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Richard Higgs: The MSK Clinic Lessons Nobody Teaches You · No Appointment Necessary

• 0:00
  Michael: Welcome to another episode of another episode of what?
• 0:05
  Michael: I always fuck the intro up every time.
• 0:07
  Michael: I should leave this blooper in.
• 0:08
  Michael: Forgotten what my own podcast is.
• 0:10
  Michael: Welcome to another episode of No Appointment Necessary.
• 0:13
  Michael: Today we have Richard from Hanforth Physiotherapy.
• 0:15
  Michael: And uh Richard's a little bit different to some of the other guests, and I actually had a suggestion from quite a few people that we should start doing more with kind of newer and younger clinic owners.
• 0:27
  Michael: And I think that uh it's a really good idea because I think we can really explore your journey.
• 0:33
  Michael: So you opened seven months ago and you know, really explore your journey and and uh where you are now, what you've done and the trials and tribulations.
• 0:40
  Michael: So welcome, Richard.
• 0:41
  Michael: Do you want to give us a quick bit of background on yourself?
• 0:44
  SPEAKER_02: Yeah, hi.
• 0:45
  SPEAKER_02: So, yeah, my name's Richard.
• 0:46
  SPEAKER_02: I'm the clinical director and owner of Hanforth Physiotherapy and Rehab.
• 0:51
  SPEAKER_02: Um we moved here about seven months ago.
• 0:55
  SPEAKER_02: So, although the the clinic is in theory seven months old, we kind of had a a micro business in the village next door, um, which was basically a room on the top floor of a dental office.
• 1:06
  SPEAKER_02: So it was kind of not much going on, but it was you know, dip dipping our toe in the water.
• 1:10
  SPEAKER_02: Other than that, I've been um round the block a few times now, so I've probably been qualified about 14, 15 years, if my math's right.
• 1:20
  SPEAKER_02: Um started off in the NHS for about 18 months, two years, figured out pretty quickly that that wasn't my my long-term thing, although I I stand by the the experience of that was invaluable.
• 1:32
  SPEAKER_02: I then went to work for one of these big private companies for about a for about really was the worst side of private practice.
• 1:42
  SPEAKER_02: But saying that when you start seeing 20 patients every day for 12 months, it there's probably a positive experience in there somewhere, especially for the.
• 1:50
  Michael: Well, actually, let's let's let's look at that, because I think it's really interesting.
• 1:53
  Michael: Actually, it's a good starting point.
• 1:54
  Michael: You don't have to name them, you can if you like.
• 1:56
  Michael: But I I I'd be interested in your experience going into a big private practice like that and kind of seeing how things work, because generally they're quite commercial, uh, which is sort of the antithesis of what many physios are all about, right?
• 2:11
  Michael: It's it's it's you're all about helping people, and generally, I don't want to say everyone, but generally they're less interested in helping people.
• 2:20
  Michael: I'm probably gonna get slated for this.
• 2:21
  Michael: I'm not talking about the individual physios, but generally less interested in helping people are more interested in the commercial side.
• 2:26
  SPEAKER_02: Did you find yeah, 1 million percent?
• 2:30
  SPEAKER_02: So I won't say who they are, but they're one of the companies who has many practices in the country, everything from GP surgeries to single runs in in sort of more retail premises, all that kind of thing.
• 2:41
  SPEAKER_02: Yeah, it was incredibly all commercial.
• 2:43
  SPEAKER_02: I think the the main negative for me, because I I tried to do the best job I could for my for my patients, was just there was a lot of negativity around how staff were managed and things.
• 2:54
  SPEAKER_02: Um very little one-on-one supervision time, even though I was still relatively inexperienced.
• 3:01
  SPEAKER_02: I was very much on my own.
• 3:03
  SPEAKER_02: Um just absolutely crazy things that I never really understood.
• 3:07
  SPEAKER_02: Like this company had a disproportionate number of complaints.
• 3:13
  SPEAKER_02: Um, if you were the physio who that patient was complaining, not even about you, but about anything in the process, um, you were the one at the sort of the consequence end of it, and you'd kind of just get this blank email through saying, complaint, and you're like, oh god, what's happened?
• 3:31
  SPEAKER_02: Um, to then read it and find that it's gone on your record, but they're complaining because they haven't even seen you yet, but you're the one they're booked in with, and their appointment's been rescheduled three times, and but then that's on your file, and you're like, this seems a little bit unfair.
• 3:46
  SPEAKER_02: Um to, and I don't they might not do this anymore, but every month they used to publish a spreadsheet that ranked you in your region according to your non-attendances that month.
• 4:02
  SPEAKER_02: Every single person in your region, and you were ranked according to your non-attendances.
• 4:06
  SPEAKER_02: The numbers included new patients who hadn't turned up.
• 4:11
  Michael: Yeah.
• 4:11
  Michael: I I it's a it's a little like school, isn't it, where you get your uh your notice notice that says uh your son's got a 98.7% attendance, or is that and you're like, where's the other where where's the rest gone?
• 4:22
  SPEAKER_02: Yeah, yeah.
• 4:23
  SPEAKER_02: But you know, I I did it for a year.
• 4:25
  SPEAKER_02: I think maybe at the time I was blind that there was a future there.
• 4:29
  SPEAKER_02: Um it became very quickly apparent that there wasn't.
• 4:32
  SPEAKER_02: And I was at a time in life then where, you know, no major financial commitments other than making sure rent was due.
• 4:38
  SPEAKER_02: So I was like, right, shit, let's go self-employed in the private practice world, and that was probably about 12 years ago now.
• 4:44
  Michael: Did did they did you learn anything about the commercial side though?
• 4:48
  Michael: Like was the was the experience good in terms of what you're doing now?
• 4:52
  Michael: Because I think a lot of physios who have worked in sort of less commercial environments tend to go in and not really understand things about metrics, they don't understand things about culture.
• 5:04
  Michael: So, for example, the the the the negative work culture will obviously have had a positive effect on you because you you I I'm sure you thought, Christ, I'm not gonna do any of these things.
• 5:15
  SPEAKER_02: Yeah, so that they they didn't sort of share many of the numbers side of things, but uh sort of things I learned, which I think had a massive overlap into clinical, was things like a 100% booked diary is not actually good for anyone.
• 5:29
  SPEAKER_02: Um it's not good for your own sanity, it's not good for providing a good patient service because you are spending that entire diet day chasing your tail.
• 5:40
  SPEAKER_02: And okay, we need busy diaries because we need to make money, but a 100% booked diary is actually not manageable for most people and and doesn't translate to good quality service.
• 5:54
  SPEAKER_02: On the flip side to that, and I would say, you know, trying to find a silver lining in a very dark cloud, um, did cement in me that you just have to see patients to learn.
• 6:06
  SPEAKER_02: You know, that that might seem slightly bizarre when I was literally being given 20 patients a day.
• 6:12
  SPEAKER_02: But at the end of the day, you are going to build clinical expertise by seeing patients.
• 6:17
  Michael: Well, though difficult, but but then and and and I know you do mentorship and we'll get into that, but I I you can see all the patients you want, but if you don't have someone senior to actually spend a massive problem.
• 6:30
  SPEAKER_02: If you're not in a supportive network and seeing those patients, that is not a good thing.
• 6:35
  SPEAKER_02: And it was all, oh yeah, but we're on the phone, end of the phone if you need us, and then you find out they've got a fully blood diary, and actually it was about your 8:30am patient, and you can't speak to them until 7 p.m.
• 6:45
  SPEAKER_02: And you're like, Well, this isn't actually support, is it?
• 6:48
  SPEAKER_02: We're 12 hours later now.
• 6:50
  SPEAKER_02: So yes, seeing patients does build experience, but it has to be within that properly supportive environment.
• 6:56
  Michael: Yeah.
• 6:57
  Michael: So just before we came on, you said uh you're really happy because after seven just seven months, you're in a position where in a couple of weeks you can go on holiday for a week.
• 7:06
  Michael: Which actually is it is quite uncommon.
• 7:09
  Michael: And as I said to you, like you have a lot of things that open and they they it takes them a long time to get moving.
• 7:15
  Michael: It say they often plateau, and it's a real struggle for the first year.
• 7:20
  Michael: And you've managed to get out of that quite quickly and and and really start, forget about revenue and stuff, but but have a business which you're incredibly happy with that seems to be working incredibly well.
• 7:31
  Michael: And I want to sort of throughout this podcast is kind of explore the things that didn't go well, the things that did go well, and and what you're doing and and and some of the things you're doing.
• 7:42
  Michael: Because it is it is quite interesting.
• 7:43
  Michael: And so I think let's let's let's start with that because I I think again, lots of listeners will be really interested.
• 7:51
  Michael: Even if you're a a big old clinic owner, I think you can learn an awful lot from the sort of more boutique businesses we do all the time, right?
• 7:59
  Michael: If there's a another little marketing agency out there in industry or not, you can learn what they're doing because I think they're the ones that are generally most innovative and and uh aren't bogged down with the the history of of physiotherapy.
• 8:12
  Michael: So um what would you say were kind of the the the the things that you you're doing that are going really well?
• 8:21
  Michael: Like what what would you put some of the success down to?
• 8:25
  SPEAKER_02: I would say a big part of our success is I I always had a massive emphasis on on visibility.
• 8:31
  SPEAKER_02: People need to know we are here and they physically need to be able to see us, even if they don't need us right now.
• 8:39
  SPEAKER_02: Um, so what we did is we we found this premises in Hanforth in in East Cheshire.
• 8:46
  SPEAKER_02: Um we are on Hanforth High Street, and when I originally spied out the premises, I got the old uh Chat GPT up and I was like, right, I want a traffic report of how many cars go in front of that front door every single day.
• 9:01
  SPEAKER_02: And it couldn't tell me how many different cars did, but something in the region of about 16,000 cars drive past our front door every day.
• 9:08
  SPEAKER_02: I was like, great, that's brilliant, good starting point.
• 9:11
  SPEAKER_02: We are gonna have a giant sign that says physiotherapy on top of our clinic.
• 9:17
  SPEAKER_02: So, yes, we've got the name and you know, nice little art and all that sort of stuff.
• 9:22
  SPEAKER_02: But there is a sign with light shining on it that says physiotherapy to 16,000 cars every single day.
• 9:30
  Michael: So I'm I'm really intrigued how you came up with that.
• 9:33
  Michael: So, first of all, actually, I think people have it much easier today being able to use ChatGPC for things like that.
• 9:40
  Michael: I'm sure if you ask it, you know, what I'm starting physio clinic, what are the most important things?
• 9:44
  Michael: It's going to say, well, you've got to be near, you've got to have car parking, or you've got to be near a bus stop.
• 9:50
  Michael: It's gonna say you've got to be visible, and it will give you lots of of of advice in terms of demographics.
• 9:55
  Michael: But you didn't ask it that.
• 9:57
  Michael: You already knew.
• 9:57
  Michael: And I'm interested how you knew that.
