The Business of a Clinic (BOAC)

E#39 | From Near Closure to 4x Revenue: How He Completely Rebuilt His Clinic, with Dr. Geoff Gamble | Business of a Clinic (BOAC)

In this episode of The Business of a Clinic, Jared Aron speaks with Dr. Geoff Gamble, chiropractor and co-founder of Niagara Health Rehab Center, a large multidisciplinary rehab clinic in Canada. Geoff shares the honest story of how NHRC grew from four practitioners and 4,000 square feet into a much larger clinic team — but not in a straight line. After several years of organic growth, the clinic hit a difficult breaking point. Staff turnover reached 85%, growth flatlined, the business started to regress, and Geoff and his team were even considering closing the clinic. What changed was the way they looked at the business. Geoff talks about the transition from clinician to clinic entrepreneur, the mistake of assuming the clinic would “run itself,” and the importance of learning business fundamentals: P&Ls, metrics, utilization, hiring, culture, and patient reactivation. He also shares how the pandemic became an unexpected reset point for NHRC, helping the team rebuild operations, rethink staffing, and create a more scalable business. Since then, the clinic has quadrupled gross revenue and significantly expanded its team. This conversation is especially relevant for clinic owners, MSK leaders, chiropractors, physiotherapists, and healthcare entrepreneurs who are trying to move from being the main practitioner in the business to becoming the leader of a clinic that can grow without depending entirely on them. In this episode, Jared and Geoff discuss: * Why early clinic growth can hide weak business foundations * The reality of going from clinician to entrepreneur * How 85% staff turnover forced NHRC to rethink the business * Why Geoff nearly burned out as the main revenue driver * The danger of building a clinic that depends too heavily on the owner * What clinic owners need to understand about P&Ls, metrics and utilization * Why culture, hiring and communication became central to the turnaround * What should stay in-house versus what can be outsourced * Why patient reactivation is both a revenue problem and a care problem * How NHRC approached a cold list of around 18,000 patients * Why “having a process” does not always mean the process is working * The challenge of letting go of control as a clinic owner * What Geoff wants to improve next as NHRC continues to grow This episode is a practical look at what it really takes to rebuild a clinic business: not just better marketing or more practitioners, but better systems, stronger leadership, clearer metrics, and a deeper understanding of the patient journey. Guest: Dr. Geoff Gamble, Niagara Health Rehab Center Host: Jared Aron, Founder of Coherent The Business of a Clinic is a podcast about the business, operations, growth, and patient experience side of running modern private healthcare clinics.

E#38 | Jonathan & Rachna: The Secret To A Five-Star Clinic | The Business of a Clinic

In this episode of The Business of a Clinic, Jared speaks with Rachna Murthy and Jonathan, two consultant ophthalmologists and oculoplastic surgeons building a highly personal private clinic across London, Jersey, and soon Bermuda and the Cayman Islands.  Rachna and Jonathan share how they moved from NHS backgrounds into private practice, and why building a successful clinic is not only about clinical skill. It is about trust, teamwork, patient obsession, communication, and creating a level of care that feels deeply human.  They discuss why they operate as a two-surgeon team, how that improves speed, safety, and decision-making, and why ego can be both necessary and dangerous in surgery. They also explore what “five-star medicine” really means: treating patients like people, not transactions; building long-term relationships; offering direct access through WhatsApp; and making every part of the patient journey feel considered.  The conversation also covers AI, wellness, longevity, aesthetics, body dysmorphia, holistic care, gut health, skin health, and why private medicine will always remain a “feeling business.” Technology can improve efficiency, but the future of great clinics will still depend on human trust, clinical judgement, and keeping the patient relationship at the center.  Rachna and Jonathan also reflect on the realities of becoming clinician entrepreneurs: starting without much capital, building through word of mouth, acquiring a clinic in Jersey, hiring around values, expanding internationally, and learning how important self-care, outsourcing, and operational discipline become when running and growing a clinic.  In this episode  *  Why business matters in medicine  *  How to build a clinic around patient trust  *  Why clinical skill alone is not enough  *  The benefits of a two-surgeon team  *  Ego, confidence, and surgical improvement  *  What five-star care means in private clinics  *  Why direct communication changes the patient experience  *  How WhatsApp groups support long-term patient relationships  *  Body dysmorphia, expectations, and knowing when not to operate  *  AI, empathy, hallucinations, and the limits of automation  *  Wellness, longevity, microbiome health, and holistic care  *  Why medicine is still a feeling business  *  Lessons from leaving the NHS and building a private practice  *  Hiring around values and learning to let people go  *  Scaling a clinic across London, Jersey, Bermuda, and the Cayman Islands  *  Why self-care matters for clinician entrepreneurs  Key idea   Great clinics are not built on clinical skill alone. They are built on trust, team, process, communication, and the feeling patients have that someone genuinely knows them, cares about them, and is looking after them. 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.

