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The New Clinic Playbook: Pricing, Technology, and Retention · No Appointment Necessary

• 0:00
  Michael: Hello everybody.
• 0:01
  Michael: Today we have Steve Hines from Wandsworth Physio and Ossio.
• 0:04
  Michael: It's still Wandsworth Physio and Ossio, isn't it?
• 0:06
  Michael: I know you primarily as a physio.
• 0:08
  Michael: Yep, still that.
• 0:09
  Michael: Still Wandsworth Physio.
• 0:11
  Michael: And um Steve owns uh a really, really good clinic.
• 0:14
  Michael: In fact, I think you own a couple now.
• 0:16
  Michael: Um uh but I met Steve it it's like six years ago now.
• 0:20
  Michael: Uh and I came down to your clinic.
• 0:21
  Michael: It was a long, long time ago, and you've you've grown a lot.
• 0:24
  Michael: And I remember at the time actually, I think um you had said that you the best decision you had made.
• 0:29
  Michael: I don't know if you remember this, best decision you had made was moving from around the corner onto the high street because suddenly your patient numbers went through the roof.
• 0:38
  SPEAKER_00: Yeah, because we were right, we're 50 metres from a busy commuter station, and there's literally thousands of people walking past each morning and each evening, and it just it massively increased the footfall, which it basically is free advertising.
• 0:52
  Michael: Yeah, it was it was it I learned from that.
• 0:54
  Michael: I remember I I tell lots of people that to this day um how important that sort of shopfront is on the high street.
• 1:00
  Michael: Anyway, so welcome Steve.
• 1:02
  Michael: Um give us a little bit of background, who you are, um, and then we'll go from there.
• 1:06
  SPEAKER_00: Okay, so I'm Steve.
• 1:08
  SPEAKER_00: I'm uh physio of 20 years, uh and trained as uh I got a sports science degree back in the late 90s, then studied physio degree, and then studied a nutritional therapy degree.
• 1:20
  SPEAKER_00: I worked in the NHS for a short period of time and then moved full-time into professional football.
• 1:26
  SPEAKER_00: I did about 10 years in professional football, mainly at Fulham, um, across like quite a successful period of that time, uh, and then transitioned out of that into private practice, initially in some other people's private practices, whilst then setting up my own, initially just renting a room and a spa and then moving to a hairdresser's basement, having two rooms there, and then taking the the shop that I'm in now, and we've continually grown that and taken more space.
• 1:54
  SPEAKER_00: So things are growing very well.
• 1:57
  Michael: What made you um what made you think about owning a business rather than just continuing to work for someone else?
• 2:04
  SPEAKER_00: Because I didn't want to work for someone else.
• 2:06
  SPEAKER_00: I think I just um I think my ex part of my experiences at Fulham, it you know, it's great to be part of that kind of team.
• 2:12
  SPEAKER_00: It was a very competitive, ego-driven, high-end sort of environment.
• 2:18
  SPEAKER_00: And I think perhaps my personality, there's only so much time you could you can last in that and being pulled in one direction and another direction and being managed.
• 2:29
  SPEAKER_00: Uh, and then I went and worked in another company's private practice, and then again there was management and expectation and KPI, and you know, I just wanted to do my own thing.
• 2:40
  SPEAKER_00: I was good at what I did.
• 2:41
  SPEAKER_00: You know, I I didn't really care that my retention rate was 75%, not 80%.
• 2:46
  Michael: So here you are, here you are, fast forwards.
• 2:50
  Michael: And you you you were that guy that was like, fuck retention rates.
• 2:54
  Michael: I just like doing clinical stuff, and now all you do as a business owner is bang on me about about retention rates.
• 2:59
  SPEAKER_00: Actually, I don't.
• 3:00
  SPEAKER_00: I've got very soft KPIs with my team, and retention is not really one of them.
• 3:04
  SPEAKER_00: Um maybe we'll come on to discuss this, but yeah, that's not one of them.
• 3:08
  Michael: So um I do you think it it was the because I think there's you you hear this a lot.
• 3:14
  Michael: I don't want to work for other people.
• 3:16
  Michael: Sometimes that's because working for other people and those specific people, or maybe in an industry, are just annoying to work for.
• 3:23
  Michael: Um if it was run properly and they were really nice people, um then you wouldn't mind working with them.
• 3:29
  Michael: And then for some people it's just an entrepreneurial thing.
• 3:32
  Michael: I do not want to work for anybody else, I want to be purely my own boss.
• 3:35
  Michael: Which one was it for you?
• 3:36
  SPEAKER_00: I think it was a bit of both.
• 3:38
  SPEAKER_00: They weren't they weren't um not nice people, they were really nice people, and obviously it was a small family business or mean medium-sized clinic, but yeah, we just had some different ideas, and I didn't, you know, I could see how they were trying to run it more as a business and trying to get more KPI and process driven, and that just didn't suit me at the time.
• 3:56
  SPEAKER_00: And I think even just entering physio the degree 25 years ago, I was pretty sure at that time I wanted my own private practice, so it's probably a little bit of entrepreneurialism as well.
• 4:08
  Michael: I think I noticed that when we first met, actually, because um you're very hands-on, or at least you were at the time on on all the little things.
• 4:16
  Michael: And I think your brother was involved for a little bit.
• 4:19
  Michael: Yeah, yeah, so he does the some marketing and SEO for me.
• 4:23
  Michael: And um, but you were very hands-on on on a lot of stuff, which is the the sort of uh one of those traits of of entrepreneurs where they do want to get their hands dirty in literally everything.
• 4:34
  Michael: Um, and you strike me as that sort of person.
• 4:36
  SPEAKER_00: Yeah, and I I I I'm probably less like that now.
• 4:38
  SPEAKER_00: It's more of an overview.
• 4:40
  SPEAKER_00: Um, so I have a couple of key staff that have taken those responsibilities off me.
• 4:45
  SPEAKER_00: But yeah, I I know everything in in the business, you know, from clinical to business to customer service, you know, some of the complaints still come through to me, or some of the invoicing errors.
• 4:58
  SPEAKER_00: I'm like, why has that happened?
• 4:59
  SPEAKER_00: You know, I want to I want to know everything.
• 5:01
  Michael: Yeah.
• 5:02
  Michael: Um that leads on to a nice base section because I think you can, as an entrepreneur, when you're smaller, you can be involved in everything.
• 5:09
  Michael: And as you grow to the to the level you have, you just can't, right?
• 5:12
  Michael: You need other people, you need a uh a bit of structure.
• 5:15
  Michael: I remember the days when I literally read every email that came in from anybody, and now you know I'd spend 3,000 days of a year doing that.
• 5:23
  Michael: So um, so moving into it, you you've got a really successful clinic now, and we're about to release the private practice barometer, or we will soon.
• 5:32
  Michael: And uh, you know, you you are in that top 1% of clinics.
• 5:36
  Michael: And what I really want to talk about and investigate today is for a clinic that is as successful as yours and very much organically grown as well over time.
• 5:46
  Michael: So it's not like you had a ton of investment and suddenly you spent a load of money.
• 5:50
  Michael: Um, what are the things now?
• 5:52
  Michael: I don't want to get into the growth element, I want to get into what you do now to keep the clinic running, how what are the things that you focus on?
• 6:00
  Michael: Um, because I imagine a lot of what you do now is much more defensive rather than off offensive.