• 9:59
  Michael: Because I I obviously speak to a huge number of new physios, and none of them ever think about visibility, it's not anything in their vocabulary.
• 10:08
  SPEAKER_02: How did I know?
• 10:10
  SPEAKER_02: I think it comes down to a bit of my own opinion perception that physios, and again, I I said to you this before, Michael, some physios are not gonna like this terminology I'm about to use, but I think we are a bit full of our own self-importance in the sense that we think everyone should know who we are, everyone should know what we do, and everyone should know why they need to see us.
• 10:33
  SPEAKER_02: And if someone's back aches, there is a 100% possibility that the first thing they're gonna do is find the local physio.
• 10:42
  SPEAKER_02: I don't actually believe that that is the case.
• 10:45
  SPEAKER_02: I believe that still the vast majority of the general public aren't quite sure what a physio does and if we can even help them and what our remit is.
• 10:54
  SPEAKER_02: So if they don't know that and they can't physically see us, well, why would they ever come to us?
• 11:01
  Michael: And by the way, that that applies to any business, right?
• 11:03
  Michael: If if I opened a company that sells trainers, or it doesn't matter what, I want to be on the high street where people walk past.
• 11:10
  Michael: You need that footfall.
• 11:11
  Michael: And I think some of the most successful clinics are the ones that have that footfall, that get those patients through just because and it is still marketing, right?
• 11:20
  Michael: It's uh we are visible, we are on a high street, we're somewhere where people go.
• 11:23
  Michael: If you're on an industrial estate, you're not selling many pairs of trainers.
• 11:27
  Michael: So yeah, I I think that's absolutely right.
• 11:29
  Michael: And then you also call and and this is something else funny because it it's so important, but you called yourself after the name of where you are, yeah.
• 11:37
  Michael: Right?
• 11:38
  Michael: And the number of people, and and I had Jack Winnied on the podcast and uh a while back, and you know, he's got a successful business now, and and I I I remember at the time before it even opened, I was like, you are not calling yourself Frontier Physio or whatever he wanted to call himself.
• 11:53
  Michael: I said you're gonna call yourself Winchester Physio in Health, and he didn't understand why.
• 11:58
  Michael: Um, what made you choose the name?
• 12:00
  Michael: Because most people are like, oh, it's so boring, I want to be sexy and have something like that's that's really cool.
• 12:06
  Michael: What made you think about the boring route?
• 12:09
  Michael: Two things.
• 12:10
  SPEAKER_02: Um, one, we actually used to be called after my name, so we used to be called Richard Higgs Physiotherapy.
• 12:15
  SPEAKER_02: At that point, I was taking on one or two people in a self-employed role.
• 12:19
  SPEAKER_02: This was way before we moved here, we're talking years ago.
• 12:22
  SPEAKER_02: Um, the problem was the business was incredibly difficult to market when it was under my name.
• 12:28
  SPEAKER_02: Everyone wanted to see me.
• 12:31
  SPEAKER_02: Everyone made the assumption that I was the best person to see, which I still stand by might not actually be the truth in a lot of circumstances for a lot of conditions for people.
• 12:40
  SPEAKER_02: Um and actually, we needed to step away from me.
• 12:44
  SPEAKER_02: I wasn't the centrepiece anymore.
• 12:46
  SPEAKER_02: That the business is bigger than this.
• 12:48
  SPEAKER_02: And probably the second point actually is the geographical thing that Hanforth isn't a big place.
• 12:55
  SPEAKER_02: You know, it's actually quite a small little village in sort of the east of East Cheshire.
• 13:00
  SPEAKER_02: But everyone in this area knows where Hanforth is.
• 13:04
  SPEAKER_02: If you live in Wimslow, you're happy to come to Hanforth.
• 13:07
  SPEAKER_02: If you live in Alderley Edge, you're happy to come to Hanforth.
• 13:10
  SPEAKER_02: If you live in somewhere in Stockport, Hanforth's not far because we got the bypass.
• 13:15
  SPEAKER_02: Actually being able to define exactly where you are in this sort of very urban area is quite important to people.
• 13:24
  SPEAKER_02: Because as you said, you go sort of an arbitrary name of you know flex physio or whatever, that doesn't mean anything to anyone because are you actually a half an hour drive away?
• 13:34
  SPEAKER_02: Well, if I'm in Hanforth, I know exactly where you are.
• 13:37
  Michael: Yeah, I I think there's a weather point, which is to do with such visibility as well on the internet.
• 13:43
  Michael: And so you know, I I say this a lot to new clients.
• 13:46
  Michael: If I'm looking for a plumber and I'm in Wimbledon, if I see Wimbledon plumbing and fuse plumbing, I immediately click on Wimbledon plumbing.
• 13:53
  Michael: Why?
• 13:54
  Michael: Because it's familiar to me.
• 13:55
  Michael: I know that they're gonna be in Wimbledon, or at least I assume they are, and fuse plumbing could be anywhere, and people like that that locality of a of a service business.
• 14:03
  Michael: So it's actually really important that you are presenting yourselves in as a local business, as someone who has sat somewhere, yeah, it's it's hugely important.
• 14:14
  Michael: Then the the the other thing is that it's way easier to rank on Google being called Wimbledon physiotherapy than it is being called Michael Schumacher physiotherapy.
• 14:22
  Michael: Yeah, absolutely.
• 14:24
  Michael: Absolutely.
• 14:25
  Michael: Talking of um, because this leads us into the next point, the the people always want to see you.
• 14:30
  Michael: I I I don't think it matters necessarily what you're called.
• 14:33
  Michael: People still want to see the business owner, they assume that you're the best person to see, and I I get it, it doesn't matter who's who's whose business uh it is, it they get the same thing.
• 14:43
  Michael: And I know you do a lot with new grads.
• 14:46
  Michael: So is it quite difficult?
• 14:47
  Michael: And how have you managed to make sure that people don't just want to see you and they are happy seeing the new grads or whoever else you've got in the business?
• 14:57
  SPEAKER_02: Yeah, so we've we we've done several things.
• 15:00
  SPEAKER_02: Uh so on on the new grad side of things, we do have people of various experience here from you know straight out of university to, you know, we've a couple of our self-employed ladies are, you know, they're seven, eight, nine years qualified.
• 15:11
  SPEAKER_02: So we do have a broad spectrum.
• 15:13
  SPEAKER_02: The new grad thing is interesting.
• 15:14
  SPEAKER_02: I wanted to bring it in because I felt in private practice I'd never been given proper support.
• 15:20
  SPEAKER_02: And I was like, right, if you look at the big institutions in anything in the world, not physio, any industry, there is a culture of learning and development, of improvement through the entire spectrum, all the way up from the new entry all the way up to the most senior person in business.
• 15:39
  SPEAKER_02: You can't have that culture of learning and development unless you have a spectrum, because then that fuels it through the entire process.
• 15:46
  SPEAKER_02: If your entire business is full of people who've been in the business 20 years and they're fixed in their way of doing things and they don't want to bring anything new or interesting or challenge ways of doing things, you're not going to get that culture of learning and development.
• 16:02
  SPEAKER_02: And if you don't have a culture of learning and development, you're then going to get stale.
• 16:06
  SPEAKER_02: You're not going to adapt to the demands of business or clinical or whatever.
• 16:11
  SPEAKER_02: Around kind of getting people to see different people in the business.
• 16:14
  SPEAKER_02: Now, the the first thing we do is I spend a lot of time champing other clinicians' talents and services that they offer.
• 16:23
  SPEAKER_02: Um, so for example, Leira, who does our Lost Dan loss syndrome physio.
• 16:28
  SPEAKER_02: You know, we've trying to get her to do an article in the air loss and loss syndrome magazine.
• 16:33
  SPEAKER_02: You know, we're reaching out to other clinics who give a similar service to try and sort of, you know, great minds think alike, that sort of situation.
• 16:40
  SPEAKER_02: Same on the Pilates side of things, we've got Emma, who is technically one of the new grads, but she's an absolutely awesome Pilates instructor.
• 16:48
  SPEAKER_02: So we spent a lot of time being like, look, Emma's fantastic.
• 16:52
  SPEAKER_02: You know, if you need to move, you need to exercise, you want to get on one of our performers.
• 16:59
  Michael: That's that's super interesting, and I think and again going back to that point of people still want to see you can say someone's the the the best Pilarsi's instructor in the world, the best person with a knee, but they still want to come see you.
• 17:12
  Michael: But at what point in a patient's journey, because this is the interesting thing, i i i someone says I've got a a TMJ and you've got a TMJ expert, at what point in the patient's journey are you telling them?
• 17:26
  Michael: Obviously, you're sort of pushing that on the website, but beyond that, I call up or I book an appointment.
• 17:32
  Michael: It's actually quite difficult, right?
• 17:33
  Michael: Because if a if an if a patient books an appointment with the I don't want to call them the wrong person, but the less expert person.
• 17:39
  Michael: Yeah, how do you then move them across?
• 17:42
  Michael: Or at the same time, if if I call up and I say, look, I've got this thing, are you also doing that on reception essentially?
• 17:50
  SPEAKER_02: Yeah, yeah, we are.
• 17:51
  SPEAKER_02: So we have a very clear remit and sort of service description on the booking process as to who is suitable to book in for what.
• 17:59
  SPEAKER_02: Um, for example, with our graduates, it very much says, you know, recent onset back pains, knee arthritis, you know, pulled hamstrings, twisted ankles, all that kind of stuff.
• 18:11
  SPEAKER_02: If something outside of that scope books in, we don't by any way tell someone not to see them.
• 18:16
  SPEAKER_02: We say, right, we're gonna sit down, we're gonna work through this patient's form together.
• 18:20
  SPEAKER_02: We might even do a joint session.
• 18:22
  SPEAKER_02: You know, we we've had one or two sessions where we've looked at the new patient form and thought, ooh, you know, they are quite advanced, they're quite a complex patient, there's an awful lot going on here.
• 18:31
  SPEAKER_02: And I go, right, I'm blocking out 45 minutes in my diary, we're gonna see them together.
• 18:36
  SPEAKER_02: So actually, they're getting the some the supports from a clinician perspective, but then we're also making sure we're developing a good patient service as well.
• 18:46
  Michael: Yeah, and you and you know, I I think if if you think about anything else in healthcare, if I've got uh and I've got a terrible cold again right now, but um if I went in to see someone about doesn't matter what, some dermatology issue, what it doesn't matter, if it it's almost a great customer experience for someone to say, do you know what I can help you here, but this person's fantastic and they're an expert in this area, and and especially if you bring someone else in, like there's no way I'm not coming back and trusting you forever because you know you've gone above and beyond.
• 19:17
  Michael: So this is almost uh an experience marketing play, right?
• 19:20
  Michael: Which is yeah, we're gonna treat you the best way we possibly can.
• 19:24
  SPEAKER_02: Yeah, and and very often, you know, going back to the graduate thing, it'll be like they might see someone who they feel is slightly outside of their experience, experience level.
