Paul is a long standing TM3 customer, former professional football physiotherapist, private practice owner, author and business coach. Paul started Paul Gough Physiorooms back in in 2007 having spent 5 seasons working with Darlington and Middlesborough football clubs. Since 2007, Paul Gough Physiorooms has grown to 4 locations, employing 15-18 members of staff, and welcoming up to 1500 clients in any given month.

In recent times, Paul made the move across the pond – switching the north-east of England for Orlando. Whilst he is no longer involved in the treatment side of things and day-to-day running of the business, he is still actively involved in the running of the company. Paul now focuses his time on writing books, delivering podcasts, and running programmes designed to help MSK business owners succeed.

We caught up with Paul to get his thoughts on the Covid-19 situation, what the future of the marketplace looks like, the evolution of the UK market and what clinic owners can do for success. Over the new two blogs, we’ll be sharing the interview with you.

Afternoon Paul! The effects of Covid-19 have changed the landscape drastically over the last few months and it’s a situation that still continues to evolve daily. In the short term, what notable challenges do you see businesses facing in the next 3-6 months?

"Anybody that is heavily reliant upon insurance referrals is going to face a number of challenges. I was around in the 2008-10 recession and insurance companies are going to be straight in the firing line. Insurers will be looking for ways to save money which will have a huge effect on clinics who rely on referrals. I see it being a threefold situation with reduced fees, reduced number of sessions and longer payment times. What this means is inevitable cashflow problems for already cash tight businesses.

Anybody who chases cash payment patients, outside of insurance - which is predominantly my model - is also going to face challenges. It’s going to take longer for people to make decisions and if you are offering premium priced services, you can expect that decision-making process to be longer.

What many businesses probably don’t understand is that the person who answers your phones is going to become the most important person in your business. Not your practitioners, not your managing director or marketing person, it’s whoever answers that phone that is going to decide how painful this is for business owners."

Do you think there are changes business owners should be making to their operational model to weather this storm in the short term?

"The strategy now has to become - more from less. The obvious thing that people will do is run to their accountant or bookkeeper who will tell them to cut every expense under the sun. In doing so, you’ll end up with no business and a business owner or clinician trying to manage everything that they can on their own.

There is going to be less patients around. Statistically 20% of patients have underlying health conditions, they aren’t coming for treatment for a long time. So, you have to move to a strategy that is more from less - how do you ensure that you go almost go back to the fundamental basics? Review every client that comes through the door, are they referring to you? Are they having all the sessions they need? Are you emailing them often? Are you turning them into long-term customers with classes, packages and additional services? Really this is the core strategy for the next couple of years.

I guess that refers back to a previous conversation we had about achieving operational excellence. Reducing your costs whilst squeezing that extra 10% out of your existing systems and processes?

"What you’ll find is that the temptation of anyone who has been shut down for a few months is to go aggressively, people will think you have to spend on marketing to grow. I’m a marketer at heart, I love Facebook, I love Google, I love newspaper ads but that’s not the way out of this. Moving forward, the way out of it is going to be to get focussed on the things you weren’t doing pre-covid.

Having the person who answers your phone trained regularly and held accountable to some level of conversion ratio. Having your practitioners aware that whilst those 3 session plans may be good for ego, they are usually terrible for everyone else concerned. Steering your clients towards packages, subscriptions, and plans where people can get more deeply involved with you. My belief is that you aren’t really helping anyone with one or two sessions for ankle sprains or back problems.

You need to really look deeply at your model in conjunction with your marketing message then get really touch tight on the operational side of it. You can’t let patients drop off and you can’t let patients not arrive, you’re going to get killed if any sloppiness remains. We were in a boom pre-covid, people had jobs and money to spend – you’re not going to get that going forward.

You definitely don’t need to go spend a fortune on marketing, you’ll have to spend on marketing but not at the rate you might believe. Instead, work out where you were losing money and use that to spend on marketing further down the line."

You touched on something really interesting with packages and subscriptions. With our latest innovation TM3 Connect, we learned from the Australian market quite heavily on the importance of this as an offering – something that the UK market has been quite slow to adopt. Do you see this being the future of the MSK industry??

"We are lightyears behind, lightyears. Sadly, we are schooled by a national health model and when private practices start, they bring the same mindset from the national health service into private practice. The model of “have one or two sessions, see how it goes then give us a call in a few weeks” isn’t working for anyone. There is a reason that private practice exists and it’s that they don’t want what the NHS are offering; they don’t want that standard of care. They want something very different, they want convenience, they want choice, they want to feel like they are being cared for from start to end.

We very rarely let anyone have one or two sessions because there’s no way we can help somebody with one or two sessions. We can fix the ankle pain, but we can’t sort the back or knee problem causing it in two sessions. We moved to packages a while ago and to answer the question, absolutely and for one reason – which has nothing to do with healthcare – its convenience. We live in a convenience society; people want to feel like they took the easiest and most seamless way possible to do business with people.

If you can get me on a subscription, much like gyms offer, I feel as though you are my physio provider. I want people to say ‘that’s my physio’ instead of ‘that’s where I go for physio’ and if you can get people on those packages and subscriptions, it’s a big mindset shift and changes the way you run that business. There’s no question now that healthcare has moved online, sadly it’s taken a big pandemic to make people realise the value of online."

Continue reading this interview now over on Paul Gough Interview Part Two.

Click here if you are interested in learning more about packages and subscriptions on TM3 or read more about Paul on his website here.