode 28 of The Business of a Clinic, Jared breaks down why PE-backed operators and non-clinician leaders often grasp Coherent’s value faster. The answer is not that they care less about care. It is that they are trained to think in terms of store-level efficiency, organic revenue growth, patient economics, and asset appreciation. 

The conversation explores how patient leakage affects site-level productivity and clinic value, why many of the biggest growth opportunities are hidden inside the patient journey, and why head office teams often cannot see leakage clearly from the P&L alone. Jared also explains the questions buyers and operators should be asking if they want to understand the real performance of a clinic beyond surface-level revenue numbers. 

This episode covers:

•  Why PE-backed groups focus so heavily on organic revenue growth 
•  The difference between clinician-led thinking and operator-led thinking 
•  How patient leakage impacts margin, productivity, and asset value 
•  Why “cost per lead” is not enough to understand clinic performance 
•  The one simple question that often reveals whether a clinic has a leakage problem 
•  How fixing leakage can increase asset value without increasing marketing spend 

If you run, acquire, or scale clinics, this episode is a useful lens on what really drives appreciation at site level and why better follow-up, retention, and conversion are not just operational details. They are value creation levers. 

In this episode of The Business of a Clinic, Jared sits down with Michael Schumacher, co-founder of HMDG, to talk about what is actually changing in private healthcare — and what still is not. They get into why healthcare remains slow to innovate, why so many clinics struggle to adopt technology well, and why AI tools like receptionists or voice agents often sound more impressive than they perform once they hit real clinic workflows. 

Michael shares his view on the Private Practice Barometer, what it reveals about clinic margins and benchmarking, why many clinic owners still undercharge, and why pricing is often one of the fastest ways to improve profitability. The conversation also explores the difference between lead volume and lead quality, how poor follow-up distorts marketing performance, why some clinics are hard to buy or scale, and what private equity often misunderstands about the realities of healthcare operations. 

The episode then opens up into a broader conversation about the future of healthcare businesses: patient trust, experience design, brand, gamification, recurring revenue, Neko Health, and why healthcare still has a long way to go in building consumer-grade experiences that actually keep patients engaged. From “bad leads” to Botox clubs, this one covers a lot of ground. 

In this episode, we cover:

•  Why healthcare is still behind on innovation and digital transformation 
•  The real problem with AI receptionists and autonomous front desk tools 
•  Why implementation matters more than the software demo 
•  What the Private Practice Barometer reveals about clinic performance 
•  Why many clinic owners underprice their services 
•  Why follow-up pricing matters more than most clinics think 
•  The difference between lead quantity and lead quality
•  Why clinic marketing often breaks after the lead comes in 
•  Why buyers and investors often misunderstand clinic value 
•  What clinics can learn from Neko Health, gamification, and membership-style models 

About Michael Schumacher
Michael Schumacher is the co-founder of HMDG, a marketing agency originally focused on MSK clinic owners and now working more broadly across healthcare. In this conversation, he brings a commercial and operational lens to clinic growth, pricing, marketing, and the future of healthcare delivery.

In Episode 26 of The Business of a Clinic, Sean sits down with Dr Arnold Gangaidzo, founder of Lancashire Smiles, to talk about the real journey behind building a private dental practice from the ground up. 

Arnold shares his path from Zimbabwe to the UK, why missing out on medical school turned out to be a blessing in disguise, and how dentistry became the right path for someone who wanted both healthcare and entrepreneurship. 

They get into what clinic ownership actually looks like when the Instagram version ends: builders missing deadlines, CQC timing, rent-free periods disappearing, loan repayments starting before revenue is stable, and the shock of cash flow once the doors finally open. 

Arnold speaks candidly about the pressure of making it work, taking little to no income from the business in the early months, and learning that profitability on paper is very different from real money in the bank. 

The conversation also explores one of the biggest mistakes ambitious clinic owners make: expanding capacity too early. Arnold explains why opening a second treatment room before fully maximizing the first created more white space, more cost, and more complexity than expected. 

From there, the discussion moves into retention, recurring revenue, lifetime value, and why growth-minded owners need to focus on strengthening the first bucket before building the next. 

They also talk about building a personal brand on LinkedIn, using systems like Asana to stay accountable, and why Arnold is building Lancashire Smiles with the long-term vision of a regional multi-site group. 

His philosophy is simple: build with the intention to sell, even if the real goal is to create something strong enough to keep and pass on to the next generation. 

This episode is for clinic owners, operators, and aspiring founders who want a more honest view of practice ownership: the risk, the pressure, the discipline, and the thinking required to build something real.

What kind of healthcare will AI actually transform first?

