Overview

Part start-up story, part industry conversation, this episode looks at what it really takes to grow a clinic when nobody knows who you are yet.

Michael sits down with Josh Newsom, founder of Ancoats Chiropractic, to talk about opening a clinic just a year after qualifying, building it from scratch, and learning very quickly that getting patients through the door takes more than simply being good clinically.

They get into the changing face of chiropractic, why younger chiropractors are moving towards more evidence-based care, and how Josh has built his clinic around rehab, patient education and a broader MSK approach rather than relying purely on adjustments.

But the bigger theme running through the episode is relationship marketing.

Josh explains how office talks, local businesses, run clubs, referrals, and simply getting out into the community helped grow the clinic when traditional marketing budgets were limited. Michael and Josh explore why these relationships can be one of the most valuable growth tools for a new clinic, especially in the early stages when nobody knows your name yet.

Show Notes

• Why Josh opened a clinic so soon after qualifying
• The changing reputation of chiropractic
• Moving away from adjustment-only models
• Combining chiropractic with rehab and MSK care
• Educating patients who only want to be adjusted
• Bringing physiotherapy into a chiropractic clinic
• Why legal and financial advice matters when starting out
• Building a clinic with very little marketing budget
• Using office talks to generate new patients
• Why cold outreach can still work
• Building relationships with local businesses
• Growing through run clubs and community connections
• Turning happy patients into referral sources
• Making referrals more personal to individual clinicians
• Incentives, bonuses and team performance
• Hiring for personality rather than just clinical experience
• Why relationship marketing matters so much for start-up clinics

What You’ll Learn

• Why being a good clinician is not enough to grow a new clinic
• How relationship marketing can generate patients without a huge ad budget
• Why local businesses can become valuable referral partners
• How office talks can create completely new patient streams
• Why existing patients can be one of your best marketing channels
• How to make referrals part of the patient journey
• How to make referral conversations feel more personal
• How rehab can sit alongside chiropractic care
• Why hiring for personality can matter more than experience
• What Josh learned from taking investment too early
• Why good legal and financial advice matters from day one
• How relationships can help a clinic grow before paid marketing really kicks in

Who This Episode Is For

• New and aspiring clinic owners
• Chiropractors considering opening their own practice
• MSK clinic owners trying to grow locally
• Healthcare businesses with limited marketing budgets
• Practice owners looking to generate more referrals
• Anyone interested in relationship-led clinic growth

Guest Details

Josh Newsom - Founder, Ancoats Chiropractic

Josh Newsom is the founder of Ancoats Chiropractic in Manchester.

After qualifying as a chiropractor, Josh opened his own clinic within around a year and has spent the last two years building the business, growing the team and developing a more evidence-led approach to chiropractic and rehabilitation.

Much of the clinic’s early growth came through relationships, referrals, local businesses and community connections, an approach that has helped Josh build visibility in a highly competitive Manchester MSK market.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

Overview

Building a physio business sounds great until you realise you are now responsible for absolutely everything.

In this episode, Michael sits down with Jack Howard, founder of Warwickshire Home Physio, to talk honestly about what it has taken to grow the business over the last five years.

They go back to the early days of bad systems, a homemade website, very little structure and a lot of trial and error, before getting into what actually changed as the business grew.

The conversation covers burnout, hiring, working with your partner, moving from clinician to manager, building a team, patient retention, gamifying rehab, and why Jack eventually realised that growing the business meant spending less time treating patients himself.

They also discuss what home physio can teach the wider MSK industry about patient experience, long-term relationships, simple rehabilitation and doing things differently.

