Attrition (Churn)

What it is

The percentage of active patients who do not return within the period that defines active for your practice. It is the mirror image of repeat rate and the reason a clinic can market hard all year and finish where it started. Aesthetic attrition is almost never announced — nobody resigns from a clinic, they simply stop appearing.

Why it matters to your bottom line

• It sets how hard you have to run to stand still. Lose 40% of your patients a year and the first 40% of everything you acquire is replacement, not growth.
• It determines how long relationships last, which determines lifetime value, which determines what you can afford to spend to acquire. Attrition sits upstream of nearly every other number here.
• It is invisible without measurement. A busy week feels like a healthy practice, and a practice can feel busy right up until the month it does not.

How it works here

1. Define active

   Usually seen within the last twelve months. Whatever you choose, keep it fixed — a moving definition makes the trend meaningless.

2. Count the disappeared

   Patients active a year ago who have not returned since, as a share of that starting group. That percentage is your attrition rate.

3. Reactivate before you replace

   A lapsed patient already knows and trusts you, and costs a fraction of a stranger to bring back. Most practices spend on strangers while a reactivatable list sits untouched in the records.

Questions owners ask

Some attrition is normal, surely?

Yes — people move, budgets change, priorities shift. The question is never whether you have attrition but whether it is 20% or 50%, and no practice can answer that from memory.

How do I bring lapsed patients back without sounding desperate?

By having a reason that is about them rather than about your diary — the interval on their treatment has passed, a new option suits what they came for, their points are sitting unused. The system knows who is due and why, which is what makes the message land as care rather than as a promotion.

Related

• Repeat Rate (Rebook Rate)The share of patients who come back within a set window — the most under-measured number in aesthetic practice.
• Lifetime Value (LTV)What one patient is worth across the whole relationship, not the first appointment — treatments, retail and referrals included.
• Marketing AutomationFollow-up that happens on its own — the reminder, the reactivation, the seasonal campaign nobody has time to send.
• CRMOne place where every enquiry, patient and follow-up lives, so nothing depends on somebody remembering.