This is the podcast clinic owners listen to when they’re done with gurus, funnels, blueprints, and templates pretending to be strategy. No hacks. No 'proven' 10X systems.
This comes from HMDG. We have worked with more than 1,000 MSK clinics. We see the accounts, the utilisation rates, the failed ideas, the profitable ideas, and the reality behind the noise. We do not deal in theory. We deal in numbers. Most of the industry advice collapses the moment it hits real-world finances.
You get the truth about how clinics actually grow. Why some print money while others burn out. What patient numbers mean once you stop pretending templates can fix capacity problems or that “mindset” builds a business. The idea that a clinic becomes successful because someone journalled harder is fantasy. We talk to people who have actually achieved something. Multi-site owners. True specialists. People with real P&Ls, not testimonial slides about a “life-changing £30k month”.
We break down marketing, pricing, staffing, finance, AI, and operations without pretending there is a magic blueprint that saves everyone. There isn’t. The only thing that works is understanding the fundamentals and executing them properly.
If you want comforting stories, find a guru. If you want the unfiltered reality of running a clinic, you’re in the right place.
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Why MSK Clinics Sink: A Former Physio’s Breakdown of Bad Advice and Bad Decisions
dimanche 7 décembre 2025 • Durée 52:44
Overview:
From Clinic Owner to Marketing Consultant: Mark Reid on What Really Sinks MSK Clinics
Mark Reid used to run a physio clinic. Now he works inside one of the UK’s biggest MSK marketing agencies. In this episode, Michael Schumacher and Mark tear into the uncomfortable truths of the industry: bad advice, guru nonsense, sunk-cost fallacy, flawed pricing, chasing “perfect patients”, social media guilt, and why most clinics don’t measure a single thing properly.
Show Notes:
Most people in marketing have never treated a patient. And most physios have never looked at a balance sheet.
Mark Reid has done both.
In this episode of No Appointment Necessary, Michael sits down with Mark, a former clinic owner, Physio Matters veteran, and now one of HMDG’s resident strategists, to talk bluntly about the mistakes clinics make every single day.
They get into the parallels between bad physiotherapy and bad marketing: guru culture, overcomplication, magical devices, false promises, and people selling answers they don’t have.
Mark explains what shocked him after switching sides: • How little commercial awareness most clinic owners have • How much money is wasted on things no one tracks • Why people still think social media “must” be done daily • Why blogs are usually unread PubMed essays disguised as marketing • How avatars and “perfect patients” became a distraction • Why stepping back from clinical work often destroys revenue
The conversation also digs into the uncomfortable but important truth: most clinic owners didn’t start a business to make money. They did it because they care about people. Which means they often avoid the commercial decisions that would allow them to help more people.
They talk through pricing models, initial vs follow-up nonsense, the obsession with cheap appointments, tiered pricing, what actually counts as marketing, and how to stop burning money on unmeasurable tactics.
This is one of the most practical episodes yet. If you run a clinic, you will recognise yourself in at least three parts of this conversation.
What You'll Learn:
Why physio and marketing suffer from the same guru-driven nonsense.
How overcomplication helps people sell products but never helps clinics grow.
Why most clinic owners can’t state their net profit or acquisition cost.
How to avoid sunk-cost fallacy with consultants, courses and “masterminds”.
Why initial vs follow-up pricing makes no commercial sense.
Why the “perfect patient avatar” is the wrong focus for 95% of clinics.
How to stop wasting money on leaflets, buses, print ads and untracked spend.
Why social media guilt is pointless and how to handle it strategically.
When stepping back from clinical hours becomes financially catastrophic.
How diversified referral channels protect a clinic from collapse.
How to think like a business owner without losing your clinical soul.
Who This Episode is For:
Clinic owners, physios thinking of stepping back from clinical work, people considering hiring an agency, anyone burned by marketing gurus, and MSK leaders who want to think more commercially without turning into caricatures
Guest Details:
Guest: Mark Reid
Background: Physiotherapist, clinic owner, Physio Matters, co-founder of CHOOSE Health, now strategist at HMDG
A Family Affair! Musical theatre, Sheffield feet and TikTok podiatry
samedi 6 décembre 2025 • Durée 54:47
Overview
This one is chaos, honesty and a masterclass in how a small clinic becomes a serious force. Emily from LR Podiatry joins Michael for a conversation that swings from musical theatre to burnout to rebuilding a clinic from the ground up. If you’ve ever felt like you’re winging it, drowning, or one bad month away from packing it in, this episode will hit home.