• 6:06
  Michael: Um, it's about operational quality as opposed to how do we get leads in, how do we get more patients through the door.
• 6:14
  Michael: Um, so be really be really interested to to kind of understand what you're doing, how you're doing it, and exploring some of those themes.
• 6:22
  Michael: And I think um the first one that I think is quite interesting is is all around margin protection.
• 6:30
  Michael: Because as you grow, margins become super, super, super important.
• 6:36
  Michael: Um, and it's probably one of the big things that you look at on a on a daily basis.
• 6:41
  Michael: Um, and and smaller clinics, it's not so much about margins, it's more about growth.
• 6:45
  Michael: So, talk to me about how margin protection has become a bit of a core skill for you today.
• 6:51
  SPEAKER_00: So, I guess the ways that we've to work around that is regularly putting prices up every year over the last four or five years and having staff tiers so people can come in and see the physio, the advanced physio, the advanced senior physio, the clinical director, and all of those things have different like price points to them.
• 7:11
  SPEAKER_00: And then I think it's it's about developing advanced services that uh we've sort of implemented again over the last sort of uh four or five years to try to drive revenue.
• 7:23
  SPEAKER_00: And then it's probably things like if um investing in technology so that we can deliver those services, and then it's other things like we we haven't done this yet, but we're we're looking we're looking at the revenue we generate.
• 7:39
  SPEAKER_00: Obviously, you've got your fixed cost base, you've got your salary, there that's doing nothing but go up, you've got your rent that's doing nothing but go up.
• 7:47
  SPEAKER_00: So, where where can we make some um more?
• 7:52
  SPEAKER_00: I don't want to say savings because that doesn't sound where can we more effective or efficient with how we spend our money?
• 7:59
  SPEAKER_00: And what we're starting to look at now is moving across the different diary systems where we've we've got a very good diary system, everything's sort of uh automated, we've got online bookings, but we're trying we want to try and explore, for example, you spoke to Tanme, Lingo, uh AI call answering, and introducing that.
• 8:20
  SPEAKER_00: That that might um reduce the need for as many reception cover, uh receptionists and reception cover, for example, and then just the back-end stuff as well, sort of like 30 30% of our revenue is still insurance-based.
• 8:35
  SPEAKER_00: That's all got to be invoice for.
• 8:37
  SPEAKER_00: That's a manual task that someone has got to perform.
• 8:39
  SPEAKER_00: So, again, getting the the right diary software where you can link into Ephra or you can link into one of these companies that take that element and do it for you, and then the person you're paying to do that, perhaps they can be retasked onto something else.
• 8:56
  Michael: I uh yeah, that's interesting because it's it's using tech and uh kind of optimising as much as you can times and so on.
• 9:03
  Michael: Um, I'm interested though, in in what you said about prices and your price increases and also your costs going up.
• 9:12
  Michael: I imagine some of this is also about not selling the cheaper services quite as much.
• 9:19
  Michael: I do wonder, five, six years ago, were you doing a lot of lot more cheap massage than you are today?
• 9:25
  Michael: Have you kind of replaced that and moved into those advanced services more?
• 9:29
  SPEAKER_00: I think, yeah, definitely.
• 9:30
  SPEAKER_00: I think five years ago we were more traditional physio clinic, physio sports massage.
• 9:35
  SPEAKER_00: We've had osteopathy podiatry all across that time.
• 9:38
  SPEAKER_00: We introduced Shockwave in 2019, and I think then I bought an ultrasound machine and did starting my ultrasound training in 2020, so started introducing that into physio services and then charging more for an appointment with an ultrasound scan, um, and then learning how to prescribe, learning how to inject, offering those as services, um, and then other other technology sort of so let me ask you a question on that because I I I have a feeling the answer is no.
• 10:10
  Michael: I don't know.
• 10:10
  Michael: But um when you're thinking about Capex and you're you're looking at your new focus shockwave, I saw we did a post on LinkedIn recently about it, you're looking at shockwave or ultrasound or whatever it might be.
• 10:20
  Michael: Are you looking that at that from a clinical perspective, like most clinical owners do, and saying this is gonna improve outcomes, and then you kind of um retrofit the pricing around it, or are you looking at it from an investment perspective of this is the the cost of it, this is the price we're gonna now increase our prices to, and this is how it's gonna make our money.
• 10:41
  Michael: Like which which side are you on?
• 10:43
  Michael: Are you now the more commercial or still the very clinical?
• 10:46
  SPEAKER_00: It's definitely both.
• 10:47
  SPEAKER_00: I mean, you you have to weigh up, it's an expensive machine, you know, 25,000 plus.
• 10:51
  SPEAKER_00: So you've got to work out like what you're gonna sell a package for, how many of those packages do you need to deliver to pay off the machine?
• 10:59
  SPEAKER_00: Uh that's usually paid off pretty quickly, to be fair.
• 11:03
  SPEAKER_00: You know, the the radial shock wave we've had for six years, it paid itself off a long time ago.
• 11:07
  SPEAKER_00: So it then then you start to say, well, okay, we'll get that machine, invest in it, pays it off, and then it's it's you know, it's a money generator from that point.
• 11:15
  SPEAKER_00: So there's definitely a commercial aspect to it, as there was with ultrasound and injections.
• 11:22
  SPEAKER_00: Like these are not like cheap things for the patients to buy.
• 11:26
  Michael: But I'm thinking commercial aspect to it, yeah.
• 11:29
  Michael: I'm thinking in terms of the pricing stretching, because I think a lot of the time you you said um you increase pricing every year, and I see that a lot in this industry.
• 11:37
  Michael: It always baffles me why people increase pricing once a year, why not once a month, why not once every three months, whenever whenever it's required or changes.
• 11:45
  Michael: Um but a lot of people, very few people rather, they don't they don't look at their pricing as a response to expenditure or a capital expenditure or increased um uh skills or or experience.
• 12:02
  Michael: They just go, okay, we charge 85, we should put it to 87 or often 87 or 95 or whatever.
• 12:09
  Michael: Do you have do you have you built out a pricing strategy in that way to think about pricing as more as just sort of a yearly we must increase by five quid a year, or is there something more deep to it?
• 12:20
  SPEAKER_00: I probably did in the past just be like, well, we charge 50 quid, so let's put it to 55 quid and let's put it to 60 quid.
• 12:27
  SPEAKER_00: I think more recently you have to look at it more from a business perspective.
• 12:31
  SPEAKER_00: So you've got your fixed, fixed cost base, you've got all of your consumables, you know, you've you've got to sort of make a certain amount of money, and then anything beyond that is profit, and then you've got to think, well, of that profit, what can I reinvest into additional space, into technology?
• 12:48
  SPEAKER_00: And then you know, you you work out what your patient visit visit average is, what your patient, what your average uh appointment cost is, how many appointments are we doing each month?
• 13:00
  SPEAKER_00: Like, what have we got to put our prices up to just meet to stay stable, never mind to grow, and then you know you kind of have to add a bit more in to enable you to grow.
• 13:12
  SPEAKER_00: So I think there's definitely some some greater thought process in it now than five years ago.
• 13:18
  Michael: Do you think that uh a little bit like house prices, um, there's gonna come a point uh where the cost of running a physio clinic, particularly with the increase of wages and so on, you get into a bit of trouble because you you're not gonna be able to increase uh patient prices enough to cover everything.
