E#43 | Why Clinics Break at Scale | Business of a Clinic (BOAC)

In this episode of The Business of a Clinic, Jared speaks with Cameron Tudor, physiotherapist and founder of West London Physio, about what really happens when a clinician becomes a clinic owner.

Cameron’s journey spans private practice in Australia, locum work in the NHS, building a clinic from one patient and one phone call, scaling to four clinics and around 50 staff, and later returning to a more focused single-clinic model.

The conversation explores the hidden operational reality behind clinic growth: leases, personal guarantees, reception, bookkeeping, hiring, burnout, systems, checklists, patient follow-up, and the uncomfortable shift from being the clinician to becoming the entrepreneur.

Jared and Cameron discuss why healthcare often has a logistics problem, not a clinical problem, and why efficiency should not be seen as cold cost-cutting. Done properly, efficiency allows clinicians to focus on care, gives patients a more consistent experience, and helps the business become more sustainable.

They also unpack what breaks when clinics scale, why centralising culture too quickly can backfire, how SOPs and checklists protect the patient journey, and why clinic owners need to listen before trying to impose change.

The episode closes with Cameron’s view on the future of MSK: rising patient demand, growing pressure on public systems, clinical care remaining deeply human, and the front desk evolving from admin processing into concierge-style patient support.

In this episode

• Cameron’s journey from physio to clinic owner
• Starting a clinic with one patient, one phone call, and a major lease liability
• Why clinicians are often forced to become entrepreneurs
• The hidden jobs clinic owners inherit: receptionist, accountant, marketer, operator
• Why burnout forces clinic owners to think in systems
• How SOPs and checklists create consistency
• Why efficiency is better care, not just cost control
• Who should own patient follow-up and recall
• Why clinicians often resist admin-led follow-up
• The tension between healthcare and “sales”
• What ethical selling looks like in private healthcare
• What breaks when scaling from one clinic to multiple sites
• Why listening matters when acquiring or integrating clinics
• The future of MSK and private practice
• Why the front desk may become more concierge than admin

Key idea

Clinics do not break because the clinical care is poor. They usually break because the systems around the care are not strong enough to scale.

About the show

The Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.

Transcript

SPEAKER_03 0:00

It was day one was one patient, one phone call. I answered the phone and I had enormous liability over my head with director's guarantees on the lease and all that sort of thing. And my proposal was we have flexi time. So you take a tea break when a patient doesn't turn up. Invariably everybody had about two a day. A union efficient who said, Never speak of this again. It's not your role in healthcare where you get criticism. Is as soon as you mention the word efficiency, it has this, it's it's an odd word insofar as people think, oh, you're cutting corners. This is about making more money. So some of them want to have complete control. And I think part of that is I think you get this. They're trained as autonomous people. They are the clinical decision makers, all contact, they want protected and the way they speak to the patient is how they speak to the patient. They don't want a or many of them don't want a an administrator saying, D Jared, just wanted to follow up, we just wanted to follow up on how your back was because you might not get their voice. And so they tend to want to keep that. But I think when you come into a clinic and you open the door and there's a some sense of warmth and de-risking. And I think that's for patients, it's an intimidating place, but particularly at the start. When a patient opens a door and they're going to see a new healthcare person, then they're going to ask me difficult questions, embarrassing questions. Are they going to make me take my clothes off? Do they know what they're talking about? Do they smell all sorts of things that are these risks? And if you can get that right environment to open the door, that sort of de-risks things a little bit, lowers our anxiety, and then they're more open to this sort of collaborative experience, which is largely what healthcare is.

SPEAKER_02 1:52

Has seen the ecosystem from many different perspectives.

SPEAKER_00 1:54

We're really excited. To have you, Cameron, do you mind giving us a sort of quick introduction and where it started and where are we now?

SPEAKER_02 2:01

Just to give us that sort of story arc of your career so far.