• 19:31
  SPEAKER_02: And I say to them, right, I want you to sit, if you're in this situation, what you're gonna do is you're gonna say to the patient, look, we've done XYZ today.
• 19:39
  SPEAKER_02: I promise you, what I'm gonna do is I'm gonna sit down with my clinical director today.
• 19:44
  SPEAKER_02: We're gonna talk about your case, we're gonna talk through your case.
• 19:48
  SPEAKER_02: I am then gonna phone you this evening to confirm that the plan is what it should be.
• 19:55
  SPEAKER_02: And actually, then it's demonstrating to the patient, because they know they've been booked in with a graduate, they've seen it on the booking process.
• 20:02
  SPEAKER_02: They've literally could have clicked graduate, senior, or clinical directors.
• 20:05
  SPEAKER_02: They know exactly who they're booking in with.
• 20:07
  SPEAKER_02: But then they've got that reassurance that actually that clinician has done the right thing, they've asked for a second opinion, they've asked for help, which I think is the most important trait in any clinician you could ever have, by the way.
• 20:18
  SPEAKER_02: Um, and that we know that they're providing that best patient service they possibly can.
• 20:23
  Michael: How practically, how do you organise that?
• 20:25
  Michael: Because I think lots of clinics or uh clinicians at clinic agents will be sat here going, that sounds great, but when the hell am I going to find the time to speak to that new grad and look at the it's like how do you practically do that?
• 20:38
  Michael: Do you set size?
• 20:39
  SPEAKER_02: So practically, I I only do two half-day clinics a week now, anyway.
• 20:42
  SPEAKER_02: So I am here a lot to doing sort of ad mini bits, service development bits.
• 20:47
  SPEAKER_02: So actually finding half an hour is not too much of a problem.
• 20:50
  SPEAKER_02: Um, in our process of the patients that are being seen, we have the new patient forms and we make a point of new patient forms are looked in in advance, not two minutes before the appointment.
• 21:03
  SPEAKER_02: So we have prior notice when someone is booking in.
• 21:06
  SPEAKER_02: And if someone's not booked in there, done their new patient form in a timely manner, we do send them a reminder and just say, look, can you try and get this done the day before?
• 21:14
  SPEAKER_02: Because then we can have a look and we can make time if we need to.
• 21:17
  SPEAKER_02: Um, probably also to my wife's despair, I very much have kind of the 21st century open door policy that you can always give me a ring.
• 21:27
  SPEAKER_02: And many times, probably too many, I've been on the phone to one of the clinicians at 6 a.m.
• 21:34
  SPEAKER_02: in the morning, 10 o'clock at night, because one, they're worried about a patient, something's stuck in their head, you know, they want to chat it through.
• 21:43
  SPEAKER_02: Or someone has booked in overnight because someone can book in 24 hours a day, seven days a week, and they've woken up at six o'clock in the morning and that patient's booked in at half seven, and they've had a quick look at their new patient form and thought, oh God, I don't know what to do here, was straight on the phone chatting it through.
• 21:58
  Michael: So that sounds wonderful.
• 22:00
  Michael: But I'll throw a little question in here, which is you can do that, but you can't scale that.
• 22:08
  Michael: No, this is true.
• 22:09
  Michael: This is true.
• 22:10
  Michael: Because you can say, well, I'll I'll hire another clinical lead and they will do that and they won't.
• 22:16
  Michael: There's you're a business owner, I'll I'll take a call at 11 o'clock at night, no problem.
• 22:20
  Michael: I can't expect the team to do that.
• 22:21
  Michael: Now they'll do that every now and again, but not ring me.
• 22:25
  Michael: So how how do you think you're gonna scale that process?
• 22:29
  SPEAKER_02: Again, no one's gonna have the flexibility that I do in terms of you know being able to answer the phone at any time of day.
• 22:35
  SPEAKER_02: The reality is gonna be we are building a structure within the team here to provide as much support in in-house as we possibly can.
• 22:45
  SPEAKER_02: Um so, for example, one of the ladies who was self-employed with us is now employed.
• 22:51
  SPEAKER_02: Um, she is coming on in a in a team leader capacity.
• 22:55
  SPEAKER_02: So she will be able to start picking up parts that are reasonable for her to do.
• 23:00
  SPEAKER_02: So she is very understanding that part of her remit is going through the new patient forms for for one or two of the new grads and all that kind of thing.
• 23:07
  SPEAKER_02: That is going to take the nine to five load off me.
• 23:10
  SPEAKER_02: Yes, what happens at 10 o'clock at night if someone books in for 7 30 a.m.
• 23:15
  SPEAKER_02: the next morning.
• 23:16
  SPEAKER_02: Haven't quite figured that one out yet.
• 23:18
  SPEAKER_02: Yeah, fair enough.
• 23:19
  Michael: I I I'd actually I have I have a it's it's quite interesting because I think that there is probably a bit of that that you can do.
• 23:28
  Michael: Um, whether you can do it right now, I think you probably can, with AI, which is a bit of triaging, auto-triaging.
• 23:34
  Michael: Yeah.
• 23:34
  Michael: I think you you know, I think a lot of clinics are gonna have to start auto-triaging patients at an early stage, getting that information across.
• 23:42
  Michael: And quite honestly, I I know that there are tools out there right now where patient comes in, puts her form in, and it spits out a we think it's this, but it could be these three things, these are the tests you need to do, this is what you need to ask, and so on.
• 23:54
  Michael: So I think that's one thing.
• 23:56
  Michael: On the other side of it, the the personal time, I was chatting to a client, we came up with this idea.
• 24:01
  Michael: So in the corporate world, you have these things called stand-ups, where and the reason they're called stand-ups is that you didn't want long meetings, and and so in fact, in one company, I know this sounds stupid, everyone had to bloody plank during these things.
• 24:13
  Michael: So it stopped meetings being like an hour long.
• 24:16
  Michael: It was it was actually quite a nice little mechanism.
• 24:18
  Michael: But what I said to the the the client was why don't you start doing stand-ups each day where everyone gets together and you stand up and you just talk through cases and everybody learns at the same time as well.
• 24:31
  Michael: Yeah.
• 24:32
  Michael: I think stand-ups are a pretty decent idea, especially if you've got an employed workforce where you say, for 10 minutes at the end of the day, maybe 20, have it on the need, but at the end of the day, this is the time we're gonna spend where I can then put time aside because as the business grows, you're gonna be doing loads and loads of other stuff as well, right?
• 24:49
  Michael: So I would recommend to people to have a think about how to do stand-ups and how that might work.
• 24:53
  Michael: It may not be at the end of the day, maybe at the first thing at the start of the day.
• 24:57
  Michael: Yeah.
• 24:57
  Michael: Yeah.
• 24:58
  Michael: During the day, and you can have multiple stand-ups actually with different team members and types of team member.
• 25:03
  SPEAKER_02: No, for sure.
• 25:04
  SPEAKER_02: And I think this leads on to something we've already sort of touched on is we are pushing very much for an employed model here because I want to do things like you've just discussed.
• 25:14
  SPEAKER_02: Trying to do that with a full self-employed staff model is tricky because trying to get people to come in for time that they're not necessarily going to be paid for is very difficult, or stay late if a patient's not booked in, blah, blah, blah, blah, blah.
• 25:30
  SPEAKER_02: With things like an employed model, you can start doing stuff like that, where we say actually, we know everyone is going to be here between 8:30 and 9 a.m.
• 25:40
  SPEAKER_02: on a Monday morning.
• 25:42
  SPEAKER_02: That is your contracted hours.
• 25:43
  SPEAKER_02: So, unless you're away on holiday, you will be here.
• 25:46
  SPEAKER_02: That is our allocated, consistent half an hour sit-down.
• 25:51
  Michael: Yeah, but it still fits in, even though we we can get onto the employed model in in a second, it still fits in with that learning and development, right?
• 25:57
  Michael: Because it's it's it's very difficult to have a really great LD process if you've got self-employed people.
• 26:06
  Michael: I mean, it's hard enough to get them out.
• 26:07
  Michael: I had a client who said to me, Yeah, I was doing a really nice night out on a Friday night or a Thursday night, and one of their self-employed physicians said, Am I going to be paid?
• 26:16
  Michael: Yeah.
• 26:17
  SPEAKER_02: He was like, What it's it's really tricky.
• 26:20
  SPEAKER_02: Everyone who's employed here has a has something that they're working on alongside.
• 26:24
  SPEAKER_02: So, for example, Leira is doing the the Edward Jenner NHS leadership programme.
• 26:28
  SPEAKER_02: You know, if she's got a bit of downtime, she's working on that, as well as some of her other duties.
• 26:33
  SPEAKER_02: We've got Emma who is doing some work on sort of pre- and postnatal Pilate, he's trying to bring all that side of things in.
• 26:41
  SPEAKER_02: You can build a structure, you know, you can you can build practices and structure when you know people are here for contracted hours.
• 26:47
  SPEAKER_02: And then it also allows me to support them as well.
• 26:51
  SPEAKER_02: Like, I've kind of very much said to people that I don't just want to invest in stuff.
• 26:56
  SPEAKER_02: I don't want to invest in the the new AI piece of software and all that kind of thing, you know, or just buying more weights for the squat rack.
• 27:04
  SPEAKER_02: I am very happy if there's a sensible business case, but also a learning case as well, and you feel like you would benefit on going on a two-day course on whatever, we can discuss that and we can start bringing in that into the business as well.
• 27:19
  Michael: So how so you're you're progressing people, and I think this is fantastic.
• 27:23
  Michael: Uh, because I think a lot of clinic owners they they think doing a CPD session once or twice a month or two is is everything anyone needs, get them subscribed to physiomatters or whatever, and that'll do.
• 27:34
  Michael: But I think they're taking it that one step further, which is fantastic.
• 27:37
  Michael: But here's the issue the churn in this industry is incredibly high.
• 27:44
  Michael: Yeah.
• 27:44
  Michael: And staff leave and they move on.
• 27:47
  Michael: What do you do to make sure that you're not essentially paying for all of these things, both in in monetarily but also in time?
• 27:57
  Michael: Uh and then that person gets her women's health qualifications and she becomes brilliant, and then she goes, Well, actually, I can get more in another clinic or I want to open my own clinical or whatever.
• 28:06
  Michael: How are you dealing with that?
• 28:08
  SPEAKER_02: So, two things.
• 28:09
  SPEAKER_02: One is more structural, one is is more wishy-washy.
• 28:13
  SPEAKER_02: Um we do have a deal in place in people's contracts that and it's not about 50 quid here and 50 quid there.
• 28:21
  SPEAKER_02: It's about look, if we are going to sit down and put you through a substantial piece of training, it is written into their contracts that there is a repayment clause if they leave within a certain timescale.
• 28:34
  SPEAKER_02: So, for example, Emma's stuff, we probably paid about six, seven hundred pounds for some of her sort of extra Pilates training for the extended scope stuff.
• 28:46
  SPEAKER_02: And it was like, look, if if you do all this and then you decide the next day you're gonna hand in your notice, you will have to repay some of that because there has to be protections for the business here.
