Podcast Ep 308: How Ruairí Gough built a global healthcare payments platform from a kitchen table in Wexford.
When Ruairí Gough began building websites for dentists from his kitchen table in Wexford 15 years ago, he says less than 10% of Irish dentists had any online presence.
“You would stumble across a dental practice more so than find them online,” he recalls. “When I Googled them, none of them would pop up.”
“There needs to be a fundamental focus on entrepreneurs like myself who are ingrained in the local community”
The gap between how dentists worked and how patients behaved would eventually shape the direction of his business.
What started as a regional digital marketing operation evolved into Paytient Payments, a healthcare payments platform that now processes orthodontic and dental membership payments across Ireland, the United Kingdom and beyond.
A market in the gap
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Gough did not set out to build a fintech company. The opportunity emerged in 2018 when several long‑standing dental clients asked for help introducing digital payment services for high value treatment plans.
“A typical example might be a mother with two children going to an orthodontist and the bill would be maybe €3,500 to €4,000. Typically, 99% of people plus do not have that money readily available,” he says.
Traditional payment providers offered card processing but lacked understanding of the long, multi instalment arrangements typical in orthodontics. After searching for a suitable partner, Gough approached Irish firm Sentenial and its Nuapay business. The partnership gave Paytient access to SEPA and BACS processing as well as early open banking software.
“The quickest way to get up and running inexpensively was to partner with somebody who was regulated and authorised,” he explains.
Paytient processed €50,000 for four clinics in its first year. Gough describes the early product as basic but functional. “It worked and clinics immediately saw the benefit,” he says.
Orthodontic growth fuels expansion
The company gained momentum during the pandemic. Clinics adopted digital workflows and patients became more comfortable setting up payment plans from home or on their phones. At the same time orthodontics entered a period of rapid expansion driven by the rise of clear aligners and a growing adult market. “People in their fifties and sixties are now seeking orthodontic treatment,” Gough says. “People are taking a lot more care of their teeth.”
A partnership with a major orthodontic group proved decisive. It clarified the company’s ideal customer type and accelerated growth.
Paytient built out its technology with new APIs that integrate with practice management systems such as Dentally and Orthobridge. It also launched Sterling and BACS (Bankers Automated Clearing System) capability as well as a dental membership plan product. Gough estimates that the United Kingdom dental membership market exceeds £1bn a year.
A regional founder in a Dublin‑centric ecosystem
Gough built the business from Wexford after leaving Dublin due to housing costs. He sees location as an asset rather than a hindrance.
“I love the country. I love being by the sea. I love the lifestyle,” he says. The nearby Hatch Lab technology hub provided a professional base and a community of founders. “What they wanted to create was technology and high salary professional services and they have been successful in doing that,” he adds.
He believes regional infrastructure has improved significantly. More than two hundred connected hubs now support remote and hybrid working across Ireland. “This is game changing even for a small country like ourselves,” he says.
A founder’s workload and the challenge of scale
The entrepreneurial narrative often conceals the strain of early stage building. Gough says running a bootstrapped fintech requires constant multitasking. “It is like a flying bicycle going over the edge of a cliff and you are trying to put the bike together before you hit the ground,” he says. “You have to wear a lot of hats.”
Paytient has never raised external investment although Gough acknowledges interest from industry groups. Bootstrapping has required careful financial management. “It is not easy with the expense of daily family life and unpredictable income,” he says. His advice to founders is simple: “Know your market, charge clients from day one and secure a second income source to avoid unnecessary pressure.”
He argues that Ireland needs stronger pre seed support for companies that have proven product market fit. Rising operating costs, including server fees that he expects could reach ten to fifteen thousand euros a year, make early funding more important for regional businesses rooted in their communities. “There needs to be a fundamental focus on entrepreneurs like myself who are ingrained in the local community,” he says.
A business shaped by customer conversations
Despite the company’s growing platform and technical sophistication, Gough keeps the focus on daily client relationships. “The most important thing has always been talking to clients,” he says. “How are we doing? How can we improve? What other features or products should we build into our platform?”
Paytient is exploring new healthcare verticals including optical, veterinary, cosmetic and hospital services. Gough believes the company is now entering its next phase. Having established a functioning payments infrastructure and secured a growing base of clinics, he is concentrating on scale rather than survival.
From a kitchen table in Wexford to partnerships across Europe, Gough’s story reflects the changing character of Irish entrepreneurship.
It is shaped by regional hubs, sector specific knowledge and patient demand for more flexible healthcare payments.
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