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Jack Howard on Growing a Home Physio Business Without Losing Your Mind · No Appointment Necessary

• 0:00
  Michael: Welcome to the latest appointment of No.
• 0:02
  Michael: Do you know what?
• 0:02
  Michael: I'm gonna stop with this intro.
• 0:04
  Michael: Let's just get into it.
• 0:06
  Michael: They've pressed the link.
• 0:07
  Michael: We'll leave that in.
• 0:08
  Michael: They've already pressed the link, they know what it's called.
• 0:10
  Michael: Exactly.
• 0:11
  Michael: Uh I should have some music.
• 0:12
  Michael: Anyway, welcome everyone.
• 0:13
  Michael: Today we have Jack Howard with us, who is probably and was my least favourite person in the world for a small amount of time.
• 0:21
  Michael: Only joking.
• 0:22
  Michael: Jack runs Warwickshire Home Physio.
• 0:24
  Michael: Um and we've got quite an interesting story because we were there as a company and I was there from pretty much the start.
• 0:30
  Michael: Not quite, but but close to it.
• 0:32
  Michael: And I think it'll be really interesting today to discuss your journey from my Christ, what have I done to shit, everything's going well.
• 0:38
  Michael: So welcome Jack.
• 0:40
  Michael: And if you want to give us a very w very brief intro, who are you?
• 0:44
  Michael: And and we'll go from there.
• 0:45
  SPEAKER_00: So yeah, I'm Jack.
• 0:46
  SPEAKER_00: I currently run Warwickshire Home Physio.
• 0:49
  SPEAKER_00: Met Michael about five years ago, um, which was about six, yeah, six to nine months after I set up uh what was then Spiral Health Physio, um, which Michael had some pretty strong opinions about from the offset, but we uh yeah, eventually I took the advice on and changed Warwickshire Home Physio.
• 1:06
  SPEAKER_00: But yeah, we've been working together for a long time.
• 1:10
  Michael: I can't believe it's five years.
• 1:11
  Michael: Yeah.
• 1:12
  Michael: Literally, time flies.
• 1:13
  Michael: Like we were saying before, when I still had hair, honestly, it's just flown by.
• 1:17
  Michael: I think you've got a really interesting story.
• 1:18
  Michael: And let's start right at the beginning because you came to us, life wasn't fantastic, you were running spiral home health, it it was you know, not all going exactly how you wanted.
• 1:30
  Michael: And and we had our first call, and I probably very arrogantly said, right, let's change all of these different things.
• 1:36
  Michael: And you went, Oh my god.
• 1:38
  Michael: And I think and I think most of them we did, but give g what give us an example.
• 1:42
  SPEAKER_00: What eventually I was I was resistant at first, but in certain areas, but also willing to listen in other areas.
• 1:48
  SPEAKER_00: I think I had the concept of home physio, and the unique part of it was that I was gonna drive round in a van which was full of equipment, and you one of your suggestions actually was to ditch the van and go round on a bicycle instead.
• 2:04
  SPEAKER_00: You were deciding I should make it really, really unique and I should be physio on a bike, and we were just like brainstorming ideas, and I went, no, I'm not gonna go around on a bike.
• 2:12
  SPEAKER_00: I think I had a logo that was designed on like Microsoft Paint and a website that I'd done myself on Wix, and then I was asking you to run ads and SEO to to that website.
• 2:23
  SPEAKER_00: And I think in the interim period, while you guys were building me a new website, like things were not going well for like the first three to six months.
• 2:31
  SPEAKER_00: We were struggling to get the ads to like generate any like leads or and so yeah, I eventually we got the new website done and that made a difference.
• 2:41
  SPEAKER_00: But yeah, the early days were definitely tough, and I think you maybe didn't have that many home physios on your books either, so it was like a learning experience for for for both parties.
• 2:51
  Michael: It's interesting because we did we did actually have a few.
• 2:53
  Michael: We always knew how hard it was, but I think yours was a slightly more of a unique situation in the I think first of all, very early stage business.
• 3:00
  Michael: Second of all, I think you because you were quite green to running a business, I think that is always difficult when you're a marketing agency because you if you look back now at how you're running things, how you retain patience and so and so on and so forth, it that that always makes life difficult.
• 3:16
  Michael: Just little things like availability and how you backed it in travel time and those sorts of things, which gave us less availability.
• 3:22
  Michael: It was it was all very yeah, it was all very very, very difficult.
• 3:26
  Michael: And we had I don't know how many calls you you chart constantly, often moaning actually to be fair, which is fine.
• 3:31
  Michael: That's it's sort of standard stuff.
• 3:33
  Michael: But it was it was really tough.
• 3:34
  Michael: And and I think when where where it all turned around, I think initially was where we actually changed the name of the business.
• 3:41
  Michael: Because I think that made a a huge difference at that point in time.
• 3:45
  SPEAKER_00: I think we yeah, I partly agree, but we actually I only changed the business name about twelve, just over twelve months ago that we actually did the rebrand.
• 3:55
  SPEAKER_00: So for a good three years we were persisting with Spiral Health.
• 3:58
  SPEAKER_00: But we were running off of two sites, weren't we?
• 4:00
  SPEAKER_00: But we trialed and we did like an an A-B thing where we trialled a Warwickshire home physio site for a little while.
• 4:07
  Michael: Yeah.
• 4:07
  SPEAKER_00: Before finally settling on it.
• 4:09
  SPEAKER_00: I mean, you said about the early stages, like I didn't have any systems in place.
• 4:13
  SPEAKER_00: It was just me.
• 4:14
  SPEAKER_00: I was in the wild west of private physio, and it was like I I was doing all my appointment bookings through a Google Calendar, I didn't have Clinico, I was just had my mobile number, people were contacting me on like I had absolutely nothing in place, and then still had the audacity to moan that we couldn't get any clients.
• 4:32
  Michael: But so let's explore that because I think that's really interesting.
• 4:35
  Michael: I I think we can explore some actually some more advanced topics later on.
• 4:39
  Michael: So I don't want everyone to think that we're just gonna talk about someone who started as a physio and the early problems.
• 4:44
  Michael: But I think they they're interesting, and and one of those things I want to explore is you know, you were an NHS physio and you thought to yourself, I want to run a business.
• 4:53
  Michael: Now, if I decide to myself, you know what, I want to start running, that's one thing.
• 5:07
  Michael: And slack bang in the middle of COVID, yeah.
• 5:09
  Michael: And slacking in the middle of COVID.
• 5:11
  Michael: What why?
• 5:12
  Michael: First of all, why?
• 5:13
  SPEAKER_00: I uh yeah, I became pretty disillusioned working in HS because of COVID, partly.
• 5:18
  SPEAKER_00: I always had a bit of an issue with the authority and the red tape and stuff, and I think the final straw was actually when there was like an announcement over the weekend that you know this this virus had come.
• 5:30
  SPEAKER_00: I was running like a group exercise class for people with lung and heart issues, and I said to my manager, I'm gonna cancel the class.
• 5:37
  SPEAKER_00: They said, We haven't been given instruction to cancel it.
• 5:40
  SPEAKER_00: I went ahead and cancelled it anyway, and then got called in for a disciplinary.
• 5:44
  SPEAKER_00: Meanwhile, Boris Johnson's announcing lockdown, and then I kind of looked at them and went, Do you think I made the right decision?
• 5:50
  SPEAKER_00: They went, Yes, but you went about it in completely the wrong way.
• 5:53
  SPEAKER_00: And I went, All right, handed in my notice because I think I'd already been thinking about it, and that was just the final straw.
• 6:00
  SPEAKER_00: But I did some calc, I I was in a a good place in terms of like I was living in a really cheap flat.
• 6:06
  SPEAKER_00: I'd done some maths that if I could see two or three clients a day, then I would earn the same amount of money as I would, and I knew that I could get a locum job like that.
• 6:16
  SPEAKER_00: So it was like an it's like a calculated risk, I would say.
• 6:21
  Michael: Yeah, there's risk and then there's calculated risk, a stupid risk and non-stupid risk.
• 6:26
  Michael: I think, particularly if you know you can always jump into another job.
• 6:29
  Michael: I had that actually.
• 6:30
  Michael: We started this up, yes, there was a risk in terms of losing lots of money, but I always knew I could walk into a job tomorrow in the corporate world, so it wasn't like I was gonna be on the streets.
• 6:38
  Michael: But I think what what is interesting is so you've got that part, fine, you take a risk, probably have a little bit of an issue with authority as well.
• 6:45
  Michael: So you wanted to be your own boss, but then beyond that, you still went into something.
• 6:50
  Michael: It's akin to me saying, you know what, I'm gonna do physio tomorrow, having no clue of what being a physio actually means.
• 6:56
  Michael: And you jumped straight in the deep end and you're like, I'm just gonna give this a go and hope for the best.
• 7:02
  SPEAKER_00: Yeah, I'm just a bit like that.
• 7:04
  SPEAKER_00: I think if you ask anyone that know me, uh they would say the same thing, like, I just throw myself into it, really.
• 7:10
  Michael: And and how did you uh because you know, you you know a lot of stuff now, and and I and I think that we we obviously covered a lot, we came up with lots of ideas, I gave you lots of ideas and so on, but there's there's a lot of learning outside of that, stuff we didn't do that you are now doing.
• 7:25
  Michael: Where did you learn that?
• 7:26
  Michael: Was that sort of self-taught through trial and error, or were you getting advice from other places?
• 7:33
  SPEAKER_00: There was a lot of trial and error.
• 7:34
  SPEAKER_00: I wouldn't say I had much advice from like no one in my family had ever like run their own business or anything.
• 7:41
  SPEAKER_00: It wasn't a case of like drawing on family members that knew how to do that.
• 7:45
  SPEAKER_00: It was just, I guess part of my personality was just like I always do a lot of like research into things, and we do live in a world where we've got unlimited information on the internet, whether that's good or bad, but you know, you can learn a lot of stuff on online, so there was that, but yeah, just learning as I went as well.
• 8:04
  SPEAKER_00: Like I made so many mistakes in the in the early stages, but you just learn from it and you know.
• 8:10
  SPEAKER_00: Do you wish you had ChatGPT back then?
• 8:12
  SPEAKER_00: Yeah, we didn't have any AI at all.
• 8:14
  SPEAKER_00: So that hence why my logo was on like Microsoft work paint or something, because like now you can just prompt it and it'll make you well, I think they're pretty crap the logos.
• 8:24
  SPEAKER_00: You can tell when it's AI, but had none of that for developing advice, like materials.
• 8:30
  Michael: You know, I remember there there was we were looking at three or four different locations, and to me, because I didn't know the area, uh, one of the locations sounded actually really good, but that's the sort of thing you can now put into GPT and say, I'm thinking of these locations, what do you think about the demographic?
• 8:45
  Michael: It'll actually spit you out some really good advice.
• 8:47
  Michael: Um and if you think about all of the things that you were doing that you had to to try and error, now you could probably just say to ChatGPT, I'm on Google Calendar, what do I do?
• 8:57
  Michael: These are the problems.
• 8:58
  Michael: It probably would spit out something pretty decent for you.
• 9:00
  Michael: So I think entry now into running a business is way, way lower than or much, much easier than it was back then.
• 9:08
  SPEAKER_00: I think to a point, yeah, and it would be remiss of me not to say that the advice from you guys was really, really useful.
• 9:15
  SPEAKER_00: Um so I would draw upon conversations with you and your team.
• 9:20
  SPEAKER_00: And then especially in the last couple of years where everything's slotted into place.
• 9:24
  SPEAKER_00: I think you launching like circle and the business coaching made me realize if you want to run a business, you've got to do it properly, like actually have to commit to it because there it was a lot of education through that as well.
• 9:35
  SPEAKER_00: So I would say it's a really, really good community that you've got.
• 9:39
  Michael: Well thanks.
• 9:40
  Michael: Yeah, it's why we did it actually.
• 9:41
  Michael: I think it was it's just important to and it doesn't matter how advanced or how big your clinic, I think you should never stop learning, you should never just say, Oh, I know what I'm doing.
