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: rhys@carterandgeorge.co.uk