• 28:56
  SPEAKER_02: But actually, if you're still here in 12 months' time, we'll say fine, cool, you know, you've worked it back.
• 29:02
  SPEAKER_02: And and actually people are very understanding of that.
• 29:04
  SPEAKER_02: They understand the investment we're putting into them, and there needs to be a sensible return on that.
• 29:11
  Michael: What is the do you do you have a flat time period?
• 29:13
  Michael: Is it 12 months for everyone?
• 29:14
  SPEAKER_02: Yeah, so it's it's 12 months and goes down 25% every three months.
• 29:19
  Michael: Okay, fine.
• 29:20
  SPEAKER_02: So it'll be after three months is 75%, six months, 50%, blah, blah, blah, blah.
• 29:25
  SPEAKER_02: And to be honest, that is really only for the substantial training.
• 29:28
  SPEAKER_02: You know, if it's a group thing, or if, as I say, it's 50 quid to do XYZ, I'm not that bothered.
• 29:34
  SPEAKER_02: But for substantial training and things that they're gonna get benefit from forever in their entire professional career, we do have sort of repayment prouses in, and people are very uncertain of it.
• 29:43
  Michael: It's interesting because one of the most citizen reasons for um clinicians leaving is no progression.
• 29:49
  Michael: So it's almost forget about all of that stuff.
• 29:52
  Michael: It's like you're gonna keep people longer because they do feel they're progressing and they're learning and and they're not just being told to see 20 patients every single day and burning them out.
• 30:01
  SPEAKER_02: Yeah, and and I think a key part of the structure here is, and what we're certainly working towards, is everyone has a role outside of physio.
• 30:08
  SPEAKER_02: So, for example, Labour has come in as that sort of team lead role.
• 30:13
  SPEAKER_02: Emma, alongside her work, sort of the plan for her is she's becoming like almost like a day-to-day practice manager sort of situation where things like ordering consumables, you know, making sure appointments cancelled, rearranged, like that is part of her remit as well.
• 30:28
  SPEAKER_02: You know, we all have an admin role here, we don't have reception stuff, but that kind of day-to-day function stuff is what we're building her towards as well.
• 30:36
  SPEAKER_02: Which again is very difficult to do with a contracted team.
• 30:39
  SPEAKER_02: It's impossible.
• 30:40
  SPEAKER_02: It's impossible.
• 30:41
  SPEAKER_02: I can't even mandate for them to answer the phone.
• 30:43
  SPEAKER_02: Now, don't get me wrong, we've got fantastic people who do answer the phone and are very happy to book them in with someone else that isn't them and know they won't earn any money, but I can't make them.
• 30:52
  Michael: You know, you know, we were having this discussion recently within HMDG, which is that one of the things I've always loved about being in a business, even some of the really big businesses I've I've been in, is that start-up mentality that all answer the deck.
• 31:07
  Michael: Everyone no one's too good to change a light bulb or change a loo roll.
• 31:11
  Michael: Yeah, everyone has to get stuck in.
• 31:13
  Michael: And I think that as businesses get bigger, there's much less of that.
• 31:17
  Michael: There's assigned roles, you have people that do these things, and you hire from outside, and you know, the physio does the physio and the other person does the other thing, whatever.
• 31:26
  Michael: And I think there's something to continuing to maintain that startup mentality of we're all gonna do stuff, we're all gonna chip in.
• 31:34
  Michael: You know, I I do uh and I think this is why it works so well, and I would recommend anyone do this, particularly physios or pods, because they're always after them.
• 31:40
  Michael: I do Christes of Christmas, and Crisis of Christmas is brilliant.
• 31:44
  Michael: It it's this homeless charity, and they uh over Christmas time where it gets all cold, they actually open up in in like colleges and they they take the space and they give homeless people a place to stay, eat, you put on films which they can't ordinarily see because they can't go, they can't go to the fucking cinema, can they?
• 32:01
  Michael: And it's a brilliant, brilliant thing, and I and and they're always looking for volunteers, but particularly people with not like me who can't do very much, but particularly with people with professional qualifications.
• 32:11
  Michael: So I would recommend anyone does it.
• 32:13
  Michael: You can go to Christ as a Christmas, they'll advert for them, but it's brilliant.
• 32:16
  Michael: One of the things that they do is you go in and you might think you're a high-flying CEO, you're cleaning the fucking toilets, my friend.
• 32:23
  Michael: Like everyone gets stuck into different things, and everyone wants to spend time in the common area where you can chat and you can like play some pool.
• 32:31
  Michael: But actually, the the the thing that keeps everyone coming back, and all we call ourselves volunteers, the the the the things that keeps us all coming back is that you aren't bored doing one thing the whole time.
• 32:41
  Michael: You're not just cleaning the toilets, you do get to work in the kitchen, you do get to work in the shop.
• 32:46
  Michael: The shop is where we we hand out uh clothes and stuff that uh it's quite funny.
• 32:49
  Michael: You get someone coming in and they you're like, Oh, do you like these shoes?
• 32:52
  Michael: They're like that, they're bloody horrible.
• 32:54
  Michael: I don't want that, I I want something brown, not in black.
• 32:56
  Michael: And you're like, bloody hell, mate, you're homeless.
• 32:58
  Michael: But it's important, you you you it honestly, it's one of the best things you can do.
• 33:02
  Michael: Anyway, I think that is just a really good example of keeping people interested in what they're doing.
• 33:08
  Michael: And I think that it makes every business better having people do something.
• 33:13
  Michael: Another thing, and I don't know, you probably I've never thought of this.
• 33:16
  Michael: This has just come to mind.
• 33:18
  Michael: Back in the old days in the corporate world, you would have things like Swapsy Fridays, right?
• 33:22
  Michael: Where you get the the marketing people to do the salesperson's job, you get the finance people to doing the and it was really interesting to swapping roles around because what happened was the marketing people were like, holy shit, I don't want to do sales.
• 33:36
  Michael: The salespeople were like, oh my god, this marketing lab's really hard and I don't like doing these.
• 33:40
  Michael: So actually, I wonder whether there's a case for getting maybe not in your clinic, because I think you run it uh slightly differently, but there's a lot of clinics where the clinicians all think that the the owner's driving around in a Ferrari and their life's just about swanning around on the golf course, when actually it's bloody awful.
• 33:58
  Michael: And I do wonder whether people could do some kind of not swapsies, but shadowing.
• 34:05
  Michael: Here's what I actually do, here are the bills I have to pay, here are the problems that I have to deal with.
• 34:10
  Michael: I think that could be kind of an interesting thing to do.
• 34:15
  Michael: It'd be good, wouldn't it?
• 34:16
  Michael: Like, I'll do a Pilates class for a day.
• 34:19
  Michael: Yeah, exactly.
• 34:20
  Michael: But yeah, it's like I'm sure some of the stuff like oh, especially when time's tough, they'll be like, oh, Richard does two blood, two half days in the clinic, like the rest of the time he's just swanning around and he's at home and you're actually on the phone with a bloody accountant trying to figure out what your corporation tax is and how you pay the bills and that would be fun to expose them.
• 34:39
  SPEAKER_02: I think I word it all slightly differently to you in the sense that I I very much talk about, you know, this is kind of this is our house, this is your house, you know, and I don't I don't mean that in a tongue-in-cheek sense of, you know, treat here like you would your own home.
• 34:53
  SPEAKER_02: But this is this is your clinic, this is your business, you know.
• 34:56
  SPEAKER_02: I want you to feel like this is your professional home.
• 35:01
  SPEAKER_02: And actually things like if you notice someone's trout's mud down the corridor, grab the Hoover because you would at home.
• 35:08
  SPEAKER_02: Like it's about appearance.
• 35:09
  SPEAKER_02: I want everyone to have pride working here, and and then that comes with the sort of little tasks as as well.
• 35:15
  Michael: I think that's brilliant.
• 35:16
  Michael: I think I think that really translates as well into a culture where everyone knows that they're chipping in.
• 35:21
  Michael: It translates into people feeling like not that they own the business per se, but that they're really involved and that they're they're proud of working there.
• 35:31
  Michael: And you know, when when you know when you're working for for a crappy company and it's all a bit miserable, that you know, someone says, Where'd you work?
• 35:38
  Michael: And you're like, uh, oh crap.
• 35:40
  Michael: But if you work for TikTok, you're like, for TikTok because it's awesome, and we get all this amazing stuff, and these are the cool things that we do.
• 35:47
  Michael: And and I think you can do that with Infizio, you can make people proud.
• 35:51
  Michael: I remember years ago, when we early on when we started, we built this amazing website for this clinic that had a shitty old website, and she came back to me and she said, You wouldn't believe the difference that it made to my team members who were like, Oh my god, I we've got a really good website.
• 36:06
  Michael: It became quite a motive motivational thing.
• 36:08
  Michael: They were really excited by it.
• 36:10
  Michael: Their pictures were done properly, and their website was done properly, and it was like, Yeah, I can send my friends to my company website now.
• 36:16
  Michael: And I was I I never thought of that, but it was kind of interesting.
• 36:20
  Michael: Yeah, yeah, yeah.
• 36:21
  Michael: It's a it's a little like uh I was uh an ex-girlfriend of mine was working, I can't say who for, but for a for a mega mega company, and they were looking at moving offices, and the CEO really knew his stuff, liked him.
• 36:35
  Michael: CEO said, you know, uh we're working somewhere that looks like the office.
• 36:40
  Michael: Yeah.
• 36:40
  Michael: And you cannot motivate and inspire people.
• 36:43
  Michael: And I noticed that your backdrop by the way, you cannot motivate and inspire people if they're working somewhere that looks like a Regis office or a you know the office with partition stuff.
• 36:54
  Michael: So they actually spent tens of millions to move into a new place that was just so slick, and people loved it.
• 37:02
  Michael: And and in fact, the people that sort of started this whole trend were I think Google and Facebook, where they had like a ball pit.
• 37:09
  Michael: Uh, it sounds a little bit, you know, but they had a ball pit in the office, they had PlayStations, there was graffiti stuff.
• 37:15
  Michael: In Facebook, you you you probably are old enough to remember the uh the Facebook wall where you could post things on on Facebook.
• 37:21
  Michael: Yeah, yeah, yeah.
• 37:22
  Michael: They have a Facebook wall so you can like write things on there every day and you know it's filled up with all the employees and visitors writing things.
• 37:29
  SPEAKER_02: But it's just it's just simple, isn't it?
• 37:31
  SPEAKER_02: Like you're somewhere for 37 and a half, 40 hours a week.
• 37:34
  SPEAKER_02: You want it to be a nice place, you want to have pride in it, you want to enjoy being there.
• 37:38
  unknown: Yeah.
• 37:38
  SPEAKER_02: You know, if you're somewhere where you know you're under artificial lights all day and it's really uninspiring, well, you're probably not gonna do a good job.
• 37:45
  Michael: Yeah.