Emily talks openly about walking away from London, moving home, joining her mum’s tiny single-chair practice, and the moment everything fell apart after a website disaster that killed their new-patient flow. Then she explains exactly how they rebuilt LR Podiatry into one of the strongest, most loved clinics in the region.
It’s real. It’s funny. It’s vulnerable. And it’s full of practical lessons clinic owners need to hear.
Show Notes
Emily breaks down:
• Leaving a music career and starting again at 25
• Joining her mum’s tiny podiatry practice and turning it into a thriving city-centre clinic
• How a bad website rebuild wrecked their traffic and almost broke the business
• Why she was in tears on her first call with HMDG
• What changed in the first 3 months that reversed everything
Michael digs into mindset, decision-making, and what actually moves the needle in small clinics:
• The danger of “speculate to accumulate” hiring
• How losing your Google rankings destroys a clinic overnight
• Why personality and brand values matter more than any marketing tactic
• Why family-run clinics often outperform bigger ones
• Where guilt shows up in clinical practice and how to manage it
They go deep on culture and values:
• “Reassuringly informal”: how LR Podiatry build safety and warmth
• Treating patients as family without burning out
What You’ll LearnWho This Episode Is ForGuest Details
The Recruitment Episode Every Clinic Owner Needs to Hear
samedi 6 décembre 2025 • Durée 43:48
Overview:
Clinics keep saying there is a “shortage” of MSK clinicians. There usually is not. In this episode, Michael Schumacher and Laura Gilham from Recruit Therapists pull apart why most clinics struggle to hire, what good recruiters actually do, and why culture and personality matter more than another certificate on a CV.
Show Notes:
In private MSK, recruitment gets treated like a cost and an afterthought. Clinics throw a lazy advert on PhysioBob or Indeed, complain that “there are no physios left”, then wonder why the only applicants want £70k and a 4–day week.
In this episode of No Appointment Necessary, Michael Schumacher is joined by Laura Gilham, founder of Recruit Therapists, to talk brutally and honestly about how clinic recruitment really works.
They cover why most job ads are useless, why clinics overestimate their own appeal, and why hiring purely on experience creates miserable teams and poor retention. They also dig into the uncomfortable bit: clinicians who massively overvalue themselves and have no idea how thin clinic margins actually are.
This is not a fluffy HR chat. It is a financial argument for treating recruitment like a revenue lever, not a grudge purchase.
What You Will Learn:
Why “there is a shortage of physios” is usually a recruitment problem, not a supply problem.
How to calculate the real cost of an unfilled position, including lost revenue and patients going to the clinic down the road.
The difference between using a recruiter as a CV-forwarding service and using a headhunter who actually networks.
Why culture, personality and basic likability beat another postgraduate course when it comes to rebookings and retention.
How ego and salary expectations from some clinicians collide with the reality of private clinic margins.
Why most clinic job ads read like a B&B listing and what to show instead: environment, team, responsibility, freedom and progression.
How your social media and website make you more (or less) attractive as an employer, not just to patients.
Practical steps to make your next hire easier without just throwing more money at the problem.
Who This is For:
The Great Physio Shake-Up with Katie Knapton and Physio First
samedi 6 décembre 2025 • Durée 40:03
Overview:
Michael Schumacher sits down with Katie Knapton, Chair of Physio First, for a blunt conversation about private practice, resistance to innovation, bad incentives, and why clinics still struggle with business basics. They get into AI, video consults, practice standards, PMI negotiations, and the brutal reality of running clinics in 2025. No fluff. No polite industry theatre.
Show Notes:
Most interviews with professional bodies are polite, filtered, and pointless. This one isn’t.
Michael speaks with Katie Knapton, Chair of Physio First, clinician, and founder of a national video physio service, about what is actually happening inside the private MSK world.
They get straight into the uncomfortable stuff: why Physio First had a reputation problem, what Katie has changed, and why clinic owners still don’t understand most of what the organisation actually does for them.