• 13:37
  Michael: So, as an example, right now I think pretty much every physio, even you, is undercharging.
• 13:41
  Michael: I know you should be charging 50% more, if not 100% more.
• 13:44
  Michael: But there will come a point.
• 13:45
  Michael: You know, no one, it's gonna be very difficult to charge£400 an appointment, for example, um, even with inflation and everything else.
• 13:51
  Michael: Do you see that happening soon?
• 13:53
  Michael: Do you see, are you worried about that?
• 13:55
  SPEAKER_00: I'm not worried about it, and I probably haven't thought too far into the future about that, to be honest.
• 14:02
  SPEAKER_00: But um perhaps I don't see that.
• 14:05
  SPEAKER_00: I think uh there's there's a pretty much a going rate, I think, for these kind of services.
• 14:10
  SPEAKER_00: You know, you see what your competitors are around you are charging in London, outside of London, what a sports physician might charge, what a surgeon might charge.
• 14:19
  SPEAKER_00: I I think our prices are pretty, pretty um well priced for that.
• 14:24
  SPEAKER_00: But yeah, I think it it just depends on wage growth.
• 14:28
  SPEAKER_00: I think you know, when you have a uh a premises, you've got a lease, there's there's um structured rent raises within that for up until a break clause.
• 14:38
  SPEAKER_00: So you can kind of project what that's gonna be.
• 14:41
  SPEAKER_00: Energy prices have been quite stable over the last few years.
• 14:44
  SPEAKER_00: You can you know you kind of factor that in.
• 14:46
  SPEAKER_00: It it really comes down to wage growth, and it is a little bit unsettling, I suppose, in a way, because you look at now what the bans are in the NHS for 5, 6, 7, 8A, and they are going up.
• 14:58
  SPEAKER_00: And you kind of wonder, well, Jesus, how how can I compete with that?
• 15:02
  SPEAKER_00: And then in a purely self-funded market, you probably could.
• 15:07
  SPEAKER_00: But what we've also got is the medical insurance market, uh, where different clinics, some clinics don't work with them at all, some clinics will see more of those.
• 15:17
  SPEAKER_00: We still work with most of them, but their prices are low.
• 15:20
  SPEAKER_00: They're like some of them are like 30% of what we're looking to charge now.
• 15:26
  SPEAKER_00: And we we're like, I don't know how much longer we can actually work with these companies.
• 15:30
  Michael: I mean, that is a common story.
• 15:32
  Michael: Uh, I I don't think I know a single clinic that isn't very quickly trying to get rid of all of the insurance stuff and just go much more private.
• 15:41
  Michael: And but they've got lots of strategies around that, such as uh you don't see anyone seeing you as an insurance patient, for example, or uh you do not get premium times, you do not get you know morning or or evenings, you only get during the day, that kind of thing.
• 15:55
  Michael: Um, I think that's that's definitely something that people are having to change.
• 15:58
  Michael: I think in in as well, in terms of the the the pricing angle, I think um I still think everyone in in the industry is undercharging, um, particularly when you compare yourself to the 300 quid haircut your missus gets, you know.
• 16:12
  Michael: Um but but I think that what's quite interesting is something I'm seeing uh at the moment, and I think it's gonna get even uh more important, is that you're gonna have this pricing mismatch.
• 16:24
  Michael: You're gonna get those clinics that are super cheap, right?
• 16:26
  Michael: They're the IKEAs, it's in, out, uh, you get seen, it's a quick point, whatever.
• 16:32
  Michael: Um, and I don't not talk clinically here, just in terms of time and the kind of vibe of that that business.
• 16:37
  Michael: Then you get the high-end ones, right?
• 16:38
  Michael: The ones that are charging serious money.
• 16:40
  Michael: Uh in London, I would that's£120 plus.
• 16:44
  Michael: Um, and then you get the ones in the middle, the ones that are sort of following the market.
• 16:47
  Michael: Everyone else charges 60 quid or 65 quid, so therefore I'll I'll charge that.
• 16:51
  Michael: I think that bracket for people are actually going to get really lost.
• 16:55
  Michael: I think patients are going for either really cheap or really expensive, they're not they're not staying with those paints in the middle.
• 17:02
  Michael: Have you seen that at all?
• 17:03
  Michael: And and I and I asked that in reference specifically, for example, to your tiered pricing.
• 17:08
  Michael: Because when you start offering tiered pricing, you can quite see, quite quickly see where the demand is.
• 17:13
  Michael: Um, and often it's the the super expensive stuff or the cheaper stuff.
• 17:16
  Michael: So are you seeing that same trend?
• 17:18
  SPEAKER_00: I don't know if I'm seeing it to be honest, but I think those cli I was just thinking that those clinics that are in the middle need to make a decision.
• 17:24
  SPEAKER_00: They need to either go cheap and and like maybe less experienced physios, lower wage, shorter appointments, fewer contacts, or they need to start going high-end, they need to start going recurring revenue, like retention, not physio retention, but business retention.
• 17:42
  SPEAKER_00: Um, but yeah, I don't know if I'm particularly seeing that yet.
• 17:45
  SPEAKER_00: And we've only just put our prices up in January, and we put them up a fair bit, to be fair.
• 17:50
  SPEAKER_00: So we'll probably see uh over the next few months where the demand lies.
• 17:57
  SPEAKER_00: But it it it also depends on the personality and the therapist.
• 18:03
  SPEAKER_00: You know, some therapists have just got, like we were discussing before this recording, like some people have just got much greater empathy, much greater connection.
• 18:12
  SPEAKER_00: It doesn't matter that they charge 85 pounds, people they just keep coming back.
• 18:16
  SPEAKER_00: Whereas somebody that's charging 70 pounds, maybe they're not as empathetic, engaging, rapport-building.
• 18:22
  SPEAKER_00: Perhaps they need to work on that to um improve their patient skills.
• 18:28
  Michael: I suppose as a as a now we'll call you that an advanced clinic, um, there is, I'd be interested to see what you how you would solve this.
• 18:36
  Michael: Let's take those clinics in the middle that have to make a decision.
• 18:39
  Michael: They don't want to go cheap because we know most physios are fantastic, good people, they want to help people.
• 18:45
  Michael: And going cheap makes it more difficult to do that.
• 18:47
  Michael: But to go more expensive, you know this as well as I do, you can't just put your prices up.
• 18:52
  Michael: You've got to offer more, which offer mean investment, which will mean putting money into a shock baby or whatever it might be.
• 18:58
  Michael: That's very difficult for many of those middling clinics to do.
• 19:02
  Michael: They don't have 25 grand in the bank account, they don't have the the margins to start spending, you know, 100 grand, 200 grand on training and investment and so on.
• 19:11
  Michael: How how did you do it?
• 19:13
  Michael: How how did you get out of that sort of that growth stage where you you didn't stop and plateau at that middling level, but you want it went on to the next level?
• 19:23
  Michael: And how would you advise other clinics to do that?
• 19:25
  SPEAKER_00: Oh gosh, I mean, we've probably done so many different things over the years.
• 19:28
  SPEAKER_00: I I one of the things that comes to mind is just customer service.
• 19:32
  SPEAKER_00: We've we've we've really worked on that uh probably from like 2016, 2017.
• 19:40
  SPEAKER_00: I did a lot of training with Celia, who who I know does some stuff with you, and really thinking about like your purpose, your vision, your values, that patient journey through the business, what you want their experience to be.