Show Notes

• Jack’s move from the NHS into private practice
• Starting a business with very little commercial experience
• The early mistakes behind Spiral Health Physio
• Rebranding to Warwickshire Home Physio
• Why systems matter as the business grows
• Working with your partner and trying to switch off
• The reality of burnout and poor work-life balance
• Why growth gets harder when you start hiring
• Moving from clinician to business owner
• What the Private Practice Barometer changed for Jack
• Hiring for personality and soft skills
• Building structure, supervision and training into the team
• Why patient relationships matter so much in home physio
• Gamifying rehab without overcomplicating it
• Why low-tech rehab can still be highly engaging
• Patient retention and the value of small gestures
• Standardising the patient journey
• Why Jack now spends less time treating patients
• Building local relationships and creating organic growth
• Whether traditional clinics should offer home physio

What You’ll Learn

• Why starting a clinic without proper systems quickly creates problems
• How business growth can damage work-life balance
• Why hiring does not automatically make life easier
• When a clinic owner needs to step away from treatment
• Why personality can matter more than experience when hiring
• How regular supervision helps newer clinicians develop
• Why long-term patient relationships improve retention
• How to make rehab more engaging without expensive technology
• Why small investments in patient experience can make a big difference
• How to create more structure across a growing team
• Why business owners need dedicated non-clinical time
• What home physio can teach clinics about service and accessibility

Who This Episode Is For

• MSK clinic owners growing their first team
• Physiotherapists considering starting their own business
• Home physio providers
• Clinic owners struggling with burnout
• Practice owners trying to step away from full-time clinical work
• Anyone interested in patient experience, retention and team development

Guest Details

Jack Howard - Founder, Warwickshire Home Physio

Jack is the founder of Warwickshire Home Physio, a home-based physiotherapy service built around delivering rehabilitation in patients’ own environments.

After leaving the NHS and starting the business during COVID, Jack spent the next five years learning how to move from sole practitioner to business owner.

Today, Warwickshire Home Physio has grown into a wider team, with Jack increasingly focused on management, training, business development and building a more consistent service across the company.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

About this episode

What does it actually take to open a physiotherapy clinic and make it work?

In this episode, Michael sits down with Richard Higgs, owner of Handforth Physiotherapy and Rehab, to talk through the first seven months of building the clinic.

They cover visibility, location, team development, employed versus self-employed models, mentorship, marketing, patient experience and why clinics need more than one way for patients to enter the business.

They also discuss investing in new services, lifetime value, and why sometimes the biggest lesson is simply backing yourself.

Show Notes

• Richard’s journey from the NHS to clinic ownership
• Why a completely full diary is not always a good thing
• Choosing a visible clinic location
• Naming the business after the local area
• Supporting newly qualified clinicians
• Building a culture of learning and development
• Employed versus self-employed models
• Giving clinicians responsibilities beyond treatment
• Investing in CPD and protecting the business
• Creating a clinic environment people want to be in
• Community visibility and local marketing
• Why constant promotional posting becomes noise
• Meta ads, SEO and AI search
• Using WhatsApp to improve patient communication
• Building multiple entry points into the clinic
• Pilates, massage and specialist services
• Understanding lifetime value
• Richard’s biggest lessons from opening the clinic
• Why every investment should add value
• Backing yourself as a clinic owner

What You’ll Learn

• Why visibility matters before any marketing begins
• How location and naming can influence growth
• Why development and progression can improve retention
• How mentorship can work inside a growing clinic
• Why employed teams can make culture easier to build
• How patient experience extends beyond treatment
• Why some marketing works better than others
• How specialist services can create new revenue streams
• Why lifetime value matters
• How to think about investment commercially
• Why confidence matters when starting a clinic

Who This Episode is For

• New and aspiring clinic owners
• Physiotherapists considering private practice
• Small and growing healthcare businesses
• Clinic owners building their first team
• Newly qualified clinicians
• Anyone interested in the reality of opening a physio clinic

Guest Details

Richard Higgs – Clinical Director and Owner, Handforth Physiotherapy and Rehab

Richard is a physiotherapist with around 15 years of experience across the NHS and private practice.

After running a smaller physiotherapy business from a single treatment room, he opened Handforth Physiotherapy and Rehab in East Cheshire.

His approach focuses on visibility, patient experience, clinician development and building a clinic where both the team and the business can grow.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

About this episode

The MSK industry is full of new technology, new ideas and new ways to sell healthcare. But how much of it genuinely improves patient care, and how much is simply hype?

In this episode, Michael sits down with Jack Chew to discuss longevity medicine, AI, rehabilitation technology, commercial incentives and the future of physiotherapy.

They explore the risks of overtesting, the role of gamification and objective measures, why younger clinicians need better mentorship, and how AI could reshape private practice.

