The Business of a Clinic (BOAC)

Jared Aron
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The Business of a Clinic (BOAC) is a podcast for private healthcare leaders who want to run not just a great clinic, but a great business. Each episode explores the overlooked commercial side of healthcare — how to grow revenue, improve patient retention, fill empty calendars, and build high-performing front-office teams. Hosted by the team at Coherent and led by founder Jared Aaron, we sit down weekly with clinic owners, practice managers, and industry experts to unpack the real challenges behind no-shows, cancellations, and disengaged patients, and share practical frameworks and playbooks that any clinic can apply. If you’re a private healthcare operator such as dentist, aesthetic practitioner, chiropractor, physio, or private GP looking to bridge the gap between excellent care and effective business operations, this is your roadmap to running a clinic that thrives — for your patients, your staff, and your bottom line. The show is hosted by Coherent: Coherent Healthcare is a Clinic Revenue Winback company, helping private healthcare practices unlock hidden revenue. By rebooking no-shows, cancellations, and lapsed patients — and by simplifying how clinics collect payments — Coherent enables practitioners to fill their diaries, improve cashflow, and focus more on patient care.

  1. MAR 20

    Hands-On Care, AI Hype, Cost Per Consultation & Clinics | Business of a Clinic E25

    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 potentialTimestamps 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

    41 min

  2. MAR 14

    Private Medicine, Patient Retention, Healthcare AI, Clinic Systems, Future of Care | BOAC Podcast #24

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

    34 min

  3. MAR 4

    Healthcare Is the Edge Case, Autonomous Front Desk, Start-to-Finish Care E#23

    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 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 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 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

    20 min

  4. FEB 21

    The Invisible Leaky Bucket, White Space, Patient Drop-Off & The Math of Scaling a Clinic | BOAC E#22

    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 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 inquiriesNo follow-through on consultationsNo structured recallNo cancellation recoveryThe 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 2,000Then 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 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 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.

    1h 2m

  5. FEB 16

    Selling a Clinic, De-risking the Principal, Black Ball Tech in Healthcare: AI Receptionists, Overcorrection Risk | BOAC #21

    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

    34 min

  6. FEB 11

    The New Breed of Clinic Owners, Project Alpha, Selling to Private Equity | BOAC Podcast #20

    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

    49 min

  7. FEB 7

    Front of House Is Sales: Follow-Up, Confidence & Why Clinics Leak Revenue | BOAC #19

    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.

    33 min

  8. JAN 29

    E#18 - Clinic SOPs, Follow-Up Debt, Your Clinic CRM Doesn't Have a User

    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.

    39 min
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About

The Business of a Clinic (BOAC) is a podcast for private healthcare leaders who want to run not just a great clinic, but a great business. Each episode explores the overlooked commercial side of healthcare — how to grow revenue, improve patient retention, fill empty calendars, and build high-performing front-office teams. Hosted by the team at Coherent and led by founder Jared Aaron, we sit down weekly with clinic owners, practice managers, and industry experts to unpack the real challenges behind no-shows, cancellations, and disengaged patients, and share practical frameworks and playbooks that any clinic can apply. If you’re a private healthcare operator such as dentist, aesthetic practitioner, chiropractor, physio, or private GP looking to bridge the gap between excellent care and effective business operations, this is your roadmap to running a clinic that thrives — for your patients, your staff, and your bottom line. The show is hosted by Coherent: Coherent Healthcare is a Clinic Revenue Winback company, helping private healthcare practices unlock hidden revenue. By rebooking no-shows, cancellations, and lapsed patients — and by simplifying how clinics collect payments — Coherent enables practitioners to fill their diaries, improve cashflow, and focus more on patient care.

Information

  • Creator
    Jared Aron
  • Years Active
    2025 - 2026
  • Episodes
    20
  • Rating
    Clean
  • Copyright
    © 2026 The Business of a Clinic (BOAC)
  • Show Website
    The Business of a Clinic (BOAC)