In this episode, Jared and Sean unpack one of the most important distinctions in modern healthcare: hands-on care vs cognitive care. Hands-on care requires the patient to physically be there — dentistry, physiotherapy, chiropractic, dermatology, aesthetics — while cognitive care can often be delivered remotely through diagnosis, advice, or telehealth. That difference matters because it shapes how AI will be adopted, where it will create leverage, and why the future of in-person care will still be deeply human for a long time. 

They explore why the real challenge in hands-on healthcare is not only what happens in the treatment room, but everything around it: logistics, movement, scheduling, follow-up, and getting patients to actually take the next step. In Jared’s view, that “next step” is 90% of the battle in many clinics, and it is where so much patient leakage begins. 

The conversation then shifts into the mindset of clinic owners versus multi-site group operators. Jared explains why group leaders think in terms of lifetime value, appointment density, ROI, and margin, while many smaller clinic owners still move too slowly or make only incremental changes. They discuss how the best operators build clinics scientifically rather than artistically, and why systems, efficiency, and reduced founder dependence matter so much if you want to grow or eventually sell. 

They also get into one of the episode’s sharpest ideas: cost per consultation matters more than cost per lead. A clinic can feel good about lead numbers while quietly losing huge value between enquiry and consultation. Jared shares an example of a clinic with roughly 100 high-intent inbound enquiries in a month, but only around a third converted into consultations, while many others sat in the dangerous “still in process” category. That invisible gap is where profitability often dies. 

Along the way, they talk about failed Salesforce implementations, why AI reception often disappoints, how “set and forget” workflows create hidden losses, why archived patients are often a goldmine nobody understands, and the simple test every clinic owner should take: go on holiday and see whether the business still runs without you.  

In this episode, they discuss:

• The difference between hands-on care and cognitive care
• Why AI doctors are more relevant to telehealth than in-person treatment
• Why hands-on healthcare is really a logistics problem
• How patient leakage happens in the gaps between steps
• The mindset difference between clinic owners and group operators
• Why group leaders think in appointment density and lifetime value
• How acquisition-minded clinics are built differently
• Why technology only works when there is ownership behind it
• The hidden cost of bad software implementation
• Why AI reception often creates more tasks instead of solving them
• How edge cases are the norm in healthcare
• Why archived patients may represent lost revenue sitting in plain sight
• Why most follow-up sequences are based on guesswork, not evidence
• Why cost per consultation is a better metric than cost per lead
• How plugging leakage can create a clinic’s best month ever
• Why founder dependence weakens clinic value and exit potential

Timestamps

00:00 – Hands-on care vs cognitive care
 02:10 – The hype around AI doctors
 03:00 – Why AI can assist but not replace hands-on practitioners
 04:00 – Neko Health and the persistent human layer
 05:08 – Why Coherent focuses on logistics, not clinical decision-making
 06:37 – The real challenge: getting patients to take the next step
 08:20 – How multi-site clinic groups think differently
 10:20 – Why clinic leaders need to shif

Healthcare often focuses on clinical outcomes — but the operational reality behind delivering care is far more complex.

In this episode of Business of a Clinic, Jared Aron sits down with Dr. John Chinegwundoh, consultant physician and Chief Medical Officer at Coherent Healthcare, to explore what actually happens behind the scenes of modern medical practice.

Drawing on more than two decades of experience across the NHS and private healthcare, John shares his perspective on how healthcare systems really function — not just clinically, but operationally.

The conversation explores the growing gap between clinical expertise and operational execution, and why so many clinics struggle to maintain consistent patient engagement over time.

They discuss the hidden challenges of managing patient journeys, the structural reasons patients quietly fall out of care, and how emerging technologies like AI may reshape how clinics stay connected with patients long after their first appointment.

This episode is a thoughtful look at the business and operational side of medicine — and why solving these problems may be just as important as the clinical work itself.

• Why running a clinic is far more operationally complex than most people realise
• The hidden administrative load behind patient care
• Why clinics often lose track of patients over time
• The concept of patient leakage across the healthcare journey
• Differences between NHS and private healthcare systems
• Why technology has struggled to solve operational problems in clinics
• How AI may transform patient communication and follow-up
• The future of patient relationship management in healthcare

00:00 Introduction
 01:03 Meet Dr. John Chinegwundoh
 03:45 The operational reality of running a clinic
 06:18 Why healthcare administration is so complex
 08:47 Managing patient relationships at scale
 11:10 Why patients quietly drop off over time
 14:36 Understanding patient leakage in healthcare
 18:05 Technology and the limits of current systems
 21:12 AI and the future of patient engagement
 24:50 NHS vs private healthcare systems
 28:32 Operational challenges facing modern clinics
 32:10 The future of patient-centred care
 35:40 Closing thoughts

Business of a Clinic explores the operational, financial, and technological challenges of running modern healthcare practices.

Hosted by Jared Aron, founder of Coherent Healthcare, the podcast features conversations with clinicians, operators, and healthcare leaders about what it really takes to build and run successful clinics.

