Early in my career, I thought sustainability was about managing overhead and making sure we had steady bookings. If the calendar was full and payroll was covered, I assumed we were doing fine.

But after years of running a busy aesthetic clinic, I’ve learned that true sustainability isn’t just about what you see, it’s about what you don’t. It’s the silent leaks. The inefficiencies you don’t notice until they cost you a chunk of your revenue. And I’ve had more than a few of those wake-up calls.

One of the most eye-opening moments came after we ran a promotional campaign that tripled our inquiries in a month. Great news, right? Except … by the time our team manually responded to all the messages, scheduled consults, followed up, and sent reminders, we had lost nearly 60% of those leads.

We were hemorrhaging opportunity, not because patients weren’t interested, but because our systems weren’t built to handle scale.

That’s when I realized: Our problem wasn’t growth. It was sustainability.

So we did what any good practice should do from time to time (we audited everything). From the moment a lead came in, to the moment a patient paid their final invoice, we mapped it all.

And what we found was sobering:

• No-shows were costing us thousands each month because we weren’t consistently collecting deposits.
• Voice messages went unchecked for hours and sometimes days.
• We had outstanding payments stuck in limbo because no one had the time to chase them.
• And worst of all, my team was exhausted and stretched too thin to keep plugging the gaps manually.

That’s when we turned to technology, not as a luxury, but as a lifeline.

We started small: automated appointment reminders with reschedule links. Then we added missed call text-backs; patients who called and didn’t get through would receive an immediate text offering to help. Our conversion rate on those jumped dramatically.

We implemented an ACH payment option with zero chargebacks. Not only did it save us on fees, but it also stabilized our cash flow. No more worrying about reversed charges on high-ticket procedures.

Then we added lead scoring and automated follow-ups based on patient behavior. If someone opened three emails but didn’t schedule, they got a text from our AI voice assistant offering a call.

The results?

• No-show rate dropped by 45%.
• Average time-to-contact for new leads went from two days to under 10 minutes.
• We recovered over $15,000 in delayed payments within the first 60 days.

And most importantly, our team was no longer burning out trying to keep up.

But here’s the kicker: Implementing these tools didn’t just help us survive, it helped us thrive. With more predictable revenue, I was finally able to reinvest in team development, new service lines, and, yes, even some well-earned bonuses.

Sustainability, I’ve learned, is about building a business that can breathe without you holding its hand every minute. It’s about creating systems that plug leaks before they become floods.

It’s not the sexiest part of entrepreneurship. There’s no confetti moment when your ACH system processes smoothly or when your AI follow-up closes a lead at 2:00 a.m. But those are the moments that keep your business healthy and growing.

One story stands out to me. A patient, Maya, had booked a series of treatments but missed her follow-up payment. Normally, this would’ve required three phone calls and a bit of awkwardness. Instead, our system sent a gentle nudge via email and text. She clicked a link, paid in under a minute, and even replied with, “Thanks for making this easy!”

That’s sustainability in action. And it’s good medicine, not just for the business, but for patient trust too.

So if you’re running a practice and feel like you’re constantly putting out fires, let me encourage you to stop and ask: “What could I automate that I’m currently doing manually?” And “Where am I losing revenue in ways I haven’t fully noticed yet?”

Technology won’t fix everything. But when it’s designed to support your mission and not distract from it, then it becomes the quiet engine behind your success.

And that’s the kind of sustainability we should all strive for. One that empowers us to care deeply for our patients while also caring wisely for our business.

What methods have you implemented for sustainability? Share in the comments.

Dr. Shitel Patel is a renowned plastic surgeon at Lift Plastic Surgery and the visionary CEO of Ad Vital Software, a company revolutionizing the delivery of health care with technology. His passion for improving patient outcomes and streamlining health care processes is evident in his professional accomplishments, which can be explored further on his LinkedIn and Instagram profiles and podcast.

Image by Ksenia Zvezdina / Getty Images