The Business of a Clinic (BOAC)

E#35: Oliver Abrams on MSK, Clinic M&A, Private Equity, Dental Rollups & Patient Retention | The Business of a Clinic

55 min · 1. Juni 2026
Episode E#35: Oliver Abrams on MSK, Clinic M&A, Private Equity, Dental Rollups & Patient Retention | The Business of a Clinic Cover

Beschreibung

In this episode of The Business of a Clinic, Jared speaks with Oli, Director of M&A at Kinetico Health, about what makes a private healthcare clinic valuable, scalable, and ready for acquisition. Oli shares his journey from dental M&A into MSK, what he learned from the consolidation of the dental market, and why MSK is now entering a new phase of professionalisation, partnership, and group-building. The conversation explores the full M&A process: origination, heads of terms, due diligence, commercial review, legal challenges, partner onboarding, and integration. Jared and Oli discuss what acquirers actually look for in a clinic, why culture is one of the most important signals, how founder reliance affects valuation, and why recurring patient revenue matters more than new patient volume alone. They also go deep on the economics of MSK clinics: insurance vs self-pay, practitioner capacity, margin, overheads, cancellation rebooking, first-visit integrity, and why patient retention is central to organic growth. The episode closes with a comparison between dentistry and MSK: what MSK clinic owners can learn from dental practice owners about preparing for sale, and what dentists can learn from MSK operators about reducing reliance on the principal practitioner. Chapters 0:00 Introduction 1:00 Oli’s role at Kinetico Health 1:45 Finding and onboarding MSK clinics 2:30 From law to dental M&A 3:40 Why working with clinic owners matters 4:25 What happens after heads of terms 5:00 Financial and commercial due diligence 6:05 The legal process and lease issues 7:20 Why M&A should not feel adversarial 8:10 How clinic owners can prepare for acquisition 9:05 What acquirers look for beneath revenue 10:00 Why the clinic owner matters first 10:45 Culture, team loyalty, and principal retention 11:30 Key person reliance and founder concentration 12:20 Succession planning inside the clinic 13:15 The “who” behind a valuable clinic 14:05 Patient body, recurring revenue, and data quality 15:00 Insurance, NHS contracts, and payer mix 16:20 Stroke-of-the-pen risk in healthcare revenue 17:15 Insurance provider rates and profitability 18:00 MSK economics vs aesthetics and dermatology 19:10 Margin improvement through revenue growth 20:15 Private equity stereotypes and cost-cutting 21:15 Revenue growth in MSK clinics 22:10 Returning patient mix and clinic performance 23:05 When low retention is fixable 24:00 Practitioners, treatment plans, and “sales” discomfort 25:00 Helping patients commit to the right care journey 26:05 The practitioner as guide, not salesperson 27:15 Who owns follow-up after the patient leaves? 28:25 Practitioner responsibility vs front desk responsibility 29:10 Booking the next appointment before exit 30:10 Patient leakage and why patients drift 31:10 First-visit integrity and cancellation management 32:15 Building a pipeline to backfill cancellations 33:10 Same-day cancellations vs seven-day cancellations 34:05 Cancellation fees, friction, and reputation 34:50 Reading culture inside a live clinic 36:10 Why Oli moved from dental to MSK 37:15 Dental consolidation and market maturity 38:20 Emotional investment in clinic partnerships 39:30 Why mature M&A markets feel different 40:20 Building an organic acquisition pipeline 41:15 Why corporates get a bad reputation 42:10 Why MSK is an exciting consolidation market 43:10 Building a group from a less mature market 44:00 Entrepreneur by accident: the clinic owner journey 45:00 Helping practitioners get back to patients 46:00 What dentistry and MSK can learn from each other 47:00 How dental owners prepare for sale 48:00 Getting accounts and operations exit-ready 49:00 Why sellers should speak to other partners 50:05 What dentists can learn from MSK owners 51:00 Reducing reliance on the principal practitioner 52:05 The next phase of Kinetico Health 53:00 Greenfield sites, acquisitions, and group growth 54:05 Integration as the foundation for growth 55:00 Building systems so clinicians can focus on care 55:40 Closing thoughts The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

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Episode From Mount Everest to Building One of the UK’s Largest Physio Groups | Tim Allardyce #47 Cover

From Mount Everest to Building One of the UK’s Largest Physio Groups | Tim Allardyce #47