SPEAKER_03 2:04

Sure. Thanks. Thanks for uh thanks for inviting me, Jared. That I started out I would have been in 1996, I think I graduated as a physio, and like most, I went in and started off as a clinician and I worked initially in private practice in Australia. Most people go into the public sector, there's probably 10% that will go in directly into private practice, and I did that. And then after a couple of years, came over to the UK and locumed for a couple of years, lots of different environments, NHS, a little bit of private practice, but got an appreciation of how it was done differently in the UK. Headed back to Australia, took, bought a four-wheel drive and drove around the country for a year and a half and worked in the Outback and in all sorts of places. Um, and then eventually returned back to the UK in 2004, set up a clinic a couple of years later in Kensington called Westland Physio, and you know, grew that organically, you know, sort of clinic where it was day one was one patient, one phone call, I answered the phone, and I had an enormous liability over my head with director's guarantees on the lease and all that sort of thing. Um and then gradually grew that and uh then acquired a couple of other clinics, ended up with four clinics, about 50 odd staff, uh, and then uh sold them down gradually and now back to one clinic, which is fantastic. But all of us all of that was under the the decisions based on different phases of life, but that's where we are now.

SPEAKER_02 3:36

Got it. There's a lot to unpack there. I'm particularly interested in the four-wheel driving part. Yeah, maybe that's for a different time. So you so it's interesting. So I guess you'd be your experience in the UK, uh, you said started on a public sector side, and then you found your way into private without spending too much time thinking public sector. I I am curious to understand why start there and then why leave there? What was the sort of in-and-out story with participating in the in-out side?

SPEAKER_03 4:06

Yeah, the the in story was easy. It was a locum company. I was moving to the UK and needed somewhere to work, and somebody said, look, there's a spot here for a couple of months is a locum. They need a waiting list to be reduced, and I took a role there. I left it because you come into these places as a clinician, but I've been doing this for I guess for four or five years by that stage. And you come into a department and look at it and think, gee, this could be a little bit more efficient here. It was felt pretty backward. We had this huge waiting list, and I looked at the waiting list and said we can reduce that. That you had all these staff tea breaks and lots of cancellations. And I said, Can we charge patients for if they cancel if they don't turn up to their appointment? Can we charge them? And in the UK NHS, absolutely not. And so I said, Can we do something with the tea breaks? And the therapy manager had said, Yeah, great, great idea. Let's and my proposal was that we have flexi time. So you take a tea break when a patient doesn't turn up. Invariably, everybody had about two a day. And so I presented that to the department, and the pushback was extraordinary. And I was approached by a union official who said, Never speak of this again, it's not your role. I was a locum. I was a locum, I was getting paid double what they were getting paid. And and I thought then there's no way the clinical side was fine, but to work in that environment for me, where you might everyone has a a view of how they like to operate. And I was looking at it and thinking it's the most efficient way that this department could run, and they weren't much interested in that. And so I thought, okay, it's this sector's not for me, I'll head into the independent sector.

SPEAKER_02 5:35

It's interesting. One of the things that we we talk a lot about in the bit of the business of a clinic is the idea that healthcare has a logistics problem, not a healthcare problem. By which we mean actually the millions, billions, trillions that go into improving in-room care are helpful, but not really where the bottleneck is. The bottleneck is often around the operational components of providing healthcare as a service. And so it sounds like you were describing obviously that's NHS scale. It's going back many years. I don't know that much has changed, but that's not my place to say. But I think what I'm taking away from that is when you were patient-facing, things were good, the quality of clinical care was good, the in-betweenness just wasn't. So fine, forgot it's a you close your NHS chapter, you become a one-man band, it's you, it's a treatment room, it's liability, it's overhead, it's a business, it's customers. What happens next?

SPEAKER_03 6:33

So the first thing was at a part early on, but where you like any new business that that requires premises, you've got to sign a lease. And typically that might be for a bunch of years. I think for us it was seven years, and from memory, I think it was sort of forty thousand a year or something like that. And so you look at a liability of a couple hundred thousand pounds that you don't have. You're young and you don't have the money, and and so the landlord will say, We don't trust your covenant, so we want a director's guarantee. And you sign up to that and basically putting your flat or house on the hook, and you sit there with this huge liability, and you've you've got to say, How do we make it work? At that point, you didn't start off with there was no receptionist that came within a month or two. But at the very start, you were doing everything. You were doing the accounts, you were figuring out what bookkeeping was, you were trying to understand what a profit and loss statement looked like and balance sheet and and those things that they don't teach you in in physio school. And you the overriding view, I mean I guess youth comes with a certain amount of naivety, which is good because you'll you you will act.