• 37:45
  Michael: And and I think it not just the the staff, but actually patients as well.
• 37:50
  Michael: They walk in and go, oh my god, this looks amazing.
• 37:52
  Michael: I want to be here.
• 37:53
  Michael: And I think that's really important.
• 37:54
  Michael: So looking at your backdrop, for people who aren't watching the video, it looks awesome.
• 37:57
  Michael: It kind of looks like I just got married and we went off to Babington House.
• 38:02
  Michael: It's like a sort of house-type thing.
• 38:04
  Michael: It kind of looks like that.
• 38:05
  Michael: You've got that sort of national trust vibe going on.
• 38:08
  SPEAKER_02: So, and and this is actually, I've put myself up in the back corner of the clinic.
• 38:12
  SPEAKER_02: So, this is actually our smallest room.
• 38:14
  SPEAKER_02: We have this colour vibe.
• 38:16
  SPEAKER_02: So, one of my regular patients, I've seen him on and off for years, he owns one of the big marketing firms in in Manchester.
• 38:23
  SPEAKER_02: Um and I still call him up about tons of stuff.
• 38:26
  SPEAKER_02: And and I was like, look, we're taking on this new clinic, you know, how should I decorate it?
• 38:30
  SPEAKER_02: And he was like, Well, you know, dark colours.
• 38:33
  SPEAKER_02: And I was like, Yeah, I've looked at a couple of places, you know, they tend to do black on the bottom half and white on the top.
• 38:38
  SPEAKER_02: And he said, do it the other way around.
• 38:40
  SPEAKER_02: So immediately we kind of tried to get that point of difference of that dark premium look, but then just completely swapping it around at the same time.
• 38:48
  SPEAKER_02: Although sourcing this paint was an absolute nightmare.
• 38:52
  SPEAKER_02: So this paint is called it's Dulux paint, it's called basically black.
• 38:57
  SPEAKER_02: So it's not black because then that's a binary colour tone and causes nightmares.
• 39:01
  SPEAKER_02: And then caller uh can't remember, I got it from BQ wherever.
• 39:05
  SPEAKER_02: I was like, I need 20 tins of basically black.
• 39:08
  SPEAKER_02: This is the Dulux rep.
• 39:10
  SPEAKER_02: And he's like, all right, cool, get the invoice through.
• 39:13
  SPEAKER_02: Day one delivery, 20 cans of matte black.
• 39:16
  SPEAKER_02: I was like, that's not right.
• 39:17
  SPEAKER_02: He's like, we'll ask for basically black.
• 39:19
  SPEAKER_02: And I was like, yeah, basically, it's the name of your paint, mate.
• 39:23
  SPEAKER_02: Like, it's literally, and I was like, if I wanted matte black, I'd say matte black.
• 39:26
  Michael: Yeah.
• 39:27
  Michael: No, it look it looks amazing.
• 39:29
  Michael: Did your did your marketing guide tell you about a clinic smell?
• 39:34
  SPEAKER_02: Yes, massively.
• 39:35
  SPEAKER_02: Yeah, literally.
• 39:37
  SPEAKER_02: Um, so now we have diffusers, all that kind of stuff, especially in the reception area.
• 39:42
  Michael: But do you have a bespoke one?
• 39:45
  SPEAKER_02: Yes, kind of came around a little bit organically in the sense that we've got a cracking garden centre about 10 minutes away from us that had all of this stuff in.
• 39:53
  SPEAKER_02: And they literally had a job lot that I I took off them.
• 39:57
  SPEAKER_02: So I can't remember what it's called.
• 39:59
  SPEAKER_02: I'm I'm not good at that kind of stuff.
• 40:01
  SPEAKER_02: My wife was there at the time and she was like, you want that one, they've got a job lock.
• 40:05
  Michael: So so for people that don't get that, having a uh a specific smell that people can remember that that's obviously a pleasant smell, yeah, is actually incredibly important.
• 40:16
  Michael: And and companies throughout time have have done this.
• 40:19
  Michael: One of the the really famous ones was Abercrombie and Fitch.
• 40:22
  Michael: So they they kind of went for that I can't see a thing that I'm trying to find because everything's really dark, but at the same time, it had this this this smell.
• 40:30
  Michael: In fact, I was recently in Singapore at the uh the what's the big thing with the I can't even remember the buttons.
• 40:36
  Michael: I've got my cold, my I'm getting old, I'm not sleeping, my memory.
• 40:40
  Michael: Marina Bay Sands.
• 40:42
  Michael: So the Marina Bay Sands, which is insane.
• 40:44
  Michael: It's a hotel, but it's got like a infinity pool at the top, and inside there's every shop you can ever imagine.
• 40:49
  Michael: But every time we walked in there, there was a smell, and I was like, oh my god, this is amazing, it's so, so nice.
• 40:55
  Michael: And uh they actually show sold it in the shop in one of their Marina Bay Sands shops.
• 40:59
  Michael: I didn't buy it, but uh it it really is important.
• 41:02
  Michael: And I actually know a guy who owns an amazing marketing agency, and he did exactly that years ago, where he said, No, every every time someone comes in, I want them to have that smell, and it's actually quite important.
• 41:12
  Michael: So it's it's uh yeah, I'm glad you did that.
• 41:14
  Michael: That's that's that's a good one.
• 41:16
  Michael: I hadn't heard many clinics doing that.
• 41:17
  Michael: Yeah, yeah.
• 41:18
  Michael: No, we had one.
• 41:20
  Michael: So in terms of uh we we've gone through most of the the the mentorship stuff, learning and so on.
• 41:26
  Michael: I want to just touch back into visibility because we touched on one part of the marketing piece, which is you want to be visible, you want to get the footfall.
• 41:35
  Michael: But beyond that, it's also you've done other things, right?
• 41:39
  Michael: So you're on socials, so I I'll watch your socials, but what else have you done for visibility?
• 41:44
  Michael: Because I I think it's the most important thing for any business.
• 41:47
  Michael: If people can't find you, they're not gonna buy from you.
• 41:49
  SPEAKER_02: Yeah, so we've done a few things, some big, some small.
• 41:52
  SPEAKER_02: The the sort of smaller side of things we've done is there's a a Facebook group around here called the UK Gossip Girl Network.
• 41:59
  SPEAKER_02: It's well used in this area for women trying to look for services, whatever.
• 42:04
  SPEAKER_02: I think we spent£35 a month doing that, and actually, disproportionately we've got an awful lot of business from it.
• 42:10
  SPEAKER_02: And then bigger things we've done.
• 42:12
  Michael: Just on that, sorry, sorry, just on that for Facebook groups.
• 42:14
  Michael: Um, it doesn't work so well if you're in Islington, but if you're in uh villages and small areas outside of London, they can work incredibly well because a lot of people live and die by them.
• 42:24
  Michael: Yeah, yeah, yeah.
• 42:26
  Michael: It's really, really useful.
• 42:27
  Michael: And another thing I just noticed, sorry, to button.
• 42:29
  Michael: Another thing I just noticed was so we're we're on this uh I don't want to name the rope, but we're on this group for our roads on WhatsApp, and everyone's always asking about what physio shall you own and see, who can do fencing.
• 42:42
  Michael: Actually, getting into those groups if you can.
• 42:44
  Michael: I don't know how, again, just popped into my head, but they're incredibly valuable.
• 42:48
  SPEAKER_01: Yeah.
• 42:48
  Michael: As well.
• 42:49
  Michael: Next door is another one, I think.
• 42:51
  SPEAKER_02: Yeah, it's to be honest, it's kind of happened organically anyway.
• 42:53
  SPEAKER_02: You know, I run with the local running club and there's 50 members in that Facebook group.
• 42:57
  SPEAKER_02: Yeah, every so often someone who's a runner hurts themselves and then they come here.
• 43:01
  SPEAKER_02: Um, you know, my wife's on a couple of groups, so it's kind of already slightly happened organically.
• 43:06
  SPEAKER_02: Yeah.
• 43:07
  SPEAKER_02: Um, but yeah, but I I think the the Facebook UK Gossip Girl Network has definitely been helpful in this area.
• 43:13
  Michael: Okay.
• 43:15
  SPEAKER_02: The general Winslow Facebook group has 200 posts on it every day.
• 43:20
  SPEAKER_02: As soon as you post on it, you're 10th on the list.
• 43:23
  SPEAKER_02: Like it's an utter waste of time.
• 43:26
  Michael: Are you are you doing because I think with with anything, you you can be a little bit aggressive.
• 43:31
  Michael: And I think it's people's tendency to go, oh my god, I've got f I've found a group, I'm gonna post 30 times on this group.
• 43:36
  Michael: We're the same.
• 43:37
  Michael: We the amount of physiotherapy groups, we've never posted once.
• 43:40
  Michael: Um, because we don't want to do that.
• 43:42
  Michael: It's more being around and visible and letting people come to you.
• 43:46
  SPEAKER_02: Yeah.
• 43:46
  SPEAKER_02: Yeah, no, absolutely.
• 43:47
  SPEAKER_02: So it the UK Gossip Girl one, you're only allowed to post, I think our days are Wednesday afternoon.
• 43:52
  Michael: Okay.
• 43:53
  SPEAKER_02: So we have probably about twelve different posts we can do and we sort of circulate them a little bit.
• 43:59
  unknown: Yeah.
• 43:59
  SPEAKER_02: Um But actually, yeah, some I've I've watched some of the other local clinics on the local groups and it it's literally every day.
• 44:06
  SPEAKER_02: It's like no one cares that you've got 10am available.
• 44:10
  Michael: Yeah, it just becomes noise, doesn't it?
• 44:12
  SPEAKER_02: Yeah, like it it just doesn't matter.
• 44:13
  SPEAKER_02: Like if they want an appointment today, they will find you if they know where to go.
• 44:17
  Michael: I I I think actually the the educational piece is really important here.
• 44:21
  Michael: And it and sometimes it can be incredibly funny.
• 44:23
  Michael: So an example might be instead of saying you've got an appointment available or talking about your latest shockwave, like how wonderful it is, no one gives a crap, right?
• 44:32
  Michael: I think what is interesting, and I gave you this idea just before we came on, is finding the top hundred silly questions you've been asked and making something fun out of it and putting the odd thing in that's really useful.
• 44:45
  Michael: Like if you're over uh in fact, this sort of came from the uh Jack the other week on the podcast.
• 44:52
  Michael: If you're over 65, are you able to get out of your seat and stand up and you know do that test?
• 44:58
  Michael: And giving people little tests to do and little interesting things, it's Christmas time and it's getting colder.
• 45:04
  Michael: And have you thought about doing this or make sure you do that?
• 45:07
  Michael: I think that actually brings a lot more through than it does, hey, come and buy from us because we're really good, or we've got this piece of equipment.
• 45:14
  Michael: And and we do the same thing as well.
• 45:16
  Michael: I think there's a lot to be learned because I think physios are very much like patients.
• 45:20
  Michael: So if I if if I started marketing campaigns with funnels all the time that said, you know, buy this or get your free audit or whatever, people wouldn't do it.