They cover: • The resistance to innovation across MSK • Why so many physios still believe manual therapy is “the treatment” • How video consultations fit into modern MSK practice • Why patients are starting to trust AI triage more than clinicians • Threats to first appointment numbers as ChatGPT gives accurate early advice • Why some physios fear AI and others embrace it • What Physio First is actually offering: business support, legal helplines, mentorship, student placements, and national advocacy • The growing divide between high-quality clinics and everyone else • What private equity is doing to the sector
Michael challenges Physio First directly on due diligence, partnerships, quality control, and whether they should be doing more to protect clinics from bad actors.
Katie gives candid answers, explains what’s changing behind the scenes, and outlines how the independent sector is evolving fast — with paediatrics, neuro, frailty, and community rehab exploding while MSK plateaus.
They finish by pulling apart the big question: What happens when private equity owns half the sector, and who is left to protect patient outcomes?If you run a clinic, this is essential listening.
The Strip Club Special - Building a Brilliant Physio Business
samedi 6 décembre 2025 • Durée 50:08
Overview
Most clinic owners try to grow by “doing more physio.” Patrick didn’t. He built a full ecosystem. He took over a strip club, turned it into a medical clinic, built a second site, hired 18 staff, and created a brand so strong that patients now enter his business at multiple points of the ladder. Physio. Pilates. PT. Massage. All under one roof. All feeding each other.
In this episode, Michael (fighting a heroic case of man flu) talks with Patrick from Move Physio about scaling, culture, retention, KPIs, hiring, why most clinics grow painfully slowly, and why yours doesn’t have to.
Show Notes
This episode is a blueprint for clinics that actually want to scale.
Patrick covers:
• Taking over a strip club and turning it into a high-performance MSK clinic
• Growing from a one-man band to an 18-person, multi-service operation
• Why Move Physio beats competitors who have been in the area for decades
• How brand trust lets patients enter the business through physio, Pilates, PT or massage
• Why the “ecosystem” is the real product, not the treatment session
Michael pushes Patrick on the key areas where most clinics stall:
• Obsessing over new patients while ignoring what happens after they arrive
• Retention confusion: everyone talks about it, almost nobody measures it properly
• Why you should stop copying “clinic blueprints” and start building your own
• The cost of hiring the wrong clinicians and how to spot it early
• How culture falls apart when people behave like room-renters instead of a team
• Why Patrick fires quickly when someone doesn’t fit the ethos
The conversation dives deep into KPIs and the numbers that actually move revenue:
What You’ll LearnWho This Episode Is ForGuest Details
Sod It, Let’s Open Another Clinic - Risk, Recurring Revenue & Burnout
samedi 6 décembre 2025 • Durée 43:46
Overview
Most clinic owners talk about taking risks. Andy actually did it. He bought a declining osteopathy clinic, rebuilt it from the inside out, then opened a second business across the road with no plan, no sleep, a newborn child and a stomach ulcer. Now he runs one of the most interesting blended MSK + strength clinics in the South West.
In this episode, Michael Schumacher sits down with Andy to unpack the real story: the messy acquisition, the resistance from inherited staff, the Notion systems that eventually saved him, the accidental launch of a gym he didn’t intend to run, and the burnout that forced him to rethink his entire approach to work.
Show Notes
This episode covers the side of clinic ownership most people never admit publicly.
• Buying a clinic from a retiring osteopath who stayed on and blocked every change
• Trying to modernise a business run entirely from someone’s memory
• Implementing Notion as the backbone of operations and finally getting staff buy-in
• Spotting a high-street unit, pitching it on the spot, and accidentally winning it over Costa
• Running validation tests to see if a gym + rehab concept would work
• Getting 150 signups in days and having the local press push the project into reality
• Launching mobility, resilience and osteoporosis classes and hitting full capacity
• Using VALD, strength testing and data tracking to keep patients engaged
• Why older adults love measurable progress more than any marketing campaign
The conversation goes deeper into where MSK is heading: diagnostics, DEXA, wearables, gamification, VO2 tracking, normative data, and why the future of private practice will rely heavily on measurement and behavioural change.
Michael also pushes Andy on the hard bit: burnout. Andy opens up about the ulcer, the fear, the workload, the second business, the newborn, the failed partnership, and the realisation that his ambition was outpacing his health.