• 9:50
  Michael: A little bit like physio.
• 9:51
  Michael: If you still did everything from the textbook at uni, you'd probably be a pretty shitty physio.
• 9:56
  Michael: So I think as a business person you've got to continually learn and see what other people are doing, because there are always better ways of doing things.
• 10:01
  Michael: But I'm interested why at the start, whether it was money or whether it was something else, why you didn't hire a business coach.
• 10:07
  SPEAKER_00: I just hadn't even considered hiring a business coach, to be honest, because I I guess it was my own kind of project.
• 10:14
  SPEAKER_00: I was working on it myself, like that was the whole point.
• 10:16
  SPEAKER_00: I think as much I set it up for myself and I wanted to to go about it in the in my own way.
• 10:22
  SPEAKER_00: So I hadn't even considered a business coach.
• 10:25
  SPEAKER_00: I'm not even convinced I knew what a business coach coach was at that point, to be honest.
• 10:29
  Michael: Yeah, I mean w we did the same.
• 10:31
  Michael: It was very much let's just give it a go.
• 10:33
  Michael: Plus, I knew everything.
• 10:35
  Michael: Uh there was a bit of that as well, yeah.
• 10:37
  Michael: What can anyone else tell me?
• 10:39
  Michael: And then I realized after uh a year or two that I needed some some help and I actually got someone in who who was really useful.
• 10:45
  Michael: And but it it's sort of different for for a company like ours because there is so there are so many people out there, and there's so much info out there, and there's so many groups and so many people sharing information that you can learn a lot.
• 10:57
  Michael: It's harder in this industry, actually.
• 10:59
  Michael: I think the the best clinics don't necessarily you can't see what they're doing necessarily, they're not sharing it.
• 11:05
  Michael: There's less opportunity to learn from other clinics, I think, in this industry.
• 11:09
  Michael: It feels like you you can be quite isolated, which is why we set up our community with HMDG Connect, it's why we do the barometer, it's you know, all of this stuff is is because I think it's quite difficult to just even picking up the phone.
• 11:22
  Michael: I do wonder if it would work if I think with some it would, but if if you've got a guy, let me ask you this question.
• 11:27
  Michael: If you've got someone who picks up the phone and calls you and said, Jack, listen, uh I heard you on the podcast, or I I've seen what you're doing, I'm in your position like five years ago.
• 11:36
  Michael: Is there any chance you give me a hand?
• 11:37
  Michael: You know, could could I take you for a beer and get some advice?
• 11:40
  Michael: Would you give it?
• 11:42
  SPEAKER_00: Yeah, I would, yeah.
• 11:43
  SPEAKER_00: Whether or not they would listen to what I had to say is another point, but because I think in my my situation then I probably didn't reach out to anyone, whether that was right or not, who knows?
• 11:54
  SPEAKER_00: But I I would give the advice now, 100%.
• 11:57
  SPEAKER_00: Yeah.
• 11:57
  SPEAKER_00: I think I saw a post on Circle.
• 11:59
  SPEAKER_00: Someone said, Oh, I'm I'm setting up a a home physio service, and I kind of liked their post, and then I wrote out a comment that was like, Oh, if you want to reach out, like feel free.
• 12:10
  SPEAKER_00: I definitely would have time to do that.
• 12:13
  Michael: I love that, and I think there should be more collaboration.
• 12:15
  Michael: And you know, I I I think that the more everyone can help each other, I think the better the industry becomes.
• 12:22
  Michael: And there's an interesting uh old quote by Steve Jobs where he said uh he was about I think he I can't remember exactly what it was.
• 12:28
  Michael: I was 13 or 14, and I needed this stuff from Dell.
• 12:31
  Michael: And this is back in the days where you could pick up the yellow pages and find the or the directory and find the the chairman of Dell's number.
• 12:37
  Michael: So he phoned up this uh chairman of Dell, he said, uh look, I need these things for my project.
• 12:42
  Michael: And the guy said, Sure, and I'll give you more of it, but you've got to make me a promise.
• 12:46
  Michael: When you graduate, you come back here and you work for me because you're brilliant.
• 12:50
  Michael: And that's what actually happened.
• 12:51
  Michael: And Steve Jobs said, you know, he's never got a no from anyone when he's asked for something.
• 12:56
  Michael: It's very, very rare.
• 12:58
  Michael: And I I think the same is true.
• 12:59
  Michael: You know, I've always had that where if I phone someone up and I did this to a guy who ran this amazing agency that I really admired, and I said, Listen, would you mind if I just you know picked your brains a little bit and ask asked a few questions?
• 13:11
  Michael: He's like, No, sure, let's do it.
• 13:12
  Michael: Um, and in fact, I saw an agency only on TikTok the other day, and I reached out to him and I was like, Do you mind if we have a conversation?
• 13:18
  Michael: And uh, because I really loved what he was doing with this specific thing, and he was like, Yeah, let's catch up.
• 13:22
  Michael: So I think you can definitely uh you know, people should do more asking, you know.
• 13:26
  Michael: I think asking for help, but of course, you have to be in the position of accepting the help, I think, which sometimes not everyone is.
• 13:35
  Michael: So it was pretty tough, you know.
• 13:36
  Michael: You also it's worth mentioning that you worked with your fiance, and so you know, that brings another element and dynamic into it as well, because now there's two of you, and I think we we had a quick chat before, and you said that you both had you know nice incomes from the NHS, and then you jump into this.
• 13:52
  Michael: Um, what was that like, like working with your other half?
• 13:55
  Michael: And did it cause a ton of issues at home ever?
• 13:59
  Michael: Was it like for me, it's brilliant, I love it because you can, you know, you you're there 24-7, you understand each other's issues, or was it really difficult?
• 14:06
  Michael: Did it put strain on the relationship?
• 14:08
  SPEAKER_00: I think it's the best and worst part of working with your other half is that you are able to bounce ideas off each other as as soon as they happen.
• 14:16
  SPEAKER_00: I think it's worth noting that I basically had to beg her to come and join because I think she was like low-coming as a band seven and earning plenty of money doing that in the NHS, and then I was like, Yeah, but you can come and do this.
• 14:28
  SPEAKER_00: And eventually she caved and said yes, and then so yeah, we you know, we were working together on it and we we still are, but yeah, it's the best and worst part.
• 14:36
  SPEAKER_00: You can bounce ideas, but also where do you draw the line between you've been at work all day and then you come home and you put the kids to bed, and then you have dinner, and then you're still talking about work at 10 pm, and then you're like no time for other stuff.
• 14:50
  SPEAKER_00: So you have to then try and draw a line somewhere.
• 14:53
  Michael: I wonder if you can, and we'll get into that in a bit, but I do wonder if you can, because we never did.
• 14:58
  Michael: We haven't been on a holiday where we didn't talk or a dinner out or anything where we didn't talk business.
• 15:03
  Michael: So I do wonder if you can draw a line.
• 15:05
  Michael: If you can, we'll we'll we'll we'll get into that.
• 15:08
  SPEAKER_00: I guess I do think there's a reason that I think it's quite common that physios end up together.
• 15:12
  SPEAKER_00: Like I don't know many other professions where there's so many couples in and you you see someone from like Unia on on socials and they've ended up with another physio.
• 15:22
  SPEAKER_00: And like there's something about physios, I think, and the way we are that means that we're like drawn to each other.
• 15:28
  SPEAKER_00: And I I I think uh yeah, there's something in that because they I I don't know, there are so many physio couples.
• 15:35
  Michael: I think you're right, and and and and this is sort of sort of off the top of my head, but I can't remember in any industry that I've ever worked in having as many clients who are husband and wife owners of the businesses as these businesses.
• 15:48
  Michael: To be fair, I haven't, you know, in my old days I never really worked with sort of local service businesses.
• 15:54
  Michael: And so maybe that maybe it's not physio, it's local service business, I don't know.
• 15:58
  Michael: But certainly we've got so many customers who are husband and wife, boyfriend, girlfriend, whatever.
• 16:02
  Michael: It's quite interesting.
• 16:03
  Michael: But it is also interesting seeing them all, and they all operate very again off the top of my head, I'm probably generalizing a bit, but as far as I can think, they all operate incredibly well.
• 16:13
  Michael: They all seem much less stressed than that some of those that are doing it themselves.
• 16:19
  Michael: I think having that extra support really does help because again, I don't think there's that much as support available out in the industry.
• 16:26
  Michael: The majority of coaches are utterly useless, in my opinion, my opinion, for someone trust suit me.
• 16:31
  Michael: And and I think not not all, but the majority.
• 16:34
  Michael: And I think having someone there for you to kind of not just bounce ideas off, but also say that was a really shitty day, and then to say, yeah, it was.
• 16:42
  Michael: And and you know, you can talk things through.
• 16:44
  SPEAKER_00: And I would draw a parallel there to when you're working in a big team in the NHS, it's you would be constantly bouncing between clients, you'd come out of your cubicle and you'd all be around a table, and it would all all it would take is like one look, and just like that was intense because you can hear the conversations everyone's having, and then you get that shared experience where you are all going through it a bit, and and you can instantly just um de stress, like offload that onto whoever's there when you're quickly writing your notes.
• 17:14
  SPEAKER_00: Whereas when you're then setting up as like a sole trader, particularly with like the home physio, I'm out on my own all day, and the only people I'm talking to are clients.
• 17:24
  SPEAKER_00: So then you're driving between clients, and then you might listen to the radio.
• 17:27
  SPEAKER_00: You can't write notes.
• 17:28
  SPEAKER_00: So you're then with your own thoughts, and so I think the isolation is really important to flag.
• 17:34
  SPEAKER_00: Whereas, yeah, if you've got a team, it takes the stress off.
• 17:37
  SPEAKER_00: And if that team happens to be your other half when you get home, or I'm constantly calling Lauren between clients to go, oh, you'll never guess what just happened with this person.
• 17:45
  SPEAKER_00: And so we are able to offload that.
• 17:48
  SPEAKER_00: Whereas if I wasn't with Lauren and I didn't have a team like I do now, you're just constantly internalizing that and you never get a chance to go, that was shit, or that was fucking stressful.
• 17:59
  SPEAKER_00: Like, so it is it's really important, I think, to have someone else to to bounce out.
• 18:04
  Michael: So I I talk to a lot of friends now who are physios and clients and they're friends, and we talk a lot about their relationships with patients because they they tend to form even not even with the longer term ones, but they they they will talk, and maybe this makes you quite a good physio because they're all really good physios.
• 18:23
  Michael: They tend to talk to clients a lot about their personal life or about business or about things that are happening.
• 18:30
  Michael: And and I really like that, and I and we certainly do that, you know.
• 18:33
  Michael: We we we really get into things as a business, and I think it's really helpful.
• 18:37
  Michael: Do you find that there's even more of that because you're in people's homes?
• 18:42
  SPEAKER_00: Yeah.
• 18:42
  SPEAKER_00: Yeah, it's a huge part of what I've done over the last five, six years.
• 18:47
  SPEAKER_00: So when you're in someone's home, it's completely different.
• 18:50
  SPEAKER_00: You can you get to know their family, you know their personal life a lot more.
• 18:54
  SPEAKER_00: I also have fallen into, I guess, having a lot of longer-term clients that you then have longer-term relationships with, whether that's clinically because they've got a long-term condition or they're elderly and they're isolated.
• 19:08
  SPEAKER_00: They also ask you questions, and I'm not someone that would hold back in talking about my family, and I think they really like that.
• 19:15
  SPEAKER_00: I think that one of the things that turns a six-week, 12-week client into a two-year client is that they trust you and they build that trust from knowing that you're a human being and that you hold their best interests.
• 19:29
  SPEAKER_00: But you those bonds develop a lot more intensely, I would say, when you're visiting someone in their home once or twice a week for a year.
• 19:37
  SPEAKER_00: Like it's a a massive thing.
• 19:39
  SPEAKER_00: And to the point where some of my clients buy my kids presents for their birthday, they got me engagement presents.