• 45:27
  Michael: We just put interesting articles out, we just put really cool stuff out that's kind of a bit controversial.
• 45:32
  Michael: So I I think that is a lesson to be learned by a lot of physios.
• 45:36
  Michael: Don't be too aggressive and start offering discounts and 10% off this week and do some fun stuff, do some engaging stuff.
• 45:42
  SPEAKER_02: Yeah, no, absolutely.
• 45:44
  SPEAKER_02: It just builds enough awareness anyway.
• 45:46
  SPEAKER_02: People just need to know you exist.
• 45:47
  SPEAKER_02: If they know you exist, they will find you when they need you.
• 45:50
  Michael: Yeah, exactly that.
• 45:52
  Michael: You know, in the olden days, it was the yellow pages, right?
• 45:56
  Michael: It was uh you put yourself in there and people find you, you know, they need someone to clean up the mess.
• 46:00
  Michael: That's where you are.
• 46:01
  Michael: You don't have that anymore.
• 46:02
  Michael: Now it's now it's the internet and it's work of mouth and it's being on groups and so on and so forth.
• 46:09
  Michael: I think that's that's the key key element.
• 46:11
  Michael: So saying on visibility, you are a client of ours, so I do want to quickly go on to the onto the marketing side because one question I had for you was it as a as a clinic owner, it's very tempting to click on an ad that says 30 patients in just 30 days, money back guaranteed, or 10x your revenue in three easy steps, you know, all the fake guru kind of crap.
• 46:31
  Michael: How did you stay away from that, or did you?
• 46:34
  SPEAKER_02: I I would say that the only trap we fell into was one of my own doing of just spending a lot of money on Meta ads thinking they were going to do something.
• 46:41
  SPEAKER_02: Don't get me wrong, we run Meta ads for our pregnancy massage service, and they are unbelievably successful.
• 46:46
  SPEAKER_02: I find it absolutely hilarious because the average booking time for a pregnancy massage is 2.34 a.m.
• 46:52
  SPEAKER_02: And you can see exactly what's happening there.
• 46:55
  SPEAKER_02: Because my wife used to do it with our daughter, she'd be sitting there up in bed at the middle of the night, ridiculously uncomfortable, and going, right, I'm booking a massage.
• 47:03
  SPEAKER_02: Um, but um no, I I think for me, just some experience of being in private practice for a long time, generating 10 times profit, 30 new patients in 20 minutes, you know, it never made sense.
• 47:16
  SPEAKER_02: I always saw what people wanted was they wanted quality and value.
• 47:21
  SPEAKER_02: And I don't mean value is in cheap, I mean value is in something that was important to them that they thought was gonna fulfill the need that they had.
• 47:28
  SPEAKER_02: And whether that was 100 quid or 50 quid for them, it probably didn't matter as long as the outcome was what they wanted.
• 47:35
  Michael: Yeah, and I suppose there's an element of as well of it being too good to be true.
• 47:38
  Michael: You know, if someone tells you gonna be a millionaire in in three months just by joining their program, it's probably not gonna happen, right?
• 47:46
  SPEAKER_02: Yeah, and actually just thinking, I did completely forget, but youngks ago, we did um we did do some group on stuff for massage.
• 47:53
  SPEAKER_02: Um, you know, you're talking years ago now.
• 47:56
  SPEAKER_02: The retention rate of those patients was basically zero.
• 47:59
  SPEAKER_01: Yeah.
• 48:00
  SPEAKER_02: They never came back.
• 48:01
  SPEAKER_02: You you weren't building quality relationships, you weren't building good reputation.
• 48:05
  SPEAKER_02: You just were there because someone wanted to treat massage.
• 48:08
  Michael: Yeah.
• 48:09
  Michael: Just one important thing, actually, which which we should mention, or I should mention, is you said that the pregnancy massage stuff sells really well at night.
• 48:18
  Michael: I think that there are two things from that.
• 48:21
  Michael: The first is that social media ads can work, they can work really, really well, but they have to be about something that you can target and is a an enticing product.
• 48:32
  Michael: So someone says to me, get a free taxi ride.
• 48:35
  Michael: I'm signing up for the app.
• 48:37
  Michael: Great, right?
• 48:38
  Michael: Someone says to me, get a 50% discount on this item.
• 48:41
  Michael: I'm thinking, item of clothing, I'm thinking, yeah, that's all right.
• 48:45
  Michael: MSK is very different, and healthcare actually in general is very, very different because what you're doing is you're dumbing down the service, you're cheapening it, which I think is a massive danger in this industry, actually.
• 48:55
  Michael: I think the amount of people out there, whether it's a Cairo or a whoever, or a physio, talking about three sessions or 20% off or 75% off or whatever, I think that really harms the profession.
• 49:07
  Michael: And and and invariably it doesn't work because when you put all the the numbers together, you end up with not very much.
• 49:14
  Michael: And so I think that's really important.
• 49:15
  Michael: But then the other part of that is you can do it to certain groups of people where the service is interesting.
• 49:20
  Michael: Pilates is a good example, right?
• 49:22
  Michael: Yeah.
• 49:23
  Michael: So Pilates, I love the offer of bring a friend for free.
• 49:27
  Michael: Because there's a lot of people who aren't very confident, they really want to try it, but they're not gonna, and it works on me once it was hot yoga.
• 49:33
  Michael: I never went again, though.
• 49:34
  Michael: Jesus Christ.
• 49:35
  Michael: But it was hot, it was not good, it was harder than it looked.
• 49:39
  Michael: But the point is that I wouldn't have gone on my own, but it was like bring a friend for free.
• 49:42
  Michael: We're like, yeah, why not?
• 49:43
  Michael: So there are offers you can do, there are certain services you can market on socials.
• 49:48
  Michael: The other point is you've got to think about the timing and when you put ads out.
• 49:52
  Michael: Now, don't believe these companies say we've got an AI algorithm that tells you the best time to post.
• 49:56
  Michael: Bullshit.
• 49:57
  Michael: No, you don't.
• 49:58
  Michael: But what you do know is when people are around.
• 50:01
  Michael: So women, pregnant women, late at night, first thing in the morning, is an obvious.
• 50:07
  Michael: We uh I used to work for a company, we did some very like I and I mean like high-end marketing things.
• 50:13
  Michael: And one of the things was looking at timings in the mornings between sort of 6 a.m.
• 50:17
  Michael: and 10am of who was going to be online, what were the demographic affinities of those people?
• 50:23
  Michael: It was super, super interesting because very few men bought anything between 7 and 8 a.m.
• 50:28
  Michael: Right?
• 50:29
  Michael: It was it was always the women, but the men were buying around the lunch time times.
• 50:34
  Michael: So it's it's it sounds very obvious now, but actually thinking about that, and maybe if you're running Meta ads, skewing your spend later on in the day, because you can do that, so skewing it later on in the day does actually make sense, yeah.
• 50:49
  Michael: And and certain times, and you can you can define when like here's what I wouldn't do at school run time, I am not marketing to mums.
• 50:57
  Michael: It's not it's not happening.
• 50:59
  Michael: So you've got to think about the school runs and you've got to think about all of those different things.
• 51:02
  Michael: It's just a tip to people, I think is it it's it's interesting, and you know, you bought it up yourself and 2 30 a.m.
• 51:08
  Michael: for pregnancy massage is brilliant.
• 51:10
  SPEAKER_02: It just it just made me laugh.
• 51:12
  SPEAKER_02: We did we did an Instagram post on it, and I just I just have this vision for when my wife was pregnant with our daughter.
• 51:17
  SPEAKER_02: Exactly.
• 51:18
  SPEAKER_02: I was waking up and she was bolt up for I just said.
• 51:21
  Michael: Yeah.
• 51:22
  Michael: Another thought I had had actually, if you're running ads or something, you can actually do competitive targeting.
• 51:28
  Michael: So let's say you wanted to sell to a little let's say you wanted to sell to clinico customers.
• 51:35
  Michael: I might run an ad.
• 51:37
  Michael: So when someone searches for clinico, it might say, we've got the best booking system ever.
• 51:43
  Michael: So you can do some of that as well.
• 51:44
  Michael: Don't do it against in this industry, don't do it against competitors, it's dumb.
• 51:47
  Michael: It doesn't work.
• 51:48
  Michael: But you can do searches for things like if someone types in a running shop, a big running shop near you.
• 51:54
  Michael: You can, now this only works if you've got some money in your big clinic, but you can start advertising your services, you know, marathon, MOT, or whatever it is you want to do.
• 52:02
  Michael: You can advertise against those as well.
• 52:04
  Michael: It takes a bit of testing and experimentation, which is why you've got to have a marketing budget to do it.
• 52:08
  Michael: I'm getting a bit into the weeds of marketing here.
• 52:10
  Michael: Let's go back to visibility, all those saying on marketing, because you joined us, and I'm I'm interested, because you obviously know a guy who runs a big, brilliant marketing agency.
• 52:18
  Michael: You joined us.
• 52:20
  Michael: What what what do you think a marketing age forget us in a way, but uh I'm interested to know what you need for a marketing agency and what a great marketing agency should do.
• 52:31
  Michael: Yeah.
• 52:32
  SPEAKER_02: Um, I think a big one is just the the time and the core skill set.
• 52:38
  SPEAKER_02: I've tried to do Google ads myself before on a modest budget.
• 52:43
  SPEAKER_02: The reality was I didn't have one, the patience or two, the time to actually sit down, analyse the data, make the necessary changes, tweak this and that to get the best results.
• 52:55
  SPEAKER_02: So the reality was my cost per acquisition was pretty high.
• 52:59
  SPEAKER_02: I could probably generate myself a physio patient, but it was probably costing me more to generate it than the revenue I'd actually get from it.
• 53:05
  SPEAKER_02: So I I I think a big thing from a marketing agency is is the time, the data, and the expertise you guys have, that I can basically say, right, I need you to, here's the budget.
• 53:16
  SPEAKER_02: I need you to generate us some patients, let us do the rest, but I need you to maximize it around that budget.
• 53:25
  SPEAKER_02: And which you guys can do because you have the data, the time, and the expertise to do it.
• 53:29
  SPEAKER_02: Um you can actually get me patients at a sensible cost per acquisition, which then means when they start coming into the funnel here, we're starting to make a sensible amount of profit on it, you know, expecting every patient is around for four appointments, time value, all that sort of stuff.
• 53:46
  SPEAKER_02: And and at the same time, I think paid marketing especially is is an essential on the visibility side, as we've said, because if SEO is brilliant, you know, we're doing a lot of work on it, but the problem is a paid sponsored ad is always going to be above you.
• 54:02
  SPEAKER_02: So if you're not sitting at absolute number one on that Google search page, you're gonna miss out on an awful lot of business.
• 54:09
  Michael: Yeah.
• 54:10
  Michael: You know, I would add just I would add on that that I think AI SEO is becoming more and more important now.
• 54:16
  SPEAKER_02: So Yeah, we're seeing more of it.
