The Business of a Clinic (BOAC)

Jared Aron

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. 5d ago

    From Running Pubs to Running an Aesthetics Clinic: A Nurse’s Story | Joolia Gilvey, BOAC #75

    In this episode of The Business of a Clinic, Jared speaks with nurse prescriber and clinic owner Joolia Gilvey about moving from hospitality into nursing, building an aesthetics business, and creating a patient experience that reflects how she wants to deliver care. Joolia’s first career was running pubs. After having children, she moved into a hospital caring role, returned to university, and qualified as a nurse at around 40. She explains how her hospitality experience shaped her approach to welcoming people, understanding their needs, and paying attention to the details that make them feel comfortable. Her decision to build a clinic also grew out of frustration. Joolia recalls raising concerns within larger organizations and feeling that little changed, including difficulties replacing equipment and a COVID-era incident involving missing thermometers. Those experiences helped her recognize how much she valued having control over her working environment. Ownership brought responsibilities of its own: recruiting, choosing systems, developing a brand, and making decisions that had previously belonged to someone else. Joolia describes starting small and working through each step. Her clinic now has three treatment rooms and around 2,500 patients on the books. Her ambition is to build a strong team and keep those rooms busy while remaining involved in the business. The conversation explores why the patient experience begins before treatment. Joolia sees calls, emails, reception, and the physical environment as parts of the same service. She describes creating a welcoming atmosphere in a Grade II listed building, with music, fresh flowers, and thoughtful details that support the clinic’s premium positioning. Drawing on her surgical nursing background, Joolia also explains why clear communication matters when patients feel nervous. A procedure that is routine for a practitioner may still be unfamiliar or unsettling for the person receiving it. Her suggestion is to sit in the patient’s chair, experience the consultation from their perspective, and notice what is easy to overlook from behind the desk. Jared and Joolia discuss the challenge of converting cold leads and her focus on people who already know the clinic. She outlines plans to reconnect with patients who have drifted away, develop annual treatment plans, and offer payment options. Memberships, rewards, and birthday vouchers also form part of her approach to maintaining relationships. The discussion turns to expanding beyond injectables and skin treatments into devices, including Neogen, EMFACE, and body treatments. Joolia explains how existing patients helped her introduce new services, and shares her interest in longevity and wellness. A potential hard-shell oxygen chamber costing around £90,000 brings the business questions into focus: patient demand, evidence, space, and whether the investment makes sense. The episode closes with Joolia’s changing priorities around teaching, brand work, and industry recognition. She explains why building her own clinic now takes precedence over opportunities that look impressive but draw time away from it. Her advice is to find a mentor, build a support network, and ask suppliers what practical help they can offer, including support she had not previously known was available. In this episode Running pubs before moving into healthcareReturning to university and qualifying as a nurse at around 40What hospitality taught Joolia about patient serviceFrustration with hospital bureaucracy and unresolved problemsWanting greater control over her working environmentTaking the first steps into clinic ownershipRecruiting staff, choosing systems, and building a brandGrowing a clinic with three treatment roomsBuilding relationships with around 2,500 patients on the booksCreating an experience from the first call or emailReception, atmosphere, and attention to detailPremium positioning in a local marketHelping nervous patients understand what happens nextLessons from surgical nursingSitting in the patient’s chair to see the clinic differentlyDeveloping the team’s approach to communicationThe difficulty of converting cold leadsReconnecting with patients who have drifted awayAnnual treatment plans and payment optionsMemberships, rewards, and birthday vouchersExpanding beyond injectables and skin treatmentsIntroducing Neogen, EMFACE, and body treatmentsBuilding new services around existing patient concernsInterest in longevity and wellnessWeighing up a potential £90,000 device purchaseConsidering demand, evidence, space, and affordabilityGrowing without losing day-to-day involvementBalancing teaching and brand work with clinic ownershipFinding mentors and a business support networkAsking suppliers what practical support is availableKey idea Joolia’s approach connects the experience patients receive with the kind of business she wants to own. Thoughtful communication, a welcoming environment, and lasting relationships guide her growth plans, while each new service or opportunity needs to justify the time, space, and investment it requires. 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.