They also discuss professional standards, innovation, the MSK Awards, and why success in healthcare should be measured by more than revenue, clinic size and growth.

Show Notes

• Longevity medicine, preventative healthcare and the risks of over-testing
• Technology, screening and the danger of always looking for something to “fix”
• Why pain and injury are more complicated than simple biomechanics
• Gamification, objective testing and measuring meaningful progress
• Why younger clinicians need better mentorship
• Commercial KPIs and the pressures facing clinicians in private practice
• AI scribes, productivity and what clinics should do with the time they save
• How AI could change the future of physiotherapy
• Professional standards, regulation and consistency of care across MSK
• Why the industry needs better incentives for genuinely good practice
• Innovation, treatment styles and unnecessary division within MSK
• The MSK Awards and recognising great clinicians, clinics and services
• What success should really look like for a clinic owner
• Why bigger clinics and higher revenue do not automatically mean better businesses
• Innovation across the MSK industry, from software to rehabilitation technology
• How Jack’s views on touch and hands-on care have changed over the last decade

What You’ll Learn

• Why preventative healthcare can become problematic when testing creates problems that were never causing symptoms
• How technology can be useful without becoming the reason patients are repeatedly treated
• Why rehabilitation should focus on meaningful function rather than simply correcting measurements
• How gamification can motivate patients when it is tied to the right goals
• Why objective testing needs to sit within a much wider clinical picture
• Why mentorship is one of the biggest challenges facing early-career clinicians
• How commercial incentives can influence the way clinicians assess and treat patients
• Why saving clinicians time with AI does not automatically make a clinic more productive
• How clinics could use AI-generated productivity gains to improve services, outreach and patient care
• Why AI could fundamentally change what patients expect from private physiotherapy
• Why the MSK industry needs better incentives for good practice and stronger consequences for poor practice
• How professional identity and attachment to specific treatment methods can prevent constructive debate
• Why innovation needs to be encouraged rather than automatically criticised
• Why a successful clinic does not have to become a large multi-site business
• How personal goals, family life and lifestyle should influence the way clinic owners define success
• Why profitability matters without needing to become the sole purpose of a healthcare business
• Why human touch may remain an important part of physiotherapy even as technology becomes more prominent

Who This Episode is For

• Clinic owners and healthcare founders
• Physiotherapists, osteopaths and other MSK clinicians
• Newly qualified and early-career physiotherapists
• Clinic managers responsible for performance and clinician development
• Healthcare professionals interested in AI and emerging technology
• Clinicians interested in rehabilitation, testing and patient experience
• Anyone working in or around the private MSK industry
• Healthcare professionals questioning where the industry is heading

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.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

About this episode

Clinic owners spend a lot of time talking about what clinicians should do better. Far fewer ask clinicians what clinic owners are getting wrong.

In this episode, Michael sits down with osteopath Chloe Gibson to explore what running a clinic looks like from the clinician’s side.

They discuss why self-employed clinicians are often treated like employees without receiving the security or support of employment, why new hires are brought into clinics without enough patient demand, and why mentoring is often too vague, inconsistent or clinically narrow.

They also examine the tension between commercial KPIs and ethical patient care, the role of hands-on treatment, what actually creates patient loyalty, and why patient experience often matters more than clinical credentials.

The conversation also covers work ethic, younger clinicians, business education, technology, difficult patients, gender in MSK healthcare, and why clinic owners may be hiring for the wrong qualities.

Show Notes

• Where clinic owners consistently go wrong
• Self-employed clinicians being treated like employees
• Why hiring before there is enough patient demand fails
• Employment versus contractor models in healthcare
• The problem with fragmented clinic systems and expectations
• KPIs, rebooking rates and ethical patient care
• Hands-on treatment versus exercise-led rehabilitation
• Why patient experience matters more than outcomes alone
• What makes patients trust and return to a clinician
• Hiring for personality, communication and emotional intelligence
• Why clinical knowledge is useless without communication skills
• Technology, shockwave, force plates and unnecessary investment
• What newly qualified clinicians actually need from mentorship
• Why business and financial education should be part of clinical training
• Work ethic, work-life balance and changing expectations
• Managing difficult patients
• Reviews, referrals and long-term patient loyalty
• Gender, authority and patient preferences in MSK healthcare