• 19:54
  SPEAKER_00: Because, like, as a physio, you're kind of caught up in in the business.
• 19:58
  SPEAKER_00: I'm I'm a physio, I know what it should be.
• 20:00
  SPEAKER_00: But what I say to my team is like, think about when you've been to a hotel.
• 20:04
  SPEAKER_00: Like, what was what did it feel like to have shit service or to have excellent customer service or a dentist or you know, sometimes in NHS clinics, I remember going to a hospital once and uh it was for a blood test.
• 20:18
  SPEAKER_00: And I walked in and I was like, Oh, hi, I'm Steve.
• 20:21
  SPEAKER_00: The the girl didn't even look at me, she just went, What's your name?
• 20:23
  SPEAKER_00: Oh yeah, he's running 45 minutes late.
• 20:25
  SPEAKER_00: I've I literally just walked, turned around and walked out, and like, oh, just book it again somewhere else.
• 20:30
  SPEAKER_00: So it's it's really about customer service, every touch point from when they click on an ad and go on your website, or how easy is the online booking?
• 20:40
  SPEAKER_00: How quickly is the phone answered?
• 20:42
  SPEAKER_00: What is the person's tone like on the phone?
• 20:46
  SPEAKER_00: And when they've made that appointment, you know, do they get their reminders?
• 20:50
  SPEAKER_00: When they arrive in the clinic, are they greeted with a smile?
• 20:52
  SPEAKER_00: Do you know their name?
• 20:54
  SPEAKER_00: Is the does the clinic look nice?
• 20:56
  SPEAKER_00: Is it look nice?
• 20:57
  SPEAKER_00: Does it smell nice?
• 20:58
  SPEAKER_00: You know, does their appointment start on time?
• 21:01
  SPEAKER_00: You know, that really pisses me off when I go to an appointment and it's five past, and I'm like, I've got to go.
• 21:06
  SPEAKER_00: Like I need to finish at half past because I need to, I've got uh another appointment myself.
• 21:11
  SPEAKER_00: So I always drilling into my my staff, start on time, finish on time, every appointment.
• 21:17
  SPEAKER_00: So it I think we've really tried to work on that.
• 21:21
  SPEAKER_00: So let's let's start that.
• 21:22
  Michael: Uh because it's interesting you started with that.
• 21:25
  Michael: Um, because I think it's the most important thing any business could do is thinking about that that patient experience, which done really well.
• 21:31
  Michael: And um, because we all know what shitty service is, and we all know, particularly when it comes to healthcare.
• 21:36
  Michael: I have a long old story about 40, which was an absolute disaster, put that in my newsletter.
• 21:42
  Michael: Um, and it you know, never gonna go there again.
• 21:45
  Michael: And and I think that there are there are a lot of people that ignore the experience part, even though in real life they go to a hotel that's crap, they go to a restaurant that's crap, and you know, everything takes an hour to get your food.
• 21:58
  Michael: They know in their own lives that it's it it that the experience is super important, but they don't think about it in clinic.
• 22:05
  Michael: And I think it's genuinely one of the most important things going forward because it's all about brand, right?
• 22:09
  Michael: It's how people perceive you and and how they think about you.
• 22:12
  Michael: And I don't know if I told this story on another podcast, but I went to a restaurant recently, it's a pretty crappy restaurant.
• 22:17
  Michael: Um, went to the toilets, the toilets are insane.
• 22:19
  Michael: We walk out of the restaurant going, that was pretty cool.
• 22:21
  Michael: I mean, it was crap, but the toilets are incredible, and it's amazing what what just a bit of thought, um putting a bit of thought into the business is is like and and how important it is.
• 22:31
  Michael: And out of interest, do you do any sort of mystery shopping at all?
• 22:35
  Michael: Because this is something I I feel like we should be doing is getting either the wife or a friend or whatever actually booking the points, going through the process to give you that objective advice.
• 22:44
  SPEAKER_00: Within my own business.
• 22:46
  SPEAKER_00: No, I've never done that, but I think you you there's there's some patients that you know really well, you that you've been seeing them for years, and they will give you honest feedback, and I always sort of welcome that.
• 22:56
  SPEAKER_00: And I remember, yeah, one what somebody told me, Oh, I spoke to one of your receptionists.
• 23:01
  SPEAKER_00: This was a few years ago.
• 23:02
  SPEAKER_00: It sounded like she was asleep on the phone.
• 23:04
  SPEAKER_00: I was like, um, so yeah, you you've really got that that front desk is the it's the first impression, you know.
• 23:11
  SPEAKER_00: That receptionist is so important.
• 23:13
  Michael: Um, and it's like if they don't look at you, you walk in and they're just completely ignoring you and say, like, hello, uh, yes, uh, I've got an appointment.
• 23:21
  Michael: What's your name?
• 23:22
  Michael: Yeah, come on, you you know, particularly, you know, it it's it's it's that kind of expectations element as well.
• 23:28
  Michael: If you're charging um big money, you can't act like that.
• 23:32
  Michael: You know, you uh you can't go to the con.
• 23:34
  Michael: You you walk into the connot, you people should do it just just for funsies and see how they treat you.
• 23:39
  Michael: I mean, they treat you like royalty um because they know you're gonna pay three grand a room here, right?
• 23:44
  Michael: Um, you're not going to some hotel in Pimlico.
• 23:46
  Michael: So I think um if you're gonna charge the big prices, you've got to align that with everything that you're doing in clinic.
• 23:52
  Michael: Because I think, and we discussed this, patients don't know what good clinicians are until they've seen them.
• 24:00
  Michael: And even when they have, they often don't know what a good clinician is.
• 24:04
  Michael: But what they do take away, because as long as you press them a bit and made them um hurt you, a bit hurt you, you know, in their sore bits, they often go away thinking, oh, that was good, then this is how bad clinicians survive and actually do quite well.
• 24:15
  Michael: But they do remember the experience.
• 24:17
  Michael: That's the one thing, as you say, was appointment on time, was it a nice waiting room?
• 24:21
  Michael: Was I sat on some plastic chair?
• 24:24
  Michael: Um, were people nice to me?
• 24:25
  Michael: Was the clinician nice?
• 24:26
  Michael: So I think those are almost more important than clinical excellence and CPD.
• 24:32
  SPEAKER_00: Well, as important, and hopefully, if you get all of those soft business uh and customer service things elements right, and you have like very good practitioners, uh, advanced skill, um, technology, and you give great service clinically as well as customer service, then I think I I perceive that is how my business has grown.
• 24:55
  Michael: So, as a uh you we're talking again, going back to it about you know, you're a middling clinic, you want to go to that next level.
• 25:03
  Michael: So you went for kind of we'll call it customer service, customer experience as the number one thing.
• 25:08
  Michael: What would be the next thing that that you you focused on?
• 25:12
  Michael: I guess some of it was investment in in training and and technology.
• 25:16
  SPEAKER_00: Um so staff and technology, you know, you staff are one of your greatest assets.
• 25:22
  SPEAKER_00: So you know we've had some good hires and bad hires over the over the years.
• 25:26
  SPEAKER_00: We've got a really good team at the moment, and uh the last couple of years I've really been focusing on my team.
• 25:32
  SPEAKER_00: So like we were talking uh about sort of soft KPIs.