In this episode of The Business of a Clinic, Jared speaks with Tim Allardyce, UK-based physiotherapist, osteopath, founder of Surrey Physio Group, and clinical director of Rehab My Patient. Tim’s story moves from private practice and clinic ownership to software, AI, property, NHS work, and most recently, summiting Mount Everest. He shares how a chance meeting with a Sherpa in Scotland planted the idea of Everest, why it took years of preparation, and what climbing at altitude teaches about discipline, resilience, and preparation. The conversation then moves into the business of MSK. Tim explains how he started his first clinic after failing to find the right job, why his entrepreneurial mindset began long before healthcare, and what it really feels like to build, buy, grow, and survive clinics over time. Jared and Tim discuss the hard parts of clinic ownership: landlords, leases, staff betrayal, sleepless nights, buying property, building senior teams, and learning how to move from doing everything yourself to building infrastructure that can scale. They also go deep on technology and AI in physiotherapy. Tim explains how Rehab My Patient evolved into an AI-powered exercise prescription platform, where AI is genuinely useful today, where the hype gets ahead of reality, and why private practice physiotherapy is still fundamentally safe because patients still want human care, human touch, and human judgement. In this episode * How Tim went from physiotherapist to clinic owner * The story behind summiting Mount Everest * Why Everest takes years of preparation * Starting a clinic after failed job applications * The mindset behind becoming the boss * The realities of buying and growing clinics * Landlords, leases, property, and clinic ownership risk * Why Tim started buying clinic premises * Moving from chaos to stability as a clinic owner * Why “it’s always something” in healthcare business * Building a senior team that reduces founder stress * Hiring the right managers and trusting the right people * The rise of private equity in physiotherapy * Building Rehab My Patient * AI-powered exercise prescription * Where AI is useful in physiotherapy today * Why AI still needs human checking * The risks of AI receptionists and broken booking flows * Why private practice physio is not being replaced by AI * What Tim would do differently if he started again Key idea Clinic growth is not just about more sites, more patients, or more technology. It is about resilience, infrastructure, people, property, systems, and knowing where human care still matters most. 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.

Gestern40 min
Episode From the British Army to Building a £24M Dental Group | Mark Aichroth #46 Cover

From the British Army to Building a £24M Dental Group | Mark Aichroth #46

Can a dental practice owner sell part of their business without surrendering its culture, identity or day-to-day control? In this episode of The Business of a Clinic, Jared Aron speaks with Mark Aichroth, co-founder and CEO of DeNovo Dental Partners, about a different model for dental consolidation: shared ownership. Mark’s career has taken him from 10 years as an officer in the British Army to hospital administration with Humana and HCA, health insurance, the early team at Circle and, eventually, dental acquisitions. Those experiences shaped his belief that healthcare businesses work best when clinicians have genuine ownership and influence. Mark explains how DeNovo grew to 16 practices, approximately £24 million in revenue and more than 300 employees. He breaks down how its partnership structure works, including its combination of cash and parent-company shares, incentives for EBITDA growth and the balance between practice autonomy and financial accountability. Jared and Mark also discuss why the traditional “buy, combine and sell” rollup model is becoming less effective, why simply acquiring more practices is vanity without operational growth, and how shared ownership can improve culture, succession and staff retention. They cover: *  How military leadership translates into healthcare  *  Earning trust and credibility with clinicians  *  Building a dental group from an idea  *  The economics of shared ownership  *  Why dentists resist top-down consolidation  *  Practice autonomy and EBITDA accountability  *  Shared services and dentist-led knowledge sharing  *  Staff ownership and retention  *  Measuring clinical excellence  *  What makes a dental practice attractive to DeNovo  *  The importance of chemistry during an acquisition  *  DeNovo’s ambition to grow beyond 100 practices  *  AI, digital imaging and the future of dentistry  A conversation for dental practice owners, healthcare entrepreneurs, investors and operators looking for a more durable way to build healthcare groups.