  2. Oct 28

    How a Non-Dentist Turned Failing Dental Practices Around | Rebecca Ding, BOAC #74

    In this episode of The Business of a Clinic, Jared speaks with Rebecca “Becky” Ding, co-owner and Chief Operating Officer of Wooding Dental Group, about turning around struggling practices, earning respect without a clinical background, and growing a family-led business under NHS pressure. Rebecca’s background is in literature. Dentistry was her husband Charlie’s ambition, and she initially stepped in because their first practice had no manager. What she expected to involve scrubs and rotas became a much wider role covering acquisitions, staffing, systems, leadership, and the launch of a dental training academy. At the time of recording, Wooding has four practices in Wales. Rebecca describes completing three takeovers in three consecutive months in 2022, alongside the growth of the main site from five team members to around 58, with expansion towards 11 surgeries. The conversation explores what it took to establish herself as an owner and leader. Rebecca recalls arriving as “Charlie’s wife” and finding that her lack of dental qualifications affected how people responded to her. She explains how she learned to distinguish clinical decisions from operational responsibilities, question established habits, and demonstrate the value of changes to how the practices worked. Turning around a practice could involve something as straightforward as giving a manager more support or authorising an extra nurse. Other situations demanded sustained rebuilding. Rebecca describes one site where staff repeatedly resigned and Charlie stepped in to work clinically five days a week while they rebuilt the team. She reflects on improvements in patient reviews and the less measurable signs of progress, including how a practice feels when you walk through the door. As the group grew, introducing a regional manager, a headquarters, and shared processes raised questions about whether the business was becoming a corporate. Jared and Rebecca discuss how to preserve a family-led ethos while creating consistency, and where practice managers and reception teams need room to respond to the patients they know. Clear responsibilities are central to that balance. Rebecca questions whether it is fair to blame someone for handling a task differently when nobody has explained who owns it or what is expected. She describes documenting processes, learning from mistakes, and turning successful experiments into standard operating procedures, while returning to check whether the changes actually worked. The discussion also covers the pressures Rebecca experienced around the Welsh NHS dental contract changes addressed in the interview. She shares concerns about care packages, administration, patient charges, targets, and clawback, and explains why she believes the contract is not fit for purpose. Through the Association of Dental Groups and contact with the Chief Dental Officer, she hopes a smaller operator can contribute to decisions affecting the wider sector. Looking ahead, Rebecca sees AI as a way to give receptionists and treatment coordinators better information so they can respond more confidently to patients. Her priorities combine growth with greater stability: clearer processes, a functioning training academy, and teams who understand their responsibilities. Further acquisitions remain led by the opportunities that arise. In this episode Moving from literature into dental practice managementStepping in when the first practice had no managerEarning respect without dental qualificationsEstablishing an identity beyond being “Charlie’s wife”Separating clinical decisions from operational responsibilitiesChallenging established habits in struggling practicesCompleting three takeovers in three consecutive monthsGrowing the main site’s team and expanding its surgeriesDefining the COO role as the business developsLaunching a dental training academyIntroducing management support and group-wide processesMaking responsibilities and escalation routes clearResponding to concerns about becoming a corporatePreserving a family-led ethos as the group growsBalancing consistent standards with local autonomyLearning from mistakes without defaulting to blameDocumenting successful changes and checking their impactOwnership, school runs, and leadership guiltSupporting managers and responding to staffing needsRebuilding a team through repeated departuresCharlie’s return to five days of clinical work at a struggling sitePatient reviews and other signs of a turnaroundWhat the atmosphere of a practice can revealUsing AI to support receptionists and treatment coordinatorsCreating greater stability alongside growthRebecca’s experience of Welsh NHS dental contract changesAdministration, patient charges, targets, and clawback concernsSeeking a voice through the Association of Dental GroupsWhether a small dental group can influence wider policyKnowing your limits, writing things down, and continuing to improveKey idea Rebecca’s experience shows how much a practice turnaround depends on supporting people and making expectations clear. As Wooding grows, her challenge is to build processes that teams can rely on while preserving the relationships, judgement, and local knowledge that give each practice its character. 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.

