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No Appointment Necessary

No Appointment Necessary

著者： Michael Schumacher - HMDG
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This is the podcast clinic owners listen to when they’re done with gurus, funnels, blueprints, and templates pretending to be strategy. No hacks. No 'proven' 10X systems.


This comes from HMDG. We have worked with more than 1,000 MSK clinics. We see the accounts, the utilisation rates, the failed ideas, the profitable ideas, and the reality behind the noise. We do not deal in theory. We deal in numbers. Most of the industry advice collapses the moment it hits real-world finances.


You get the truth about how clinics actually grow. Why some print money while others burn out. What patient numbers mean once you stop pretending templates can fix capacity problems or that “mindset” builds a business. The idea that a clinic becomes successful because someone journalled harder is fantasy. We talk to people who have actually achieved something. Multi-site owners. True specialists. People with real P&Ls, not testimonial slides about a “life-changing £30k month”.


We break down marketing, pricing, staffing, finance, AI, and operations without pretending there is a magic blueprint that saves everyone. There isn’t. The only thing that works is understanding the fundamentals and executing them properly.


If you want comforting stories, find a guru. If you want the unfiltered reality of running a clinic, you’re in the right place.

© 2025 No Appointment Necessary
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  • No One Gets Out Alive! Networking for People Who Hate Networking

    No One Gets Out Alive! Networking for People Who Hate Networking
    2025/12/16

    Most clinic owners think they’re networking. Jonathan Shearer explains why they’re wrong.

    In this episode of No Appointment Necessary, Michael speaks with Jonathan Shearer, podiatrist and founder of Footsteps Clinic, about what networking actually looks like when it works. Not letters to GPs. Not one-off events. Not vague “being visible”.

    They unpack why networking fails for most clinics, how trust is built through consistency and inconvenience, and why transactional thinking kills long-term results. Jonathan traces his approach back to selling fruit and veg as a teenager, where presentation, urgency and human connection decided whether stock sold or rotted. The same principles now underpin his referral networks across sports clubs, businesses and communities.

    If you think networking “doesn’t work”, this episode explains exactly why.

    Show Notes

    Jonathan’s background

    • Nearly 30 years in podiatry
    • NHS training, then building a five-chair multidisciplinary clinic
    • How early retail work shaped his focus on presentation and experience

    Defining networking properly

    • Networking as a sphere of influence, not an activity
    • Why sending letters isn’t networking
    • Visibility vs trust

    Jonathan’s networking system

    • Why it starts with team culture, not referrals
    • Staff as the front-facing network
    • Why owner-only networking becomes a bottleneck

    How networking generates revenue

    • Real examples from football, hockey and sports clubs
    • Why inconvenience builds trust faster than pitches
    • How free help led to hires, referrals and new services

    The “free work” myth

    • When free help works
    • When it backfires
    • Why forcing early ROI leads to bad decisions

    Education as a lever

    • Small talks that produced the biggest clients
    • Why audience size doesn’t matter
    • Effort and follow-up over format

    Maintaining relationships

    • Networking as “watering a plant”
    • Why neglect kills results
    • How Jonathan cuts parasitic relationships

    Team-led networking

    • Staff attending events and visiting businesses
    • Why this needs PAYE or hybrid models
    • Why associate-only models struggle

    Tracking what works

    • Offers and vouchers for offline attribution
    • Why “vibes” aren’t metrics
    • Measurement still matters

    Cities vs towns

    • Why networking works anywhere if executed properly
    • Cities as opportunity-rich environments
    • Affinity beats geography

    Mindset

    • Networking isn’t about being extroverted
    • Fear of rejection is the real blocker
    • Start small, repeat, build confidence

    The 90-day reset

    • What Jonathan would do in the first 90 days
    • Visibility, relationships, talks and clubs
    • Why something has to give

    They finish on collaboration, why isolation fuels bad advice, and why real networking is about being known, trusted and useful over time.

    What You’ll Learn

    • Why most clinic owners misunderstand networking
    • Transactional vs transformational relationships
    • How trust is built through inconvenience
    • When free help works and when it doesn’t
    • How to turn teams into networking assets
    • How to measure offline networking properly
    • Why networking works in cities and towns
    • What to prioritise in your first 90 days

    Who This Episode Is For

    Clinic owners who think networking “doesn’t work”.

    Owners over-reliant on ads.

    Clinicians who hate selling but want sustainable growth.

    Guest Details

    Jonathan Shearer

    Podiatrist and founder
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    1 時間 1 分
  • From Cryo Chambers to Clinic Chains: The Carter & George Expansion Story

    From Cryo Chambers to Clinic Chains: The Carter & George Expansion Story
    2025/12/11

    Overview

    Most clinic owners fantasise about scaling. Rhys Carter actually did it.

    In this episode of No Appointment Necessary, Michael speaks with Rhys Carter, co-founder of Carter & George, about how a bored physio in Dubai, a conversation with Jamie George and an overbuilt first clinic turned into one of the fastest-growing MSK groups in the UK. They cover the early mistakes, the “celebrity effect”, the point Rhys had to stop treating, and why data, people and unit economics became the backbone of everything.

    Then they get into the part everyone wants: acquisitions, valuation reality, funding without investors, deal killers, multiples, and why most clinic owners have no idea what their business is actually worth. If you’re thinking about adding a site or selling a clinic, this is the clearest look you’ll get at what it really takes.

