Overview

Pilates is either a nice add-on you never quite monetise, or it becomes the engine room of your clinic.

In this episode, Michael speaks with Lowry O’Mahony (Max Physio & Pilates, and Maxona) about how she integrated Pilates so tightly into a multi-site MSK business that it now generates roughly half of revenue, stabilises cashflow, and creates a workforce pipeline when physio hiring gets tight. They get into where Pilates fits in the patient pathway, how to make it recurring without it feeling “salesy”, and why the best lessons often come from entrepreneurs outside MSK, not the usual industry gurus.

Lowry also explains why she built Maxona: training, studio fit-outs, equipment, and smart reformers designed to measure progress and keep people engaged.

Show Notes

• Why so many clinics “offer Pilates” but fail to integrate it properly
• Australia vs UK/Ireland: why Pilates is more embedded in private practice there
• Pilates as recurring revenue: why it smooths out the peaks and troughs
• The patient pathway: where Pilates fits (day one, mid-rehab, end-stage, or standalone)
• “Physios hate selling”: how free intro classes remove friction and awkwardness
• The real Pilates customer base: why 50+ and 60+ is the market, not influencers
• Staffing reality: using Pilates to broaden your workforce beyond the physio bottleneck
• Culture and systems: KPIs for behaviour, values, and how to protect standards as you scale
• Expansion: opening multiple sites off the back of stable demand and better predictability
• Maxona: teacher training, Pilates Academy, maintenance/support, equipment finance
• Smart reformers and measurement: using objective feedback to drive adherence and outcomes
• Community strategy: macro events and micro cohorts to improve retention and seasonality

What You’ll Learn

• How to position Pilates as a core service line, not a side hustle
• How to move people from reactive physio to proactive memberships without hard selling
• What to prioritise first: space, training consistency, booking tech, and retention mechanics
• How to use blocks, memberships, and community to reduce seasonality
• How to think about staffing when physios are scarce: building a parallel workforce
• Why measurement and progress tracking matter for adherence (and revenue stability)

Who This Episode is For

• Clinic owners doing £300k to £2m who want a second engine of growth
• Owners stuck on physio capacity, utilisation, or staffing constraints
• Clinics offering Pilates but not making meaningful money from it
• Anyone considering reformer Pilates and worried about space, cost, or team buy-in
• Owners who want more predictable revenue before scaling, hiring, or exiting

Guest Details

Lowry O’Mahony

Founder of Max Physio & Pilates (Ireland) and Maxona.

• Trained as a physiotherapist (RCSI, Dublin) and Pilates instructor early in her career
• Worked in the UK and Australia, where Pilates is deeply integrated into private practice
• Built a multi-site physio and Pilates model with Pilates contributing ~50% of revenue
• Created Maxona to help clinics implement Pilates end-to-end: training, equipment, support, and studio success

Find Lowry and Maxona

• Instagram: @lowryphysiopilates
• LinkedIn: Lowry O’Mahony
• Maxona: https://maxsona.com/

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

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