E#37 | Cyrus Hessabi: AI, Clinics & Private Equity | Business of a Clinic (BOAC)

In this episode of The Business of a Clinic, Jared speaks with Cyrus, an investor focused on traditional services, AI-enabled businesses, and small business growth. Cyrus brings a different perspective to the podcast: not as a clinic operator, but as someone thinking deeply about how traditional businesses are bought, scaled, modernized, and supported. The conversation explores the “real economy” — the clinics, service businesses, local operators, and offline companies that underpin daily life — and why healthcare sits at the center of that opportunity. Jared and Cyrus discuss how investors think about clinic acquisitions, the difference between strategic and financial buyers, and why consolidation is not just an acquisition game. It is an integration game. They explore why acquirers need to understand the day-to-day work inside each clinic, why transformation should start from the unit level, and why patient relationships, team culture, and operational detail matter as much as the financial model. They also go deep on AI in healthcare: where it can create real efficiency, where the hype gets ahead of reality, and why AI receptionists are more complicated than simply “answering the phone.” The question is not just whether AI can do a task, but what happens next — and whether the workflow actually works in the real world of patient care. The episode closes with reflections on VC, private equity, entrepreneurship through acquisition, the importance of small operational details, and why, even in a world of automation, business is still ultimately about people. In this episode *  What investors mean by the “traditional economy”  *  Why healthcare is a major opportunity for modernization  *  Strategic buyers vs financial buyers  *  Why clinic rollups are really integration businesses  *  How acquirers think about unit-level value creation  *  Why bottom-up thinking beats top-down transformation  *  The importance of integrating people, culture, and patient books  *  Why patient relationships create value for clinics and groups  *  How to think about AI ROI in healthcare  *  Why AI receptionists are harder than they sound  *  The “then what?” problem in clinic automation  *  Why process foundations matter before AI  *  What changes when moving from VC to private equity  *  Why small operational details can become big problems  *  Why buying or selling a clinic still comes down to people, trust, and legacy  Key idea AI and capital can help clinics grow, but the real value is created in the details: the people, the workflows, the patient relationships, and the ability to integrate a clinic without losing what made it valuable in the first place.  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.

E#36 with Joshua Catlett: Why Most Clinic Owners Are Not Exit Ready | BOAC

Joshua Catlett bought his first private healthcare practice at around 22 years old. He started at the front desk, answering phones, making tea, fixing the website, managing the diary and learning how a clinic actually works from the inside. That first practice eventually became the foundation for BodySet, a 36-site healthcare group that went on to take private equity investment. Today, Joshua is the Founder and Managing Director of Verilo, a specialist healthcare business brokerage and advisory firm supporting clinic owners through valuation, sale, acquisition and exit planning. In this episode, Jared Aron speaks with Joshua about the real business of buying, selling and scaling healthcare clinics. They cover what buyers actually look for, why concentration risk can reduce valuation, how maintainable EBITDA is assessed, what makes a clinic genuinely exit ready, and why many owners only discover operational weaknesses when they enter a sale process. Joshua also shares stories from his own acquisition journey, including how he structured early deals, what he learned from sitting on reception, why the front desk gives you one of the clearest views of the business, and how small details such as insurance, lease terms or poor financial visibility can put an entire transaction at risk. Later in the conversation, Jared and Joshua discuss technology adoption in healthcare, the rise of AI, the pressure on clinics to become more efficient, and why online booking is still far more difficult than it should be for patients. In this episode, they discuss: * Buying a private practice at 22 * Building BodySet into a 36-site clinic group * Selling into private equity * What Verilo does for clinic owners * Why selling a clinic is not just about finding a buyer * The emotional side of healthcare M&A * Concentration risk and owner dependency * Lease security and premises risk * Maintainable EBITDA and clinic valuation * Why buyers care about data quality * The importance of understanding the patient body * Why many clinic owners do not know their numbers * AI, workforce transformation and operational efficiency * Why clinics need to make booking easier for patients * What it means to build an exit-ready clinic This episode is especially relevant for clinic owners, founders, healthcare operators, MSK clinic leaders, aesthetics clinic owners, dental practice owners, buyers, sellers and anyone thinking about the future value of their healthcare business. The Business of a Clinic is hosted by Jared Aron, founder of Coherent. The podcast explores how private healthcare clinics can grow by improving the business and operational side of care, including patient engagement, follow-up, retention, technology, clinic operations and the overall patient experience.

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

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.