• 25:37
  SPEAKER_00: I don't sort of sit and have one-to-ones and I'm like, you've done this many patients, this is your patient average, this this is your retention rate.
• 25:45
  SPEAKER_00: I did that in the past, you know.
• 25:46
  SPEAKER_00: I don't do that now.
• 25:47
  SPEAKER_00: It's like, what do you want to do?
• 25:49
  SPEAKER_00: Like, what what excites you?
• 25:51
  SPEAKER_00: I want to learn Pilates, great.
• 25:53
  SPEAKER_00: So when when can we get you on a course?
• 25:55
  SPEAKER_00: Um, so that they become the KPIs.
• 25:58
  SPEAKER_00: Like, I want to learn ultrasound scanning, great, let's get you on that course.
• 26:02
  SPEAKER_00: Like, I'll supervise you.
• 26:03
  SPEAKER_00: So it's really about engaging the staff, getting them to do what they want to do.
• 26:10
  SPEAKER_00: Uh Celia, uh many years ago on her one of her courses talked about Daniel Pink Pink's book, Drive, Mastery, Autonomy, and Purpose.
• 26:19
  SPEAKER_00: So, you know, they want to master something.
• 26:21
  SPEAKER_00: So, can they master a skill?
• 26:23
  SPEAKER_00: And can I facilitate that?
• 26:25
  SPEAKER_00: They want to be autonomous in how they how they practice, and then you know, you've got to work towards a common purpose, and that's all about the the business ethics, the business values, the business purpose about like our purpose.
• 26:39
  SPEAKER_00: We just want to get people back to what they love doing, and everyone sort of invested into that.
• 26:44
  SPEAKER_00: So that's how I sort of retain this the staff and incentivize the staff, and then it's providing the environment for them.
• 26:51
  SPEAKER_00: So that is an investment in the technology.
• 26:54
  SPEAKER_00: So we've got for ultrasound scanning machines, that's 100 grand of like investment.
• 26:59
  SPEAKER_00: We've got a radial and a focus shock wave, we've been um getting the valved technology in, we've got blood flow restriction um devices, you know.
• 27:09
  SPEAKER_00: We're as we were talking about earlier, we're we're now look looking at going down a reformer um pathway.
• 27:15
  SPEAKER_00: And so, you know, reformers are not cheap, especially if you want several of them.
• 27:19
  SPEAKER_00: So creating creating that.
• 27:21
  SPEAKER_00: So it's about environment, it's about staff.
• 27:25
  SPEAKER_00: Uh they're the they're the the the things that I'm trying to do to grow.
• 27:30
  Michael: Yeah, I mean, and uh that focus on staff, because it you can't split it up really, it's staff, it's training, it's technology, it's all of it put together.
• 27:36
  Michael: Alvin, who's your worst staff member?
• 27:38
  Michael: No, it's Joe.
• 27:40
  Michael: Oh no, I was like, mmm, probably um okay, let's move on to uh a topic that everyone's probably bored of, but I think it's super important, which is AI.
• 27:52
  Michael: Um I think that you're again as a as a clinic a little further down the line, you are not using AI necessarily for growth.
• 28:01
  Michael: I think lots of people are, um, which is a good thing, by the way.
• 28:04
  Michael: That's that's great, but that isn't the sort of the focus for you, right?
• 28:09
  Michael: That's it's it's about using AI, whether it's AI or automation or whatever it might be, it's about optimization now.
• 28:15
  SPEAKER_00: Yeah, we definitely want to get it into the business.
• 28:17
  SPEAKER_00: We use AI for uh like Heidi for the notes.
• 28:20
  SPEAKER_00: I certainly do.
• 28:21
  SPEAKER_00: I know some of my other team members do, and that has really been game changing.
• 28:25
  SPEAKER_00: You can just sit and listen to the patient, you don't have to be sitting and typing, and you know, after five or six patients in the past, like which one had the back, which one had the elbow?
• 28:34
  SPEAKER_00: You know, it's it was a nightmare.
• 28:36
  SPEAKER_00: I I had to sit and type my notes there in front of a patient.
• 28:39
  SPEAKER_00: Um, but yeah, that that's fantastic.
• 28:41
  SPEAKER_00: Uh, as we've discussed, yeah, love to get in the call answering, the invoicing.
• 28:47
  SPEAKER_00: Um, and then yeah, I'm not sure.
• 28:49
  SPEAKER_00: I use ChatGPT a lot just for formulating policies and email responses and you know, various various things.
• 28:58
  Michael: And and and probably think something like a knowledge base, like a notion or something for all of your staff, documents, CPD, hollow, or you know, all of that stuff as well.
• 29:07
  Michael: I think um I'm interested because I I heard or I read someone talk about AI notes being the devil.
• 29:15
  Michael: And they were talking about unit cost economics and how it doesn't isn't worth it and actually harms patients and so on and so forth.
• 29:22
  Michael: And my view on that is it's bullshit.
• 29:24
  Michael: I think it's it's about changing your processes because you can't just go, we do everything like this, now just plump something in.
• 29:32
  Michael: You've got to really think about how you integrate that and and how you use it, rather than just going, well, let's bunk it in and hope for the best.
• 29:39
  Michael: Um it's that's something you've looked at as well, is is it's not just the implementation of the technology, it's the processes around it, um, and and how you use that technology.
• 29:49
  SPEAKER_00: Yeah, I think implementing AI notes was pretty pretty straightforward.
• 29:53
  SPEAKER_00: You just go from typing and listening to switch, you just got to remember to switch the device on at the beginning of the consultation and switch it off at the end.
• 30:00
  SPEAKER_00: But yeah, I think implementing some of the other things is definitely gonna be a big process and a big challenge that needs uh a lot of thought and a lot of investigation, trying to find the right things, and then yes, like trying to strategize the problems that it might cause and like foresee them and think about solutions to them for sure.
• 30:22
  Michael: What what would you say are the two, three, four, whatever um biggest issues you'd love to solve or you have already solved with um AI or or tape?
• 30:34
  SPEAKER_00: I think the biggest issues that we want solving are I think as we were talking about is uh invoicing.
• 30:41
  SPEAKER_00: So we still see a fair amount of uh insurance-based patients.
• 30:47
  SPEAKER_00: If there is an easy automate automated way of doing that, then that will be that would be excellent.
• 30:56
  SPEAKER_00: Uh, and then um, yeah, maybe just the the bookings element.
• 31:01
  SPEAKER_00: Like I think online bookings, you know, think 10 years ago we didn't have that, but being able to book online, pay online, it you know, maybe 30% of our bookings are online, and that rem removes a somebody from our business having to do that, having to answer questions, take card details, it's kind of it's done, you know.
• 31:19
  SPEAKER_00: It just simplifies the whole process.
• 31:21
  SPEAKER_00: That's actually very low, 30%.
• 31:24
  SPEAKER_00: Yeah, I'd I'd have to look.
• 31:26
  SPEAKER_00: I think it's about 30%, yeah.
• 31:28
  SPEAKER_00: Still got a lot of telephone calls.
• 31:30
  SPEAKER_00: So, like implementing that some kind of telephone service, or we have a human-based overflow service, and maybe we could get that answered by AI.
• 31:40
  SPEAKER_00: Um because human error comes into it quite a lot, you know.
• 31:43
  SPEAKER_00: It depends on the different therapist, on the different uh sorry, the different receptionists, different day, their knowledge and understanding of the different appointments, their manner and tone with customers.