• 19:46
  SPEAKER_00: Like, I I you just you you end up knowing a lot about them, and then they know a lot about you.
• 19:52
  SPEAKER_00: And that just happens naturally.
• 19:53
  SPEAKER_00: But that's part of the reason that I think they become such long-term clients.
• 19:57
  Michael: Yeah, I think so.
• 19:58
  Michael: And I think you I think it is it's interesting because by Hannah, when she was right in the early days, she was doing home um women's health physiotherapy at home.
• 20:07
  Michael: It was only women's health, and and I remember her saying, like, it was it was really interesting because those patients they came in with a problem, but actually, you know, by appointment three or four, they were talking about completely different things, and often the problem that they came in with wasn't necessarily the problem that they needed sorting, but beyond that, she was essentially charging them, and she you know, she she made sure they weren't understood this, but she was charging them for a chat.
• 20:33
  Michael: You know, it was like I want to talk about my annoying kids or my annoying husband or whatever, and I think that but beyond that, I think that you I think a lot of physios in clinic have a lot to learn in terms of building those relationships.
• 20:47
  Michael: It may not be as intense because they're not in the in in in someone's home, but I think you can still do that.
• 20:52
  Michael: I think you can still build that relationship and that personal relationship.
• 20:55
  Michael: And I think that that some of the best physios I know, and I've only just thought about this, they are the ones that have really great relationships with clients where they will talk about their own business and say, life's really tough, or I'm struggling with this, or and they'll get advice.
• 21:07
  Michael: I I know one in particular recently was talking to someone that was a very well-off, you know, really great businessman who had actually said, like, let me help you through this, like I can do some stuff for you.
• 21:17
  Michael: And another one I know uh has got investment from a patient to open a second clinic that's all singing and all dancing.
• 21:25
  Michael: So I don't know how ethical that is, I don't know, but in any case, I think relationships are really important.
• 21:30
  Michael: A lot of physios forget that.
• 21:31
  SPEAKER_00: Yeah, I've definitely taken advice off clients.
• 21:34
  SPEAKER_00: When I turn up to their house and they realise that I'm for some reason I'm turning up in uh 2008 banger of a car instead of my van, they're like, no, Jack, what now?
• 21:47
  SPEAKER_00: Because one of the worst things about this home service is that the vans are constantly breaking down.
• 21:52
  SPEAKER_00: And then they there's this ongoing joke with a few of them where, oh, is the cut is is the van in the garage again?
• 21:58
  SPEAKER_00: Like, what's happened this time?
• 21:59
  SPEAKER_00: I'm gonna Going into a massive detail between exercises about how I'm got the van in the garage and the DPF's clogged and the electrics have gone and it's costing me a fortune and they're like okay, but then I'm opening the boo, I've got all the equipment in the back of this estate car.
• 22:16
  SPEAKER_00: And it's just like, yeah, that's like an an an ongoing saga, basically.
• 22:22
  SPEAKER_00: And I could, you know, I could talk about a few other things, it's not just the vehicles, but they're things that are going on in my life.
• 22:28
  SPEAKER_00: Maybe the football, or because I'm a big commentary fan, and then we were crap for ages, and then we got promoted, and now we're in the Premier League and we're crap again.
• 22:35
  SPEAKER_00: But they all take the piss out of me basically for that as well.
• 22:38
  SPEAKER_00: Going back to the vans, yeah, I'm gonna have to say it.
• 22:41
  SPEAKER_00: Bicycle.
• 22:41
  SPEAKER_00: Wouldn't have happened if you got a fucking bike.
• 22:44
  SPEAKER_00: Two wheels, two wheels and more trusty than four.
• 22:47
  SPEAKER_00: I also wouldn't be able to travel like 18 miles in 20 minutes to get to my next client.
• 22:53
  SPEAKER_00: I'd see like two clients a day on my bike and be absolutely knackered.
• 22:57
  Michael: Yeah, fitter.
• 22:58
  SPEAKER_00: Right.
• 22:58
  Michael: Before we spoke, came on we we talked about the identity of the business.
• 23:02
  Michael: And I I will always say to clients, and it doesn't matter how established they are, your business is gonna look very different in two years than it does today, because everybody's does.
• 23:13
  Michael: And most people are like, Well, don't be silly, that's not the case, and and invariably I'm I'm right.
• 23:19
  Michael: You went through that exact same thing, right?
• 23:21
  Michael: Because you had this this vision of what your business was gonna be, and then two years down line, it's a very different business, and then two years further down line, it's again a very different business.
• 23:30
  Michael: So talk me through that.
• 23:31
  SPEAKER_00: I think I actually like before I came on the podcast, I was trying to go through like a timeline in my head about how and I did that by going through my camera role because it like it's quite a nice some summary because you can see visually like what you were doing, and in the early stages, I because I was an MSK physio previously, and I thought I'd be doing a lot of MSK and sports, so all the equipment I bought was like strength and conditioning equipment, and I thought I was gonna be doing injury prevention classes, and I thought I was gonna be rolling up to sports clubs and delivering like sessions on the side of the pitch.
• 24:07
  SPEAKER_00: So I had all these like ideas of what that would look like, and then I realized that all the inquiries were coming through were like older people and long-term conditions, and I was like, for a while, I was I was thinking, Oh, I don't want those clients, and then I was like, actually, these ones are great fun, like that, and I kind of then realized both commercially but also just like personally that I did quite I really enjoyed those sessions, and then I became quite obsessed with like the gamification of physio to the point where I was buying and like again people take the piss out of me because I will just impulse purchase, but I bought like a VR headset, I bought like some fancy dynamometers, I I had and then I the I didn't I never even strapped this VR headset onto anyone, but I wanted to gamify it, but I was thinking that was way too high tech, basically.
• 24:59
  SPEAKER_00: So now a big part of what we do is gamified, but it's low tech.
• 25:05
  SPEAKER_00: So it's like how do we turn what they're interested in?
• 25:08
  SPEAKER_00: So what are their passions, their hobbies, and how do we turn that into a really engaging, fun physio session that is also clinically indicated?
• 25:18
  SPEAKER_00: So it's like if we have lots of bean bags, buckets, weighted balls, hurdles, and we try and design our sessions to be really fun because I've found that if you can make the sessions fun with these people, they're generally people that don't want to lift weights or do traditional exercise.
• 25:36
  SPEAKER_00: So it's applying the principles of physio with just like, yeah, low-tech gamification, setting up little circuits in their house and getting them throwing balls.
• 25:46
  SPEAKER_00: And you find out a lot about someone saying, Oh, what you know, what did you used to like?
• 25:50
  SPEAKER_00: Oh, netball or hockey or one recently Gaelic football.
• 25:54
  SPEAKER_00: And so we bought some just some really cheap little nets and some weighted balls, and we get them weaving in our cones, banging the ball and bouncing it.
• 26:01
  SPEAKER_00: And he's like 80 and he hasn't even thought of Gaelic football in years.
• 26:05
  SPEAKER_00: But for him, he's like looking forward to the sessions now, whereas if he was just doing 20 sit-to stands, it's boring, and they don't you don't get the same number of follow-ups.
• 26:15
  Michael: So it's a big part of what we do now.
• 26:17
  Michael: This is this is actually we can leave the identity thing because I think this is fascinating.
• 26:21
  Michael: And and I've talked about gamification on on a number of podcasts so far, and um very few people have been able to sort of codify it and say, here's what we do, because I think gamification is incredibly important.
• 26:34
  SPEAKER_00: When you're in the But you you always talk about it in terms of like apps and rewards and and like no kind of immersive thing.
• 26:43
  Michael: In the in the corporate world or in the business world, you it is somewhat about that.
• 26:47
  Michael: So, for example, on HMDG Connect, the community, one thing you could do is actually give rankings to people the more they post, right?
• 26:54
  Michael: So you are an elite member because you post more, and and it's funny how how people will gravitate towards that and try and post more to get that status.
• 27:02
  Michael: You see on LinkedIn, the way that LinkedIn does it, um, when you first sign up, and it's like you only have one star, you need to add all these things to get five stars.
• 27:09
  Michael: So I think when it comes to software, when it comes to all sorts of sort of corporate business thing, gamification is incredibly important.
• 27:16
  Michael: What I what I think is in terms of physio, I think gamification of the rehab process is the thing that really makes sense to me and really inspires me because I think that's where you most likely get the mo the the most engagement and traction with a client, right?
• 27:31
  Michael: And so what we just said about the the guy with Gaelic football stuff, like that's gonna be something he wants to do because he loves it and and he can develop it.
• 27:38
  SPEAKER_00: But it's also unfortunately, it's when you're dealing with the population I'm dealing with, it's not always something they can do on their own, and they might not have someone that's able to support them with that.
• 27:49
  SPEAKER_00: So if it is a higher level of exercise that's gonna test their balance significantly, it wouldn't be something that we can leave with them and it's safe for them to do.
• 27:59
  SPEAKER_00: Sure.
• 28:00
  SPEAKER_00: So so it in a way that means that we we can create something very meaningful for them that sparks a bit of joy in them that they really look forward to doing that they otherwise wouldn't be able to do.
• 28:12
  SPEAKER_00: But it's on the premise of we're not just playing games, it's okay, we've identified from our assessment that they struggle with this element of their vestibular system.
• 28:21
  SPEAKER_00: We're gonna work on that, but it's applying the principles of physio to the person and and and then making it really enjoyable and forming a relationship.
• 28:31
  Michael: Agreed, and and I think you can even extend it a little further to um to some extent challenges.
• 28:36
  Michael: So I remember once in fact this to a client that they uh they're a neurophysio, and they happened to be only the only place they could find a clinic had a big flat of stairs on the front.
• 28:45
  Michael: And it's not ideal with neuropatients, but actually they called it and I can't remember what it was called, it was like the the stairs of doom or something.
• 28:54
  Michael: And the idea was that we're gonna get you to a point where you're gonna be able to use these stairs on your own.
• 29:00
  Michael: So that was almost gamification in a in a weird way, but you had challenges, right?
• 29:04
  Michael: So it could be something as as simple as be careful with this with older people getting to do it on their own.
• 29:09
  Michael: But um lie down on your on the floor on your back, get back up without using your hands or without grunting and and and whatever, and see if you can achieve that now.
• 29:18
  Michael: And let's see if we can get you there by doing these other things and and so on, and then eventually do a Turkish guess up or something.
• 29:24
  Michael: Um probably less appropriate with an 80 80 year old.
• 29:27
  SPEAKER_00: But I think that I think that's what neurophysios do best, and I think uh neurophysios are inherently more creative in what they have to do because they have to think on their feet on their feet and overcome obstacles and challenges that just appear within a session.
• 29:43
  SPEAKER_00: Um I when I do my training sessions with my team now, a lot of what I talk about is applying the principles of neuro rehabilitation even to our MSK clients because there's I think there's a lot to be learned from neurophysio that can be applied to every client we see.
• 30:00
  SPEAKER_00: Um, a lot of that is behaviour change and like cueing, so external cues versus intrinsic cues.
• 30:08
  SPEAKER_00: But I think that applies for every patient we see, and that's what I try and push with my team is that we want to make the sessions enjoyable and we're trying to make someone change their behaviour and learn these new movements and exercises, and if we can make that accessible, then it's going to be more successful for for for all of our clients, not just people that have had a stroke.
• 30:29
  Michael: Yeah, give me just just for the listeners, give me a couple of examples of other things that you might do to gamify a normal MSK rehab.
• 30:38
  Michael: Like give me a couple of examples.
• 30:40
  SPEAKER_00: I would say, you know, if if you want someone to do 10, just keep it really simple.
• 30:46
  SPEAKER_00: If you want someone to do 10 squats or 10 sit-to-stands, rather than just getting them to do a sit to stand off a chair, if they hold on to a a weighted ball and then as they stand up, they, you know, stand.
• 30:59
  SPEAKER_00: I was about to do it then.
