Deliverability hinges on sender reputation, correct email authentication (SPF, DKIM, DMARC), list health and the content and engagement signals your messages generate. Reputation builds over time through consistent sending patterns, low bounce rates and few spam complaints; authentication helps mail servers verify your domain and prevents spoofing. List hygiene — removing hard bounces, validating new addresses and re-engaging inactive recipients — preserves the engagement metrics ISPs use to decide inbox placement. Selecting an Email Service Provider (ESP) with a solid reputation and clear data-handling policies is also important for small clinics aiming for local compliance and predictable deliverability.

Consent under the Act may be express or inferred depending on context, and clinics must be able to show when and how consent was obtained for marketing or informational messages. Express consent is best for marketing — ask patients to opt in at booking or via web forms — while inferred consent can cover transactional messages like appointment confirmations where a prior relationship exists. Record consent in your CRM or practice system with date, method and purpose; this helps with compliance and preserves deliverability if questions arise. Also minimise health details sent by plain email and, when necessary, use secure portals to reduce privacy risk and complaint triggers.

Prevent complaints with clear opt-in language, sensible frequency limits and a visible unsubscribe link in every message. Process unsubscribe requests quickly and make sender identity explicit in the header and preheader to avoid confusion that leads to spam reports. Track complaint rates and add alerts that pause campaigns if complaints spike, then investigate segmentation or messaging errors that might be the cause. These operational controls reduce regulatory exposure and improve the engagement signals ISPs use to decide inbox placement.

An engaged patient list begins with ethical opt-ins at multiple touchpoints and steady hygiene to preserve the engagement signals that drive deliverability. First-party sources — reception sign-ups, online booking confirmations and consent checkboxes — produce higher-quality lists than purchased data. Regular hygiene tasks such as removing hard bounces, validating new addresses and running re-engagement campaigns for inactive patients keep lists healthy and lower bounce and complaint rates. Below is a short step list for ethical growth, followed by segmentation guidance so clinics can match messages to patient needs and lifecycle stage.

Collect consent at point of care and sync list records with your CRM so segmentation reflects clinical context and patient preferences over time.

Grow your list ethically with clear consent wording, purpose limits and easy ways for patients to update preferences. Use brief consent prompts at booking or on intake forms that explain the types of emails patients will receive — reminders, recalls, newsletters — and offer granular preference choices to reduce unwanted messages. Don’t buy third‑party lists: those contacts usually give low engagement and high complaint rates that harm deliverability. Finally, store consent metadata (where, when, how) centrally to prove lawful basis and refine segmentation by service type and patient choices.

Segment by lifecycle stage and clinical needs — new patients, active patients, lapsed patients and by treatment type — so messages meet expectations and increase relevance. Use behaviour signals like opens and clicks to build dynamic segments for re-engagement or for higher-frequency outreach to engaged groups. Example segments: appointment reminders for active patients, recall prompts for those due for check-ups, and condition-specific updates for patients who opted in. This reduces irrelevant messaging, lowers unsubscribes and complaints, and strengthens sender reputation over time.

When clinics prefer hands-on help turning these practices into patient-facing campaigns, Milkcan Marketing can create compliant, patient-centred email copy and templates that respect privacy and deliverability requirements. Our work complements in-house processes and provides practical support aimed at small practice owners who want measurable results.

Subject lines are often the biggest driver of opens: concise, benefit-led copy that sets expectations increases curiosity without tripping spam filters. Personalisation that stays non-sensitive — first name, service type or appointment date — makes emails feel relevant and safe, improving open and click rates while avoiding clinical details in headers. Run A/B tests to compare approaches and validate lifts, and always validate personalisation fields to avoid embarrassing errors. When paired with good list hygiene, controlled personalisation boosts engagement and helps your sender reputation.

Most patients read email on mobile, so responsive single-column layouts, clear CTAs and touch-friendly buttons improve usability and conversion. Keep content scannable with short paragraphs, clear headings and legible type sizes; ensure links are easy to tap and that the preheader communicates the main action for readers on the go. Mobile mistakes lead to fast deletes, low engagement and negative signals to mail providers — so test templates across common devices and clients and prioritise mobile-first design.