Why Hands-On Clinics Leak Value
Why hands-on care resists automation, how clinics hit an invisible ceiling, and why cost per consultation is the number to watch.
Jared Aron
Show notes
Jared begins by separating two kinds of healthcare: hands-on care, where the patient has to be physically present, and cognitive or remote care that can be delivered over a screen. AI can accelerate the cognitive side, but the embodied nature of hands-on care means the practitioner is not going away, which is why Coherent focuses on the operations and logistics around care.
He then contrasts how single-site clinic owners and multi-site group owners think. Group leaders speak the language of profit and loss and move fast, while many clinic owners make one or two incremental changes and stop. Using a food-chain analogy, he shows how two clinics with the same revenue can be worth very differently on exit depending on margin.
The rest of the episode is about leverage and leakage: why buying enterprise software like Salesforce can backfire, why AI receptionists still hand tasks back to humans, and why archived patients, arbitrary follow-up sequences and the 'still in process' label quietly bleed value out of a clinic.
Key takeaways
- Hands-on care requires physical presence, so while AI can support diagnosis and notes, it will not replace the practitioner the way it might in remote or cognitive care.
- Coherent focuses on the operational and logistical layer around care, working backward from whether a patient actually took the next step.
- Group owners think in profit-and-loss terms and move quickly, while single-site owners tend to make one or two incremental changes and then stop.
- Two clinics with the same revenue can be worth very differently on exit, since doubling EBITDA can double the sale value for the same years of work.
- Buying powerful software or an AI receptionist rarely helps if no one on site can run it, because the real work still falls back on the human team.
- Track cost per consultation rather than cost per lead, and treat 'still in process' as the status where lead profitability quietly dies.
“Still in process is where your profitability goes to die.”— Jared Aron
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Coherent gives private clinics one patient relationship engine, recovering revenue lost at enquiry, recall and billing.