• 54:17
  SPEAKER_02: Yeah.
• 54:18
  Michael: Yeah, so that's something that it is something we're putting most of our effort into now.
• 54:23
  Michael: Because if you can get into search results when people are high intent in searching on ChatGPT or on Google, and the first thing that comes up is uh Geminize AI thing, you know, who's the best person to see from Sciatica, and you're in there, that's I think that's really important.
• 54:35
  Michael: What about uh uh sort of know the answer?
• 54:37
  Michael: Because I I I think it's one thing we do quite badly and we're looking at doing more of, but what about access to people and being able to talk to people and getting good advice?
• 54:47
  SPEAKER_02: Yeah, it it is helpful, and I probably disproportionately jump on more calls with you guys than a lot of people do.
• 54:54
  Michael: You you genuinely don't.
• 54:57
  Michael: We we are inundated.
• 54:58
  Michael: I think most of my work now is is talking to people.
• 55:01
  SPEAKER_02: Yeah, I don't know, speak to Chris.
• 55:02
  SPEAKER_02: I've had one or two fun conversations with him.
• 55:05
  SPEAKER_02: Um, but no, I I do find it really useful to be able to jump on a call with you guys and actually I'd say it's more sanity checking.
• 55:13
  SPEAKER_02: I don't think you've ever given me an answer that I probably didn't already know in my heart of hearts.
• 55:18
  SPEAKER_02: Yeah.
• 55:18
  SPEAKER_02: But it's kind of um, I think at the moment we're doing a lot of work around our sort of secondary services, and it was kind of we need to improve the visibility around these.
• 55:26
  SPEAKER_02: We can't be spending thousand pounds on Google ads for every single service that we do.
• 55:32
  SPEAKER_02: Um then it was kind of like, well, the way forward on this is SEO and AI SEO.
• 55:36
  SPEAKER_02: And I was like, yeah, but you know, we're already doing XYZ.
• 55:40
  SPEAKER_02: And it was like, well, if you want to be top of the rankings for Pilates in hand force, you've got to have your SEO absolutely nailed on for that side of things.
• 55:50
  SPEAKER_02: And I think it was kind of a good thing to be able to sit down and have that conversation and actually say, look, this is what you're needing.
• 55:57
  SPEAKER_02: This is the process to get it.
• 55:58
  Michael: Well, it's also the knowledge, right?
• 56:00
  Michael: So so if you say to me, I want to be number one in Hanford for force plates, yeah.
• 56:04
  Michael: My answer is don't be stupid.
• 56:06
  Michael: Because, like, who cares?
• 56:08
  Michael: No one's searching for it.
• 56:09
  Michael: So it's having that sort of expertise, then having someone who might say to you, Well, it may sound a thousand pounds on every service.
• 56:16
  Michael: Now I know you don't have the the capacity to be spending a thousand pounds for every service, but let's say you did for a second.
• 56:22
  Michael: Spending a thousand pounds on every service for me is not a bad thing.
• 56:27
  Michael: And what I have to do is convince you that actually, if your lifetime value of a patient is£500, just high hy hypothetically is£500 quid in that service, and you get 20 people from a thousand pounds spend, who cares about the thousand pounds spend?
• 56:40
  Michael: So I think there's a little bit of sort of gentle persuasion sometimes.
• 56:44
  Michael: Not to say we're because you know, as we we often say don't spend more money, but there is that sort of gentle persuasion.
• 56:50
  Michael: It's actually something that we don't in in terms of communication, and something I think we're we're doing badly at the moment, is is actually outreach and being more proactive in our comms.
• 57:00
  Michael: Yeah.
• 57:00
  Michael: And that's something that that we know we have to fix, and we have something insane coming, that's not necessarily to do with that, but I I can't say too much because it's gonna be very, very exciting.
• 57:11
  Michael: But uh, I think you know, every business has problems, and that's one of the things that we're not doing enough of, which is proactivity, which I actually think lots of physios don't do.
• 57:19
  Michael: They make say they do, and then you ask them what they do, and they go, Oh, we got an automation that sends a newsletter every month, or we that's not proactivity, right?
• 57:26
  Michael: I think I think you can learn a lot from from being truly proactive with patients with a personal outreach.
• 57:32
  Michael: Do you do do you do any of that?
• 57:34
  SPEAKER_02: Not consistently.
• 57:36
  SPEAKER_02: Um I I I I've worked places that do newsletters, and I've kind of always struggled with the concept a little bit.
• 57:42
  SPEAKER_02: Um, I I think the key outreach thing we do is around making it easy for patients to contact us when they need to.
• 57:49
  SPEAKER_02: Yeah.
• 57:50
  SPEAKER_02: So for for example, we are very pro around uh getting people to people can WhatsApp us.
• 57:56
  Michael: So on that, I I had a surgical procedure and I said this in another podcast, but I was I loved it, when the next morning I got a little WhatsApp saying, Hey Michael, just want to check in on you.
• 58:07
  Michael: How are you doing?
• 58:08
  Michael: If there's anything you need, let me know.
• 58:10
  Michael: And and it was so nice to the next day.
• 58:14
  Michael: Now I know it was automated, it didn't look automated, it didn't sound automated, but it was actually really nice to check in.
• 58:20
  Michael: So if you're using WhatsApp, then you can actually set up some automations for the following day.
• 58:26
  Michael: You know, how was the session?
• 58:27
  Michael: Or well, it you know, you you can decide what what you want to say to the patient.
• 58:30
  Michael: But I think that as outreach can work really well, that's automated, but is personal because it's checking in on them and makes them feel better and gives them the the chance to say, actually, it's it's feeling even worse now.
• 58:43
  Michael: Okay, no problem.
• 58:44
  Michael: Let's have a chat about it, you know?
• 58:46
  SPEAKER_02: Yeah, yeah.
• 58:47
  SPEAKER_02: No, but we have found the WhatsApp side of things really useful.
• 58:49
  SPEAKER_02: And I I think some people are a bit hesitant to bring it in because they're like I was you know, invading your space a little bit.
• 58:55
  SPEAKER_02: I was like, well, I've got the emails on my phone.
• 58:57
  SPEAKER_02: Does it actually make that much difference?
• 58:59
  SPEAKER_02: You know, um, and and just things like, you know, we had a patient comment that she needed to reschedule her appointment and it was a bit annoying to have to call up, but actually just sending a WhatsApp made that patient experience for us so much easier.
• 59:13
  Michael: I think it's really important.
• 59:15
  Michael: I I you will not get me phoning people.
• 59:18
  Michael: I spend enough time on on the phone, I just I can't be asked.
• 59:21
  Michael: So if I have the ability to WhatsApp someone, it's way, way better.
• 59:24
  Michael: In fact, someone when when I was moving, we had a there was a removals company that said uh they gave you different options and whatever, but one of the options was send us a video of everything you've got uh and we'll give you a quote straight away and we'll have a chat with you.
• 59:38
  Michael: And I used them simply because it was so so easy.
• 59:41
  Michael: I didn't need to go through a big list and try and measure out my items, it was just walk through your house and we'll see what it's gonna cost.
• 59:46
  Michael: So I think WhatsApp is is hugely important because it's a communication that is much more personal.
• 59:51
  Michael: And by the way, you can see generally when someone's got blue ticks, and because of that, people respond a little bit more, right?
• 59:58
  Michael: I will say if you are gonna use it, use it properly and be responsive.
• 1:00:02
  Michael: Do not be that company that implements WhatsApps and then makes people wait seven hours to answer it and sort of have the the ability to answer quickly.
• 1:00:10
  SPEAKER_02: Yeah, yeah, it has to be treated in a way like you would communicate with people normally with WhatsApp.
• 1:00:16
  SPEAKER_02: And to be honest, I would say that's most of the conversations we have with people.
• 1:00:19
  SPEAKER_02: It's a very quick check-in, it's a very quick can I just move my appointment by an hour?
• 1:00:24
  SPEAKER_02: You know, it's it's the simple informal stuff, um, which we found it really strong for, but also patients really value.
• 1:00:31
  Michael: Have you found that that's implementing that has reduced your DNAs or your cancellations?
• 1:00:37
  SPEAKER_02: Yes, yes, I think it has.
• 1:00:39
  SPEAKER_02: Yeah.
• 1:00:39
  SPEAKER_02: We take prepayments for physio anyway, so our our DNA rate is is really, really low.
• 1:00:45
  SPEAKER_02: Um we sort of recommend online booking and stuff so you can see what availability is and all that kind of thing.
• 1:00:50
  SPEAKER_02: So generally, all of that is really quite low for us.
• 1:00:53
  SPEAKER_02: The cancellation side of things, it's the ones we can't really help.
• 1:00:56
  SPEAKER_02: The GP has said they can't exercise because they might have some arthritis in their back.
• 1:01:02
  Michael: And I'm like, I I can't.
• 1:01:04
  Michael: Just just a point on WhatsApp as well for people thinking a WhatsApp is like their personal WhatsApp.
• 1:01:08
  Michael: You do have WhatsApp for business, it is different.
• 1:01:10
  Michael: You have to use, yeah.
• 1:01:12
  Michael: Yeah, you can put out of offices on and close it off and turn it.
• 1:01:16
  Michael: So it is a separate app to your normal WhatsApp, so I don't think you're gonna the experience is just like a personal WhatsApp.
• 1:01:23
  Michael: Just put that out there because I did have a question once from someone who said, Oh my god, another like patient's gonna be able to WhatsApp me.
• 1:01:29
  Michael: No, no, no, it's a it's a little bit different.
• 1:01:31
  Michael: Okay, so what have we not covered?
• 1:01:33
  Michael: Something really interesting, because uh it's the multi-entry point part of the business, and I think that's a really important one.
• 1:01:40
  Michael: So talk us through that.
• 1:01:41
  Michael: What what do we mean by multi-entry point?
• 1:01:44
  SPEAKER_02: So I am very keen that we are not, and this sounds really weird coming from a physio business, not everything is about that physiotherapy initial consultation.
• 1:01:54
  SPEAKER_02: Okay, it's always going to be probably 50 to 75% of what we do, but the and I mean standard physio, I don't mean specialties, I mean just mechanical backbone physio consultation.
• 1:02:06
  SPEAKER_02: Patients coming in at the Pilates level is really important.
• 1:02:09
  SPEAKER_02: Patients understanding that they can just come here for a massage is really important.
• 1:02:14
  SPEAKER_02: You know, the Elos-Danlos syndrome stuff we do, the uh TMJ stuff we do, the women's health, the pregnancy massage, the shockwave, that all the services we offer have a very definite value.
• 1:02:29
  SPEAKER_02: And there's 50 it goes two ways with this for me.
• 1:02:32
  SPEAKER_02: Firstly, from the business perspective, if people can come in at multiple entry points in the businesses for different services, it's going to make the business more accessible to patients.
• 1:02:42
  SPEAKER_02: You know, a patient knows that they don't really need to see a physio about their pelvic, girdle, pain when they're pregnant because actually they're they just want a massage and it's all they want.