What You’ll LearnWho This Episode Is ForGuest Details
Buy My Clinic, Not My Soul: Valuations, Roll Ups and MSK Reality
samedi 6 décembre 2025 • Durée 43:56
Overview:
There has been more noise about MSK acquisitions in the last two years than in the previous twenty. Most clinicians still misunderstand what M&A actually is, what private equity is, and why so many clinics are suddenly being bought. In this episode, Michael Schumacher speaks with Claire and Yoni, co-CEOs of Kinetico Health, one of the most active buyers in the sector. They talk openly about acquisitions, valuations, culture, patient care, competition, and the long-term future of MSK.
Show Notes:
Kinetico Health didn’t come from healthcare. Claire and Yoni both worked in high-level finance before leaving to build something with more purpose. Two years later, they have four clinics in their group and are targeting 40 across the UK. Their model is simple: buy strong clinics, preserve their culture, take over the operational load, and grow them.
In this episode, they walk Michael through the parts of M&A that most clinic owners never hear about:
• Why private equity is misunderstood and why Kinetico is not private equity
• How they differ from “fund-led rollups” that act at a distance and swap CEOs when things go wrong
• Why they stay involved operationally and know every practitioner by name
• Why they refuse to strip clinics of their identity, branding or local culture
• What sellers actually get when they sell: capital, support, stability and less stress
They also address the big fears in the sector:
• Does M&A harm care quality?
• Will corporates push quick wins and short-term profit?
• Will small clinics be outspent or squeezed out?
Their view is blunt: good care is the only sustainable model, large clinics run more efficiently than tiny ones, and competition forces everyone to raise standards. They make the case that investment brings better facilities, more staff, stronger systems, and better outcomes — not worse.
What You’ll LearnWho This Episode Is ForGuest Details
Clinics, Consolidation and Bad Advice: An Investor’s Unfiltered View of MSK
samedi 6 décembre 2025 • Durée 58:27
Overview:
When HMDG sold, most people assumed it was a simple acquisition. It wasn’t. Michael Schumacher sits down with new owner Ben Marcilhacy to talk openly about buying an agency, why he walked away from building a clinic group, and what he’s learned from seeing hundreds of MSK businesses up close. They cover culture, integrity, corporate creep, data, patient experience, and why MSK is changing faster than most clinics realise.
Show Notes:
Ben originally spent months travelling the UK trying to buy physio clinics. After multiple LOIs and rounds of due diligence, he abandoned the plan. Not because clinics were bad businesses, but because he realised he’d never control the core product: clinical care.
A long call with HMDG changed everything. A year later, he bought the company.
In this episode, Michael and Ben dig into:
• Why HMDG’s honesty is an asset, not a liability • How to scale without becoming a corporate caricature • Why integrity still decides who HMDG works with • The difference between clinics that know their numbers and those guessing • Why dashboards don’t matter if you never act on the data • The three to five metrics that actually drive clinic growth • Why younger patients expect healthcare to feel like every other modern service • How experience, speed, and convenience now decide winners and losers • Why consolidation is happening, who will regret it, and why spreadsheet logic collapses when real patients are involved
This is one of the clearest conversations yet on what actually drives MSK businesses, what the market is becoming, and what clinics need to fix now.
What You’ll Learn
• How HMDG maintains honesty while scaling • Why clinics overcomplicate data • The essentials of patient experience in 2025 • The risks and myths of clinic consolidation • Why investors often misunderstand MSK • The future shape of private MSK
Who This Episode Is For
• Clinic owners who want clarity, not fluff • Anyone considering selling or buying a clinic• MSK leaders worried about corporatisation• Founders who avoid their numbers but know they shouldn’tGuest DetailsGuest: Ben MarcilhacyRole: Owner of HMDGBackground: Google, software, healthcare investmentSpecialisms: Strategy, systems, scaling service businessesLocation: LondonWeb: www.hmdg.co.uk
The Realities of Expanding Your Business Through Acquisition - It Ain’t All Sunshine and Rainbows!
samedi 6 décembre 2025 • Durée 50:39
Overview:
Everyone talks about buying clinics like it’s a cheat code to success. The reality is debt, staff friction, culture clashes and years of delayed payoff. In this episode, Michael Schumacher sits down with Leeds-based clinic owner Ove Indergaard to break down the truth behind MSK acquisitions and what really happens after completion.