Learn more about Coherent Healthcare:
 https://coherenthq.com

Follow Coherent on LinkedIn:
 https://www.linkedin.com/company/coherent-healthcare

Most healthcare providers believe they already “do follow-up.”

They call twice.
 They send an email.
 They assume patients will come back when they need care.

But when you open the practice management system and ask one simple question —

How many patients currently have no next appointment booked?

— the answer is often uncomfortable.

In this episode, we unpack the structural patient drift problem inside private healthcare clinics:

• Why up to 50% of patients who start care never complete it
 • Why “we already follow up” rarely means what people think it means
 • Why thousands (sometimes tens of thousands) of patients sit in systems with no discharge status
 • Why 30%+ of patients miss essential annual reviews
 • Why AI receptionists solve only a tiny fraction of the real issue

We explore the concept of the “Office of the MD” vs the “Office of the COO.”

Clinics are full of highly trained practitioners delivering world-class care.

But commercially?

There is usually:

• No retention team
• No sales team
• No operational strategy
• No structured follow-up infrastructure
• No ownership of the full patient journey

The result isn’t bad care.

It’s operational failure.

We also discuss:

• The difference between automation and true workflow ownership
 • Why interoperability between PMS, CRM, and marketing tools usually breaks down
 • The myth of “autonomous front office AI”
 • Why healthcare is fundamentally an edge-case environment
 • Why empathy still matters in high-value treatment decisions
 • What “superhuman follow-up” actually means
 • Why “eyes on, hands off” is the future of healthcare operations

Healthcare is not e-commerce.

You cannot afford to miss the 20% edge cases — because in healthcare, the edge case is the case.

If your clinic has:

• Thousands of patients with no next appointment
• Treatment plans that stall
• Annual reviews that go uncompleted
• Leads that never convert
• Cancellations that never rebook

Then this episode will challenge how you think about patient management — and what real operational transformation looks like.

00:00 – Discovery calls and confusion about what we actually do
 01:00 – The “spaghetti” patient journey
 02:00 – Why less than half of patients complete care
 04:10 – Lead conversion, post-consultation follow-up, recall
 06:20 – The 30% missed annual check-up problem
 07:40 – What is the real drop-off rate?
 09:00 – Recurring care in MSK, physio, dentistry
 10:10 – Thousands of patients with no status
 11:10 – The missing Office of the COO
 13:00 – Why AI receptionists are only 1% of the problem
 14:20 – Interoperability, PMS limitations, and software overload
 15:40 – Autonomous front desk vs augmentation
 16:20 – Healthcare as a living organism
 17:40 – Why healthcare is the edge case
 18:10 – Empathy, treatment blockers, and feedback loops

Most clinics believe retention is strong.

The diary looks full.
 Revenue is up.
 Marketing is working.

But beneath the surface, patients are quietly falling off track.

In this episode of Business of a Clinic, Sean and Jared unpack one of the most misunderstood problems in healthcare operations: invisible patient leakage.

This is the silent drop-off that happens at every stage of the journey:

• New inquiries that never get followed up
• Consultations that don’t convert
• Cancellations that aren’t rebooked
• Patients discharged without continuity
• Thousands of active patients with no next appointment

And because it’s not measured properly, it feels like everything is fine.

What You’ll Learn in This Episode

1️⃣ Why “80% retention” is misleading

When you multiply 80% across multiple visits, it’s not 80%. It compounds downward. What looks healthy on paper often masks cumulative disengagement.

2️⃣ The difference between a System of Record and a System of Action

EMRs, PMS platforms, CRMs, RCM tools — they store information.
 But they don’t necessarily take action.

Owning software is not the same as owning outcomes.

Most clinics have tools.
 Very few have execution.

3️⃣ Why white space isn’t a marketing problem

Empty slots in your calendar are terrifying. The instinct is to spend more on ads.

But often the problem isn’t lack of demand.

It’s:

• Unmanaged inquiries
• No follow-through on consultations
• No structured recall
• No cancellation recovery

The revenue is already inside the business.

4️⃣ Clinical follow-up vs service-based follow-up

Clinical follow-up is table stakes. It’s your duty of care.

But service-based follow-up is what separates good clinics from great ones.

The five-star hospitality mindset doesn’t stop at fixing the issue. It extends beyond the visit.

Healthcare rarely does this well — not because providers don’t care, but because systems aren’t designed to support it at scale.

5️⃣ Why hiring more coordinators doesn’t solve scaling

Every clinic has a ceiling.

You only have so many treatment rooms.
 You can’t multiply revenue infinitely with more headcount.

As your historical patient base grows, the math breaks:

• 1,000 patients becomes 2,000
• Then 5,000
• Then 10,000

But your physical capacity doesn’t grow at the same rate.

At some point, adding people stops solving the problem.

Operational leverage matters more than headcount.