SPEAKER_02 7:39

Yeah, you'd never find that.

SPEAKER_03 7:40

Um you never, yeah. You look back and you think, my God, all the things that go wrong you didn't consider. You just didn't consider them. And my view is pretty simple, right? And it was we have a product, and for us it's healthcare. We we're going to listen to a patient, understand their story, they present with a problem, whether that's pain or it's something that's stopping and doing whatever it is they want to do in the way they want to do it, the way they want to feel. We diagnose a problem, we look after them, we make sure their journey is fantastic, and if we do it right, our reputation will build over time. And how could it possibly go wrong? And that's what happened. And it grew very organically from that. And word of mouth grows, you start getting GPs and surgeons referring in, and that's where it, that's where it started out. Yeah, a good journey.

SPEAKER_02 8:21

It's interesting when you describe it, and we've heard the story many times. It's not a surprise to hear that you have this clinical background, you make a decision, okay, I'm gonna do it differently, I'm gonna do it better, I'm gonna focus on efficiency, etc. etc. And suddenly I'm gonna become a property legal associate, I'm gonna become a financial accountant, I'm gonna start to very quickly almost get force-fed these other job titles that you didn't necessarily sign up for. You start as a clinician and then now you're a clinician and and you're a clinician and a marketer, and you're a clinician and a receptionist, and you're a clinician, and and I think what we see it in that transition for a lot of people is that we describe it as the clinician entrepreneur, it's the person who uh was a clinician, and then they almost accidentally became an entrepreneur, and then they said, Hey, there's opportunity here. So I'm wondering in your journey, you start as you start in one room, you were doing all the jobs, and then that one room became four sights. And so somewhere along that journey, I presume you went from being the clinician to being the entrepreneur. And I'd be very curious to understand the emotional shift, the mental shift, the intellectual. What changed for you, even in how you saw yourself holding up the mirror to go from I'm gonna triage patient care to I'm gonna think about site two, site three, site four. That's a that's a totally different operating model. So, how did you navigate that?

SPEAKER_03 9:49

You have a busy diary and you have a waiting list and you've got 50 hours a week of seeing patients and then trying to run the business on top of that. You can do that for a little while and then until you start to realize that you're burning out. And so you've got to then step back and say, okay, I need to reduce my clinical time, and that means someone else is gonna have to do that clinical time. So we we need to recruit somebody to do it. And the first time you do that, it's a bit of a mess, and you think, hey, why didn't that work? Why didn't the patients all go across? And why wasn't that that why didn't that clinician quite do it how I wanted it to be done? And so it doesn't take long for you to think. The only way that to make this sustainable is you've got to you've got to have this systems thinking, you've got to implement systems, you've got to implement checklists. Simple things when the when you get into a treatment room in the morning, is the tissue box full? Now, it's fun to say, remember to fill up the tissue box. It's another thing to have a checklist where the receptionist the night before has to come in and say, yep, tick. Somebody has accountability for every little detail. Are there enough acupuncture needles? Are there any stains on a carpet or anything? And you have to have a checklist pretty much for everything that you that's operationally important. Once you have once you're things, then you think, okay, now we can scale this. You can't scale anything without a system. And so step one was you're forced, you're forced to think like that when you're starting to burn out. And then other people don't. They burn out and they go and become an employee somewhere. And then the other thing was that someone given gave me advice quite early on, and it was a simple little thing, which was to write a postcard to yourself from the future and be quite detailed in what that description was. And for me, I guess I was in my 20s. And so it was what did life? No, it must I must have been a bit older, I must have had my first kid. And what does life look like? And you describe it, and it might be I'm sitting here watching my kids throw snowballs at each other. Therefore, we're in the Alps, we're skiing. I go back to Australia once a year to see my family. And you describe what that future is, and you think, okay, but there's just some certain commercial requirements to to be able to fulfill that. And it might not be an employee physio. Um, so I need to work back. Oh, it turns out that probably needs either a larger practice or four practices, whatever it is. Um, I mean, if that postcard includes a super yacht, then you need to probably leave the profession. But for most things, you say, okay, I'm just going to scale this. Um, but again, that comes back to how do you scale it, and you know that that that sort of personal uh vision really drives what you need to do, I think. Yeah, it's interesting.