Show Notes:
On social media, clinic M&A looks glamorous. In practice, it’s risk, spreadsheets, hard conversations and short-term pain disguised as growth.
Ove has built a four-clinic group through acquisitions and new sites. On paper, it sounds smooth. In reality, it has been unstable cash flow, exhausted teams, and Ove stepping back into clinical hours just to keep things alive.
In this episode, Michael and Ove strip out the fantasy and talk about:
• How deals are actually structured: deposits, deferred payments, loans
• Why acquisitions often produce zero personal income for years
• The cultural collision when an old team meets a new owner
• Why staff pushback is the hardest part of buying a clinic
• How integration breaks even the most organised owner
• The hidden cost of multiple PMS, systems and processes
• Why standardising workflows is harder than scaling revenue
• When you should not buy a second clinic
• The emotional cost nobody talks about: stress, doubt, and the “what have I done?” moment
They also cover operational traps:
• Hiring when cash is tight
• Why stepping back from clinical work too fast destroys revenue
• Why “bad care but good marketing” is not a stable business model
• The reality of PVA, retention and how long turnarounds actually take
What You’ll LearnWho This Episode Is For
Podiatrists Eat Their Young! A Conversation with Nick Knight
samedi 6 décembre 2025 • Durée 59:43
Overview:
Podiatry is one of the most misunderstood professions in MSK. Nick Knight joins Michael Schumacher to talk honestly about why podiatry struggles with visibility, why the public still thinks pods cut toenails, and what needs to change. They cover tech, orthotics, FHPs, bad marketing, inter-professional politics and why podiatry is actually one of the most exciting parts of MSK when done properly.
Show Notes:
If you asked the average patient what podiatrists do, most would say “cut toenails”.
In reality, podiatry is one of the most advanced, tech-enabled, and clinically interesting parts of MSK healthcare. But the profession has a branding problem, a visibility problem, and a long history of under-marketing its own value.
In this episode of No Appointment Necessary, Michael Schumacher sits down with podiatrist and founder of NK Active, Nick Knight, to take a brutally honest look at where podiatry is right now.
They cover the profession’s internal politics, the cultural divide between routine care and MSK rehab, why podiatry never advertises what it’s actually good at, and how AI is already redirecting patients toward specialists like Nick.
The conversation also dives into the messy topics: • Overuse and underuse of orthotics. • Tech that helps vs tech that is pure theatre. • The ethics of selling high-ticket gait analysis. • Why foot health practitioners are not the enemy but the lack of regulation is. • Why most MSK problems don’t need insoles and most kids with flat feet need nothing at all.
Nick also explains why podiatrists need to be far bolder in how they communicate with the public, why clinics should stop trying to guess what patients think, and how AI is about to become podiatry’s biggest growth engine.
If you work in MSK and still don’t know what a podiatrist actually does, this episode will fix that. If you are a podiatrist, this might be the wake-up call.
What You'll Learn
Why podiatry has a branding issue and why clinics have caused it.
Why most of the public have no idea podiatrists treat Achilles, plantar fasciitis, tendon issues or running injuries.
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Découvrez des podcasts liées à No Appointment Necessary . Explorez des podcasts avec des thèmes, sujets, et formats similaires. Ces similarités sont calculées grâce à des données tangibles, pas d'extrapolations !
Clinic owners, clinical directors and practice managers in MSK who are sick of reposting the same job advert every month, burning hours on rubbish CVs, or losing good clinicians to “nicer” clinics that are not even paying more.
Guest and Contact Details:
Guest: Laura Gilham, founder and co-director of Recruit Therapists, specialising in permanent and locum roles for private clinics across the UK. Contact Laura: laura@recruittherapists.co.uk Company: Recruit Therapists
Why Physio First is changing and what it actually offers now
How video consultations fit into modern patient pathways
Why AI triage will reduce unnecessary first appointments
Why poorly informed physio is now a commercial risk
How resistance to innovation weakens clinics
How private equity is reshaping the MSK landscape
Why PMIs negotiate the way they do
The real hierarchy of what a professional body should protect
Why many clinics still lack business fundamentals
How student placements and graduate support could fix workforce issues
Who This Episode Is For:
MSK clinic owners, physios frustrated with the CSP, clinicians curious about Physio First, anyone worried about AI replacing parts of their workflow, and every clinic owner who wants the sector to grow rather than loop old mistakes forever.
