No Appointment Necessary

Most clinic owners think they’re networking. Jonathan Shearer explains why they’re wrong.

In this episode of No Appointment Necessary, Michael speaks with Jonathan Shearer, podiatrist and founder of Footsteps Clinic, about what networking actually looks like when it works. Not letters to GPs. Not one-off events. Not vague “being visible”.

They unpack why networking fails for most clinics, how trust is built through consistency and inconvenience, and why transactional thinking kills long-term results. Jonathan traces his approach back to selling fruit and veg as a teenager, where presentation, urgency and human connection decided whether stock sold or rotted. The same principles now underpin his referral networks across sports clubs, businesses and communities.

If you think networking “doesn’t work”, this episode explains exactly why.

Show Notes

Jonathan’s background

• Nearly 30 years in podiatry
• NHS training, then building a five-chair multidisciplinary clinic
• How early retail work shaped his focus on presentation and experience

Defining networking properly

• Networking as a sphere of influence, not an activity
• Why sending letters isn’t networking
• Visibility vs trust

Jonathan’s networking system

• Why it starts with team culture, not referrals
• Staff as the front-facing network
• Why owner-only networking becomes a bottleneck

How networking generates revenue

• Real examples from football, hockey and sports clubs
• Why inconvenience builds trust faster than pitches
• How free help led to hires, referrals and new services

The “free work” myth

• When free help works
• When it backfires
• Why forcing early ROI leads to bad decisions

Education as a lever

• Small talks that produced the biggest clients
• Why audience size doesn’t matter
• Effort and follow-up over format

Maintaining relationships

• Networking as “watering a plant”
• Why neglect kills results
• How Jonathan cuts parasitic relationships

Team-led networking

• Staff attending events and visiting businesses
• Why this needs PAYE or hybrid models
• Why associate-only models struggle

Tracking what works

• Offers and vouchers for offline attribution
• Why “vibes” aren’t metrics
• Measurement still matters

Cities vs towns

• Why networking works anywhere if executed properly
• Cities as opportunity-rich environments
• Affinity beats geography

Mindset

• Networking isn’t about being extroverted
• Fear of rejection is the real blocker
• Start small, repeat, build confidence

The 90-day reset

• What Jonathan would do in the first 90 days
• Visibility, relationships, talks and clubs
• Why something has to give

They finish on collaboration, why isolation fuels bad advice, and why real networking is about being known, trusted and useful over time.

What You’ll Learn

• Why most clinic owners misunderstand networking
• Transactional vs transformational relationships
• How trust is built through inconvenience
• When free help works and when it doesn’t
• How to turn teams into networking assets
• How to measure offline networking properly
• Why networking works in cities and towns
• What to prioritise in your first 90 days

Who This Episode Is For

Clinic owners who think networking “doesn’t work”.

Owners over-reliant on ads.

Clinicians who hate selling but want sustainable growth.

Guest Details

Jonathan Shearer

Podiatrist and founder

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

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Overview

Most clinic owners fantasise about scaling. Rhys Carter actually did it.

In this episode of No Appointment Necessary, Michael speaks with Rhys Carter, co-founder of Carter & George, about how a bored physio in Dubai, a conversation with Jamie George and an overbuilt first clinic turned into one of the fastest-growing MSK groups in the UK. They cover the early mistakes, the “celebrity effect”, the point Rhys had to stop treating, and why data, people and unit economics became the backbone of everything.

Then they get into the part everyone wants: acquisitions, valuation reality, funding without investors, deal killers, multiples, and why most clinic owners have no idea what their business is actually worth. If you’re thinking about adding a site or selling a clinic, this is the clearest look you’ll get at what it really takes.

Show Notes

They start with the Dubai origins: Rhys losing interest in the Middle East, Jamie George visiting while injured, and the drunken brainstorm that led to a high-spec first clinic with a 3,500 sq ft lease, a cryo chamber and little understanding of the model.

They unpack the Jamie George effect: why Rhys expected instant traction, why it didn’t happen, and why the real benefit was trust, not bookings. He explains why they intentionally avoided building the brand around Jamie to avoid risk and make the model scale.

Michael pushes on the transition from physio to business owner. Rhys explains how COVID forced his first non-clinical day, why stepping out too early destroys most clinics, and why data changed how he thought. They discuss session averages, condition patterns and occupancy, and why acting on data separates real operators from dashboard collectors.

They move to people and culture. Rhys outlines how Carter & George kept internal attrition around 5 percent, why most physios aren’t driven by money, and how letting staff design their own benefits changed engagement. They talk progression, mentoring and why loyalty is built through development, not perks.