What You’ll Learn

• Why filling a clinician’s diary should begin before they are hired
• How contractor models can damage culture, consistency and retention
• Why strict KPIs can create poor clinical and commercial decisions
• How good communication improves both patient care and revenue
• Why patients often decide whether to return within the first few minutes
• What effective mentoring should include beyond clinical skills
• Why clinicians need to understand business, finance and profitability
• How patient experience drives reviews, referrals and repeat business
• Why expensive technology does not automatically create a better clinic
• What clinic owners should look for when recruiting clinicians
• Why long-term profitability usually follows good care rather than aggressive selling

Who This Episode is For

• Clinic owners and healthcare founders
• Physiotherapists, osteopaths and chiropractors
• Newly qualified and early-career clinicians
• Clinic managers responsible for recruitment and performance
• Healthcare professionals considering self-employment
• Clinicians planning to open their own clinic
• Anyone interested in the commercial realities of private healthcare

Guest Details

Chloe Gibson – Osteopath and Personal Trainer

Chloe is an osteopath with a background in personal training. She has worked across a range of private healthcare businesses, from small room-rental clinics to larger multi-site organisations.

Her experience gives her a direct view of the differences between well-run clinics and those that struggle with recruitment, culture, mentorship, patient experience and clinician retention.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

Overview

Most people see the success story of a business. Very few see what it actually costs to build one.

In this episode, Michael sits down with HMDG co-founder and his fiancée, Hannah, to talk honestly about what building HMDG actually looked like behind the scenes.

Not the polished LinkedIn version. The real version.

From having almost no money and wondering how they were going to pay bills, through to building and selling one of the best-known healthcare marketing businesses in the UK, this episode breaks down the stress, burnout, scaling problems, health scares and emotional pressure that came with it.

They also talk about building a business together as a couple, leadership, female founders in healthcare, selling the company, and why entrepreneurship often feels far less glamorous than people imagine.

Show Notes

• How HMDG actually started
• Going from broke to building a million-pound business
• Burnout, stress and health problems from scaling
• Working together as a couple
• Leadership, team culture and managing people
• Selling the company and the reality behind exits
• Female founders and being underestimated in healthcare
• Why business ownership can feel isolating
• The emotional pressure of entrepreneurship

What You’ll Learn

• What building a healthcare business really looks like
• Why growth often creates more stress, not less
• The hidden emotional cost of entrepreneurship
• Why systems become critical as businesses scale
• What selling a business actually involves
• How leadership changes as companies grow
• Why luck plays a bigger role than people admit

Who This Episode Is For

• Clinic owners and healthcare founders
• Entrepreneurs building service businesses
• Couples working together in business
• Healthcare professionals considering starting a company
• Anyone struggling with stress, burnout or scaling problems

Guest Details

Hannah Humphries – Co-Founder & Managing Director, HMDG

Originally trained as a physiotherapist, Hannah co-founded HMDG and helped grow it into one of the UK’s leading healthcare marketing businesses.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

Overview

Part honest conversation, part industry insight, this episode explores one of the most misunderstood topics in healthcare: sales.

Most clinics think they have a marketing problem. In reality, many have a follow-up problem. Enquiries come in through forms, phone calls, WhatsApp, social media, and email, but too often nobody really knows what happens next. Patients drift away, systems miss them, and clinics lose revenue without ever spotting where the leakage is happening.

In this episode, Michael sits down with Jared Aron, founder of Coherent, to talk about why sales should not be a dirty word in healthcare. They unpack patient drop-off, recall, reactivation, lead conversion, poor PMS data, and the hidden cost of clunky clinic systems. They also touch on how better visibility tools like the HMDG Capacity Engine (https://capacity.hmdg.co.uk/) and Retention Engine (https://retention.hmdg.co.uk/) can help clinics actually understand what’s going on beneath the surface.