• 31:00
  SPEAKER_00: I'd just naturally do stand up with a weighted ball and then throw it onto the floor and then do a deadlift to pick it up, or bend down, pick up a beanbag and throw it into a bucket and see how many beanbags they can get in the bucket, right?
• 31:13
  SPEAKER_00: This is stuff that neurophysios do every day, but MSK don't.
• 31:18
  Michael: So there's a there's a lot you can do there without technology, and I am a tech geek.
• 31:23
  Michael: When you look at what neurophysios have, they also have the ability to do a lot more with cool toys, right?
• 31:30
  Michael: So uh I think it's Neurophenix, for example, have this thing that you can do remotely and virtually and you can play games by um moving hands, so it's more for straight patients, I think.
• 31:39
  Michael: I uh do you think there's a role for technology as well in gamification?
• 31:43
  Michael: So an example might be uh you need a patient who is just completely inactive and whatever, and you get them a whoop, and you read every appointment, you come in and you say, right, let's look at you know how many steps you've done, how have you been keeping up with things?
• 31:57
  SPEAKER_00: Yeah, is that something you think there's a role for?
• 31:59
  SPEAKER_00: Definitely, and it's something we've explored, something even because I think price point on a lot of the technology is a massive barrier.
• 32:07
  SPEAKER_00: So you can't just give ever you can't just expect every client to purchase a whoop, or you can't give every client a whoop.
• 32:13
  SPEAKER_00: But we looked even something simple as you know, like the old serial box pedometers that you just strap to your shoe and and because we wanted to track, because we'd be we wanted to track how many steps people are doing in a day.
• 32:24
  SPEAKER_00: And I we and from a price perspective, it's easier just to put a pedometer on their shoe.
• 32:28
  SPEAKER_00: Um they're not that accurate, but uh it gave us something to something to gauge.
• 32:33
  SPEAKER_00: And again, with the neuroclinics and I think the the tech stuff is amazing, and I'm fascinated by it, but there is a massive barrier to you know, you can only use that in the clinic because these pieces of kit are thousands of pounds, and you just can't expect someone to go out and buy that.
• 32:47
  SPEAKER_00: So I quite like the fact that a lot of the stuff we do, which is low tech, low cost, is I would say equally as engaging, but more accessible, and they can do it in between in between appointments as well.
• 32:59
  SPEAKER_00: So yeah, there is definitely a role for the tech, and yeah, but it has to be balanced with accessibility as well.
• 33:06
  Michael: Yeah, you you mentioned uh VR earlier, and I remember speaking to uh Adam at Foundations, who was a previous guest.
• 33:13
  Michael: I don't think we brought this up, but I think there's VR with Neuro can certainly work really well.
• 33:19
  Michael: But he actually talks about the fact that you can use it for other things like shoulder rehab, for example.
• 33:24
  Michael: Is that something you've explored?
• 33:26
  SPEAKER_00: I literally never use the VR headset because it's a BAF to put on.
• 33:29
  SPEAKER_00: It it poses it makes me feel sick when I put VR headsets on.
• 33:33
  SPEAKER_00: Like a lot of people will feel sick when they put it on from experience anyway.
• 33:37
  SPEAKER_00: So it's it's not something I've actually used that much.
• 33:40
  Michael: I'm thinking more of not that because I'm the same, like my son gave me one and sat me on a roller coaster.
• 33:45
  Michael: It was like three hours of feeling like absolute crap.
• 33:48
  Michael: Never never use it again.
• 33:49
  Michael: But you can do the VR stuff where it's almost like you're in person with someone, and so you can see them from across the table, and it will track arm movement and hand movement.
• 33:58
  Michael: I mean, it's always something I've been interested in, is whether for some patients who you know they whether it's for you in home physio or whether it's for a a a I was gonna say a normal clinic, but whether for a clinic you you could actually see people at distance for certain rehab by them having a VR headset where you can do that kind of in-person thing but not be in person.
• 34:17
  SPEAKER_00: That puts a lot of faith in the fact that they're gonna be able to put it on themselves or they have someone that can put it on them and set it up and for it to work without 10 minutes of faffing around trying to get the connection sorted and all of that when it's probably quite time limiting anyway.
• 34:35
  SPEAKER_00: So you are spoiling all my fun, honestly.
• 34:38
  SPEAKER_00: I know.
• 34:39
  SPEAKER_00: Because you don't have to, you don't always have to overcomplicate things like rehabilitation should be simple.
• 34:47
  SPEAKER_00: It shouldn't need to have all these barriers.
• 34:49
  SPEAKER_00: Yeah.
• 34:49
  SPEAKER_00: So I don't I don't really use tech that much, as much as I'd love to, because outside of work, and for ages I was trying to get as much tech as possible, but I it just wasn't working, so I just swapped focus because I don't think you need to overcomplicate things a lot of the time.
• 35:04
  Michael: I think it's really good, and and I think the the more you can simplify it, the cheaper it is, the more accessible it is for people, and the more people you can have doing it, right?
• 35:13
  Michael: I mean I still like the idea of VR headset how many people can afford, or or a whoop.
• 35:18
  Michael: I don't know where a whoop costs now, 30 quid a month and 100 or whatever.
• 35:21
  Michael: You know, to tell people that isn't particularly affordable, particularly when you're already charging money for the visit.
• 35:27
  Michael: So right, moving on.
• 35:29
  SPEAKER_00: Okay, I was last point on that, what we do, which I think is nice that we've introduced in the last year or so, is if we know someone we if we know we're gonna be seeing someone for a once or twice a week for 12 weeks, and then when you come to the end of that kind of initial period of treatment, I always say to my physician, it's something I've always done, is we will purchase some of the equipment that they're gonna use for them.
• 35:53
  SPEAKER_00: So we also we'll use it in the session, and at the end we'll go, Oh, you can keep this, by the way.
• 35:58
  SPEAKER_00: Like it's a couple of ham weights, it's a ball, it's it's they're relatively inexpensive things compared to the amount of money they're gonna be spending within the clinic.
• 36:07
  SPEAKER_00: And I think they go, Oh, that that's a that's brilliant.
• 36:09
  SPEAKER_00: Like that's often they're vis visibly like taken aback.
• 36:12
  SPEAKER_00: I I go, you can keep that, I want you to use it.
• 36:14
  SPEAKER_00: I'm gonna lend it to you, I want you to use it.
• 36:16
  SPEAKER_00: So it helps with the engagement between sessions as well.
• 36:19
  SPEAKER_00: You're like, right, I'm it whether it's a loan or what, you can keep it, use it.
• 36:23
  SPEAKER_00: We're gonna do it again next time.
• 36:24
  SPEAKER_00: I want you to be better at this, or I want you to be, you know, to the point where I had like these netting, it's like kids' toys, some of it.
• 36:31
  SPEAKER_00: It's like a a netting thing that pops up and they throw balls, beanbags into the net, and um and it's got points on each one.
• 36:38
  SPEAKER_00: And it's like, I want you to be able to show me next session that you've been practicing this.
• 36:41
  SPEAKER_00: And it's just a little thing like that.
• 36:43
  SPEAKER_00: People find those gestures are really important.
• 36:46
  SPEAKER_00: A little bit of equipment goes a long way when you say you can have that.
• 36:49
  SPEAKER_00: And it's like it's only cost 20 quid or something, but it's to them, it's a lot.
• 36:52
  Michael: I'm gonna use that because I came across a a clinic clinic the other day who was selling therabands to his patients on the advice of the business coach because he could monetize uh therabands for every patient.
• 37:04
  Michael: And I was like, Are you kidding me?
• 37:07
  SPEAKER_00: That's another reason I left the NHS.
• 37:08
  SPEAKER_00: They were trying to get us to charge a pound for a stretcher theraband, and I never would, and then I got in trouble for that.
• 37:13
  SPEAKER_00: So I always like have said often if they need some therabands, I say just go on jeffbezos.com and they'll be here tomorrow.
• 37:20
  SPEAKER_00: Get yourself some therabands or whatever.
• 37:22
  SPEAKER_00: But if it's just yeah, some other equipment, and again, with our population, they don't want to order stuff online, like the older, the slightly older people might not feel comfortable just ordering something off Amazon.
• 37:32
  SPEAKER_00: So for us to then either do it for them or say, look, it's gonna be delivered to your house tomorrow, or here, just have this one and I'll replace it, like I may have hemorrhaged a lot of money over the years doing that, but I also think I've gained a lot of clients doing that.
• 37:45
  Michael: No, but that I was gonna touch on that because so obviously, you know, most companies have budgets and and for different things, and we have a budget for things like charities and things that we do for clients and so on.
• 37:56
  Michael: But do you have anything in your PL that says this is the budget that I have for this purpose, and then tying it into the PL to see if there is some level of return on it?
• 38:08
  Michael: That may be more appointments, whatever that might be.
• 38:10
  SPEAKER_00: Have you have you done that?
• 38:12
  SPEAKER_00: It's not something I've formally tracked, it's something that I probably have just noticed as a pattern in myself and something that I I just believe strongly in enough that I think in terms of patient retention, like making those gestures is something that distinguishes us and f from other providers.
• 38:30
  SPEAKER_00: And and as a home physio business, I think you do rely more on patient retention, and you also have to build like the the patient journey has to be even it's like even more important than when you're in a clinic because you you have less things to establish your author, not your authority, but a phrase I use a lot with my team is like, What how do you make yourself the expert in the room?
• 38:56
  SPEAKER_00: Because that is a big thing that I think CD Champion talks about with like retention of clients ethically.
• 39:02
  SPEAKER_00: I think it's really it's much harder to establish yourself when you're going into someone's home because you don't have the fancy reception, you don't have the fancy equipment, you don't have that that psychological when they walk into your clinic, they are preparing themselves for meeting an expert and they're preparing themselves to be recommended a course of treatment.
• 39:22
  SPEAKER_00: Whereas sometimes you turn up to their house and then the hierarchy is quite a lot flatter.
• 39:28
  SPEAKER_00: So it's it's a lot harder to establish yourself, to then have the conversation, to be like, and I want to see you again next week and the week after, and this is the course of care that I'd recommend.
• 39:39
  SPEAKER_00: Because it's different because you've walked in their front door, you've taken your shoes off, and then you're sitting having a cup of tea on their sofa, and it's a much more informal relationship.
• 39:48
  SPEAKER_00: So the way that you can then turn that upside down is partly how you like present yourself, so with the vans in the making sure your uniform is spot on and presenting yourself well, the way that you hold those conversations and then yeah, little gestures like having, as I said, having the right equipment that you can then give them to use in between.
• 40:09
  SPEAKER_00: You have to it's a very different patient journey when you're doing home video.
• 40:12
  Michael: See, I'll disagree with you because I think, well, to some extent, I actually think that if you first of all, I think that even clinics should use the same concept and follow the same concept.
• 40:25
  Michael: Uh there's no reason you can't do those same things.
• 40:27
  Michael: And I actually think if you opened a clinic, you would still do those things inside your clinic.
• 40:31
  Michael: Um so yes, I can see why it's a learned thing from your experiences doing home physio, but I think that all of those are concepts that should be applied to to patients in any scenario, no?
• 40:45
  Michael: Yeah, I think I I knew you'd push back on that.
• 40:48
  Michael: No, I think it's brilliant and I think you're absolutely right, and I think it's great, but I I just I I I don't think I I would hate for a clinic owner who owns a clinic to sit there and go, Oh yeah, that's what Jack's doing, that's quite interesting, that's for home physio, when actually I think that applies to in-person in a clinic as well.
• 41:06
  SPEAKER_00: Yeah, yeah.
• 41:07
  Michael: Because I bet I bet you would do the same thing.
• 41:09
  Michael: I bet you don't start charging for stuff when you're in clinic.
• 41:12
  Michael: I bet you do you know what I mean?
• 41:14
  SPEAKER_00: No, I I wouldn't.
• 41:15
  SPEAKER_00: I think when I've walked past clinics and then in the front of their clinic is like a display cabinet full of like massage balls and bands for sale.
• 41:26
  SPEAKER_00: I always think like that is not a good look.