6️⃣ Revenue vs EBITDA: what really drives valuation

Healthcare businesses are not SaaS companies.

They aren’t valued primarily on revenue multiples.

They’re valued on profitability.

If top-line revenue grows while bottom-line stagnates, the gap between the two is where invisible leakage lives.

Fixing leakage is often more powerful than chasing growth.

The Core Question

How many patients in your clinic right now do not have a next appointment booked?

If you can’t answer that with a precise number — in real time — you’re not measuring leakage.

And if you’re not measuring it, you can’t fix it.

This Episode Is For You If:

• You run a single-site clinic
• You manage a multi-site group
• You lead operations
• You’re responsible for revenue performance
• You’re thinking about scaling
• You’re considering an exit in the future

This conversation challenges the default belief that “more marketing” is the solution.

Sometimes the biggest growth opportunity is not outside the business.

It’s inside.

🎧 Listen in to rethink retention, rethink follow-up, and rethink what true operational excellence looks like in healthcare.

What actually makes a clinic valuable? In this episode, Sean and Jared unpack the uncomfortable truth: great clinicians aren’t enough — the business is won or lost in the operational “plumbing” around care. They explore patient retention as an asset, the gap between “booked” and “completed” care, and why many clinics look healthy on the surface but fall apart under diligence.

From there, the conversation turns to AI: AI receptionists, AI scribes, and the hyped “AI doctor.” The key question isn’t capability — it’s responsibility. Who checks the work? Who holds the risk? And what happens when AI introduces a “verification tax” that forces humans to double-check everything anyway?

If you’re building, scaling, or preparing for an exit, this one is a practical lens on what matters: brand, systems, accountability, and the patient journey — not just technology for technology’s sake.

Key themes and takeaways

1) Clinic value is operational, not just clinical

A clinic becomes investable when outcomes don’t depend on one hero operator. They break down the shift from “principal-led” to “process-led”: consistent delivery, repeatability, and a patient journey that doesn’t leak revenue through missed follow-ups and drop-offs.

2) Retention is the hidden asset on your balance sheet

They frame patient history and “off-track” patients as a recoverable asset — not a marketing problem. The clinic that wins isn’t the one that generates the most leads; it’s the one that reliably converts intent into completed treatment.

3) Due diligence exposes the truth

You can run a clinic on adrenaline and spreadsheets — until someone tries to buy it. They talk through why deals fail: messy data, unclear ownership, inconsistent processes, and a gap between what leaders think happens vs what actually happens at the front desk.

4) AI isn’t free — it can create a “verification tax”

AI may book patients or draft notes, but if staff must re-check everything to avoid mistakes, the promised efficiency collapses. The conversation sharpens around “humans-in-the-loop” and the difference between automation that removes work vs automation that adds oversight.

5) AI doctors raise the hard question: who carries liability?

The future of AI in healthcare isn’t just a product question — it’s an underwriting question. If an AI system influences diagnosis or care decisions, who is accountable, and how do you build guardrails that preserve patient safety and trust?

6) Healthcare is logistics wrapped around care

They argue the bottleneck is rarely the clinical moment — it’s the scheduling, follow-up, payments, coordination, and operational reliability that gets a patient to the right room at the right time with the right context.

Chapters:

00:00 Intro — the big ideas: clinic value, retention, AI risk
 02:10 Practitioner → founder: building beyond the principal
 04:10 Retention as an asset: patient “stickiness” and leakage
 06:30 Why diligence kills deals: data, process, ownership gaps
 08:40 Brand and clinic DNA: what makes you meaningfully different
 10:40 The operational skeleton: “plumbing” that creates reliability
 13:10 AI in clinic ops: what’s real vs what’s hype
 15:20 The verification tax: when automation adds oversight
 18:20 Healthcare as logistics: admin lifecycle vs clinical moment
 21:10 AI doctors: liability, underwriting, supervision, safety
 25:30 Guardrails, accountability, and humans-in-the-loop
 29:10 What to do now: practical steps for operators building value
 33:00 Closing — empathy, trust, and sustainable scale

Every clinic starts with a simple promise: give great care to the patient in front of you. But scale changes everything.

In Episode 20, Jared unpacks a core paradox: your clinic has finite capacity (rooms, hours, staff) — but your patient history grows forever. That mismatch creates “leaks” across the journey: leads that aren’t worked, consults that don’t convert, cancellations, DNAs, recalls, and quiet drop-offs. Most clinics respond by spending more on acquisition… while the bucket keeps leaking.

He then breaks down why PMS/EMR systems weren’t built to own conversion, why generic CRMs often turn into tool-sprawl when interoperability is weak, and why the real lever is a true Sales Desk function — one team (or system) accountable for utilization and eliminating calendar white space.