  3. Oct 24

    He Lost 70% of His Revenue. Then This Physio Started Buying Businesses | Ross Tomkins, BOAC #73

    In this episode of The Business of a Clinic, Jared speaks with Ross Tomkins about moving from physiotherapy into healthcare ownership, losing 70% of his revenue, and learning to build businesses that depend less on one client or one person. Ross started his first business in 2006 because he wanted more time with patients. He is now the founder and CEO of Balmoral Partners, a healthcare holding company pursuing growth through acquisitions. Across nine years, he says he has completed 29 deals, including acquisitions and exits, with businesses employing close to 1,000 people across clinics, elderly care, mobility, medical supplies, and devices. The turning point came when his original business had grown to 35 staff. Linked contracts unravelled, and 70% of revenue disappeared over a short period. Ross explains how that experience pushed him towards mergers and acquisitions as a way to grow and reduce dependence on a single client. His first deal showed him how an acquisition, after lengthy negotiations, could change the size of a business in an afternoon. Growth also brought a personal decision. Ross recalls treating a patient while thinking about contracts and recruitment, recognising that his responsibilities were pulling his attention away from the care he had set out to provide. Stepping back meant confronting his identity as a clinician. Even after leaving clinical work, he kept his licence for another six or seven years. Jared and Ross discuss learning sales and marketing, hiring people with stronger skills than his own, and finding purpose through the work of a larger team. Ross reflects on how his contribution changed as he moved from treating individual patients to supporting businesses delivering care at greater scale. The conversation then turns to AI and the mixture of enthusiasm and anxiety it creates across the portfolio. Ross’s preference is to increase what teams can accomplish rather than reduce headcount. He shares examples of back-office time savings, his disappointment with AI marketing promises so far, and how his own reluctance to move from handwritten notes to software informs his understanding of resistance to change. Jared challenges whether saving minutes necessarily improves business performance. Ross brings the discussion back to the patient experience: whether that time can support better conversations, stronger relationships, and improved retention. He also acknowledges the difficulty of measuring all those effects. Asked what he would do differently, Ross focuses on choosing business partners. He describes how excitement about an opportunity can overshadow questions about working together when things become difficult. He now spends more time getting to know potential partners outside formal meetings, paying attention to how they treat others and respond to everyday situations. Ross also reflects on selling a four-clinic physiotherapy business. The exit enabled his wife to retire, but did not mean he could stop working indefinitely. He outlines Balmoral’s priorities in elderly care and mobility, its interest in US ketamine clinics, and the potential role of technology in measuring patient outcomes. The episode closes with Balmoral’s growth ambitions. At the time of recording, Ross reports £42 million in revenue under management, hopes to reach around £70 million by the end of the company’s second year, and sets out a five-year ambition of £500 million. In this episode Starting a physiotherapy business to spend more time with patientsGrowing the original business to 35 staffLosing 70% of revenue as linked contracts unravelledRecognising the risk of depending on one major clientTurning to mergers and acquisitionsHow the first acquisition changed Ross’s view of growthCompleting 29 deals across nine yearsEstablishing Balmoral PartnersLearning sales, marketing, and business leadershipRecognising when clinical work and ownership compete for attentionStepping away from treating patientsHolding onto a clinical licence for another six or seven yearsFinding purpose beyond the treatment roomHiring people with stronger skills than your ownLeading businesses employing close to 1,000 peopleAI enthusiasm and anxiety across healthcare teamsUsing technology to increase capacityBack-office time savings and disappointing marketing promisesLearning from personal resistance to digital notesQuestioning whether minutes saved translate into business resultsConnecting efficiency with patient experience and retentionThe difficulty of measuring improvements in relationshipsChoosing partners beyond the appeal of the opportunityGetting to know people outside formal business meetingsSelling a four-clinic physiotherapy businessWhat the first exit made possible for Ross’s familyInvestment priorities in elderly care and mobilityExploring opportunities in US ketamine clinicsTechnology and the measurement of patient outcomesRevenue under management and the five-year £500 million ambitionKey idea Ross’s experience shows how growth can require changes in both the business and the founder’s role. Losing a major source of revenue led him to acquisitions, while stepping away from clinical work created space to build stronger teams. His reflections centre on reducing dependence, choosing partners carefully, and keeping patient experience in view as the business expands. 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.