• 31:53
  Michael: Whether they're having a good day or a bad day, like we all have them, right?
• 31:56
  Michael: And impact it.
• 31:58
  Michael: Um yeah, I think I think you know, I did talk to Lingo, uh, and and I love Lingo.
• 32:03
  Michael: There's others as well, you know.
• 32:04
  Michael: Motix, Motix is a is another one um that are very, very good.
• 32:08
  Michael: Yeah, I I I Ephra, I know that's not an on-thone answering side, but I think are you using Ephra as well?
• 32:15
  Michael: Not at the moment, no.
• 32:16
  SPEAKER_00: Okay.
• 32:17
  SPEAKER_00: That's something we're looking into.
• 32:18
  SPEAKER_00: And I think the other sort of um big challenge for for physiotherapy and and specifically AI is this AI physiotherapy that's sort of coming into the space.
• 32:28
  SPEAKER_00: Um, you know, there's there's companies now that are triaging, managing, diagnosing, giving exercise plans to and discharging uh NHS patients purely through AI.
• 32:41
  SPEAKER_00: And you know, I think that has a place for sure.
• 32:45
  SPEAKER_00: Um and I think that's gonna be a bit of a disruptor over the next few years for maybe the NHS, less so for private practice, but certainly for those cheaper um NHS private practices where it's just sort of uh assessment, diagnosis, exercise, and advice.
• 33:06
  Michael: Yeah, I actually think it's gonna have a massive impact on the private industry.
• 33:09
  Michael: Um I I think it already is having.
• 33:12
  Michael: Um, because I mean, you you tell me, but everyone I've spoken to has said, yeah, patients now come in with a full diagnosis and the rehab program.
• 33:22
  Michael: Um I think also so I think that's one thing.
• 33:25
  Michael: I think clinics, and it's not a threat, I think it's a massive opportunity.
• 33:28
  Michael: Um, I think the people who think it's a threat are you know doomongering and a bit scared.
• 33:34
  Michael: It's not.
• 33:34
  Michael: I think you should see an opportunity in it.
• 33:36
  Michael: But I think that that that's definitely an issue.
• 33:39
  Michael: How do you handle that?
• 33:40
  Michael: How do you handle a much more informed patient?
• 33:43
  Michael: For many clinics, you have to be very, very careful.
• 33:48
  Michael: Um, I mean, any business has to be careful now.
• 33:50
  Michael: We got customers doing a chat GPT.
• 33:52
  Michael: Is this ad account any good?
• 33:54
  Michael: And fortunately, so far, everyone's gone, oh, chat GPT says it's great.
• 33:57
  Michael: But if I come in and you say I'm gonna do some laser red light cupping on your head to cure your ED, like I'm gonna put that into GPT and it's gonna say this guy's a moron.
• 34:07
  Michael: So you've got to be careful clinically, you've got to be consistent, I guess, um, across the board.
• 34:12
  Michael: You can't probably get away with saying some of the things about uh not you, uh certain people can't get away with saying some things about the tech that they say it can do that actually it can't, um, maybe certain treatments.
• 34:25
  Michael: I think that's a real threat for many, many clinics.
• 34:28
  Michael: But then beyond that, uh uh I I see a big threat in terms of the delay and reduction of patients that would come into clinics for conditions that they're gonna get better with anyway over the next three, four, five, six days.
• 34:45
  Michael: So, an example might be a sprained ankle.
• 34:47
  Michael: Um HIFGPT, I've fallen over, I've sp I've twisted my ankle, it really hurts, it's blown up the size of a football.
• 34:53
  Michael: First question can you walk on it?
• 34:55
  Michael: Yes, I can, it's just painful.
• 34:57
  Michael: In that case, don't worry about it, don't need to see a physio, don't need to do anything, stick some ice on it, put it up, you know, relax for a few days.
• 35:04
  Michael: Come to me in three or four days uh if it hasn't got better or if it gets worse.
• 35:09
  Michael: Now that same person would have gone straight to the physio.
• 35:12
  Michael: Now they don't.
• 35:13
  Michael: And I think there's a lot of that happening.
• 35:15
  Michael: And I see that uh in all of our stats is those newer patients with those less complex conditions are not coming in as much as they did.
• 35:22
  Michael: And I think it's only going to get worse as AI becomes more prevalent.
• 35:26
  SPEAKER_00: Yeah, I would agree.
• 35:27
  SPEAKER_00: And I think that that's certainly the case that you might not see people so acutely presenting with minor uh injuries that that can be managed that way.
• 35:37
  SPEAKER_00: I'd probably say that what I'm experiencing as a clinician is people are coming in, and there's not everyone, but some of that are saying, Oh, I've chat GPT'd or I've looked up on A AI and this is what my problem is, and I'm like, No, it's not.
• 35:50
  SPEAKER_00: You know, that that's completely wrong.
• 35:52
  SPEAKER_00: Or we're offering advanced services so we can sort of ultrasound scan or um you know use other technology to give people better diagnoses, or we're seeing people like in exactly that scenario with an ankle sprain, they'll come in eight weeks, ten weeks later and going, Yeah, it's not not better.
• 36:11
  SPEAKER_00: Like, you know, I thought it was just an ankle sprain, and yeah, you scan it and you're like, you've got an avulsion fracture, that's why, you know, it's gonna take three months, not not three weeks.
• 36:19
  SPEAKER_00: So, yeah, there's an element of that, and I think what we're how we're trying to counter that is to ad offer advanced service, advanced skill, advanced technology.
• 36:28
  Michael: And I think it's partly about going back to that experience element, right?
• 36:33
  Michael: Um, I I I think that it's maybe a silly analogy.
• 36:37
  Michael: I don't need to go to the gym today, but I'm going to because I want to, I enjoy it.
• 36:41
  Michael: Um, and I think the same goes for many services, where you're you're broken in some way.
• 36:47
  Michael: You know what, I want to go and see Steve.
• 36:49
  Michael: I want to go and see the clinic, it's a comfortable place for me to be.
• 36:52
  Michael: And I think if you are providing that experience, ChatGPT, I think, is brilliant.
• 36:56
  Michael: And and it's already two or three times stopped me from going anywhere for different things.
• 37:02
  Michael: But it's it's not the same thing as going to see a person.
• 37:06
  Michael: And even if you say, Yeah, ChatPT's got it absolutely right.
• 37:08
  Michael: Now let's look at you know why and how it's happening.
• 37:11
  Michael: Because also I think explaining it as a human being to a human being, we're talking about how people have different personalities.
• 37:17
  Michael: With me, just give me the card hold facts.
• 37:19
  Michael: I don't need a 15-minute explanation and cuddles and hugs, but some people do, and and so I think that's something that ChatGPT can't do or AI can't do and can't necessarily recognize.
• 37:30
  Michael: Um, so again, I don't think it's necessarily a threat for people who think about it carefully and and and innovate.
• 37:36
  Michael: It's a threat for those people, you know, if you're still doing in two years' time, if you're still doing what you did five years ago, I think it's fucked well, honestly.
• 37:44
  Michael: Um I think physio for too long a time has got away with saying, we'll just do the same thing as we've always done.
• 37:50
  Michael: I think that's ending for all sorts of reasons, not just AI.
• 37:53
  Michael: I think because of the roll-ups, because of the acquisitions, mergers, I think because um younger clinicians are becoming much more innovative and they're they're driven.