• 41:29
  SPEAKER_00: I I would I would say like if someone is going to be spending hundreds of pounds in the clinic, then you can probably afford to write off a couple of quid for like some Theraband or or or something like that.
• 41:39
  SPEAKER_00: So yeah, it it I think it's short-sighted to try and pinch pennies in those areas when when you look at the bigger picture, like it's far more valuable for someone to come back again.
• 41:51
  SPEAKER_00: Agreed.
• 41:51
  Michael: But as business as a business person, I would also say you should also track that, you should have a budget for it.
• 41:57
  Michael: I I mean I'm not talking about necessarily tracking the ROI on doing it, but certainly make sure you've got business budgets in place.
• 42:03
  Michael: So you're not just your physios aren't throwing out like two grand worth of kit and it's gonna be.
• 42:08
  SPEAKER_00: We have I've only just introduced it and it's part of like a bigger concept that we're introducing.
• 42:14
  SPEAKER_00: But it there's there is a budget there.
• 42:16
  SPEAKER_00: I think I I set the budget at absolute maximum 50 50 pounds worth, but that's only for people that have completed quite a long course of treatment, and then we are essentially then gonna maybe check in with them once a month, and you go, you know what, as a sign of this relationship, we're gonna give you all of the stuff that you've been using with us on kind of the proviso that we're probably gonna check in once a month.
• 42:40
  SPEAKER_00: And is that something that you want to do basically?
• 42:43
  SPEAKER_00: And if one in ten of those people say, Yeah, we want to continue with a monthly appointment and track these outcome measures once a month and make sure that it's from a good place, really, because we will be, you know, taking these measurements once a month and making sure that you're still on the right track.
• 43:00
  SPEAKER_00: Because I think there's a lot to be said, and I'm going off track a bit, but with this whole like self-management obsession within physio where people are expected, like we're we're kind of taught at university and in the NHS that our goal is to get someone to self-manage, but I'm not sure that that is the pinnacle of physio because most of these people can't self-manage, and to have a semi-regular check-in with a healthcare professional is is super, super valuable, and it will keep them on track, and they're gonna get better outcome measures through that.
• 43:32
  SPEAKER_00: So I yeah, I don't know how many people can self-manage effectively, otherwise, we wouldn't be in this mess.
• 43:39
  Michael: I will leave that argument for someone that knows what they're talking about, that that knows what they're talking about.
• 43:44
  Michael: Let's switch this up because I I went out for dinner the other day with a with a brand new client, actually, and he was mentioning it how he listened to mine and Hannah's podcast about how shit it is running a business and how hard it is, and and and so on and so forth.
• 43:58
  Michael: And he was like, Oh my god, uh, it was just brilliant.
• 44:00
  Michael: Brilliant.
• 44:00
  Michael: It was so nice to hear someone else be roar about their experience.
• 44:03
  Michael: So I might bring in a section because I think every single person that that comes on the podcast is like, oh you know, life was shit or life is shit or whatever.
• 44:11
  Michael: And we talked a little bit about it before.
• 44:13
  Michael: Talk me through like Talk me through that, you know, that that whole experience of like oh Christ, what have I got myself into?
• 44:20
  SPEAKER_00: Yeah, my main driver for starting it was to like regain some work-life balance.
• 44:26
  SPEAKER_00: And then the work life balance was probably really good for the first six, nine months, because I'd just had my first child, and you know, I was able to just give myself a Monday off to take him swimming, and I knew that I could still earn money the other four days, and like my overheads were so low that I could easily just do that, and it was pretty happy days.
• 44:46
  SPEAKER_00: At the time, I don't think I saw it like that, but in hindsight it was.
• 44:49
  SPEAKER_00: And then as soon as you start like trying to build the team or get anyone else involved, things just really spiral out of control, basically, both in terms of like the cost of everything goes up exponentially.
• 45:03
  SPEAKER_00: You have to put the and then you're working longer hours, and then you find yourself basically you're working to pay someone else's wages, essentially, and then you're like, what am I doing?
• 45:12
  SPEAKER_00: Like it was so much better when it was just me.
• 45:14
  SPEAKER_00: But once you get through that point, I think that's a really like it's a really sticky point when you go from just you to like two or three.
• 45:21
  SPEAKER_00: But then if you can push past that, then it gets a little bit better again.
• 45:25
  SPEAKER_00: But I think that patch in the middle where Lauren and I would be out all day, and then we'd get back, and as I said, we'd then be like doing admin and business development for hours into the evening, and then you'd have like no work-life balance at all.
• 45:40
  SPEAKER_00: Whereas then I I I think pushing past that to now having like there's six of us now.
• 45:45
  SPEAKER_00: I'm the things got exponentially better for me the less clients I saw.
• 45:50
  SPEAKER_00: So then I would I first gave myself one day off for non-clinical work, so I can't call it a day off.
• 45:57
  SPEAKER_00: I gave myself one day of not seeing clients, and then I gave myself two days not seeing clients, and now I'm up to basically seeing clients twice a week and having three business days, and that has made a big difference to actually growing the business.
• 46:09
  SPEAKER_00: I couldn't have grown it because grown the business how it is now because I was too busy working, seeing clients.
• 46:15
  Michael: So that period, I suppose, where life is pretty shit, like because I always joke, I remember seeing this video of this guy going, I'm gonna run a business, I'm gonna start my own business, I'm gonna be able to work the own my own hours, I'm gonna be my own boss, I'm gonna have great, you know, I'll finish at 5 p.m.
• 46:30
  Michael: And then it was about a year later he posted a video and went, life's shit, business is crap.
• 46:34
  Michael: I work all the hours in the world, it's harder than my my previous job.
• 46:38
  Michael: I think people always go into a business thinking, oh, life is gonna be easy, and then they realise it's not.
• 46:43
  Michael: And I think you probab you went through that obviously.
• 46:46
  Michael: Um and you know, what's interesting is is also the the couple thing there because there was a point when because it was both me and Hannah doing it together, there was a point where we were sort of egging our bad behavior on.
• 46:58
  Michael: There was no one to say, shut up, stop talking about work, or be more healthy, or and so when there's two of you, we're both eating crap and putting on weight.
• 47:08
  Michael: Neither of us are going to the gym.
• 47:10
  Michael: No one saying, hold on a second, like stop.
• 47:13
  Michael: Did you find the same thing?
• 47:14
  SPEAKER_00: Yeah, yeah, we both put on loads of weight.
• 47:17
  SPEAKER_00: We also threw two little children into the mix, which was you know, crazy, not sure what we were thinking, and threw a full house reno into the mix.
• 47:27
  SPEAKER_00: So yeah, we both put on loads of weight, we weren't looking after ourselves, like our mental health definitely both of us went through periods of really low mental health with that and just the stress of everything, really.
• 47:37
  SPEAKER_00: Like, and it was actually all when in hindsight it's all self-inflicted as well because we chose to do it.
• 47:43
  SPEAKER_00: But you get you get so caught up in it, and and you just a c you get so caught up in a bubble of being co-directors of a a f a fledgling physiobusiness or whatever you want to call it, but we're you know, there was no escape from that.
• 47:57
  SPEAKER_00: Like so, so a couple of things on that.
• 47:59
  Michael: First is I've I've I've thought about this a lot because there were days where I didn't spend enough time with the kids and so on and so forth.
• 48:06
  Michael: And I've wondered since whether or not I needed to do that stuff for the company to get as big as it did and operate as well as it did, or whether, do you know what?
• 48:17
  Michael: If I'd have just not done those things, the company still would have been fine.
• 48:20
  Michael: And I don't know the answers to that.
• 48:22
  Michael: I I don't know if if I had just gone, you know what, I will work a little bit less, I will look after my I will find an hour to go to the gym every day.
• 48:29
  Michael: Whether that all that extra work and effort and stress, which was self-inflicted, was actually worth doing.
• 48:35
  Michael: What what are your thoughts on that?
• 48:37
  SPEAKER_00: I think there's a certain amount of work it takes to run a business, and that amount of work takes an amount of time.
• 48:43
  SPEAKER_00: So if you're there is no I don't think there's another way of getting everything that needed to be done done without just working longer hours, basically, until you and and and as I said, until you can get over the fact that you have to basically sacrifice some revenue, short-term revenue.
• 49:00
  SPEAKER_00: Like I was the on, you know, earning the most revenue, but then I had to take a short-term hit to reduce that to then actually expand it.
• 49:10
  SPEAKER_00: So you like if you only look at the next week ahead and you go, well, I've I could book in 30 clients and I could earn X amount, but then you put push back all of the wider development side by another week and then another week and then another month, and then you never actually get round to doing any of the projects that you talk about because we'd sit and we'd have all these great ideas and we'd never implement them because we just wouldn't get round to doing it, because you'd have eight, six sets of notes to write after dinner between eight and ten pm.
• 49:42
  SPEAKER_00: So when do you actually do the work?
• 49:44
  SPEAKER_00: Yeah.
• 49:44
  SPEAKER_00: Like so you have to I think we both basically just said we need to schedule in when we're gonna do the work and not just expect it to happen, basically.
• 49:53
  Michael: I I think you're right.
• 49:54
  Michael: I think though for me, there are points where I'm I'm like, that day I worked till 4 a.m.
• 49:59
  Michael: If I'd have just worked till 1am instead, would those three extra hours that I had, would they really have made such a big difference?
• 50:06
  Michael: Or instead of when the kids said, Can we go to borrow market and I said I'm working, how much difference to my business would it really have made just to go to bloody borough market?
• 50:16
  Michael: And and I think there are times where you have to, right?
• 50:18
  Michael: There's uh there's no getting away from it.
• 50:19
  Michael: And I think anyone who thinks that they can just live a happy life and have work-life balance and run a business and a successful business is wrong.
• 50:26
  Michael: But I think there are I I I I certainly took it to the extremes.
• 50:29
  Michael: I think you took it to the extremes as well.
• 50:31
  Michael: And I think sometimes there's there's just a little bit of the extreme that you can dial back on a bit and still do okay.
• 50:37
  SPEAKER_00: Yeah, I think but then you just that takes a level of discipline, I think, that Lauren and I didn't have, or you probably don't have either because you're being disciplined with your with your time and and work-life balance.
• 50:50
  Michael: It's hard, right?
• 50:51
  Michael: Because there's always something like like could we have had that dinner date without talking about work the entire time?
• 50:57
  Michael: Would the company have still been alright?
• 50:59
  Michael: Yeah, it probably would, but it's hard not to, right?
• 51:01
  Michael: It's hard night.
• 51:02
  Michael: Yeah.
• 51:03
  SPEAKER_00: It's hard not to.
• 51:04
  SPEAKER_00: We have always drawn some barriers, I guess, which is like we don't we've never have and never will work weekends.
• 51:10
  SPEAKER_00: I say that now.
• 51:11
  SPEAKER_00: I'm gonna hate myself in a few years, probably, when we do something over the weekend, but we'd always have the weekends.
• 51:17
  SPEAKER_00: I think that was really important.
• 51:18
  SPEAKER_00: And yeah, we might talk a little bit about it, but having family time at the weekends for us is like our our time, I suppose.
• 51:25
  Michael: Yeah, we should have implemented that.
• 51:27
  Michael: We we never did.
• 51:28
  SPEAKER_00: We ne we've we've never worked worked weekends basically.
• 51:31
  SPEAKER_00: Okay.
• 51:31
  SPEAKER_00: So that is something that I would highly recommend.
• 51:34
  SPEAKER_00: And I think that again is a a lot easier with home physio because like no one expects you in their house on a Saturday or Sunday.
• 51:41
  SPEAKER_00: Equally, they don't expect you in their house late into the evening.
• 51:45
  SPEAKER_00: Like you just work between nine and five, seeing clients.
• 51:48
  SPEAKER_00: So you there's a line to be drawn there.
• 51:51
  Michael: Just one question.
• 51:52
  Michael: So life was pretty bad, you were unhealthy, you weren't you know, looking after yourselves.