  4. Oct 19

    How a Small Surgery Practice Competes in Manhattan | Stephanie Romeo, BOAC #72

    In this episode of The Business of a Clinic, Sally speaks with Stephanie Romeo, practice manager of 740 Park Plastic Surgery, about growing from a front-desk role into practice leadership and maintaining personal service in Manhattan’s competitive aesthetics market. Stephanie joined the practice at 21. Eighteen years later, she oversees the operations that keep it running alongside Dr. Stafford Broumand. She shares her progression from receptionist to patient coordinator to practice manager, and how each role deepened her understanding of the patient journey. With one surgeon, one operating room, and a close-knit team, the practice depends on clear communication and continuity. Stephanie discusses the work behind an accredited in-office surgical suite, preparing patients for surgery, sharing knowledge across the team, and making sure someone knows what needs to happen next. The conversation also explores how the practice has changed. Stephanie describes a shift from a strong reconstructive focus towards a mix of around 90% cosmetic and 10% insurance-based work. Adding an aesthetic nurse and nonsurgical services allowed patients to access more care in a setting they already trusted, while creating new questions about recruitment, skills, and cultural fit. Sally and Stephanie discuss the balance between booking surgery and giving patients space to decide. Some people are ready after one consultation; others return two years later. Stephanie explains how she approaches price questions, potential dates, and follow-up without making patients feel pressured or overwhelmed. Discretion is part of that process. A surgical quote can reveal a patient’s intended procedure, identity, and personal spending. They consider how to use gentle reminders and automated communication while remaining thoughtful about the sensitivity of the information being shared. The discussion turns to Instagram, influencers, and before-and-after images. Stephanie explains why discovering a surgeon online should lead to a closer look at credentials, aesthetic preferences, and whether the patient feels heard during a consultation. They also explore expectations around recovery, including why being able to leave the house is different from feeling ready for work, social plans, or exercise. Behind the personal service is a longstanding approach to reporting. Stephanie’s spreadsheet contains data going back to 2006. She tracks surgical and injectable activity, looks for changes in demand, and reviews performance with Dr. Broumand each month. Patient feedback adds another perspective, highlighting improvements that numbers alone might miss, from communication to an uncomfortable postoperative garment. The episode closes with staff loyalty, onboarding, covering absences, and the possibility of expansion into Florida or another Manhattan location. Stephanie reflects on what growth would require and why a higher-volume aesthetics business would need a different operating model to the practice she manages today. In this episode Joining the front desk at 21Progressing from receptionist to patient coordinator and practice managerLearning the patient journey through different rolesRunning a small practice with one surgeon and one operating roomSharing knowledge across a close-knit teamSupporting an accredited in-office surgical suitePreparing patients and coordinating the steps before surgeryMoving from reconstructive work towards cosmetic careAdding an aesthetic nurse and nonsurgical servicesHiring for skills, judgement, and fitReferrals, returning patients, and long-term relationshipsInstagram, influencers, and how patients discover surgeonsLooking beyond a social media profileCredentials, aesthetic preferences, and before-and-after galleriesClarifying what patients mean by downtimeHandling the first inquiry and questions about priceGiving patients time to decide about surgeryFollowing up without creating pressureHolding potential dates within a limited surgical diaryGentle reminders, automated emails, and discretionRecognising the sensitive information within a surgical quoteDeciding which new treatments to introduceRepeat appointments and patient remindersTracking surgical and injectable activityUsing NextGen, Excel, and monthly performance reviewsLearning from patient feedback alongside the numbersFiller trends, patient education, and seasonal demandStaff loyalty, onboarding, and covering absencesConsidering Florida and satellite locationsCompeting with med spas while protecting personal serviceKey idea Stephanie’s experience shows how personal care depends on consistent work behind the scenes. Clear handovers, thoughtful follow-up, trusted staff, and regular reporting help the practice respond to patients without rushing their decisions. As the business considers growth, the challenge is preserving those relationships and the time patients need. 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.