Finally, he introduces Project Alpha: an experiment in giving patients 1:1 coordinator support outside the clinic — before and after appointments — covering follow-up, rebooking, payments, and escalation. The goal: reduce pressure on the front office while improving continuity of care and patient confidence.

Chapters

00:00 Clinical ambition vs the reality of scale
 01:20 The “personal WhatsApp” concierge—and why it breaks
 02:40 Finite capacity, infinite patient accumulation (the first 1,000 vanish)
 06:10 Why PMS/EMR is built for process, not revenue
 07:20 The ownership gap: nobody “owns conversion”
 08:50 You need a different engine to stop the leaking
 09:50 Conversion isn’t art—it’s a data science playbook
 11:10 Tech + technique + team (the 3-part system)
 17:30 Stop funding acquisition while the bucket leaks
 20:00 CRM vs PMS: the ~£1m inflection point and tool sprawl
 21:30 Pipedrive/Klaviyo/HubSpot: order vs optimization
 26:10 APIs, integration, and why healthcare stacks don’t talk
 29:40 Project Alpha: 1:1 patient support outside the clinic, at scale
 31:10 Follow-up reveals problems patients don’t verbalize
 32:30 “Four Seasons” care: bringing outside signals into the clinic
 36:20 Why it’s called Sales Desk, not Front Desk
37:00 White space economics, waitlists, and “110% utilization”
40:20 Case example: 81 appointments booked in ~2.5 weeks
41:00 The psychographics of top-performing clinic owners
46:50 Valuation, EBITDA multiples, and building leverage early
49:00 Closing thoughts: retention and optimization before exit

In this episode of The Business of a Clinic, we speak with Sara Cheeney, Founder and Director of Pure Perfection, an established medical aesthetics clinic in North Wales, UK and a client partner of Coherent.

Sara brings a rare combination of perspectives: a medical professional who embraces sales, targets, and commercial ownership — and sees first-hand how clinics quietly lose revenue despite delivering excellent care.

This is a candid, ground-level conversation about what actually breaks inside clinics as they grow.

We discuss:

• Why front of house is a sales function, whether clinics label it that way or not
• How NHS conditioning creates fear around money, pricing, and asking for payment
• The confidence gap that stops teams from recommending treatment plans and products
• What real patient connection and trust look like — before, during, and after treatment
• Why follow-up collapses at scale (and why SOPs, CRMs, and task lists don’t fix it)
• The difference between doing the task vs owning the outcome
• How recall lists fail when the wrong people, scripts, or incentives are involved
• Why clinics panic into ads, discounts, or Groupon instead of fixing follow-through
• The emotional and financial toll of poor follow-up on clinic owners

Sara also shares her experience working with an external follow-up partner — including the initial fears around tone, trust, patient data, and brand, and what actually mattered once results started to show.

This episode is for clinic owners who:

• Feel like patients “drift” despite good care
• See white space in the diary they can’t explain
• Carry too much of the business in their own head
• Know follow-up matters — but can’t get it done consistently

The Business of a Clinic explores the real operational, commercial, and human challenges of running healthcare businesses — beyond surface-level tactics and software promises.

In this episode of The Business of a Clinic, we unpack the operational realities behind SOPs, follow-up, and patient retention — and why most clinics unknowingly leak patients long after treatment, consultations, or enquiries.

We discuss why SOPs are rarely fully documented, how critical context lives inside people’s heads instead of systems, and why this creates risk when clinics attempt to automate or scale.

The conversation also introduces the concept of follow-up debt — the slow accumulation of missed follow-ups, stalled patients, and unresolved issues that quietly undermine growth and patient trust.

Topics covered include:

• What SOPs actually mean in a healthcare setting
• Why intake SOPs get attention — but recall and issue resolution don’t
• How undocumented nuance breaks automation and AI workflows
• The difference between complaints vs bad feedback — and why escalation matters
• Why CRM systems struggle with real patient journeys
• Transactional vs relational patient communication
• The limits of rules-based automation in healthcare
• Where AI helps — and where human ownership is non-negotiable

This episode is essential listening for clinic owners, operators, and healthcare leaders who want to understand why patients drift, why recall fails, and how operational debt quietly builds inside growing practices.

Most clinics deliver excellent care in the treatment room — yet still lose patients quietly, months or even years later.

In this episode of The Business of a Clinic, we break down where patient journeys actually fail, why recall is misunderstood, and why follow-up is one of the most strategic (not administrative) functions in healthcare.

We explore why patients don’t “leave” clinics — they drift — and how manual processes, overloaded front desks, and misapplied technology create invisible drop-off across the patient lifecycle.