• 51:57
  Michael: What was the point at which you went, no, uh we're not doing this anymore?
• 52:01
  Michael: Was there was there a trigger?
• 52:02
  Michael: Was there anything that happened?
• 52:04
  SPEAKER_00: Yeah, there's they're they're what?
• 52:06
  SPEAKER_00: Um how do I put this?
• 52:08
  SPEAKER_00: It you get to breaking point, basically.
• 52:10
  SPEAKER_00: I think I ended up having to have a few weeks off because I was completely burnt out.
• 52:14
  SPEAKER_00: So that was one trigger.
• 52:16
  SPEAKER_00: I think there was another point shortly after like the birth of our second child where we were saying like we're gonna have to do something differently because you just yeah, it's a shame because it ha it it has to end up at breaking point for you to to make those changes.
• 52:30
  SPEAKER_00: Like it probably shouldn't be that way, but it often is those it it it takes going all the way to breaking point, I think, before you realize what you're actually doing.
• 52:37
  Michael: Yeah, I I I I agree.
• 52:39
  Michael: I mean, we knew what was happening, but we didn't do anything about it until and I was spoken about this before, where I'm I'm stood in the kitchen one day and I can't remember the kids' names and I'm slurring, and we all think I'm having a stroke, and it wasn't, it was just pure burnout.
• 52:54
  Michael: And and I was like, something has to change.
• 52:56
  Michael: I took four days off, and this is this is just so fucking typical.
• 53:00
  Michael: I took four days off, right?
• 53:02
  Michael: And I just did YouTube and watched Netflix and chilled out.
• 53:06
  Michael: By Monday, I'm feeling top of the world.
• 53:08
  Michael: I'm like, yes, I feel great.
• 53:10
  Michael: And what do I do?
• 53:11
  Michael: Do I learn my lesson?
• 53:12
  Michael: No, I go straight back into it, work 20 hour days, three days later I'm back slurring and breaking down again.
• 53:18
  Michael: Um so it was actually the second time where I was like, okay, that now, now I know, now I you know I can't do it.
• 53:24
  Michael: But it is hard, right?
• 53:25
  Michael: It is hard to even when you recognise what's happening or your relationship suffering, or even for me, for it manifested, and I think it did with you as well, because I've had some of these calls with you.
• 53:35
  Michael: I would often get quite angry about stuff, and even though I'm I'm externally not too I'm I'm bullshy, but I don't really get angry.
• 53:43
  Michael: We we had a few calls where you were actually very angry, which is you know, not it's not criticism at all.
• 53:48
  Michael: I think that's just what happens, right?
• 53:51
  Michael: You go into that sort of as well.
• 53:53
  SPEAKER_00: Yeah, and I d I don't know.
• 53:56
  SPEAKER_00: I I think that's the first I didn't realise I was coming across angry to be fair in the uh in the early stages.
• 54:01
  SPEAKER_00: But I don't think I uh yeah, I don't think I would recognise that anyway, because funny enough, like what was it?
• 54:08
  SPEAKER_00: What one of the members of the team said something to Lauren, like, Oh, I find Jack quite scary, and I've never thought of myself as a scary person at all.
• 54:16
  SPEAKER_00: And and she was like, but in a good way, like you wouldn't want to mess with him.
• 54:19
  SPEAKER_00: There's like that kind of because I'm very like open book and very friendly and like everything like that.
• 54:26
  SPEAKER_00: But I guess people do see that side where if you piss me off, like I'm I'm you're you I probably don't realise that I am outwardly pissed off, but clearly I do because you've said it and now someone else has said it.
• 54:38
  Michael: So I'll do too uh for the listeners.
• 54:40
  Michael: I'm gonna attach all the recorded calls to the end of this podcast, and you can just re-arp that though.
• 54:44
  SPEAKER_00: No, that it was when things weren't going well, right?
• 54:47
  SPEAKER_00: I think it's easy when you're when you feel like you're spending a fair amount of money on something and then it's not working.
• 54:54
  SPEAKER_00: I guess frustration can soon boil into anger.
• 54:58
  Michael: Listen, it is understandable and and at no point is it a criticism, you know, it it it it it was just quite apparent.
• 55:04
  Michael: And and we know as a as a company you have to deal with people.
• 55:08
  Michael: And we spoke about this, you know, it's not like you've got a million quid in your pocket and no who cares.
• 55:12
  Michael: You know, it's stressful.
• 55:13
  Michael: You're running a business, you've got children, you've got your extension going on, your innovation going on.
• 55:17
  Michael: But yeah, there was points where you got quite angry I couldn't get on a call, uh, because you got me on WhatsApp and you're quite angry that I couldn't do a call straight away.
• 55:25
  Michael: And you could tell, like, when we got the call done, it was but but it's again not a criticism, because I did the same thing, you know.
• 55:32
  Michael: I I think we can but it's funny how your personality changes under extreme stress, especially when you try to feed kids, right?
• 55:39
  Michael: It's it's just it's yeah, it's interesting.
• 55:41
  Michael: Right, taking a complete U-turn, because now shit's going well.
• 55:44
  Michael: I wanna sort of look at the barometer because we talked about this and you two things.
• 55:51
  Michael: The first is that you you said, you know, I I read the barometer and said to Lauren you should read it, and then you realised quite quickly that you were gonna be the person that was gonna be doing the management of the clinic and the the and and that side.
• 56:04
  Michael: And then you also said, I'm now more manager than physio.
• 56:07
  Michael: But you kind of said, hmm, reluctantly.
• 56:10
  Michael: And I'm I'm interested in both those things.
• 56:12
  Michael: So you read the barometer.
• 56:13
  Michael: What made what made you think, you know what, it's i I I should be doing the business side of things rather than Laura?
• 56:20
  SPEAKER_00: I think it's just play playing to strengths, like, and that's where again we uh we do make a great team because I think clinically Lauren's much stronger as a physio.
• 56:30
  SPEAKER_00: Just she's just clinical knowledge-wise, like she's much stronger.
• 56:34
  SPEAKER_00: But then from business development and statistics and all the nitty-gritty non-physio business stuff, I've always actually quite liked that.
• 56:43
  SPEAKER_00: Like that's something I've always been interested in, the the the business side of things, and looking at the figures and looking at the uh yeah, like all of that sort of thing.
• 56:52
  SPEAKER_00: I've always I've always been interested in that.
• 56:54
  SPEAKER_00: Uh so when the barometer came out and I read it, we were on holiday.
• 56:58
  SPEAKER_00: We were on holiday when it came out, and it was like we were abroad, we were on the balcony, the kids were in bed asleep, thank god, when we're on the balcony, because you're doing that holiday thing where you you can hear everyone having fun in the hotel, but you're having to sit on your balcony because like you don't want to leave the kids in bed.
• 57:13
  SPEAKER_00: And we're just having like a drink on the balcony, and she was like, Why are you on your phone?
• 57:18
  SPEAKER_00: I was like, You're not gonna like this.
• 57:19
  SPEAKER_00: We'd said no work while we were away, and I was like, I'm reading the barometer, and I said, It's really interesting.
• 57:25
  SPEAKER_00: Do you wanna do you want me to tell you about it?
• 57:27
  SPEAKER_00: And she was like, Not right now, I don't want you to tell me about it.
• 57:30
  SPEAKER_00: And I think if I asked her now, have you read it yet?
• 57:32
  SPEAKER_00: This and obviously it came out a while ago now.
• 57:34
  SPEAKER_00: Have you read it?
• 57:35
  SPEAKER_00: I don't think Lauren would have read it, but that's fine, because we actually don't both need to do that role, so she's much more nurturing with like the staff, and she's much better at answering the phone and actually talking to people on the phone, and I'm better at doing the statistics, and also like I was looking at some statistical model the other day of how many new clients we need to get in and how long do we need to keep them for to build a caseload.
• 58:04
  SPEAKER_00: Like, I was doing all this modeling for how do we maintain and build caseloads and expansion plans, and we we just balance each other well there, but yeah, yeah.
• 58:12
  SPEAKER_00: Yeah, do you find that that that happened quite naturally as well?
• 58:15
  SPEAKER_00: Because it did for us.
• 58:16
  SPEAKER_00: It's always been that way, like it's been like that from the start.
• 58:19
  SPEAKER_00: Yeah, we haven't changed roles in that way at all.
• 58:23
  SPEAKER_00: It's just I've kind of given myself the chance to do that properly now.
• 58:27
  SPEAKER_00: And there's some days where I'm sat in front of the computer and I'm really missing going and seeing clients, but then there's some days when I'm doing a full day of clients where I'm missing just being able to sit in front of the computer and just write down a load of ideas.
• 58:40
  SPEAKER_00: Like um, it's always the grass is always greener.
• 58:43
  SPEAKER_00: When I'm doing one thing, I'm like, oh, it'd be so much better if I was doing that.
• 58:46
  SPEAKER_00: But I I think we're currently in a in a pretty good balance now.
• 58:50
  Michael: So on the barometer, because we can tie this back into something earlier.
• 58:53
  Michael: So, first of all, for anyone that hasn't read the private practice barometer, do a search, private practice barometer.
• 58:58
  Michael: It's fantastic.
• 58:59
  Michael: One thing that I do now suggest to people as well, all of the data and the data set and everything, and the PDF is in that is on the site.
• 59:05
  Michael: You can actually throw that into GPT, into a project, and you can ask questions, and it will actually, you know, so you can query it directly.
• 59:12
  Michael: I highly recommend that.
• 59:13
  Michael: Uh, it's how I because I forget all the information all the time.
• 59:16
  Michael: It's really good to just see what what benchmarks might be also and so on.
• 59:20
  Michael: But with a promise, one thing in there was uh, because you mentioned it earlier, uh, without mentioning it, was the happiness curve.
• 59:26
  Michael: That kind of where it's like, yeah, everything's really good.
• 59:30
  Michael: Six, nine months, and with life's brilliant.
• 59:33
  Michael: And then you start hiring people and you get more and more and more miserable.
• 59:36
  Michael: And then as time goes on, you get happier, and it just shows it happened to you, right?
• 59:41
  SPEAKER_00: That actually, when you said was there a turning point, I actually now recognize that I do think reading the barometer opened my eyes to the fact that we were for a couple of years, we were stuck in that phase.
• 59:53
  SPEAKER_00: And I I but I think I now remember like saying to Lauren, we need to basically blast through this phase, like we need to get past it because there is light at the end of the tunnel.
• 1:00:03
  SPEAKER_00: And I think we just need to invest more and take a risk on expanding the team and expanding our marketing, because if we can get past this really boggy, sticky bit, then I think we're not necessarily going to earn more money, but we might have more time for ourselves.
• 1:00:18
  SPEAKER_00: So it wasn't a financial thing to go, because I always compare like my clinicians to treatment rooms.
• 1:00:24
  SPEAKER_00: The only way I could do it with the barometer, because the barometer often talks about utilisation.
• 1:00:28
  SPEAKER_00: I always think my treatment room is my van, right?
• 1:00:31
  SPEAKER_00: So we have four vans on the road, those are our treatment rooms.
• 1:00:34
  SPEAKER_00: How can we utilize that?
• 1:00:36
  SPEAKER_00: I said to her, we need more staff and we need more vans we basically to earn some more time back for ourselves.
• 1:00:43
  SPEAKER_00: So it was reading that where I went, you know what, we're gonna have to just take another dive into the unknown and bring people on because we'd dabbled with it.
• 1:00:52
  SPEAKER_00: So we'd done, we'd had it early stages where we took someone on as a like as a soldier, like they were a self-employed and we were paying them per client.
• 1:01:00
  SPEAKER_00: And then they pretty well, they stayed with us for about nine months, but they left and we said, Why did you leave?
• 1:01:05
  SPEAKER_00: And she said, I want to get a mortgage with my boyfriend, and like I can't do it self-employed, and the work is just a bit up and down.
• 1:01:13
  SPEAKER_00: Like I'm at my some days I'm only seeing two people, some days I'm seeing five, but I need a security, basically.