• 38:02
  Michael: Um, and I think the space has changed.
• 38:04
  Michael: I think it's it's moving at a much faster pace than I've seen in in a long time.
• 38:09
  SPEAKER_00: Yeah, I mean, I sort of made some comments uh on LinkedIn a while ago, just calling that old school school physio.
• 38:15
  SPEAKER_00: That was the kind of physio I had 30 years ago, and we can't keep doing that now.
• 38:20
  SPEAKER_00: You know, we need we need to sort of evolve and progress.
• 38:23
  SPEAKER_00: And some of the pushback from that was that it's also about the human element and the empathy and the interaction and the communication.
• 38:31
  SPEAKER_00: Yeah, absolutely.
• 38:32
  SPEAKER_00: I I get that, but we've also got to keep up with the times, integrate tech, integrate AI, integrate advanced services.
• 38:40
  SPEAKER_00: We've got to be kind of progressing.
• 38:44
  Michael: Yeah, and I suppose that um that progression requires more investment, and I suppose potentially uh acquisition as well, because progression is about you know, you've only got so much room.
• 38:56
  Michael: This is one of the problems for a physio.
• 38:57
  Michael: You've got five rooms, let's say.
• 38:58
  Michael: You've only got five rooms, you can only do so many appointments a week.
• 39:01
  Michael: Yeah, okay, maybe you can shorten them and whatever, but there is a ceiling, so that means probably expanding, opening whether it's it's opening a brand new clinic or acquiring a new clinic.
• 39:12
  Michael: Um, and I guess that's the route you kind of have to go to, unless you want to run that lifestyle business.
• 39:17
  SPEAKER_00: Yeah, I think it that's exactly what we're trying to do, taking more space where we are, trying to do an acquisition at the moment, opening up satellite clinics so that you've got more space for more customers.
• 39:30
  SPEAKER_00: And I think perhaps with some of your other guests you've had on the on the podcast, you you're also looking at introducing and growing these polyclinics.
• 39:37
  SPEAKER_00: It's not just a physio clinic, you know, it's physiopodiatry, osteopathy, women's health, men's health, um aesthetics, reformer Pilates, exercise classes.
• 39:50
  SPEAKER_00: So you you know you can have the same customer base, but you can offer them multiple appointment types and you can retain them longer term.
• 40:00
  SPEAKER_00: So you know, we were talking think talking earlier about the patient's journey through the business.
• 40:05
  SPEAKER_00: It's also the journey through their lifetime.
• 40:08
  SPEAKER_00: And can you, you know, we've had customers for 10 years now that we've been open and they they buy multiple things across across that 10-year um time span.
• 40:19
  SPEAKER_00: So if we're open 20 years, 30 years, you know, you've got children that came in with their parents and then they're coming back as adults.
• 40:26
  SPEAKER_00: You've got adults coming in, and then maybe when they're older adults and they've got different problems, they're they're coming back to you.
• 40:32
  SPEAKER_00: So, you know, that that's also what we're trying to build and offer is this um you know, this polyclinic where patients can come and stay with us and we can take them through their life journey.
• 40:44
  Michael: Yeah, and that that expansion of services, I think it's it's people want to go to one place to get the different things.
• 40:51
  Michael: It's like I'd much rather um go and see my physio and get the ultrasound in the same place rather than you know wait two days, go somewhere else.
• 41:00
  Michael: And um, we do that, that's what supermarkets became so popular, right?
• 41:03
  Michael: Everything in one place.
• 41:05
  Michael: Um, so is that your strategy for the the coming years is is expanding both in space, services, tech, and so on?
• 41:13
  SPEAKER_00: Yeah, so everything that we've got in my current clinic, so all those services I just mentioned, uh trying to do an acquisition with a clinic that's got very similar offerings, and then trying to um, you know, equal that out across the different clinics.
• 41:28
  SPEAKER_00: And my initial thoughts were, well, if I get if I just try and get as many clinics as possible, you know, 10 clinics, but I'm sort of thinking, well, you could do that, but right running 10 different sites, 10 rents, you know, 10 different problems, maybe you can focus down into three or four larger ones rather than two or three larger ones and ten smaller ones.
• 41:50
  SPEAKER_00: So yeah, my thought processes are always changing, but I I want growth in terms of business and being able to being able to offer the I think we've got a really good like um offering to our community in Wandsworth Town, and it's trying to replicate that into other areas.
• 42:07
  Michael: If I went to 25, 30 year old you and said, um, how old are you now?
• 42:12
  Michael: 48.
• 42:13
  Michael: No, with the same age as I.
• 42:15
  Michael: If I said to you at 48, you'll have X amount of money, and this is what you'll be making each month.
• 42:20
  Michael: I think you would have gone, fucking hell, that's great.
• 42:22
  Michael: I I'd be happy with that.
• 42:24
  Michael: You're not happy with that.
• 42:25
  Michael: You're now you you you're just not, you want to grow more.
• 42:28
  SPEAKER_00: What's driving that?
• 42:29
  SPEAKER_00: Uh ego, isn't it?
• 42:30
  SPEAKER_00: I think we're all driven mostly driven by ego, isn't it?
• 42:32
  SPEAKER_00: You know, you've I'm quite a competitive person, I think in a in a good way, but you kind of you look at what someone else is doing, you're like, I want to be able to do that.
• 42:41
  SPEAKER_00: I want to be able to ultrasound scan and inject.
• 42:43
  SPEAKER_00: And then you look at someone else doing a different service, I want to be able to do that.
• 42:46
  SPEAKER_00: And then another person's got five clinics, and I've got one, and I'm like, I want I want three clinics.
• 42:52
  SPEAKER_00: So I think it's it's definitely ego, um, partly.
• 42:56
  SPEAKER_00: And it's just like I like doing new things, you know.
• 43:00
  SPEAKER_00: I I'm still I like what I do, but I'm I'm a little bit bored of having the tendonopathy conversation and the load management conversation and you know, the back non-specific low back pain or whatever.
• 43:10
  SPEAKER_00: I just like to learn new things, both clinically, but not clinically as well.
• 43:16
  SPEAKER_00: And this whole business growth and acquisition, MA, and you know, going through that whole process is what I've been learning over the last two years.
• 43:24
  SPEAKER_00: It's it's interesting, and ultimately you've got to do it.
• 43:27
  SPEAKER_00: Things that you're you're interested in.
• 43:29
  Michael: It's funny because I've I've asked many people the same question.
• 43:33
  Michael: The physios, not once has anyone ever said money and wealth.
• 43:39
  Michael: They never say it's money and wealth that drive them.
• 43:41
  Michael: It's always, I want to learn more, I want to do more, I want it, ego, whatever.
• 43:45
  Michael: Um, in other sexes, it's I want to be rich, I want to buy that Ferrari, I want to buy it's it's really, it's just it's it's it's a very commendable thing because I think physios are a very strange species.
• 43:56
  Michael: Um I should do a little uh David Attenborough voice now.
• 43:59
  Michael: Yeah physios, but it's it is interesting that you didn't mention money once though.
• 44:03
  Michael: No, I'm an element of it, I suppose, right?
• 44:06
  SPEAKER_00: Yeah, and I think the money money will come with all of that.
