Today, I’m going to do what those stupid ads do—you know the ones, they claim to be able to make you 10X profit out of nothing. Except I’m really going to show you how to do it, just by simply changing your online booking system and, more importantly, I’m going to tell you which one you should use and why.
This is more important than you think!
Your booking system is the MOST important consideration for any clinic in 2024/25. Forget about the cost of your lease, your consumables bill, your tax; these pale into insignificance when you compare them to the losses you’re making by potentially using the wrong booking platform.
Practice Management systems…
I’ve purposefully not used those words in this article; I’m referring to just booking systems. I recognise there’s a big difference between the two; indeed, some products don’t even offer real practice management. There are some fantastic practice management systems, but they’re about as useful at online booking as I am at making TikTok dance videos. Good practice management software is obviously important, but it’s less important when you don’t have any patients to manage.
Okay, so how am I losing money?
A good booking system can make thousands of pounds of difference to your monthly revenue. Let’s do the sums to really get this point across. I’ll begin by making some lowball assumptions. I’m going to assume the average lifetime value of your patients (how much the average patient spends with you over their lifetime) is £250. You can adjust this to your liking. I’m on the low side judging by most of our clients’ numbers, and it’s probably over £500.
I’m also going to assume that the average clinic gets 200 new potential patients to their booking system each month. Again, a very conservative estimate, and you can adjust; even small clinics will see far in excess of this number.
A good booking system can generate you a 20% conversion rate. That is, if 100 people hit your booking system, 20 will book an appointment. That means that if 200 people hit your booking system and it’s decent, then you’ll get 40 patients. This would mean a revenue of 40 X £250 (lifetime value), which equals £10k in new patient revenue.
However, imagine your booking system gets you a 5% conversion rate (i.e. only 5 people out of every 100 book). This would mean that from 200 patient visits to your booking system, you’d get 10 patients. Using the same formula as above, this would mean that you’d generate £2.5k.
That’s a difference of £6.5k just in terms of straight-up revenue. But even if you’re a smaller clinic and it only makes a difference of two patients, that’s £500 and £6k a year!!! If you’re a larger clinic, it could be 10/20 patients. The numbers are eye-watering. Ten patients is £2,500 a month, so £30k a year. That’s a good few holidays!
Essentially, the wrong booking system can make the difference between being a highly profitable clinic or struggling along trying to make ends meet. For all those clinic owners running about giving themselves palpitations about retention rates on their clinicians, you could probably put a couple of extra years onto your lives by just switching a piece of software!
There are of course variables such as pricing, your reputation, the level of competition, your availability, and so on, but even so, the conversion rate will still apply.
But that’s not all...
There are also other factors to consider. We often see that those with the worst booking systems are also those that have to spend extraordinary amounts on their marketing just to stay busy. Furthermore, you’re not going to get the same level of word of mouth, and you’re also losing patients to competitors who make the booking process seamless, which in turn makes you less competitive and improves their brand and reputation. I know clinic owners that put more thought into their logo than their booking system, which is crazy when you think about it!
Let’s do the one thing that’s really stupid!
So you’re struggling to get patient numbers through or you have a few gaps, and you want to fill them. You might be one of the many that then say, “I know, I’ll do social media marketing.”
We’ve seen this trend—clinics, because they have a shoddy website and booking process, because the customer experience is so bad, they turn to running Facebook and Instagram ads to generate revenue. And where do they turn? You know where. Those marketing agencies promising you a gazillion pounds with their “unique patient acquisition generator system.” And what happens next? You end up running ads for free appointments.
So now you’re spending money, doing free appointments just because your onboarding process is poor.
So why not just move to a new system?
I don’t believe you!
Sometimes people just don’t believe us! For anyone that doesn’t think their booking system is really all that important, think about your own purchasing behaviour. If it took you 15 minutes to book a restaurant appointment or buy a pair of trainers, would you?
This is why companies spend hundreds of millions on their purchasing systems. Why do you think Amazon has a ‘Buy now’ button? Why do you think Shopify has invested so much money in their new payment platform? Ease of use and speed of purchase are crucial to every business selling products or services online.
Who are you to tell me what’s good and what’s not?