• 1:01:19
  SPEAKER_00: So that we realized that didn't work.
• 1:01:21
  SPEAKER_00: About a yeah just over a year ago, we took on our first full-time employed physio, and that then was a big investment in terms of buying him a van, buying all the equipment, everything like that, increasing the marketing to try and fill his diary.
• 1:01:36
  SPEAKER_00: But I I then handed some of my clients over to him, which took a bit of time as well.
• 1:01:40
  SPEAKER_00: So initially I was increasing my workload because I was having to come with him to appointments to hand over, do some supervision, and also because it was my first hire, I was a bit overbearing, probably in terms of wanting to supervise too much and not letting him get on because it's like your baby that you've created, and then you're trusting someone else with it.
• 1:02:01
  SPEAKER_00: So I was a bit, and I learned from that as well.
• 1:02:03
  SPEAKER_00: Then we took very quickly after that, took on another employed staff, but we only took them on part-time.
• 1:02:10
  SPEAKER_00: So they had like a bank role in the NHS, it was a new grad, but we took him on two days a week, and that didn't really work either because he ended up with two days a week of the same clients, and then he got bought, I think, and then basically said, I want to do more MSK, and we said, Go and do it.
• 1:02:26
  SPEAKER_00: He was looking for part-time roles alongside ours, but that didn't really work.
• 1:02:29
  SPEAKER_00: So then this time round, which was coming up to three months ago, we were like, we're gonna recruit again and we're gonna go all in.
• 1:02:36
  SPEAKER_00: And basically, we did go all in.
• 1:02:38
  SPEAKER_00: We recruit we wanted to recruit two more full-time physios, and we ended up getting three because we in because we interviewed, I don't know, the advert was on for two days.
• 1:02:48
  SPEAKER_00: We had 12 applicants, we interviewed six, and we couldn't set them apart.
• 1:02:52
  SPEAKER_00: So we just took on all three.
• 1:02:54
  SPEAKER_00: So then we had to buy two more vans, we had to buy two more sets of equipment.
• 1:02:58
  SPEAKER_00: So it was a big investment, basically.
• 1:03:00
  SPEAKER_00: Good question.
• 1:03:01
  SPEAKER_00: Where where did you yeah, where did you advertise to get that many applications of good people?
• 1:03:05
  SPEAKER_00: Um some came through like me and I both just really chatty people.
• 1:03:12
  SPEAKER_00: So we've just got a network of physios like that we know.
• 1:03:14
  SPEAKER_00: Physio is such a small world, you know people.
• 1:03:17
  SPEAKER_00: One came through that, and then we literally just put it on our social media and on Indeed.
• 1:03:23
  SPEAKER_02: Okay.
• 1:03:23
  SPEAKER_00: And then the NHS job freeze means that there are hundreds of new grads scrambling for jobs.
• 1:03:29
  SPEAKER_00: So they're um a couple of them are new grads, and then one is got like three years' experience.
• 1:03:35
  SPEAKER_00: But we always tend to go for new grads because I feel like what we do from a rehabilitation point of view, new grads are actually really, really good at that because they're so like I don't know, enthusiastic.
• 1:03:46
  SPEAKER_00: And that we our hiring criteria was mainly personality and soft skills rather than we weren't testing their clinical knowledge really, very maybe one question, two questions.
• 1:03:57
  SPEAKER_00: We weren't really interested in their clinical knowledge, we were interested in them being good people and being able to communicate.
• 1:04:03
  Michael: I think that's quite unusual.
• 1:04:04
  Michael: I think it's right.
• 1:04:05
  Michael: And uh the more and more more people I'd speak to now, especially recently, there's a lot more sort of soft skills and personality hiring going on, which I I actually agree with, but it's it's quite rare in this industry.
• 1:04:16
  Michael: Anyway, I just wanted to ask because most people are like, I can't hire for shit.
• 1:04:20
  Michael: I thought you had the magic secret you could uh you could say.
• 1:04:23
  SPEAKER_00: There's no magic.
• 1:04:24
  SPEAKER_00: There's no magic.
• 1:04:25
  SPEAKER_00: We just realized that, and I think we learned that from our first hire, that we were gonna have to do loads of training anyway, because what they're taught at universities like just crap.
• 1:04:34
  SPEAKER_00: So we knew we were gonna have to do loads of training and we scheduled that in so we have a a team meeting training once a week with the whole team, and then we also do an hour one-to-one supervision with each one.
• 1:04:46
  SPEAKER_00: So we put a lot of time in like training, so we knew that we're gonna have to do that anyway, so it wasn't that important.
• 1:04:53
  Michael: So going back to the barometer, so first of all, I'm really pleased because that that was the reason we wrote it was to inspire people and to show people that they're and and for you to kind of see that and then take action against that is is genuinely like makes me so happy.
• 1:05:06
  Michael: And especially and especially it's working as well.
• 1:05:09
  Michael: So go and read the barometer if you haven't already.
• 1:05:11
  Michael: So going quickly back to your day now, so you know, more manager than physio.
• 1:05:16
  Michael: So, what do your days consist of now?
• 1:05:18
  Michael: What kind of things are you are you doing?
• 1:05:20
  Michael: Because you also said you couldn't grow the business if you weren't doing these things.
• 1:05:23
  Michael: So, what is what is it you are doing?
• 1:05:27
  SPEAKER_00: Uh one of the biggest things I was just trying to standardize what we deliver because it's easy for me to be saying I know what I do because I've been doing it for five years, but what is it that I do that was working?
• 1:05:40
  SPEAKER_00: And then trying to standardize that into our like core principles and the and the the training that we deliver.
• 1:05:47
  SPEAKER_00: It's like spending just time just like writing down and trying to standardize systems in in place, like how should the first appointment look?
• 1:05:56
  SPEAKER_00: And I don't know, it's it's hard to put a finger on exactly.
• 1:06:00
  SPEAKER_00: What that looks like because it comes back to that personality thing.
• 1:06:03
  SPEAKER_00: You can't teach personality.
• 1:06:05
  SPEAKER_00: But I guess putting the systems in place, um, part of it is obviously like replying to inquiries.
• 1:06:12
  SPEAKER_00: I think my next our next hire will be like an administrative member of staff, basically, to help try and take that off my plate as well.
• 1:06:20
  SPEAKER_00: But then it's just looking at ways to grow the business and market because not all marketing can come through you guys.
• 1:06:27
  SPEAKER_00: Like a lot of it is organic stuff that going out and actually talking to people, making relationships with other local businesses like other local home care companies and stuff, which I've never had time for in the past.
• 1:06:39
  Michael: Um have you thought about I don't know if you heard the Jack Chew podcast, but the the Timothy trundle that he does?
• 1:06:44
  Michael: Have you thought about doing something like that?
• 1:06:46
  SPEAKER_00: Yeah, it's it's it's something that's like high up on the list of things we're gonna be launching soon.
• 1:06:51
  SPEAKER_00: We spoke about that years and years and years ago.
• 1:06:54
  SPEAKER_00: Like one of the first things you said to me was like, Jack, uh you basically probably said, Jack, you can get angry about our ads not performing, but like you're not doing anything to try and get your own clients, which was partly true.
• 1:07:05
  SPEAKER_00: I did go and hand out like 5,000 flyers that I got off VistaPrint through people's doors and maybe got like two clients from it.
• 1:07:11
  SPEAKER_00: But you were like, you need to go out and speak to people.
• 1:07:13
  SPEAKER_00: I was like, I don't have time, like just get me clients.
• 1:07:16
  SPEAKER_00: But I, you know, there is a big there, there's a big part of that now where yeah, forming those relationships.
• 1:07:22
  SPEAKER_00: Obviously, like looking after the members of staff as well, like my clinicians are like the most important asset.
• 1:07:28
  SPEAKER_00: So taking time to chat through their caseload regularly and check in with them, often they'll come to so we we like have to we had to find a base because like we I'm I don't want people coming and going for my house.
• 1:07:41
  SPEAKER_00: So we like base ourselves at a local tennis club where there's like a a nice, quiet, modern bar area.
• 1:07:48
  SPEAKER_00: It's easy to park there with the vans and stuff, and the place you can get coffee or a drink or whatever.
• 1:07:52
  SPEAKER_00: So we just have like a social and gym membership there where we all meet, so I encourage them to come back for their lunch so we can chat and offload if they're local to enough.
• 1:08:02
  SPEAKER_00: And then at the end of the day, I try and encourage them to come back to the club to uh yeah, as I said earlier, I think like just to offload and vent and and do clinical discussion and stuff like that.
• 1:08:13
  SPEAKER_00: So I'm there most of the time, which is when I'm doing my non-clinical days.
• 1:08:18
  Michael: And I suppose you also now have time for when when the shit hits the fan and something's on fire, it drops on your lap, and you're like, right, I actually have time to deal with this now.
• 1:08:26
  SPEAKER_00: Yeah.
• 1:08:27
  Michael: Yeah.
• 1:08:27
  SPEAKER_00: Okay.
• 1:08:28
  SPEAKER_00: I mean tr I'm in spending increasingly large amount of time on Slack.
• 1:08:32
  SPEAKER_00: Like, so we we we in implemented that, which was really good for our team, but just a central hub of communication because we haven't got a central clinic, like we needed somewhere where we can communicate.
• 1:08:42
  SPEAKER_00: Was that my suggestion as well?
• 1:08:44
  SPEAKER_00: No, I had it before you suggested.
• 1:08:45
  Michael: I was gonna say, because I need central hub, I need you another invoice.
• 1:08:49
  SPEAKER_00: No, we we we had that kind of already because we were before it was like a WhatsApp group, and I was like, we've got all these documents coming in, all these different like types of discussions going on, and it's all getting lost.
• 1:09:03
  SPEAKER_00: So I think Slack does well where it categorizes things into just a little tip.
• 1:09:08
  Michael: If you're using anyone listening, if you're using Slack, a few things that and you may already be doing this, but a few things we use it for, um which I think are really effective, is we have a chit-chat channel, which is just shooting the breeze and whatever, telling jokes or whatever.
• 1:09:20
  Michael: Within that channel, we use something called Geekbot, and Geekbot allows you to uh do automated stand-ups.
• 1:09:26
  Michael: So on a Monday morning, everyone's asked a stupid question, like what's your favourite pizza?
• 1:09:30
  Michael: or sometimes they're like completely ridiculous, but it gets everyone kind of talking, and then on a Wednesday afternoon there's one that says, Post your favourite picture of the week, it's got to be your own picture, and everyone gets involved with that and they post a picture of their dog or whatever.
• 1:09:44
  Michael: Getting people engaged on stacking that way in a more fun way can work incredibly well.
• 1:09:48
  Michael: And then on a Friday we have one that goes out which is anonymous and it asks various questions.
• 1:09:53
  Michael: Is there anything we can do better?
• 1:09:55
  Michael: What could we improve on?
• 1:09:56
  Michael: What's your work-life balance like?
• 1:09:58
  Michael: How are you coping?
• 1:09:59
  Michael: What's the stress?
• 1:10:00
  Michael: Are you feeling productive?
• 1:10:01
  Michael: It's really nice to also get that sort of anonymous feedback and you can look at that at the end of a a month and kind of calculate how the team are feeling as well.
• 1:10:09
  SPEAKER_00: I think like for you guys, that seems like an obvious solution because I'm guessing most of your team work remotely and and uh up and down the country, whereas my preference for that would be that we meet in person and and have those conversations, to be honest, because we all like we live locally and we we do have those in-person meetups.
• 1:10:27
  SPEAKER_00: No, we do as well.
• 1:10:28
  Michael: We have a lot of those.
• 1:10:30
  Michael: But what I find is that for for the engagement stuff, the picture stuff, that's just fun because people are doing it.
• 1:10:36
  Michael: But certainly for the feedback, you get even though listen, you can come talk to me about anything, it doesn't matter what.
• 1:10:42
  Michael: You find you get much more honest feedback that people might not listen, Jack, you were an asshole last week and didn't enjoy it.
