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    Medical aestheticsCase study

    +19% more revenue.
    Zero new ad spend.

    How The Mayfield Clinic unlocked 9,000 patients it already had — without adding a single pound of marketing spend.

    Clinic
    The Mayfield Clinic
    Edinburgh · by Dr Nestor
    Vertical
    Medical aesthetics
    9 years operational
    Programme
    Engage
    Recall & reactivation
    Told by
    Dr Nestor
    Founder, The Mayfield Clinic
    The results

    The lift came from patients they already had.

    +19%
    Revenue per quarter
    Every full quarter since Coherent went live has come in above the pre-programme baseline. The trend has held without exception.
    1.34×
    Strongest month in nine years
    April 2026 — the clinic's single best booking month in its entire history — came nine months after Coherent launched.
    £0
    New marketing budget
    Not a penny of new ad spend. Every booking came from patients already in the database — contacted in the clinic's voice, on their channel, at the right time.
    Reported by The Mayfield Clinic & Coherent · Engage live since Aug 2025 · 9 months of data
    What is Coherent?
    A CRM
    An AI receptionist
    A front-of-house hire
    A SaaS subscription
    Coherent is
    A working relationship.
    01
    The challenge

    Nine years of patients.
    A leaky recall.

    Nine years operational. Over 9,000 patients seen. Hour-long consultations in a 120-year-old Victorian mansion in Edinburgh, where the right outcome is a patient who looks great, full stop — never a patient who looks like they've had something done.

    The problem every clinic of this size eventually hits: a patient leaves happy, an automated email goes at nine months, another at twelve, and if they don't reply — nobody follows up. Life gets in the way. They meant to book. They didn't.

    Dr Nestor had tried MailChimp. He'd tried an AI system. Neither stuck. They didn't sound like the clinic. They sounded like a marketing funnel.

    The opportunity
    9,000 patients who already knew the clinic, already trusted the team — and hadn't heard from them in a way that felt personal.
    We tried different clever systems — MailChimp, AI systems. None of them sounded like us.
    Dr Nestor
    Founder, The Mayfield Clinic · Edinburgh
    02
    Why Coherent

    Not automation.
    A team that learns your voice.

    Dr Nestor didn't need more software. He needed a team who could write to his patients the way he speaks to them — the same care, the same tone. "How are you getting on?" not "it's time to rebook."

    Coherent embedded an account lead who learns the clinic's voice and runs every patient touchpoint under it. No templates. Not a SaaS subscription you configure and forget. A working relationship that adapts as the clinic does.

    The front of house and clinical assistants no longer carry the recall. It sits with Coherent.

    03
    What Coherent did

    Multi-channel recall
    that still sounds personal.

    Coherent runs recall and reactivation end to end — the right number of touchpoints per patient (not the seven or eight that feels harassing), every one written in the clinic's voice, on the channel the patient actually uses.

    Nine months in, the numbers on mechanism:

    Nine months of activity
    14,800+ outbound messages across WhatsApp, SMS, email and voice
    4,000+ WhatsApp messages read
    2,300+ inbound replies routed back to the clinic
    642 patient-facing tasks closed at a 78% completion rate

    The diary filled. The team didn't change.

    04
    What changed

    Revenue up every quarter.
    Marketing budget unchanged.

    Engage went live in August 2025. Since then, revenue has averaged 19% above the pre-programme baseline every single quarter. H1 2026 has come in as the strongest half in the clinic's nine-year history — and April 2026 is the strongest individual month on record.

    What matters as much as the lift is where it came from. Not new ad spend. Not a new channel. Patients already in the database — contacted in the clinic's voice, at the right moment.

    Revenue by half-year vs. pre-programme baseline
    Indexed · H2 2024 – H1 2026 · Baseline 1.00× = avg monthly revenue before programme start
    Pre-programmePost-programmeBaselinePost-programme avg
    ENGAGE LIVE · £0 NEW MARKETING SPEND 1.3× 1.2× 1.1× 1.0× 0.9× 0.8× +19% avg 0.94× 1.04× 1.16× 1.21× AUG 2025 H2 2024 H1 2025 H2 2025 H1 2026* *partial (Jan–May)
    Source · TMC PMS data via Coherent · Indexed half-yearly revenue · Volume figures suppressed at client request
    Retention is probably the biggest lever every clinic can pull to increase their revenue.
    Dr Nestor
    Founder, The Mayfield Clinic · On where to spend management attention
    Hear it from Dr Nestor

    Nine years of practice. In his own words, why it finally worked.

    Dr Nestor on why previous systems failed, what made Coherent different, and what he'd tell another clinic owner considering it.

    The economics
    “The acquisition cost on a reactivation is zero. The patient already knows you.”
    05
    Beyond the booking

    Your existing database is an untapped asset.

    Dr Nestor's view on the economics of a clinic this size is clear. New patients are great. But with 9,000 already in the database, the better return on management time isn't acquiring the next thousand — it's engaging the nine thousand you already have.

    The acquisition cost on a reactivation is zero. The patient already knows the clinic, already trusts the team. The only friction left is a conversation — well-timed, in the right voice.

    When someone is actually speaking to your patient — not automating at them — things happen a lot faster.
    Dr Nestor
    Founder, The Mayfield Clinic
    06
    Where we landed

    Same team. The diary filled.

    Nine months in, the clinic runs with the same team and the same hands-on standard of care. The difference is what they're no longer carrying. Recall sits with Coherent. Patient follow-up sits with Coherent. The front of house and CAs have their attention back.

    Revenue is up 19% quarter-on-quarter. The marketing budget is the same it was a year ago. April 2026 was the strongest single month in the clinic's history.

    Related use cases

    Patient retentionPatient engagementPatient engagement software
    Your clinic

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    before you spend on new leads.

    Most clinics have more in their database than they realise. A 30-minute call to map what's there, what's dormant, and what's ready to move.

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    Led by Jared Aron, founder of Coherent and former clinic operator.