  5. Oct 12

    This Physio Owner Had £70 Left After Payroll. Now He Runs 20 Clinics | Rhys Carter, BOAC #71

    Eight years ago, a conversation between Rhys Carter and England rugby player Jamie George in a Dubai bar turned into an idea: could they bring some of the healthcare experience available to elite athletes to everyday patients? That idea became Carter & George. Today, the group operates 20 clinics across the UK, employs more than 80 people and sees around 65,000 patients a year. Its next target is 50 sites by 2030. But Rhys's story is as much about what went wrong as what went right.  In the early days, he remembers paying payroll and discovering he had only £70 left in the overdraft. Later, rapid growth outpaced the group's management infrastructure and cost the business good people.   In this conversation with Jared Aron, Rhys explains what he has learned about scaling a healthcare business without losing the culture, people and patient experience that made it successful in the first place. They get into the 300% growth of Carter & George's first acquisition, why talented physios need genuine career progression, the decision to remove receptionists from clinics and centralise patient support, why patient experience needs to remain consistent from Google search to post-treatment follow-up, where AI belongs in healthcare operations, and why retail, hospitality and veterinary groups may have more to teach MSK operators than other physio clinics do. Rhys also shares the question now sitting behind Carter & George's next phase of growth: once you have the infrastructure to run 20 clinics, does going from 20 to 50 actually become easier than going from 10 to 12?

  6. Oct 8

    After 15M Patient Interactions, The Real Problem Isn't AI | Frederick Mueller at Third Way Health, BOAC #70

    In this episode of The Business of a Clinic, Jared speaks with Frederik Mueller, co-founder and CEO of Third Way Health, about building a healthcare business in a market captivated by AI, and why people remain central to his approach. Third Way Health combines dedicated teams with technology to manage front-office operations, including patient calls, scheduling, referrals, prior authorizations, and document management. Frederik says the company handles around 15 million patient interactions a year across approximately 2,000 providers and 16 specialties. The conversation explores the gap between answering a call and helping a patient. Frederik describes the operational work behind seemingly straightforward requests, from understanding a clinician’s booking preferences to keeping track of leave, cover, and changing instructions. Across Third Way’s providers, he says there are roughly 1,000 operational changes every week. Technology needs a reliable way to keep up with those changes. Jared and Frederik also question how automation is measured. A call marked as resolved may leave the patient with another number to ring and the same problem to solve. Similarly, automating 20% of calls does not necessarily mean a practice needs 20% fewer staff. The remaining workload, staffing structure, and responsibilities still need to be understood. Online booking offers another example. Frederik explains how unwritten rules and individual clinical preferences can make scheduling difficult to standardise, even when the software is available. He discusses the trust, clear processes, and ongoing maintenance needed to turn a technical capability into a service that works consistently. Patient choice is another central theme. Some people want a quick digital interaction, while others need help with a complicated situation. Frederik reflects on the importance of preserving access to human support and how a poor automated experience can damage trust long after the technology itself improves. The conversation also covers the staffing pressures behind the interest in automation. In Third Way Health’s survey of 200 healthcare executives, 86% said their organisations were not sustainably staffed. Frederik argues that automating part of the workload still leaves recruitment, training, and turnover to address. He shares how he stays focused on client results while competing with heavily funded companies promising AI-led alternatives. Looking back, Frederik identifies an early assumption he had to reconsider: that improving healthcare administration was primarily a technology problem. Experience showed him how much depends on processes, clear responsibility, and keeping systems current. Jared and Frederik discuss underused software features, the work involved in maintaining integrations, and the need for a fallback when something stops working. The episode closes with the choice between managing these operations internally and working with a specialist, followed by a comparison of UK and US healthcare. Drawing on experience in both markets, Frederik discusses payer complexity, fragmented technology, and approaches to innovation. He considers what each system could learn from the other about simpler administration and trying new ways of delivering care. In this episode Building Third Way Health around people and technologyManaging around 15 million patient interactions a yearSupporting approximately 2,000 providers across 16 specialtiesPatient calls, scheduling, referrals, and prior authorizationsWhy healthcare administration problems recur across marketsClinician autonomy and the need for consistent operationsHidden booking rules and changing instructionsWhy online scheduling can be harder than it appearsKeeping up with roughly 1,000 operational changes a weekThe difference between answering a call and helping a patientQuestioning what a resolved call actually meansWhy fewer calls do not automatically mean fewer staffUnderstanding the workload left after automationGiving patients a choice of digital and human supportThe lasting effect of a poor patient experienceCompeting with heavily funded AI companiesStaying focused on client results amid technology hypeThird Way Health’s survey of healthcare staffing pressuresRecruitment, training, and turnover after automationLearning that healthcare admin requires more than technologyAssigning responsibility for processes and keeping them currentEvaluating tools, integrations, and fallback plansMaking better use of existing softwareFinding time to maintain what a practice implementsManaging operations internally or choosing a specialist partnerUK and US differences in payers and technologySimplifying administration and creating room for innovationKey idea Answering the phone is one step in a much larger patient journey. Frederik’s approach centres on combining technology with people who understand the work, clear processes, and ongoing updates. The measure of success is whether patients receive the help they need and the practice can deliver that service reliably. 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.

