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    MSK · ChiropracticCase study

    A patient base that became a parallel new-lead source.

    How Advanced Chiropractic, a two-site MSK practice in Essex, turned recall and reactivation into a lead channel that, in peak months, books more appointments than its new-patient intake.

    Clinic
    Advanced Chiropractic
    Chelmsford + Maldon, Essex
    Vertical
    MSK · Chiropractic
    Family practice, all ages
    Programme
    Engage + Payments
    Reactivation & consolidation
    Told by
    Dr Elliott
    Co-owner, Advanced Chiropractic
    The numbers

    An existing patient base, treated like the lead source it always was.

    Aug 2025 – May 2026
    1,000+
    Reactivation appointments
    Additional bookings, accounting for up to 3 additional appointments following activation.
    2.6×
    Reactivation vs. new patient
    In peak months, retained patients exceed new-patient bookings by up to 2.6×.
    41
    Payment gateways consolidated
    GoCardless, Stripe, WorldPay, and an in-clinic terminal collapsed into a single payment hub spanning card, link, phone, and direct debit.
    Reported by Advanced Chiropractic & Coherent
    Watch the story

    Reactivation now outperforms new-patient flow some months, without any of the marketing spend.

    A short walk-through from Dr Elliott on what changed.

    01
    The challenge

    The front desk isn't a sales desk.
    And now it doesn't have to be.

    The clinic's chiropractic assistants were responsible for recall, but in practice those calls were always deprioritised. Reaching out to patients across a busy reception isn't practical, so the list slipped to the end of the day, then the end of the week. Many patients were never contacted.

    The practice had previously adopted a standalone reminder tool. It could send generic email reminders, but the team had no visibility into whether any of it was working. The messages were minimal — a basic email and an SMS line — with no personalisation and no structured follow-up.

    The patients who had lapsed were the easiest to bring back. They already knew the clinic and already trusted it. They simply needed a genuine conversation.

    Our existing patients know and trust us already. They're our perfect patient avatar. We just didn't have time to engage them.
    Dr Elliott
    Co-owner, Advanced Chiropractic
    02
    What Coherent did

    End-to-end recall,
    in the clinic's own voice.

    Recall and reactivation are now run end to end as a managed service. The assistants no longer carry it. Calls, messages, and follow-ups all sit outside the clinic walls, delivered under Advanced Chiropractic's own voice and branding.

    The shift was in how patients are spoken to. Generic templates gave way to personalised conversations that reference the patient's history, their last visit, and their reason for coming in. And the channels widened to meet patients on the channel they prefer — WhatsApp, SMS, email, and voice — selected per patient based on what they respond to.

    There is a quieter benefit, too. Clinicians gain an air gap: they focus on care while a third party handles the conversation. Patients will often share feedback with that third party they wouldn't raise with the practitioner directly, which is exactly the insight the clinic wants to see.

    The air gap
    “Patients don’t feel like we’re just after their money. We’re checking to see how they are.
    03
    What changed

    Over 1,000 appointments.
    From the database, not the ad budget.

    From August 2025 to May 2026, the programme generated over 1,000 appointments for Advanced Chiropractic, across first, second, and third bookings. That last point matters: a reactivated patient doesn't return once. They return into a programme of care.

    One month saw a 59% year-on-year increase in six-month reactivations. In most months, the effect compounds steadily. And in recent months, reactivation bookings have exceeded the clinic's new-patient bookings, by up to 2.6× in March 2026.

    The data

    Reactivation is behaving like a parallel lead source.

    Coherent reactivation vs. new-patient bookings
    Monthly appointments · May 2024 – May 2026
    Coherent enabled bookingsNew patient bookingsCoherent as % of new patient
    250% 200% 150% 100% 50% 261% May 24 Aug Nov Feb 25 Aug 25 Jan 26 Mar May 26 PROGRAMME START
    Source · Advanced Chiropractic SBR dashboard · Coherent enabled & clinic new-patient bookings
    04
    The challenge

    Four gateways, one owner,
    and the back office on the kitchen table.

    Advanced Chiropractic was running on four separate payment systems: GoCardless for direct debits, Stripe for online payments, WorldPay on the card terminal, and a fourth tool for in-clinic add-ons. Each one did its job. None of them spoke to each other.

    The bigger problem sat above all that. Memberships, recurring direct debits, custom billing rules: Dr Elliott didn't want the front desk team to have access to those systems, so he set up every one himself. The back office was built on the kitchen table after the children went to bed.

    05
    What Coherent did

    One hub. Every payment type.
    Tagged by site.

    The payment stack was consolidated. Card terminal payments, payment links, phone-based payments, one-off invoices, and recurring direct debits now run from a single payment hub under Advanced Chiropractic's account.

    Two pieces matter most. First, the front desk can now safely set up membership and recurring plans themselves. The customisations that used to need the owner's hands now happen at the front desk, the moment the patient signs up. Second, payments are tagged by location. Chelmsford and Maldon settle to the same account but report separately, something the previous providers couldn't natively do.

    Behind that sits service: a Coherent response on any payment issue inside five minutes during clinic hours.

    The consequence is, you actually make it home for dinner. I'm not spending my evenings doing payment admin any more.
    Dr Elliott
    Co-owner, Advanced Chiropractic
    06
    Where we landed

    Same team. More care delivered.

    Six months in, the team size hasn't changed — but what the team can prioritise has. The assistants aren't carrying a recall worklist they were never set up to work. The front desk runs payments and patient flow without a four-tool juggling act. And the owner isn't doing membership admin at 10pm.

    In its place sits a single system: one recall engine, one payment platform, one source of truth. And a clinic where the existing patient base, for the first time, is treated like the lead source it always was.

    Treated like the lead source
    it always was.
    Advanced Chiropractic · On what changed

    Related use cases

    Patient recallPatient follow-upPatient engagement software
    Your clinic

    If your front desk is carrying a recall list it never had time to work,
    it's a systems problem.

    A 30-minute conversation about where reactivation is hiding inside your existing patient base, and how much of it your current tooling is missing.

    Book a discovery call
    Led by Jared Aron, founder of Coherent and former clinic operator.