• 1:02:51
  SPEAKER_02: So absolutely come in for a pregnancy massage.
• 1:02:54
  SPEAKER_02: Um, but the second thing is is putting the value on the specialties that my clinicians want to offer.
• 1:03:01
  SPEAKER_02: So I want, for example, Leyra, who does the Ellos-Danlos syndrome stuff.
• 1:03:05
  SPEAKER_02: She knows that I am really proud that we can provide that service, and I think it's really important to the local community that we work in.
• 1:03:15
  SPEAKER_02: And okay, I'm not going to spend£5,000 a month advertising here, but actually, I do want to develop it.
• 1:03:21
  SPEAKER_02: I want to make it a really good quality service and I want to attract those patients.
• 1:03:25
  SPEAKER_02: And for me, that is part of this clinician growth thing as well, and then feeling like they have a place here that they can be the clinician they want to be.
• 1:03:35
  SPEAKER_02: If they want to go away and do a bit of extra specialist training in XYZ, they can come back to me and say, Can I practice that here, Richard?
• 1:03:42
  SPEAKER_02: Can we create this service?
• 1:03:43
  SPEAKER_02: Or say, Yeah, let's have a chat about it.
• 1:03:46
  Michael: Yeah.
• 1:03:46
  Michael: Yeah, and and I suppose you just open yourself up to a wider audience if you aren't just I'm a physio come in and see me.
• 1:03:55
  Michael: It's like, yeah, we're a physiotherapy business, but actually we have all these different things and you can go directly into that.
• 1:04:01
  Michael: Yeah.
• 1:04:01
  Michael: And you see that commonly with Pilates and Physio, but not necessarily with other services that physios offer.
• 1:04:08
  Michael: But I think it's important the point that I've made before is that I think that over the next three, five years, physios are going to have to offer a broader spectrum.
• 1:04:17
  Michael: And it may even be that they're no longer classified as physios because they're truly multidisciplinary and they're offering all kinds of different things because people want to come to a place where it they can get help for multiple things, not just for that one specific thing.
• 1:04:31
  Michael: And I think that also commercially makes a lot more sense as well, right?
• 1:04:34
  Michael: Because you've got multi-streams, streams of revenue in different places.
• 1:04:39
  SPEAKER_02: Yeah, and I was, you know, when we started working on the SEO, I was I was talking with you guys about, you know, we're not a big Pilates clinic, we're never going to be.
• 1:04:46
  SPEAKER_02: Our Pilates studio is we'll maximum fit five people in it.
• 1:04:51
  SPEAKER_02: But I was like, look, if and our huge thing here for us has been the one-to-one Pilates.
• 1:04:57
  SPEAKER_02: But people see so much value in it, they really like it.
• 1:05:00
  SPEAKER_02: A one-to-one Pilates patient, their average lifetime value is nearly a thousand pounds.
• 1:05:08
  SPEAKER_02: Because every the vast majority of them have gone on to purchase at least two or three ten package blocks.
• 1:05:17
  SPEAKER_02: And that and that's just that's from a secondary service.
• 1:05:20
  SPEAKER_02: A lifetime value of one client is a thousand pounds.
• 1:05:24
  SPEAKER_02: That has that has to have value in the structure of the business.
• 1:05:28
  SPEAKER_02: It can't be all about those physio-only patients all of the time.
• 1:05:32
  Michael: Yeah, I think that's an important point because you you have to, as a business and as a marketing agency actually, think through what are the most profitable services, what can we do to generate revenue.
• 1:05:44
  Michael: And you know, you're not you're not gonna do as well just from doing your bob standard physio appointments as having different services that are of a higher cost.
• 1:05:53
  Michael: Um and I'm not talking about being unethical and getting people to sign up to 20 courses of some kind of new fad technology.
• 1:05:59
  Michael: I'm talking about proper.
• 1:06:00
  Michael: Of things, but they have higher lifetime values.
• 1:06:02
  Michael: And that's actually, you know, the amount of clinics I've spoken to, that's actually now taking a lot more of their revenue than than physio is, you know, the amount of so one of the patients I'm kind of most proud of that we've had here was um he came to see us in the first couple of weeks, I think slightly bucking the trend, he'd found us also on Instagram.
• 1:06:22
  SPEAKER_02: Um and he came in, he'd had back pain for donkeys years, and and he said, Richard, what I really want help with.
• 1:06:29
  SPEAKER_02: He said, I know that the pain's probably never going to go away.
• 1:06:33
  SPEAKER_02: But he said, when I go to prayers at the mosque on a Friday, and this guy's probably early 60s, he said, I'm really embarrassed because I can't kneel down and pray with my mates, basically.
• 1:06:46
  SPEAKER_02: He said, I have to sit on the chairs at the back with the guys in their 70s, 80s, and 90s, who, you know, most of them are in wheelchairs.
• 1:06:55
  SPEAKER_02: And he said, it's simply because I can't get down to the floor.
• 1:06:58
  SPEAKER_02: And I said, Look, I said, I think the number one thing we need to be doing is getting you moving here.
• 1:07:02
  SPEAKER_02: We need to be getting you doing exercise regularly.
• 1:07:05
  SPEAKER_02: And this is a guy who doesn't do much, you know, exercise completely alien to him for his entire life.
• 1:07:11
  SPEAKER_02: He now comes to see Emma, our physio and Pilates instructor, religiously, twice a week, every single week, and he said it's the most life-changing thing he's told.
• 1:07:22
  Michael: First of all, that's a great pun religiously.
• 1:07:24
  Michael: Secondly, sounds like me and I need you, because I can't get down to the bloody floor either.
• 1:07:29
  Michael: All right, let's let's get into because we've broken uh Richard said uh if he runs for an hour and if a podcast goes for more than an hour, he can't listen to it.
• 1:07:36
  Michael: So I was trying to keep this down to a bloody hour, but we're at an hour 11.
• 1:07:40
  Michael: I want to just quickly look at one last topic, which is advice you would give people.
• 1:07:45
  Michael: Because you know, you opened the clinic in the new space seven months ago.
• 1:07:48
  Michael: What what advice would you give people?
• 1:07:50
  Michael: It what's the top two or three things that you think are super important?
• 1:07:54
  SPEAKER_02: Top two or three things.
• 1:07:57
  SPEAKER_02: I'm gonna put visibility again at number one.
• 1:07:59
  SPEAKER_02: You need to find somewhere where people can see you and you need to find a way of making them aware of you.
• 1:08:06
  SPEAKER_02: Now, I'm not gonna go into depth of, you know, does that have to be thousands of pounds of marketing and all that kind of thing?
• 1:08:12
  SPEAKER_02: It could be as simple as if you are a single room practitioner, get yourself in a gym with a huge footfall, you know, so people know you are there and they can see you.
• 1:08:23
  SPEAKER_02: If people don't know you're there, they're not gonna come and see you.
• 1:08:26
  SPEAKER_02: It's kind of as simple as that.
• 1:08:27
  SPEAKER_02: The second thing is don't be afraid to spend money, but it should always be calculated and it should always add value.
• 1:08:37
  SPEAKER_02: So if that means paying money on marketing, even if it means buying a new piece of equipment, ask yourself is this adding value to the service that I can offer?
• 1:08:49
  SPEAKER_02: Okay.
• 1:08:50
  SPEAKER_02: And what I mean by that is don't go out and spend 500 quid on another set of kettlebells when actually you're probably not gonna use them that much.
• 1:09:02
  SPEAKER_02: You know, when you've already got a full weight slack on my over my right shoulder.
• 1:09:07
  SPEAKER_02: If you're gonna make purchases on things, be it services or or physical items, they have to add a value and you have to to some degree be able to quantify that.
• 1:09:16
  SPEAKER_02: And I think the third and final thing is just back yourself.
• 1:09:22
  SPEAKER_02: Because I can guarantee most other people will say, crack on and do it.
• 1:09:26
  SPEAKER_02: Like no one's gonna, you know, you can do it if you are a good clinician and you've got good business sense and you are really motivated to do it.
• 1:09:34
  SPEAKER_02: Just back yourself.
• 1:09:36
  Michael: I agree with that one.
• 1:09:38
  Michael: Back yourself.
• 1:09:39
  Michael: I know I said that it was gonna be last topic.
• 1:09:41
  Michael: I want to just explore number one and number two.
• 1:09:43
  Michael: Number one was don't spend thousands, or do not necessarily spend do spend thousands with HMTG.
• 1:09:47
  Michael: That's an important one.
• 1:09:48
  Michael: Yeah.
• 1:09:49
  Michael: Top piece of advice, number one.
• 1:09:51
  Michael: No, but in in in all seriousness, the adding value bit, I think that something I just want to add to that is that don't just think about if you're gonna invest, and I'm talking specifically about investing in equipment, don't just think about the value it adds to the patient.
• 1:10:07
  Michael: Think about the value that it adds to the business.
• 1:10:10
  Michael: And by that I mean it's all well and good saying I'm gonna buy this new machine, it's gonna make all my patients better more quickly.
• 1:10:15
  Michael: How do you monetize that?
• 1:10:17
  Michael: How does that actually help the business in the PL?
• 1:10:21
  Michael: And then beyond that, something I hate hearing, and I hear it every fucking day, is I'm gonna buy this thing and I'll pay it off if I just get five appointments per month.
• 1:10:30
  Michael: That isn't how you should be thinking about investing into technology or equipment.
• 1:10:34
  Michael: It's how much money can I get it to make me?
• 1:10:37
  Michael: It should make me three or four times what I've paid for it.
• 1:10:40
  Michael: You don't just, it's not a case of just paying it off.
• 1:10:43
  Michael: Yeah.
• 1:10:44
  Michael: Because if you get into that, in into that mode, then you aren't thinking as a business person.
• 1:10:49
  Michael: So you've got to think if I spend 10,000 pounds on this, it needs to make me 50.
• 1:10:54
  Michael: How does it make me 50?
• 1:10:55
  Michael: Not, oh well, if I spend 10,000 pounds and I'll easily sell 10,000 pounds worth of appointments.
• 1:11:00
  Michael: How does it make you 50?
• 1:11:01
  Michael: Because if you otherwise, take your 50 grand or your 10 grand, put it into into a nicer, it'll make you more money.
• 1:11:07
  Michael: So I think that's that's that's an important one.
• 1:11:09
  Michael: Anyway, thank you so much.
• 1:11:10
  Michael: Sorry, one hour 15.
• 1:11:11
  Michael: You're gonna have to go on a longer run.
• 1:11:13
  Michael: Yeah, well, I'm I've got the London house thing to train for, so you know, bit of motivation.
• 1:11:16
  Michael: There you go.
• 1:11:17
  Michael: Perfect.
• 1:11:18
  Michael: Thank you so much for coming on.
• 1:11:19
  Michael: It's been really, really nice chatting.
• 1:11:20
  Michael: It's been good to chat.
• 1:11:21
  Michael: See you soon.