The Business of a Clinic (BOAC)

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 careWhy AI doctors are more relevant to telehealth than in-person treatmentWhy hands-on healthcare is really a logistics problemHow patient leakage happens in the gaps between stepsThe mindset difference between clinic owners and group operatorsWhy group leaders think in appointment density and lifetime valueHow acquisition-minded clinics are built differentlyWhy technology only works when there is ownership behind itThe hidden cost of bad software implementationWhy AI reception often creates more tasks instead of solving themHow edge cases are the norm in healthcareWhy archived patients may represent lost revenue sitting in plain sightWhy most follow-up sequences are based on guesswork, not evidenceWhy cost per consultation is a better metric than cost per leadHow plugging leakage can create a clinic’s best month everWhy founder dependence weakens clinic value and exit potentialTimestamps00:00 – 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.In this episode we discussWhy running a clinic is far more operationally complex than most people realiseThe hidden administrative load behind patient careWhy clinics often lose track of patients over timeThe concept of patient leakage across the healthcare journeyDifferences between NHS and private healthcare systemsWhy technology has struggled to solve operational problems in clinicsHow AI may transform patient communication and follow-upThe future of patient relationship management in healthcareChapters00:00 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 thoughtsAbout the PodcastBusiness 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.LinksLearn more about Coherent Healthcare: https://coherenthq.comFollow 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 issueWe 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 teamNo sales teamNo operational strategyNo structured follow-up infrastructureNo ownership of the full patient journeyThe 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 operationsHealthcare 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 appointmentTreatment plans that stallAnnual reviews that go uncompletedLeads that never convertCancellations that never rebookThen this episode will challenge how you think about patient management — and what real operational transformation looks like.⏱ Episode Breakdown00:00 – 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 upConsultations that don’t convertCancellations that aren’t rebookedPatients discharged without continuityThousands of active patients with no next appointmentAnd because it’s not measured properly, it feels like everything is fine.What You’ll Learn in This Episode1️⃣ Why “80% retention” is misleadingWhen 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 ActionEMRs, 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 problemEmpty 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 inquiriesNo follow-through on consultationsNo structured recallNo cancellation recoveryThe revenue is already inside the business.4️⃣ Clinical follow-up vs service-based follow-upClinical 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 scalingEvery 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 2,000Then 5,000Then 10,000But 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 valuationHealthcare 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 QuestionHow 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 clinicYou manage a multi-site groupYou lead operationsYou’re responsible for revenue performanceYou’re thinking about scalingYou’re considering an exit in the futureThis 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 takeaways1) Clinic value is operational, not just clinicalA 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 sheetThey 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 truthYou 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 careThey 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.Chapters00:00 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 notHow NHS conditioning creates fear around money, pricing, and asking for paymentThe confidence gap that stops teams from recommending treatment plans and productsWhat real patient connection and trust look like — before, during, and after treatmentWhy 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 outcomeHow recall lists fail when the wrong people, scripts, or incentives are involvedWhy clinics panic into ads, discounts, or Groupon instead of fixing follow-throughThe emotional and financial toll of poor follow-up on clinic ownersSara 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 careSee white space in the diary they can’t explainCarry too much of the business in their own headKnow follow-up matters — but can’t get it done consistentlyThe 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 settingWhy intake SOPs get attention — but recall and issue resolution don’tHow undocumented nuance breaks automation and AI workflowsThe difference between complaints vs bad feedback — and why escalation mattersWhy CRM systems struggle with real patient journeysTransactional vs relational patient communicationThe limits of rules-based automation in healthcareWhere AI helps — and where human ownership is non-negotiableThis 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 recallWhy “one call, one email” recall doesn’t workHow clinics reconnect with patients 5–10+ years laterWhy follow-up feels salesy — and how to do it without being salesyManual work, process debt, and hidden operational riskWhy front desks are not designed to