In this episode, we cover:

• Why the patient journey is not linear (and never was)
• The difference between follow-up and patient recall
• Why “one call, one email” recall doesn’t work
• How clinics reconnect with patients 5–10+ years later
• Why follow-up feels salesy — and how to do it without being salesy
• Manual work, process debt, and hidden operational risk
• Why front desks are not designed to manage patient populations
• Proactive vs reactive engagement in healthcare
• Voice AI vs asynchronous messaging (WhatsApp, SMS, email)
• Why AI-first front offices often fail in practice
• Payments, billing friction, and how they damage patient experience
• Why PMS, EMRs, and CRMs weren’t built for patient relationships
• The case for human-led, AI-powered patient coordination
• Paying for outcomes vs paying for software seats
• What winning clinics will do differently in the next 2–3 years

Healthcare doesn’t usually fail because of poor clinical care.

It fails because no one owns the relationship once the appointment ends.

Most clinics don’t have a technology problem. They have a user problem.

In this episode, Jared Aron breaks down why even “modern” practice management systems (PMS/EMR/EHR) often get used at 10–20% of their potential in real-world clinics — and why that gap creates downstream issues like DNAs, cancellations, poor follow-up, lost revenue, and hidden clinical/legal risk.

We dig into the category error of using a booking system like a CRM, why clinics end up stacking multiple disconnected tools, and why “we already send reminders” doesn’t solve what happens after a patient goes quiet.

Jared also shares a provocative prediction: healthcare software will increasingly be implemented like medical devices — with training, certification, and “forward-deployed” support living inside clinic workflows — because the bottleneck isn’t more features. It’s adoption, continuity, and execution.

Topics covered

• Why clinics only use a fraction of their PMS feature set
• Front desk turnover, fragmented workflows, and why “nobody pushes the buttons”
• The difference between practice operations vs patient operations
• Why reminders don’t prevent DNAs, cancellations, and drop-off
• The hidden consequences of weak follow-up: revenue leakage + clinical/legal risk
• The future: software delivered like hardware (training, certification, embedded support)
• “Nice-to-have” vs “need-to-have” and why clinics underestimate the delta

Mentioned

• Practice management software (PMS), EMR/EHR, CRM tools, pipeline/funnel management (e.g., Pipedrive)
• Patient relationship management beyond the calendar + clinical notes

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If you enjoyed this episode, please follow the show and leave a rating/review — it helps more clinic operators find it.

Most clinics believe their CRM is “good enough.”

In reality, many are quietly losing patients, follow-ups, and revenue because they’re using systems that were never designed for healthcare.

In this episode of The Business of a Clinic, we unpack why generic CRMs — from HubSpot to Pipedrive to GoHighLevel and even healthcare-branded variants — fail to support real patient journeys. These tools assume linear funnels, predictable triggers, and email-first engagement. Healthcare doesn’t work that way.

Patients pause, disappear, return months later, change channels, ask emotional questions, and move through care in anything but a straight line. Trying to force that reality into a traditional CRM leads to impersonal follow-up, broken relationships, and operational strain on front-desk teams.

We discuss:

• Why CRMs built for B2B and agencies break down in healthcare
• The difference between managing pipelines and managing patient relationships
• Why “we’ve got it sorted — we use a CRM” is often a false sense of security
• How clinics end up retrofitting tools instead of fixing the underlying problem
• What healthcare actually needs to support patients between visits

This episode is for clinic owners and operators who feel like patients are quietly drifting away — even though they have “systems” in place.

Healthcare doesn’t need better automations.

It needs systems built around patient relationships, not sales funnels.

Most clinics believe they deliver great patient experience — and inside the building, they usually do.

So why does engagement so often break down once the patient walks out the door?

In this episode of the BOAC Podcast, we unpack the hidden gap in modern healthcare operations: the failure to actively manage patient relationships beyond appointments, reminders, and transactions.

We explore why traditional Practice Management Software (PMS) and CRMs fall short, and why Patient Relationship Management (PRM) is a fundamentally different discipline — one that blends people, process, and technology to extend care across the full patient lifecycle.

In this episode, we cover:

• Why most patient experience happens outside the clinic, not inside it
• The difference between transactional reminders and true patient reactivation
• Why CRMs and automations don’t create relationships
• The capacity mismatch that grows as clinics scale
• How front desks quietly become cost centres instead of experience drivers
• Why patients disengage emotionally — not intentionally
• How “patient signals” should guide follow-up, not arbitrary timelines
• The role of human coordinators supported by technology (not replaced by it)
• Why long-term patient value is built through continuity, not compliance

This conversation reframes retention, recall, and lifetime value as relationship problems, not marketing problems — and explains why scaling healthcare requires preserving human connection, not automating it away.

Ideal for clinic owners, practice managers, healthcare operators, and healthtech leaders who want to grow without losing the personal touch that patients actually pay for.