• 44:08
  SPEAKER_00: I mean, if you're doing if you've got five clinics and you're doing two million pounds of revenue and your ebidars at a certain level, then you're obviously making more money than you were doing with one clinic.
• 44:18
  SPEAKER_00: But I don't think people get into healthcare for money, you know, it's unless like doctors make good money.
• 44:24
  SPEAKER_00: I think the the rest of the allied healthcare professionals probably make less money for sure, and we don't do it for money.
• 44:30
  Michael: Yeah, no, exactly.
• 44:32
  Michael: Just as you're growing, um, and and I suppose even within the clinic, as you're offering you services and expanding services and bringing you services in, how are you managing to run the clinic?
• 44:45
  Michael: Like you said, you've got two staff members, but what does that that that take a bit more responsibility?
• 44:50
  Michael: What does that look like in the day to day?
• 44:51
  Michael: Because you know, in the past you were you're on top of everything, and now you're not, and with acquisitions and other things, you've even just building your own brand, right?
• 45:00
  Michael: Whether it's the posting on Links or whatever, you don't have the time to do that.
• 45:03
  Michael: So, how does that operate now in in Wandsworth City?
• 45:06
  SPEAKER_00: So I have a practice manager who I pass a lot of stuff on to, uh, to her delight.
• 45:11
  SPEAKER_00: So she takes a lot of the sort of customer service element off my table, um, dealing with all the reception staff, and probably actually she says she deals with a lot of the therapy, therapist staff and their issues that they don't necessarily come to me with.
• 45:26
  SPEAKER_00: I'm probably more um clinical.
• 45:29
  SPEAKER_00: They'll come to me with all the clinical issues, but non-clinical issues that they're not coming to me.
• 45:33
  SPEAKER_00: Um, they're going to her mate.
• 45:35
  SPEAKER_00: She's probably more empathetic and better placed to do that.
• 45:39
  SPEAKER_00: Um, so yeah, she's like invaluable.
• 45:41
  SPEAKER_00: Um, my brother, who we mentioned, he still does uh some like SEO and marketing tasks, and he he he does all the financial uh aspects for me, so a lot of the insurance invoicing, excess invoicing.
• 45:55
  SPEAKER_00: Um, and then I have another member of staff who I just sort of call my operations manager.
• 46:01
  SPEAKER_00: So she she'll just do like all of the bits and pieces for me.
• 46:05
  SPEAKER_00: If I need something bought, if I need something ordered, if I need uh to organise a photographer or to do a community event.
• 46:13
  SPEAKER_00: She she likes having that sort of heterogeneity in her role and um you know doing all those different things.
• 46:22
  Michael: Running a a a bigger, advanced, more successful clinic, what are the things you hate most?
• 46:29
  SPEAKER_00: What are the things I hate most?
• 46:31
  SPEAKER_00: Um dealing with difficult customers.
• 46:35
  SPEAKER_00: We're like there's a there's a there's an old joke, I suppose, that uh you know being a physio would be great if you didn't have to deal with patients.
• 46:43
  SPEAKER_00: So but I mean, you know, most patients are great, love them, but you know, you get difficult ones, um, people that complain or moan or you know, just haven't got uh realistic expectations of what they're gonna receive and what they can actually achieve uh from our treatment.
• 47:00
  SPEAKER_00: So just like managing those sorts of things.
• 47:02
  SPEAKER_00: Uh just all the little bits of shit, you know, day-to-day stuff that just I find quite irritating, and I just like to pass that on.
• 47:10
  Michael: And then things that that weren't there with this let's say five years ago that are there now that you're like, ugh, this is really annoying.
• 47:18
  Michael: Sorry, did you say staff?
• 47:19
  Michael: No, stuff, other things uh yeah, employing team member.
• 47:25
  Michael: Um, no, things that that weren't there five years ago, but as you grow, so for us, for example, there's way more clients, so clients is an issue.
• 47:33
  Michael: Um, I think expectations as you grow.
• 47:36
  Michael: For actually, one thing for us is we've become so big, um, we're getting a bit of pushback at times.
• 47:41
  Michael: They're like, oh, these guys are a massive company, and you know, they're faceless, and actually we're not, but you know, there's storytelling to be done.
• 47:48
  Michael: Um, have you found anything like that?
• 47:50
  SPEAKER_00: Uh, I think we've probably ironed out a lot of those things.
• 47:53
  SPEAKER_00: It's really just probably going back to that customer journey and giving that so much thought early on, so that we know what those touch points are, and outlining the expectations of the staff that uh what they should do.
• 48:08
  SPEAKER_00: These sort of, I think Celia termed it as these sort of key moments in the business.
• 48:13
  SPEAKER_00: What are these key moments and like thinking through these key moments and making sure that every one of them is delivered upon?
• 48:20
  SPEAKER_00: So I think if you want to grow, if you've given that some thought beforehand and almost like strategized it, I think, then maybe that transition, that growth should be smoother.
• 48:31
  Michael: What about uh the amount of tax you now pay?
• 48:34
  SPEAKER_00: Yeah, that's annoying.
• 48:35
  SPEAKER_00: I keep my personal tax quite low, to be fair, but yeah, the corporation tax growth.
• 48:40
  SPEAKER_00: I I I I I think a way of keeping that down as well is reinvestment, just reinvestment into business, uh maximising pension, like your uh my pension, my partner's pension, that gets quite a lot of money out of um the business.
• 48:55
  SPEAKER_00: So, but you know, you can't really do anything with it.
• 48:57
  SPEAKER_00: I'm too young, so yeah, it's true.
• 48:59
  SPEAKER_00: Well, it's only seven or eight years now, isn't it?
• 49:01
  Michael: Well, I mean currently, but they'll probably uh they'll probably move that up.
• 49:06
  Michael: It'll be 70 by the time we're at it.
• 49:08
  Michael: Exactly.
• 49:08
  Michael: Yeah, and Mike Hatten's always says when I'm mailing about tax bills, he's like, you should be happy.
• 49:13
  Michael: You successful, you've got a big tax bill.
• 49:14
  Michael: It's like, yeah, make me happy at all.
• 49:17
  Michael: Yeah.
• 49:18
  Michael: But yeah, pensions, invest in pensions.
• 49:20
  Michael: Um and foreign conferences, places you might want to go on holiday.
• 49:24
  SPEAKER_00: Yes, yeah, we do do that as well.
• 49:26
  SPEAKER_00: Having um some investment now in Dubai, there's a legitimate reason to go there regularly for board meetings and um holidays.
• 49:34
  Michael: Yeah, yeah.
• 49:35
  Michael: Shouldn't say that too loud.
• 49:36
  Michael: HMRC could be listened by everywhere.
• 49:39
  Michael: All right, listen, it's been a lovely chat.
• 49:40
  Michael: It's been really nice having a a chat through all of this.
• 49:43
  Michael: Uh anything you uh feel we haven't covered?
• 49:48
  SPEAKER_00: Well, there's loads of things we could talk about, but yeah, you've probably covered them on multiple other podcasts, and uh your other guests will probably speak about those in the future.
• 49:55
  SPEAKER_00: But yeah, I think we've we've had a good chat and I've I've got across uh uh a fair amount of stuff.
• 50:01
  SPEAKER_00: Good.
• 50:02
  Michael: No, listen, it's been a pleasure.
• 50:03
  Michael: Thank you so much, and um yeah, I'll chat to you soon.
• 50:08
  Michael: All the best.