Good question. Let’s talk about data and why we’re qualified to have an opinion. Most of you understand the scientific method, so I won’t go into depth on it. As the largest MSK marketing agency in the UK, we work with hundreds of clients and have more data points than anyone else on the planet.
For example, here’s a look at our Google Ads spend:
![The one thing every MSK clinic owner should consider in 2024/25 and why you MUST take action or lose money 1 Screenshot 2024 07 18 at 09.12.31](https://t4b7i5m5.rocketcdn.me/wp-content/uploads/2024/07/Screenshot-2024-07-18-at-09.12.31-1024x148.png)
When you spend close to £6m and have more than 4.5 million clicks, you get access to some pretty decent data. We track everything, so we know conversion rates, drop-offs, and bookings made against pretty much every (if not every) system on the market. Not only this, but we also have millions of data points on how patients use websites because we design them, we run SEO, we’re experts in patient behaviour, and the numbers don’t lie.
Imagine you saw 5m patients. That would be a pretty good data set, wouldn’t it?
So we know what we’re talking about!
Conversion tracking
Okay, I know this is boring, but it’s important. I’ll keep this as non-technical as possible. One of the key elements for any system is to know where a patient converts from. For example, let’s say you spend £100 on an ad. With great booking systems, we can see exactly how many patients you got from your ad spend, which ad they came from, and also how much those people spent.
In other words, spend £100 on back pain ads, get five patients with revenue at £500. This way you can work out your ROI. £5 for every £1 spent. We wrote an article a while back on evidence-based practice requiring evidence-based marketing.
If your system doesn’t allow you to track these things, then you can’t possibly be running your business in an optimal way. And you’d be amazed how few systems allow this. Quite honestly, if yours doesn’t, it should probably go in the bin. It’s like trying to treat patients without being able to see or hear. You just can’t do it, and nor can you really run a business properly under the same conditions.
How impartial are you?
Before we do the big reveal, it’s really important to say a few things.
HMDG nor I have never taken money in return for recommendations of a product. We are independent and agnostic. As you can imagine, given our customer list, plenty of people try, but the answer is a big fat no. I also couldn’t care less which system wins or doesn’t. I wish everyone won because it would make my job a lot less stressful.
Furthermore, no one knows about or has paid for this article, and I’m writing it on a whim. So before anyone asks, IT’S NOT SPONSORED. Why am I spending my time writing it? Because I’m sick and tired of people losing money hand over fist because they get swayed by slick marketing from system suppliers or fancy UIs (basically how a system looks). I’m also bored by the lies our customers get told and the team at HMDG having to tell new customers that they’ve made a mistake and then spending precious hours explaining why. I’m also personally put out because I spend hours a week talking about bloody booking systems. Finally, clinic owners are clinic owners. They do not understand UI, UX, CRO, conversion tracking or any of the other things that are crucial when choosing a product. They’re not supposed to, but it does mean that often they choose an inferior product.
Okay, so what is the best system?
Cliniko. This is our number one choice by a country mile. If I were to open a clinic tomorrow, you couldn’t pay me to use any other product. In fact, it’s so important that if someone wanted me to invest in a clinic, using Cliniko would be a condition of any investment. It has ridiculously high conversion rates, patients love it, it’s simple, it’s optimised for speed of appointment making, and when a new client joins us, the team all have a smile on their faces if they’re using Cliniko. This tells you a lot! We’re an MSK marketing agency, and we’re here to make people money. We know that our job is much easier when clients use Cliniko; they don’t just make more money, they save it as well. We’ve yet to find a clinic using it where we don’t have easy success.
For those that skimmed through and got to this part of the article, no, we haven’t been paid to say this, and Cliniko doesn’t even know we’re writing it. Although hopefully, they’ll send me some branded freebies like Cliniko socks, which I can give to the kids because lost socks are costing me a fortune. I’ll update this article if they do. 🙂
However, do I think Cliniko is perfect? No, I absolutely do not. There are many missing features; I’m not a big fan of their self-service support; I don’t think they’re the most customer-friendly business I’ve ever seen either. I’d love to see Healthcode implemented, classes and group management, better reporting, the storing of credit cards just to name a few. However, they do offer an open API, so it’s easy for third parties to complement it, whether that’s products like Cliniq apps or Dataplayer.