Chapters:

00:00 Introduction: The Importance of Patient Experience

00:11 The Patient Journey: From Inquiry to Post-Op

01:32 Challenges in Managing Patient Relationships

03:07 The Role of Technology in Patient Care

06:19 The Difference Between PRM and CRM

08:23 Effective Patient Communication Strategies

16:57 Reactivation vs. Reminder: A New Approach

22:31 Creating a VIP Experience in Healthcare

25:15 The Challenge of Maintaining Personal Touch in Growing Clinics

26:20 Case Study: Retention and Challenges in Scaling

28:15 The Reality of Clinic Operations and SOPs

29:33 The Cost and Impact of Front Desk Operations

33:26 Extending Patient Lifetime Value

43:10 The Role of Technology in Patient Relationship Management

47:29 The Importance of Patient Signals

Every clinic believes they “do recall.”

But in reality? Most are running a blunt, ineffective, unmeasured process that leaks revenue, frustrates patients, and quietly erodes growth.

In this episode, Jared breaks down why patient recall, reactivation, and ongoing engagement cannot be done well in-house — and why clinics consistently underestimate the complexity of doing it properly.

We unpack:

🔍 The myths clinics believe about recall

• “We call patients the moment they miss an appointment.”
• “We send three emails and three phone calls — so we’re on top of it.”
• “Our team is great with leads, so we’ll just reuse that process.”
• Spoiler: none of this works in reality.

📉 Why traditional recall fails

Wrong channels (email + daytime phone calls = dead on arrival)

• Wrong timing (recall when you’re free, not when patients actually respond)
• Wrong people (recall is not an admin job — it’s a revenue-centric coordinator role)
• No measurement, no reporting, no optimisation

🏥 The operational ceiling every clinic hits

Clinics try to “just hire someone” — but one person cannot handle the complexity, data, timing, sequencing, or volume of a modern recall engine.

And when that person goes on holiday? The entire revenue function collapses.

(We call this the Holiday Blackout.)

📈 What great recall actually looks like

A business function, not a side duty

• Multi-channel, multi-touchpoint, personalised communication
• Timing optimised around patient behaviour, not clinic convenience
• Full funnel visibility: who is disengaged, why, and what to do next

💡 The uncomfortable truth

Most clinics say they don’t do “sales.”

But if you have a website, run ads, post on social, or want patients to come back — you already are in sales.

You just don’t have the structure, talent, or tooling to run it properly.

🔧 The rise of PRM

Jared also explains the difference between:

• PMS
• CRM
• PRM (patient relationship management)

…and why PRM is becoming the missing engine inside modern private healthcare.

🎧 Listen if you want to learn:

• Why your recall program “feels” active but produces no results
• Why thousands of patients in your database have no next appointment
• Why clinics overspend on marketing instead of fixing the real leak
• How to shift from reactive patient management to proactive
• What an end-to-end recall engine truly requires

In this glossary-style episode, we unpack the hidden patterns of “revenue malpractice” that quietly drain private clinics of profit and patient outcomes.

We walk through a series of core concepts and give real-world examples from front desks, physio clinics, dentists, and hospitals, including:

• The Leaky Bucket – pouring money into marketing while patients fall out of the funnel
• Front of House Empty Desk – unanswered phones vs. a true revenue mindset
• Admin Fog – why a constantly busy front desk still doesn’t move the business forward
• Revenue Orphan – when nobody actually owns revenue in the clinic
• The Follow-Up Fallacy & 48-Hour Drift – why “we sent an email” is not recall
• Hero Receptionist Trap & Talent Hole – expecting one person to do clinical, admin and sales
• Payment Pinball & Dinnertime Reconciliation – how scattered payment systems steal your time
• Five-Pound Touch & Invoice Black Hole – the real cost of payment “admin”
• Kitchen-Only Mindset & Care-Only Fallacy – great treatment, broken experience
• CRM Mirage, Acquisition Addiction & Legacy List Graveyard – why your PMS isn’t a CRM and your best growth is already in your database

If you run or manage a private clinic and feel like you’re working harder every year for the same (or less) growth, this episode gives you a language and a lens to finally see where the leaks are.

In this episode of The Business of a Clinic, we speak with Guy Mayout, Managing Director of The Cadogan Clinic — one of the UK’s leading plastic surgery and dermatology hospitals.

Guy shares how he helped the clinic grow from a family-run specialist practice to one of the most respected names in aesthetics and dermatology, earning an Outstanding CQC rating for leadership. He discusses what it really takes to scale a private clinic, from firefighting and building systems to maintaining culture as headcount grows.

We explore:

💡 The operational and cultural pillars behind the Cadogan Clinic’s success

💡 How to grow from £1M to £5M revenue without losing control

💡 Why front-desk chaos is a commercial problem, not a staffing one

💡 The real-world challenges of implementing AI in private healthcare

💡 Why every clinic needs a “sales desk” — and why “sales” isn’t a dirty word

This is a must-listen for any clinic owner or operator thinking about scaling, modernising operations, or navigating the rise of AI in healthcare.

