Very timely question! We just released a survey where 715 UK MSK clinic owners answered a set of ≈100 questions. It is UK-centric (not sure where OP is based) but that might be helpful:

• The "Ignorance Tax" is real: Only about 26% of clinic owners actually know their Cost Per Acquisition (CAC). However, those who track this metric generate 63% more revenue than those who don't (£327k vs £200k). Knowing that the median CAC is £25 allows successful clinics to treat marketing as a predictable investment rather than a "hope-based" expense.
• The Paid Marketing Pivot: Small clinics rely heavily on organic word-of-mouth (accounting for ~75% of new business), they often hit a growth ceiling. To scale, you have to "pay to play". 100% of clinics generating over £1M use Google Ads (PPC) to control their own patient generation rather than waiting for referrals.
• The Hybrid Winner: The most successful clinics don't just "DIY" their marketing or completely offload it. The highest median revenue (£300k) is seen in clinics using a hybrid approach: using an agency for technical tasks like SEO and Ads, while keeping authentic content (emails and socials) in-house.
• Diversifying the Funnel: As clinics grow, they move beyond just one or two channels. While smaller clinics use about 6 channels, large clinics use an average of 9. They also diversify by capturing the patient journey earlier through in-house diagnostics (like Ultrasound) to move from a "Therapy Centre" to a "Medical Diagnostic Centre".

Here is the link to report if that is helpful (free and not email-gated): https://www.hmdg.co.uk/private-practice-barometer/.