So, if you’re not using Cliniko, the chances are, you’re losing patients and money.
I also want to give a shout-out to Nookal. For us, they’re in second place behind Cliniko. They actually have a great overall product, definitely more advanced in many areas with far greater functionality than Cliniko. They’re also very responsive to us when we make suggestions, and as a team, I really like them. The team behind a product is often forgotten, but it shouldn’t be. They’re who make the product run, develop it, and communicate with customers, and no matter how good a product’s features, a bad team will ruin it.
They’ve worked hard on improving their online booking, and it’s certainly much better today than a year ago. They’re growing fast, are really customer-focused, and Cliniko definitely needs to watch out! Their customer service is also fantastic.
However, I do wish they’d get rid of their absolutely ridiculous migration fee, which is close to £1k. It’s great they offer a migration service, but loading customers with a hefty upfront fee is not a good look and almost stops me from wanting to put them in second place. You’ll make plenty of money over time and be far more accessible by taking a hit. We spend far more time onboarding a client than they do, and we don’t charge. For them, margins once a customer is onboard are fantastic, and this just strikes me as short-termism and a lack of understanding as to how this industry works.
Finally, Practice Hub. This is a pretty cool little company. Culturally they’re great, and they do have pretty fast development. I’m not a fan of where they’re spending their dev time—mobile apps, for example (if they focused on UI and UX, it’d be money far better spent, IMO), and their conversion rates and usability for marketing is actually very poor. However, many companies we’ve come across in the space will outright lie to clients, fob us off, be completely unresponsive to both us and customers, and will develop their products very little because they care more about saving money than making a better product. To be fair to PH, they’ve definitely shown themselves to be different. We chatted recently, and they essentially said, “We have faults, we can see them, help us and watch what happens with our next release.” I really like that in a company. So although not a product I would use just yet (although I can see it for some use cases), I think they’re definitely one to watch, and we’ll be keeping a close eye. It’s also worth mentioning that (if they’re reading) they’re very chiro-focused but, quite honestly, they should be much more open to the whole MSK market.
So there you have it!
But my system isn’t on the list, and it’s amazing!
No, it probably isn’t. If it was, it’d be on the list above. Is there a small chance that there’s a system we don’t know? Sure, but it’s unlikely.
I don’t use Cliniko, and I’m doing amazingly well
Absolutely, and that speaks volumes about how well you run your business in spite of being hampered by your tech. I’m not saying you can’t be doing brilliantly; I’m saying you’d be more efficient and making more money switching systems. We have one client who, for various reasons, can’t move systems, and they’re making a small fortune. But they’re also answering an ungodly amount of calls because people just don’t want to book online! Imagine how much it costs to hire people to answer calls! Don’t forget to add that to the monthly cost of your booking system.
I’m annoyed, and you’re wrong!
I know, confirmation bias is a crazy thing, as are the number of people that are so emotionally tied to their booking system they won’t even accept real-world data. Suffice it to say, we’re not wrong. I’m also not writing this to annoy you or to put people out; we genuinely care about clinic owners and their businesses and want them to make as much money as possible.
Can you review my system/other systems?
We considered doing an in-depth review of 10+ systems; we even did some mystery shopping! You’d be amazed at how some can’t even get back to you with pricing! This would then have been much more of a review piece, but we decided against it for a few reasons.
First, just use Cliniko. I don’t want to start talking about an amazing feature of product X when the product as a whole is a mess that no one should even dream of using. I also think a fair few aren’t doing all that well financially and doubt they’ll be around in the next 24/48 months.
Second, although this is opinion backed up by a lot of data, some of them are going to get litigious. We’re far too busy to deal with vendors wanting to silence criticism through the courts rather than spending their money on improving their products.
Finally, I don’t actually think it’s beneficial. This isn’t like comparing a Chattanooga Shockwave to Venn or Swiss Dollarcast where they all have strengths in certain areas (although let’s be honest, it’s the same product with a different badge); booking systems are so different that if you had Cliniko and then Nookal in one and two, everything else starts at number 20 on the list. Why compare a Ferrari and a scooter?
Hopefully, you found this useful, and it goes without saying we’re amazing, so it’s about time you got in touch to work with us. So do!