13. Juli 202654 min
Episode Why Clinics Break Invisibly: Excel, Front Desks & AI Receptionists | BOAC #45 Cover

Why Clinics Break Invisibly: Excel, Front Desks & AI Receptionists | BOAC #45

In Episode 45 of The Business of a Clinic, Jared Aron, founder of Coherent, explores why the business side of healthcare is still so operationally fragile. Jared begins with a story from his own clinic: four separate systems, none of them speaking to each other, and a senior team member spending days every month tying everything together in Excel. From there, he explains why this is not a small-clinic problem — even sophisticated healthcare providers are still running major parts of the business through exports, spreadsheets, and manual reconciliation. The conversation then turns to the front desk. Jared reflects on the mistake many clinic owners make: assuming the front desk is a single role, when in reality it becomes 50 or 60 jobs at once. Reception, hospitality, stock checks, social media, cancellation recovery, patient follow-up, and diary management all get layered onto the same team — then owners wonder why patients slip away. Jared and Sean also discuss why “we have a system” often falls apart after a few follow-up questions, why operational gaps get worse as clinics scale from one site to many, and why durable revenue growth depends on more than simply increasing marketing spend. Later, Jared explains the thinking behind The Business of a Clinic community, why healthcare needs more space to discuss operations and commercial infrastructure, and how Coherent Engage differs from a CRM, a Mailchimp-style automation tool, or an AI receptionist. The episode closes with a discussion on AI doctors, AI receptionists, and the future of patient support. Jared’s view is clear: the goal is not to remove the human from healthcare. The goal is to remove the administrative bloat around them, so humans can spend more time doing what matters — serving patients with empathy, judgement, and continuity.

9. Juli 202641 min
Episode The Hidden Data Risk Behind Healthcare AI | Bharat Reddy, CTO of Coherent Healthcare, #44 Cover

The Hidden Data Risk Behind Healthcare AI | Bharat Reddy, CTO of Coherent Healthcare, #44

Healthcare is in the middle of an AI gold rush. AI receptionists, AI doctors, AI agents, automated workflows — everyone is racing to move faster, automate more, and do more with data. But healthcare is different. Patient data is not just behavioural data. It is medical history, vulnerability, access to care, and trust. That makes security, governance, and accountability far more important than many people realise. In this episode of The Business of a Clinic, Sean speaks with Bharat Reddy, CTO of Coherent Healthcare (CoherentHQ.com), about AI, cybersecurity, patient data, and what healthcare can learn from bank-grade security. Before joining Coherent, Bharat was VP of Security Architecture at Morgan Stanley, where his role was to think like an attacker before the attacker arrived: reviewing systems, data flows, weak points, and the potential consequences of failure. That lens is becoming essential in healthcare. Sean and Bharat discuss legacy systems, siloed patient data, AI regulation, data sovereignty, the NHS and Palantir debate, vendor risk, and what clinic leaders should ask before trusting any AI tool with patient information. The core message of the episode is simple: AI in healthcare cannot just be powerful. It has to be secure, auditable, accountable, and built with the minimum data necessary.

6. Juli 202648 min
Episode E#43 | Why Clinics Break at Scale | Business of a Clinic (BOAC) Cover

E#43 | Why Clinics Break at Scale | Business of a Clinic (BOAC)

In this episode of The Business of a Clinic, Jared speaks with Cameron Tudor, physiotherapist and founder of West London Physio, about what really happens when a clinician becomes a clinic owner. Cameron’s journey spans private practice in Australia, locum work in the NHS, building a clinic from one patient and one phone call, scaling to four clinics and around 50 staff, and later returning to a more focused single-clinic model. The conversation explores the hidden operational reality behind clinic growth: leases, personal guarantees, reception, bookkeeping, hiring, burnout, systems, checklists, patient follow-up, and the uncomfortable shift from being the clinician to becoming the entrepreneur. Jared and Cameron discuss why healthcare often has a logistics problem, not a clinical problem, and why efficiency should not be seen as cold cost-cutting. Done properly, efficiency allows clinicians to focus on care, gives patients a more consistent experience, and helps the business become more sustainable. They also unpack what breaks when clinics scale, why centralising culture too quickly can backfire, how SOPs and checklists protect the patient journey, and why clinic owners need to listen before trying to impose change. The episode closes with Cameron’s view on the future of MSK: rising patient demand, growing pressure on public systems, clinical care remaining deeply human, and the front desk evolving from admin processing into concierge-style patient support. In this episode * Cameron’s journey from physio to clinic owner * Starting a clinic with one patient, one phone call, and a major lease liability * Why clinicians are often forced to become entrepreneurs * The hidden jobs clinic owners inherit: receptionist, accountant, marketer, operator * Why burnout forces clinic owners to think in systems * How SOPs and checklists create consistency * Why efficiency is better care, not just cost control * Who should own patient follow-up and recall * Why clinicians often resist admin-led follow-up * The tension between healthcare and “sales” * What ethical selling looks like in private healthcare * What breaks when scaling from one clinic to multiple sites * Why listening matters when acquiring or integrating clinics * The future of MSK and private practice * Why the front desk may become more concierge than admin Key idea Clinics do not break because the clinical care is poor. They usually break because the systems around the care are not strong enough to scale. 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. Juli 202634 min