• 1:10:49
  SPEAKER_00: Like they're not necessarily gonna tell you that to your face or I think doing the anonymous thing, I didn't I I think that's a yeah, doing the anonymous feedback, that's a good way of doing it.
• 1:10:57
  SPEAKER_00: It's really what bot was that?
• 1:11:00
  SPEAKER_00: Geekbot or something from the era.
• 1:11:02
  Michael: Yeah, geek bot.
• 1:11:02
  Michael: I'm sure there's a million different ones where we use geek bot.
• 1:11:05
  Michael: Right, last question.
• 1:11:07
  Michael: I'm really interested in in uh how few clinics, physical clinics, do any kind of home physio.
• 1:11:13
  Michael: And I always feel like it's something that would add an extra bow to to what they're doing and I think would generate an awful lot of revenue.
• 1:11:20
  Michael: I think it's quite easy, no, I think it's easier to find people who are happy to travel and do more home physio and so on.
• 1:11:27
  Michael: I wonder what your thoughts are and if you'd give any advice on like first of all, am I just completely bananas and you're like, do not do it, it's stupid.
• 1:11:36
  Michael: Or do you think you could, and if so, what advice would you give?
• 1:11:39
  SPEAKER_00: I will I don't I don't think so.
• 1:11:41
  SPEAKER_00: I think because it part of it comes back to like competing on price.
• 1:11:46
  SPEAKER_00: So we've developed our whole thing about delivering home physio.
• 1:11:50
  SPEAKER_00: So that all of that's like built into our pricing structure.
• 1:11:53
  SPEAKER_00: Whereas I think it's sometimes the biggest barrier, I've never owned a clinic, so I don't know.
• 1:11:57
  SPEAKER_00: But one of the barriers maybe that is that they try and charge because a home visit basically takes 90 to 120 minutes out of the diary, they basically just charge it as two hours.
• 1:12:08
  SPEAKER_00: So they might then if they charge£70 for their in-person clinic appointment, they'll then go, okay, we're gonna charge£140 for that home visit.
• 1:12:17
  SPEAKER_00: Um, because they've already got all the overheads and everything of the clinic.
• 1:12:21
  SPEAKER_00: So they're just seeing it as time spent.
• 1:12:23
  SPEAKER_00: And so they're potentially then gonna be charging a lot more than what we charge.
• 1:12:28
  SPEAKER_00: So there's that.
• 1:12:29
  SPEAKER_00: And I think there's also the the limitations of equipment that you can take.
• 1:12:34
  SPEAKER_00: So if how are they going to actually deliver it at home effectively?
• 1:12:37
  SPEAKER_00: So are they gonna put stuff in the boot of their car and go and do that?
• 1:12:41
  SPEAKER_00: Are they used to investment fees where I say they would have to buy a van, there's there's equipment.
• 1:12:46
  SPEAKER_00: You don't have to have a van though, do you?
• 1:12:48
  SPEAKER_00: It depends on the client.
• 1:12:48
  SPEAKER_00: And that but that's where we're trying to do it differently, because I think the long-held view on home physio is that it's second rate to in person and that it is just someone that goes along to their person's home and tries to deliver physio at home.
• 1:13:04
  SPEAKER_00: Whereas that's where we try and differentiate.
• 1:13:07
  SPEAKER_00: We are solely home physio and we have built all our systems to to to make that what we say the gold standard, right?
• 1:13:14
  SPEAKER_00: But yeah, I don't know if clinics need to do home physio because I don't think the profit margins are as good in home physio anyway.
• 1:13:24
  SPEAKER_00: So why would they need to?
• 1:13:25
  Michael: Well, because I think first of all, there's a lot of clinics at capacity, they simply can't fit any more people into the clinic and they don't have any more space.
• 1:13:32
  Michael: But beyond that, I think there's a service and experience element to it.
• 1:13:36
  Michael: So if you think about uh a really great private GP, they will all do home visits for those patients, for those patients that want it or need it or don't have the time or whatever.
• 1:13:47
  Michael: And I think that if you're gonna deliver a service, if you can offer just one extra step of actually, we'll come visit you if you want, if you can't get out.
• 1:13:56
  Michael: And it also gives them access actually to patients that may not necessarily be able to get into the clinic.
• 1:14:02
  Michael: I I understand that there are obviously I think you probably do need a ban from from for a for a live clinic like that because I think it's just for professionalism and so on.
• 1:14:11
  Michael: And I think this the pricing angle is an interesting one.
• 1:14:14
  Michael: But if they're not, even if they're making a smaller margin, you're right, they can't look at it in the same way as clinic time.
• 1:14:19
  Michael: They need to look at it as a slightly smaller margin, but sm slightly smaller margin is still margin that they're not getting from the clinic, and also at the same time, they're providing a much better service.
• 1:14:30
  Michael: And you can call it you don't have to call it home physio, you can call it concierge physio, for example.
• 1:14:35
  SPEAKER_00: But I remember you saying once about I think you were trying to encourage people to use Uber to get clients, to get clients to go to clinic, but then you're basically just flipping that and saying, why don't we just get the clinic physios to go out to the home?
• 1:14:48
  SPEAKER_00: And I think the only way that you could see that as a accessibility thing would be that if eventually you thought that by doing that home visit you would then be able to attract them into the clinic, like so you get them a bit better to the point where they can leave the house and then they come and see you in clinic.
• 1:15:03
  SPEAKER_00: But if you're gonna then only follow them up at home, then I I think it would be hard to to justify the the kind of profit margin on that.
• 1:15:12
  SPEAKER_00: No, it's not interesting.
• 1:15:13
  Michael: The Uber one was was cool because that that it was an idea I had.
• 1:15:16
  Michael: And I don't know if they're still doing it, but one of our employees, Danny, she uh worked at Uber Health and she was selling uh Uber Health to clinics.
• 1:15:24
  Michael: And the idea was that you could call an Uber for the client, you'd have an account and you could track it and stuff.
• 1:15:29
  Michael: And for those patients who found it difficult to get into the clinic, you could offer that kind of concierge service and and bring patients in and I and and also back, which I thought was a really interesting thing.
• 1:15:38
  Michael: Very few clinics.
• 1:15:39
  Michael: I know some did, and I know some found it to be really successful.
• 1:15:43
  Michael: Very few took it up, but I suppose it just adds an extra layer of complexity to a business where you're already overrun with things to do.
• 1:15:50
  Michael: So maybe it was a bit too too much for some clinics, but yeah, it was an interesting one.
• 1:15:54
  Michael: I I I suppose for me I always feel like the physio world, well, the MSK world, is a little bit and not everyone, I don't uh you know I love you all, but sometimes from a service perspective, a little bit blinkered.
• 1:16:07
  Michael: And I always like thinking about how can you do things differently.
• 1:16:10
  Michael: I remember back during COVID, there's a guy called Andy Hosgood, he still he owns a cool clinic up in uh Bolton, Summit Physio, and he's also a coach.
• 1:16:19
  Michael: And I remember him finding the biggest issue with doing uh online physio was that people didn't have the kit.
• 1:16:25
  Michael: So he just he used, I can't remember who it was, ph physi whatever they're called, uh he created a home rehab kit which he sent out to patients so they could, you know, it's it's doing little it's doing things a bit differently, innovating, finding new ways of doing things, and you're doing it yourself with the idea of kind of bringing the neuro concept into MSK Physio at home, which I think is amazing.
• 1:16:46
  Michael: Like, what else can clinics do and be a bit more innovative and then maybe offer a service that patients would buy and would like, but they're just not doing it at the moment.
• 1:16:55
  Michael: Um and I'll give you a really good example of this.
• 1:16:58
  Michael: Non-Physio world, there's this clothes brand called Luca Filoni.
• 1:17:02
  Michael: Really good yeah, really love the clothes brand.
• 1:17:04
  Michael: What they do, and the reason I love them is you know how you go to one shop and another shop and they have two different sides, two products, both white shirts, and they with they're both medium, and one fits you like a sack and the other one's like too tight because you don't have proper standardized sizing.
• 1:17:18
  Michael: So they've solved this.
• 1:17:19
  Michael: So what they do is you go online, you add 50 things to your basket, they actually send someone out with the stuff and say, there you go, you don't pay for anything up front, there you go, try it all on, and things that you like you keep and we'll charge you as you leave.
• 1:17:33
  Michael: And I just think it's such a clever idea, right?
• 1:17:36
  Michael: You can you can kind of it's not like oh you have to worry about sending things back and doing the ASOS thing.
• 1:17:41
  Michael: It's just like we'll deliver it for you and and and they also bring you a few extra items where they think, oh, you might like this clever little sales, sales tactic.
• 1:17:48
  Michael: But it's an example of a shop that is it thought outside the box and didn't think why, right, we we don't want people using it and then returning it and then it getting lost.
• 1:17:56
  Michael: We'll just spend a bit of money and you know send it out.
• 1:17:59
  Michael: So I do wonder, I always think about how this industry can innovate a little bit and change things up a little bit.
• 1:18:05
  Michael: And seems to me that yeah, you've done so bloody well with home physio.
• 1:18:10
  Michael: Maybe it's because you only do home physio, but could clinics learn from that and maybe incorporate that into their offering?
• 1:18:16
  Michael: We'll leave it at that.
• 1:18:18
  Michael: So thank you so much for coming on because I've known you for such a long time and it's it's really uh it happens all the time.
• 1:18:24
  Michael: Whether you are quite an established clinic or a young clinic, we always see people who aren't doing as well as they could be doing.
• 1:18:31
  Michael: And when you see them after a year, two years, five years doing incredibly well and actually being happy and uh living the dream, uh it's amazing to see it.
• 1:18:39
  Michael: And to know that I know I know we only were a tiny part of what you've managed to do, it still just honestly brings me a lot of joy, whether it's because of the barometer or because we've done some nice marketing for you.
• 1:18:50
  Michael: It genuinely brings me a lot of joy to see it.
• 1:18:52
  Michael: Um, because obviously we want people to be successful, and and I hopefully it's it's it's it's expi inspiring, inspiring for people listening as well.
• 1:19:01
  Michael: That you can go from shit to you know, oh my god, this is hard, to okay, I've got a life that I want to leave slightly less shit.
• 1:19:09
  Michael: Slightly less shit.
• 1:19:10
  Michael: It's ultimately shit, you own a business, but I mean, yeah, you just used the phrase living the dream.
• 1:19:16
  SPEAKER_00: I wouldn't necessarily describe it as that yet.
• 1:19:18
  Michael: There's still always room for more.
• 1:19:20
  Michael: You know how I like to disagree with you.
• 1:19:22
  Michael: If I said thank you for yeah, thank you for having me on.
• 1:19:25
  Michael: No, it's it's been amazing.
• 1:19:26
  Michael: It's been fun.
• 1:19:26
  Michael: But I'll tell you what, if I said to you, I if I showed you now where you are compared to five years ago and said this is where you'll be, I think you would have bitten my hand off to be in that position.
• 1:19:36
  Michael: Yeah, true.
• 1:19:37
  Michael: So won't argue.
• 1:19:39
  Michael: I think you always have to be really like I know life is always gonna be shit running business, and there's always further to grow and always, but I think sometimes you have to live in the moment and go, Jesus Christ, I've achieved something here.
• 1:19:51
  Michael: And and okay, maybe it's not living the dream, you don't have the Ferrari, but you're living the dream compared to what you thought you might have.
• 1:19:57
  Michael: And I always say this to people in in my personal life when you were fifteen, if you if your fifteen year old self could see you today, what would they say?
• 1:20:04
  Michael: And most times like, Holy shit, you've done it.
• 1:20:06
  Michael: You know, you you Yeah, I'd agree with that.
• 1:20:08
  Michael: I'd definitely yeah, I would agree with that.
• 1:20:10
  Michael: So I think you have made it.
• 1:20:11
  Michael: I'm really pleased for you.
• 1:20:12
  Michael: Anyway, thanks for coming on and I hope everyone enjoyed it.
• 1:20:14
  Michael: Thanks, Margot.