Show Notes

• Why sales is misunderstood in healthcare
• Jared’s background in clinics and healthcare technology
• The idea of patient leakage and where clinics lose people
• Why PMS data is often inaccurate or misleading
• The gap between medical records and customer records
• Why many clinics stop following up too early
• How better follow-up improves lead conversion and recall
• What healthy inquiry-to-booking conversion can look like
• Why poor booking systems create friction and lost revenue
• How irrelevant automation trains patients to ignore clinics
• Why timing, channel, and relevance matter in patient communication
• The real ROI of better follow-up

What You’ll Learn

• Why sales in healthcare is really about better follow-up
• How clinics lose patients without realising it
• Why PMS retention figures can be misleading
• What stronger lead handling actually looks like
• Why consistency matters as much as speed
• How reactivation varies across different services
• Why poor systems reduce bookings
• How better communication can improve conversion
• Why tools like the Capacity Engine (https://capacity.hmdg.co.uk/) and Retention Engine (https://retention.hmdg.co.uk) help you understand performance properly
• Why ROI includes both revenue gained and time saved

Who This Episode Is For

• Private practice owners who feel they are losing patients
• MSK clinic owners looking to improve conversion and recall
• Healthcare businesses frustrated by poor systems and messy data
• Practice owners who want growth without being overly salesy
• Marketing and growth teams working with clinics

Guest Details

Jared Aron - Founder, Coherent

With a background in clinic leadership, medical devices, and healthcare technology. After seeing how difficult it was for clinics to manage patient drop-off, retention, and recall with existing systems, he founded Coherent to help practices improve revenue by fixing leakage across the patient journey.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100

Overview

Part industry analysis, part honest conversation, and a clear reality check for clinic owners who want to know where they actually stand.

Most clinics don’t know what the average physio appointment costs in their region. They don’t know what a good rebooking rate looks like. They don’t know whether their marketing spend, utilisation, or team structure is healthy compared to the rest of the industry.

In this episode, Michael sits down with Alex Kyriacou, co-owner of Flex Physiotherapy, to walk through the results of the Private Practice Barometer, one of the largest benchmarking surveys ever conducted in the MSK industry.

Using data from hundreds of clinics, they compare Flex Physio’s numbers against national benchmarks. From pricing and retention to staffing models, technology, marketing costs, and owner wellbeing, the conversation explores what “normal” actually looks like in private practice.

Show Notes

• Why the Private Practice Barometer was created
• How Flex Physio grew from satellite clinics to a 13-person practice
• Typical physio pricing across the UK and how Flex compares
• Why raising prices doesn’t necessarily reduce patient demand
• Admin support, staffing models, and clinician productivity
• PAYE vs contractor clinicians and the impact on culture
• Utilisation rates: what a healthy diary actually looks like
• DNA rates and systems that reduce missed appointments
• Rebooking rates and the role of patient trust
• Technology in modern clinics: ultrasound, shockwave, and force plates
• Understanding patient acquisition cost and marketing spend
• Why many clinics lack financial visibility
• Scaling vs staying small, and the reality of clinic growth

What You’ll Learn

• Why most clinic owners don’t know their true performance benchmarks
• How pricing compares across different UK regions
• Why raising prices often improves retention
• The systems that reduce DNAs and improve rebooking
• What a healthy utilisation rate actually looks like
• How admin support affects clinician productivity
• Why contractor models can limit long-term growth
• The relationship between clinic size and owner happiness
• How technology can increase pricing power and retention
• Why understanding patient acquisition cost matters

Who This Episode Is For

• Private practice owners who want to benchmark their clinic properly
• MSK clinicians thinking about starting or scaling a practice
• Clinic owners unsure whether their numbers are “good” or “bad”
• Healthcare businesses trying to improve profitability
• Practice owners who want clearer strategic decisions

Guest Details

Alex Kyriacou - Co-Owner, Flex Physiotherapy

Alex is a physiotherapist and co-owner of Flex Physiotherapy in Burgess Hill, Sussex. After joining as an associate in 2019, he became part of the leadership team alongside founders Matt Prout and Kieran Barnard.

Flex has grown from small satellite clinics into a multidisciplinary practice with a rehabilitation gym, diagnostics, and a team of more than a dozen staff.

Alongside running the clinic, Alex continues to work full-time in the NHS, giving him a unique perspective on both public and private healthcare systems.

Visit https://hmdg.co.uk for further information.

Follow Michael on LinkedIn. https://www.linkedin.com/in/mjschumacher100