    Show Notes

    They start with the Dubai origins: Rhys losing interest in the Middle East, Jamie George visiting while injured, and the drunken brainstorm that led to a high-spec first clinic with a 3,500 sq ft lease, a cryo chamber and little understanding of the model.

    They unpack the Jamie George effect: why Rhys expected instant traction, why it didn’t happen, and why the real benefit was trust, not bookings. He explains why they intentionally avoided building the brand around Jamie to avoid risk and make the model scale.

    Michael pushes on the transition from physio to business owner. Rhys explains how COVID forced his first non-clinical day, why stepping out too early destroys most clinics, and why data changed how he thought. They discuss session averages, condition patterns and occupancy, and why acting on data separates real operators from dashboard collectors.

    They move to people and culture. Rhys outlines how Carter & George kept internal attrition around 5 percent, why most physios aren’t driven by money, and how letting staff design their own benefits changed engagement. They talk progression, mentoring and why loyalty is built through development, not perks.

    Part two covers scaling: the accidental first acquisition the day before COVID, the painful three-clinic phase, and why hiring a finance director made growth make sense. Rhys explains their three clinic categories—high performers, growers, need-sorting—and how they stop strong sites from subsidising weak ones.

    They break down valuations: what EBITDA really means, what gets added back, how directors’ clinical time must be costed, and why inflated multiples are rarely sustainable. They discuss deal traps like corporation tax, undeclared contracts, bad brokers and emotional attachment.

    They close with the psychology of selling: letting go, identity, and why you must be absolutely certain you want to sell before you do it.

    What You’ll Learn• How Carter & George scaled from one site to seventeen

    • Why celebrity branding rarely drives patient volume

    • When to stop treating and when not to

    • How to use data to change behaviour, not just track numbers

    • Why most MSK churn is preventable

    • How real clinic valuations are calculated

    • What multiples are realistic in 2025

    • Hidden costs sellers forget

    • How to fund growth without investors

    • What makes a buyer walk away

    Who This Episode Is For

    Clinic owners considering scaling, selling or acquiring. Clinicians thinking about stepping out of treatment. Anyone who wants commercial reality over industry myth.

    Guest Details

    Rhys Carter — Physiotherapist, co-founder and managing director of Carter & George. Known for rapid multi-site growth, transparent acquisitions and a data-driven, people-first operating model
    Email: rhys@carterandgeorge.co.uk
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    1 時間 10 分
  • Jack Chew - Live and Undressed. Part 1

    Jack Chew - Live and Undressed. Part 1
    2025/12/10
    Overview
    Most people in MSK talk about “community” like it’s a slogan. Jack Chew actually built one.

    In this episode of No Appointment Necessary, Michael sits down with Jack, founder of Physio Matters, co-creator of Therapy Live and clinic owner at Choose Health, for a blunt conversation about the realities MSK keeps avoiding. They start with the Timperley Trundle, a walking group that accidentally became a public health intervention, then dig into AI, business ethics, evidence, over-servicing, CPD, and why the industry still refuses to call out nonsense.

    If you want an honest look at where MSK is heading, this episode hits every nerve.


    Show Notes
    Michael and Jack begin with the Timperley Trundle: how a simple walking group grew into a 30–40 person weekly fixture with frailty testing, social cohesion and genuine clinical impact. Jack explains why real community work looks uncommercial but becomes the highest-trust marketing a clinic can do, and why most clinics copy it badly because they refuse to invest time or leadership.

    They move into AI and business practice: how AI is already acting as the new regulator by telling patients to avoid over-treatment, why free consultations and funnels force clinicians into unethical incentives, and how both chiropractors and physios fall into the same trap of causal storytelling dressed up as “specific” care. They discuss why many minor MSK issues would improve with time alone, and what happens when AI starts telling patients exactly that.

    The conversation shifts to evidence and education: the backlash to evidence-based practice, the gap between evidence-informed reasoning and NICE-worship, and how outdated university teaching still shapes clinical habits. They explore why CPD is broken inside most clinics, why owners rarely invest in learning for their teams, and how ideological silos replace critical thinking.

    They also confront the topics MSK avoids:
    • Why it remains too easy to be clinically poor and fully booked
    • How politeness culture protects weak ideas
    • The ethics of placebo, nudging and “ends justify the means” care
    • Why health tech and gamification can be powerful or pure theatre
    They close with Whoop, VO2 testing and full-body scanning outfits like Neko Health, and what these trends mean for future MSK clinics trying to stay credible without drifting into hype.


    What You’ll Learn
    • How community work becomes the strongest marketing a clinic can do
    • Why funnels and packages push clinicians toward over-servicing
    • How AI exposes weak reasoning and inflated clinical claims
    • Why evidence-based practice is under attack
    • How outdated education harms new grads
    • Why CPD is weak in most clinics
    • How tech and gamification help or mislead
    • What future-proof MSK clinics will need to survive


    Who This Episode Is For
    Clinic owners, physios, osteopaths, chiros, sports therapists, new grads, and anyone who prefers honest industry analysis over polite noise. Essential listening for anyone preparing for a future where AI shapes patient expectations and exposes poor practice.


    Guest Details
    Jack Chew — Physiotherapist, founder of Physio Matters, co-creator of Therapy Live and co-owner of Choose Health. Known for calling out nonsense, modernising MSK reasoning and building genuine community initiatives. One of the few voices in MSK willing to say what others won’t.
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    1 時間 8 分
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