  7. Oct 5

    He Sees 1,200 Dental Tech Applications a Year. Only a Few Get Backed | Dr. Jeremy Krell, BOAC #69

    In this episode of The Business of a Clinic, Jared from Coherent Healthcare speaks with Dr. Jeremy Krell, managing partner at Revere Partners, about building dental practices, backing healthcare technology, and helping clinic owners make better decisions about the tools they use. Jeremy brings the perspective of a dentist, startup operator, and investor. After building, scaling, and exiting ten dental practices, he worked at Oscar Health, Quip, and Simplifeye before establishing Revere Partners to invest globally in dental-related software, fintech, and medical technology. He recalls how investors repeatedly dismissed dental technology as too small or too specialised. Quip was viewed as a beauty product, while Simplifeye’s fundraising story centred on fintech. Those experiences helped shape his decision to build specialist investment support for an industry whose problems he understood firsthand. The conversation moves from founders seeking investment to clinicians choosing software. Jeremy says an average private dental practice may use around 25 pieces of software, often without the time or resources to assess each one thoroughly. At Revere, he describes receiving more than 1,200 applications a year, tracking 120 structured data fields per company, and investing in no more than eight to ten companies annually. For clinic owners, Jeremy recommends starting with the patient journey. From the first inquiry through to treatment, where are patients being lost, what does the schedule prioritise, and can the team see reliable performance data? His rocks, pebbles, sand, and water analogy explores how different procedures fit together and why a full appointment book does not necessarily mean the practice is operating efficiently. Jared and Jeremy also examine how trust influences technology purchases. A recommendation from a friend or adoption by a large dental group does not establish whether a product will suit another clinic’s workflows. They discuss looking beyond the demo, understanding how a tool works, testing assumptions, and moving on when the fit is wrong. On AI, Jeremy argues that effective adoption can give practices a competitive advantage, while emphasising human judgement, context, and repeated evaluation as the technology changes. He shares how his own fund uses AI while keeping people responsible for the process. The discussion also covers rising staffing and operating costs, pressure on reimbursement, and the need to rethink practice finances. Jeremy explores automating routine work, connecting systems, and building a stable financial foundation as prevention becomes a larger part of dental care. Asked to name his most important growth priority, Jeremy returns to the team. He argues for consistent associate training, helping clinicians become effective and productive, and tracking performance so an owner can step back while retaining visibility. Throughout the conversation, technology sits alongside the people, processes, and clinical work it needs to support. In this episode Building, scaling, and exiting ten dental practicesMoving from clinical practice into technology and investmentJeremy’s experience at Oscar Health, Quip, and SimplifeyeEstablishing Revere PartnersWhy investors dismissed dental technology as too nicheBuilding specialist investment support for dental businessesAssessing more than 1,200 company applications a yearUsing structured data to evaluate investment opportunitiesThe complexity of managing multiple software tools in a practiceStarting technology decisions with the patient journeyFinding gaps between inquiry and treatmentUnderstanding what the appointment book prioritisesRocks, pebbles, sand, and water as a scheduling analogyWhy a full schedule is not automatically an efficient oneLooking beyond software demonstrationsTesting recommendations against the clinic’s own workflowsWhy adoption by a large dental group does not prove fitRecognising a poor technology choice and moving onAI adoption and competitive advantageKeeping human judgement and context in the processReassessing tools as their capabilities changeConsolidation and changing practice ownershipRising costs and pressure on practice marginsAutomating routine tasks and refocusing staff on patientsConnecting systems and improving access to performance dataRethinking finances as prevention becomes more prominentFirst-visit economics and hygiene revenueBuilding a stable base for growthMaking associate training a priorityTracking performance so the owner can step backKeeping people central as technology developsKey idea Jeremy’s approach starts with understanding how the practice works: its patient journey, schedule, team, and finances. Technology decisions become more useful when owners can identify a specific problem, assess whether a tool fits, and measure what changes. His strongest growth priority remains developing the clinicians who deliver the care. 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.