🎙 Hosted by Jared Aron, Founder & CEO of Coherent — the Clinic Sales Desk for UK private clinics.

#PrivateHealthcare #ClinicGrowth #Aesthetics #Dermatology #HealthcareBusiness #AIinHealthcare #FrontOffice #ClinicLeadership

What can we learn by comparing the US and UK healthcare landscapes? In this episode, we dive into the starkly different market dynamics shaping innovation, adoption, and patient experience across both systems. From AI-driven medical scribes to end-to-end clinic transformation models, we explore which solutions actually move the needle for providers and patients alike.

We cover:

• Why the US healthcare market breeds faster adoption and bolder innovation than the UK
• The role of AI in admin, process transformation, and patient engagement
• The rise of medical scribes and voice AI — and where they fall short
• Why clinics need to rethink their “front door” and back-office operations
• What patient-centric design really looks like in practice (and why most clinics get it wrong)
• The cultural stigma around commerciality in UK healthcare — and how it’s holding back progress

Whether you’re a founder, operator, or healthcare practitioner, this conversation will challenge assumptions about where the next wave of healthcare innovation should focus — and what truly matters in building clinics patients love.

Reception can’t run your pipeline. Episode 04 defines a Clinic Sales Desk — the dedicated function for converting enquiries, taking deposits, and re-engaging lapsed patients. We cover ownership of revenue, why “sales” in healthcare is patient guidance, and a practical framework to grow from £1.2m to £5m without adding headcount prematurely.

Show notes (bullet highlights)

• Sales Desk vs Front Desk: Separate functions; sales = conversion, deposits, show-up rate, and recall.
• Ownership: Revenue is an owner-level accountability; practice managers are stretched — don’t bury sales under admin.
• Redefining “Sales”: Not pushy — it’s discovery and guidance from problem to solution.
• Apple analogy: Fast triage, delightful support, consistent follow-up — build that layer around your clinic.
• ROI > revenue: Uplift plus continuity (no single-point failure), process, and readiness for campaigns/new services.
• Scaling from £1.2m: 1) Plug the bucket (no-shows/cancellations), 2) instrument the funnel & unit economics, 3) then scale acquisition.
• Capacity reality: You may hit site limits before £5m; don’t open site two until playbooks work in site one.
• Legacy list: Typically 5–15% re-engagement potential with consistent outreach.

Pull quotes / audiograms (5)

• “A Sales Desk is a function, not a person — and its metric is revenue.”
• “Reception’s job is the person in front of them; pipeline is a different job.”
• “Sales in healthcare isn’t pressure — it’s guiding a patient to the right solution.”
• “If recall pauses every time the clinic gets busy, you don’t have a revenue function.”
• “Stop the leaks first, measure the funnel second, then scale acquisition.”

This episode explores the new generation of private clinic owners—commercially minded clinicians who pair great medicine with great operations. We discuss how hospitality principles are reshaping patient experience, why front-office execution determines cash flow, and where AI is (and isn’t) ready for prime time. Most importantly, we break down the single highest-leverage move any clinic can make this quarter: patient recall—what it is, how to run it, and the results you should expect.

What you’ll learn

• The traits of modern, tech-savvy clinic operators (and why they think about liquidity as well as care)
• Practical examples of five-star patient journeys vs. the “don’t call us” experience
• A simple framework for auditing front-office performance (intake, response time, reminders, payments)
• A realistic view of AI in clinics: administrative offload, human-in-the-loop, and risk tolerance
• Patient recall as a revenue engine: channels, ownership, measurement, and ROI benchmarks

Key ideas

• “Service business with clinical rigor” beats “clinical business with ad-hoc service.”
• Design for the time between appointments. That’s where engagement wins or dies.
• Recall done right can generate multi-X ROI in weeks, not quarters.

Resources mentioned

• Front Office Assessment / Scorecard
• Patient Recall playbook & messaging cadences

Keywords: private healthcare, clinic operations, patient recall, patient experience, front office, healthcare payments, AI in healthcare, dentistry, dermatology, physiotherapy, MSK, aesthetics, UK clinics

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Want the scorecard or recall playbook? Check the episode notes or get in touch with Coherent Health.

When I ran my own clinic, I saw first-hand how broken healthcare operations can be. The care inside the treatment room was world-class, but everything around it—payments, follow-ups, patient experience—was messy, inefficient, and often painful for both staff and patients.

In this episode, I share what I learned about why profit and care must work together. This isn’t about squeezing patients for money—it’s about building systems that reduce friction, improve retention, and ultimately allow clinicians to spend more time doing what they do best: delivering great care.

We talk about lessons from running a clinic during COVID, why outsourcing can sometimes save a practice, how poor payment systems erode patient trust, and why patient experience design matters just as much as medical excellence.

If you’re a clinic owner, manager, or just curious about where healthcare is heading, I think you’ll find this conversation useful.