manage patient populationsProactive vs reactive engagement in healthcareVoice AI vs asynchronous messaging (WhatsApp, SMS, email)Why AI-first front offices often fail in practicePayments, billing friction, and how they damage patient experienceWhy PMS, EMRs, and CRMs weren’t built for patient relationshipsThe case for human-led, AI-powered patient coordinationPaying for outcomes vs paying for software seatsWhat winning clinics will do differently in the next 2–3 yearsHealthcare 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 coveredWhy clinics only use a fraction of their PMS feature setFront desk turnover, fragmented workflows, and why “nobody pushes the buttons”The difference between practice operations vs patient operationsWhy reminders don’t prevent DNAs, cancellations, and drop-offThe hidden consequences of weak follow-up: revenue leakage + clinical/legal riskThe future: software delivered like hardware (training, certification, embedded support)“Nice-to-have” vs “need-to-have” and why clinics underestimate the deltaMentionedPractice management software (PMS), EMR/EHR, CRM tools, pipeline/funnel management (e.g., Pipedrive)Patient relationship management beyond the calendar + clinical notesConnect / Follow(Insert your links here)Website:LinkedIn:Newsletter: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 healthcareThe difference between managing pipelines and managing patient relationshipsWhy “we’ve got it sorted — we use a CRM” is often a false sense of securityHow clinics end up retrofitting tools instead of fixing the underlying problemWhat healthcare actually needs to support patients between visitsThis 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 itThe difference between transactional reminders and true patient reactivationWhy CRMs and automations don’t create relationshipsThe capacity mismatch that grows as clinics scaleHow front desks quietly become cost centres instead of experience driversWhy patients disengage emotionally — not intentionallyHow “patient signals” should guide follow-up, not arbitrary timelinesThe role of human coordinators supported by technology (not replaced by it)Why long-term patient value is built through continuity, not complianceThis 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 Experience00:11 The Patient Journey: From Inquiry to Post-Op01:32 Challenges in Managing Patient Relationships03:07 The Role of Technology in Patient Care06:19 The Difference Between PRM and CRM08:23 Effective Patient Communication Strategies16:57 Reactivation vs. Reminder: A New Approach22:31 Creating a VIP Experience in Healthcare25:15 The Challenge of Maintaining Personal Touch in Growing Clinics26:20 Case Study: Retention and Challenges in Scaling28:15 The Reality of Clinic Operations and SOPs29:33 The Cost and Impact of Front Desk Operations33:26 Extending Patient Lifetime Value43:10 The Role of Technology in Patient Relationship Management47:29 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 failsWrong 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 hitsClinics 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 likeA business function, not a side dutyMulti-channel, multi-touchpoint, personalised communicationTiming optimised around patient behaviour, not clinic convenienceFull funnel visibility: who is disengaged, why, and what to do next💡 The uncomfortable truthMost 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 PRMJared also explains the difference between:PMSCRMPRM (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 resultsWhy thousands of patients in your database have no next appointmentWhy clinics overspend on marketing instead of fixing the real leakHow to shift from reactive patient management to proactiveWhat 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 funnelFront of House Empty Desk – unanswered phones vs. a true revenue mindsetAdmin Fog – why a constantly busy front desk still doesn’t move the business forwardRevenue Orphan – when nobody actually owns revenue in the clinicThe Follow-Up Fallacy & 48-Hour Drift – why “we sent an email” is not recallHero Receptionist Trap & Talent Hole – expecting one person to do clinical, admin and salesPayment Pinball & Dinnertime Reconciliation – how scattered payment systems steal your timeFive-Pound Touch & Invoice Black Hole – the real cost of payment “admin”Kitchen-Only Mindset & Care-Only Fallacy – great treatment, broken experienceCRM Mirage, Acquisition Addiction & Legacy List Graveyard – why your PMS isn’t a CRM and your best growth is already in your databaseIf 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 wordThis 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 UKThe role of AI in admin, process transformation, and patient engagementThe rise of medical scribes and voice AI — and where they fall shortWhy clinics need to rethink their “front door” and back-office operationsWhat 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 progressWhether 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 learnThe 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” experienceA 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 tolerancePatient recall as a revenue engine: channels, ownership, measurement, and ROI benchmarksKey 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 mentionedFront Office Assessment / ScorecardPatient Recall playbook & messaging cadencesKeywords: private healthcare, clinic operations, patient recall, patient experience, front office, healthcare payments, AI in healthcare, dentistry, dermatology, physiotherapy, MSK, aesthetics, UK clinics—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.