  8. Oct 1

    Can a Small Clinic Survive Big Insurance? A Chiropractor at a Crossroads | Chris Anselmi, BOAC #68

    In this episode of The Business of a Clinic, Sally from Coherent Healthcare speaks with her longtime chiropractor, Dr. Chris Anselmi, about building an independent practice, navigating financial pressure, and delivering the care he believes in as the economics of healthcare change. Chris started his practice in 2000, gradually bringing together chiropractic, physical therapy, massage, and acupuncture. He shares how the team developed around complementary skills, alongside his own experience of learning to run a business while treating patients. His career includes 15 years affiliated with the Hospital for Special Surgery and treating New York Knicks players. Chris recalls a year-long interview process, writing a scope-of-practice document for a role the hospital had not previously had, and learning alongside other musculoskeletal specialists. He reflects on how those relationships shaped his development and opened new opportunities. The conversation also covers disruption. Chris experienced 9/11 early in his practice journey, then faced a different set of challenges during COVID. The clinic closed for almost eight weeks while financial obligations continued. He describes using relief loans and savings, reopening gradually, and rebuilding in a city where remote work had changed commuting patterns and patient demand. A move to larger premises created an opportunity to sublet space, but keeping the clinical team busy required further decisions. After years of working primarily out of network or on a fee-for-service basis, Chris began accepting selected health insurance plans. He explains how that helped rebuild activity, but says low reimbursement and restrictions on covered services have since pushed the practice towards a volume model he does not want. Sally and Chris discuss the risks of changing that model, including his consideration of a gradual move away from some insurance participation. They also explore rising patient acquisition costs and his decision to reduce Google Ads spending after more than a decade as competition made attracting patients increasingly expensive. Patient relationships offer another area to examine. They distinguish general newsletters from personal check-ins about someone’s care and discuss how follow-up could help the practice understand why patients do not return. The conversation considers what happens after a care plan is presented, particularly when a patient declines or leaves without explaining their concerns. Chris also shares how a seven-week programme and an immersive weekend in Chicago changed his approach to discussing money. He describes learning to explain the value of care through the activities patients want to regain and taking more responsibility for making fees and financial expectations clear. On hiring, Chris recalls choosing to trust his own judgement despite a former employer’s warning about a candidate who became a longstanding team member. The episode closes with his experience researching and renting a SoftWave device before buying it, introducing a service outside insurance, and becoming more confident in explaining its price. He shares his own observations and patient experiences along the way. In this episode Starting an independent practice in 2000Bringing chiropractic, physical therapy, massage, and acupuncture togetherBuilding a team with complementary clinical skillsJoining the Hospital for Special SurgeryA year-long interview process and defining a new roleLearning alongside musculoskeletal specialistsTreating New York Knicks players and other athletesMaintaining patient relationships over decadesEarly entrepreneurial experience through a landscaping businessExperiencing 9/11 as a young practice ownerManaging the many responsibilities of an early-stage clinicMoving to larger premises and subletting spaceClosing for almost eight weeks during COVIDRelief loans, savings, and the cost of reopeningRemote work and changes in the patient baseAccepting selected insurance plans to rebuild demandLow reimbursement and pressure towards higher patient volumeConsidering a gradual change in insurance participationTrusting personal judgement when hiringPersonality, teamwork, and finding the right peopleLearning to discuss value, benefits, and feesConnecting care plans to activities patients want to regainTaking responsibility for the financial conversationReducing Google Ads spending as acquisition costs risePersonal follow-up versus general newslettersUnderstanding why patients do not returnResponding when a patient declines a care planImaging and patient communicationResearching and renting a SoftWave device before buyingIntroducing a paid service outside insuranceFirst-visit pricing and explaining fees with confidenceKey idea Chris’s practice is at a point where keeping the team busy and delivering his preferred model of care are becoming harder to reconcile. His experience explores how insurance participation, acquisition costs, patient follow-up, and clearer financial conversations all influence whether an independent clinic can sustain the care it wants to provide. 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.

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.

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