Guest Details:
Guest: Katie Knapton
Roles: Chair of Physio First, physiotherapist, founder of a national video physio service
Specialisms: Clinical leadership, sector advocacy, business support, graduate development, national partnerships
• The metric nobody tracks: average time between appointments
• Why an 80%+ rebooking ratio is non-negotiable
• Saturation levels and why “fully booked” means you’re losing money
• Revenue per hour vs revenue per appointment
• How Data Player, Cliniko and a few basic systems transformed decision-making
They also tackle the tech stack clinics should care about, from AI receptionists to CRMs to the humble robot vacuum cleaner (Ufi), which Patrick swears by.
• How to build a multi-service ecosystem that keeps patients for years
• The KPIs that predict growth with terrifying accuracy
• Why most physios don’t know how to communicate value
• How to train clinicians to sell without ever “selling”
• The culture patterns of clinics that grow vs clinics that collapse
• Why new patient numbers matter far less than you think
• How to build a business you can step away from without it falling apart
• Clinic owners stuck at £300k–£700k turnover
• One-man bands who want to scale
• Owners trying to fix poor retention and empty diaries
• Clinics adding Pilates, PT or massage and not seeing the return
• Anyone tired of generic “coaching” with no measurable outcomes
• How groups should collaborate rather than isolate
• Why some valuations in the market are delusional
• Whether today’s high multiples are sustainable
• Why many clinic owners overestimate what their business is worth
Claire breaks down valuations in practical terms: adjusted EBITDA, how multiples work, what increases or decreases value, and why practitioner concentration and stability matter more than most owners realise.
They finish with a discussion on timing. Should owners sell now or wait? With tax changes coming, macro uncertainty rising and multiples inflated, the honest answer is simple: certainty now is often worth more than maybe later.
• How M&A actually works in MSK
• Why private equity is misunderstood
• What buyers look for in a clinic
• What really determines valuation (beyond turnover)
• Why consolidation isn’t automatically bad for the profession
• Where smaller clinics can still win
• Why legacy, culture and patient experience matter more than spreadsheets
• Clinic owners considering selling in the next 3–5 years
• Anyone trying to understand valuations and multiples
• Clinicians worried about corporate consolidation
• Owners debating whether to scale or stay independent
• Why owners obsess about top-line revenue and forget about margin
Finally, they dive into whether consolidation is good for the industry, why many buyers overpay, and why spreadsheet logic collapses the minute you step inside a real clinic with real staff and real patients.
If you are romanticising multi-site ownership, this is the episode that forces you to think in years, not months.
• The unglamorous reality of clinic acquisitions
• How to judge whether a clinic is fixable
• What integration actually involves
• The difference between scaling and overextending
• How to avoid crippling early mistakes when expanding
• Why most owners underestimate culture and overestimate numbers
• Clinic owners thinking about buying a second site
• Single-site owners debating whether to scale or optimise
• Anyone being sold the “clinic empire” dream
• MSK owners who want honesty, not hype
Guest Details Guest: Ove Indergaard Profession: Chartered Physiotherapist Role: Owner of Indergaard Physiotherapy (multi-clinic group) Specialisms: MSK rehab, shockwave, clinic operations, acquisitions Location: Leeds, UK
How internal toxicity and inter-professional bickering damages the profession.
The real ratio of routine care vs advanced MSK podiatry and why it matters.
Why Gait & Motion and similar tech can be useful but also easily abused.
The difference between clinically justified orthotics and retail upselling.
Why MSK patients increasingly turn to AI before choosing a clinician.
How AI is already sending patients directly to podiatrists instead of physios.
Why FHPs are not the problem, but unregulated scope creep is.
Why pods must stop being scared of marketing and start showing what they actually do.
Who This Episode is For:
Podiatrists who want to work at the top of their license. MSK clinicians who still misunderstand what podiatrists actually treat. Clinic owners looking to expand into foot and ankle services. Anyone trying to understand where AI fits into modern MSK care. Runners, coaches and rehab clinicians fed up with outdated foot and ankle advice.