Part two covers scaling: the accidental first acquisition the day before COVID, the painful three-clinic phase, and why hiring a finance director made growth make sense. Rhys explains their three clinic categories—high performers, growers, need-sorting—and how they stop strong sites from subsidising weak ones.

They break down valuations: what EBITDA really means, what gets added back, how directors’ clinical time must be costed, and why inflated multiples are rarely sustainable. They discuss deal traps like corporation tax, undeclared contracts, bad brokers and emotional attachment.

They close with the psychology of selling: letting go, identity, and why you must be absolutely certain you want to sell before you do it.

What You’ll Learn• How Carter & George scaled from one site to seventeen

• Why celebrity branding rarely drives patient volume

• When to stop treating and when not to

• How to use data to change behaviour, not just track numbers

• Why most MSK churn is preventable

• How real clinic valuations are calculated

• What multiples are realistic in 2025

• Hidden costs sellers forget

• How to fund growth without investors

• What makes a buyer walk away

Who This Episode Is For

Clinic owners considering scaling, selling or acquiring. Clinicians thinking about stepping out of treatment. Anyone who wants commercial reality over industry myth.

Guest Details

Rhys Carter — Physiotherapist, co-founder and managing director of Carter & George. Known for rapid multi-site growth, transparent acquisitions and a data-driven, people-first operating model
Email: [email protected]

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

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

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

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

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

Specialisms: Clinical communication, commercial strategy, clinic operations, marketing clarity

Email: [email protected]

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

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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.

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

• Why no job in the clinic is too small

• Working with parents without losing your sanity

The conversation also covers:

• Community marketing: building real relationships with climbing gyms, Pilates studios, run shops

• How one talk from Jonathan Shearer changed their growth trajectory

• Why TikTok beats Instagram for clinic discovery

• How LR Podiatry built a social presence that actually works

• Why only 5 percent of their patients come from social media and why that’s still a win

Plus:

• The future of AI for small clinics

• Why face-to-face care will never be replaced

• What Emily wishes she’d done earlier

• The real reason clinicians struggle to say no

• How to rebuild a clinic when everything collapses at once

• Why your website can make or break your income

• How to use community partnerships to drive consistent referrals

• What authenticity actually looks like in a healthcare business

• How to manage guilt, boundaries and emotional labour

• Why TikTok is the most underused resource in MSK

• How to grow without losing your humanity

• Clinic owners in crisis

• Pods, physios and chiros who feel isolated

• Small clinics who want to grow without becoming corporate

• Anyone scared to niche or show personality online

• Practitioners trying to build confidence and brand identity

Guest: Emily

Clinic: LR Podiatry

Team: Family-run: Emily, mum Louise, dad Paul

Location: Sheffield City Centre

Specialities: Skin, nail, MSK, gait analysis, gait & motion

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

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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.

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:

• 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

Guest: Patrick

Clinic: Move Physio

Team: 18 staff across two sites

Services: Physio, Sports Rehab, Pilates, Reformer, PT, Massage

Location: South West England

Email: [email protected]

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

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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.

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.

• Why taking over an existing clinic is harder than starting from scratch

• How to test demand before investing a penny

• How recurring revenue stabilises an MSK business

• Why strength training and S&C are becoming essential, not optional

• How to use tracking, data and wearables to improve retention

• Why most owners ignore burnout until something breaks

• What the next five years of MSK will look like

• Clinic owners considering expansion

• Practitioners thinking about buying their clinic

• Anyone curious about adding S&C, classes or diagnostics

• Owners who feel close to burnout

• Clinicians who want a realistic picture of what growth actually costs

Guest: Andy

Profession: Osteopath and Clinic Owner

Businesses: Motion Clinic (MSK + Strength)

Location: South West England

Website: https://motion-clinic.co.uk

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

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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.

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.

Michael pushes them on the controversial topics:

• Whether consolidation can damage innovation

• 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

• MSK leaders who want clarity rather than rumour

Guests: Claire & Yoni

Roles: Co-CEOs of Kinetico Health

Background: Investment banking, private equity, consulting, Harvard MBAs

Specialisms: M&A, operations, clinic integration, scaling private healthcare

Group Clinics: Leeds, Tunbridge Wells, Sale, and more planned

Website: https://kineticohealth.com/

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

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

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’t

Guest Details

Guest: Ben Marcilhacy
Role: Owner of HMDG
Background: Google, software, healthcare investment
Specialisms: Strategy, systems, scaling service businesses
Location: London
Web: www.hmdg.co.uk

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

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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.

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

• 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

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

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