The Business of a Clinic (BOAC)

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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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.

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