SPEAKER_02 12:30

I think there are a lot of professions you'd need to leave if the future has super yacht. That's right. I don't think that's unique to physio, although physical might be on that list. Yeah, it's interesting. I I I used to run clinic as well in the medical static exorbitology space, and I remember we opened uh first clinic in the middle of COVID, which was a terrible idea, but we did. And one of the things we're so paranoid about hygiene and uh infection control, etc. Is we we went out, we purchased a bunch of sterilizing UV lights. And we used the UV lights on all the surfaces and everywhere, temperature guns and put shoe cover, it was everything to just try and get open. And what we complete and you're thinking about this because you said checklists turn plug the UV light in, turn the how do you use the UV light? And what we forgot to put on the checklist was don't point the UV light at the plants because I used to do this at the end of closing SOPs, right? So what do you do at the end of the day? Yeah, and it was intuitive to me, you don't point the UV light at the plant, and then the first time I asked someone to reach to do that for me, they point that at the plant, came back the next day, all the plants are dead. And it's like something you completely don't and it was the first time I realized that the SOP is it means it's everything. It's amazing. Yeah, you know, without the SOP, even as you're saying, like checkpoints on a list, yeah, it's amazing how badly things fall out of shape.

SPEAKER_03 14:00

And I think what that that sort of all falls under what is effectively trying to make things more efficient. And I think in healthcare, where you get criticism is as soon as you mention the word efficiency, it has this it's an odd word insofar as people think, oh, you're cutting corners. This is about making more money. And actually, I've always thought of it in terms of the on the physio side. We're trying to create an environment where the physio can come in and just do the thing that they want to do. They don't have to, they don't have to walk in and like I said before, you know, get more tissue boxes. They don't they don't want to walk into a room and go, oh, there are no towels, right? So making things more efficient is ensuring that all of that stuff is taken care of. Physio can do their job. The patient, this idea that the patient at the start of the day has the same experience as the patient at the end of the day, all of that happens if you've got systems in place to ensure that rooms are clean and all that sort of thing between your sessions. And this is the order that we do things. Um, it's efficient, it creates a better experience. And then if you scale that out, yes, sure, the business becomes more profitable, you can then reinvest those profits in the business. Of course, shareholders then take a share of that, and that's the reward for taking the risk. But in healthcare, somehow efficiency gets branded as almost a cold sort of cost-cutting term, and it's not that.

SPEAKER_02 15:20

I think it's interesting. We we have on on the podcast every now and then people who come from the sort of capital allocator side, the buyer side, yeah. The private equity of ONO, right? And obviously, as you want to the focus for private equity, is we're gonna make it more efficient. And it's interesting because I can absolutely see where the word efficiency gets its bad name, right? It's easy, it's easy to understand how that becomes a word that carries with it this great stigma. But I think you're absolutely right. Actually, efficiency is a way in many cases of delivering better care. And we often use the example of a restaurant. It's very efficient to quickly clean up a table and put the next table setting out before the next customer walks in. You wouldn't expect the chef to come out of the kitchen to do that. You just it it's it just doesn't make any sense.

SPEAKER_03 16:09

That would be inefficient, yeah. That's right.

SPEAKER_02 16:10

It would be completely inefficient, and yet in in a healthcare setting, much like you referenced your sort of early days in the NHS, it in in in private practice as well, that is exactly efficiency, that non-clinical component that allows the care to really shine through. That's right. It is interesting. What one of the things we work across a lot of different clinical specialties, MSK is a big one for us in growing medical aesthetics, dentistry, GP, etc. One of the things that we see in MSK, I'm curious to get your views on it, is this idea that the practitioner is responsible for consistently and continuously checking in with following up with, recalling the patient as a sort of part of the care journey. And yet we see this as a quite a like a divisive topic. Some people say it has to be the practitioner. Other people say, Why on earth would it ever be a practitioner? It's an email, it's a phone call to WhatsApp. That is exactly what they did not show up to work to do. So how where do you fall on that line? How do you think about it?

SPEAKER_03 17:11

We uh historically our recall lists so we would have a list that's produced each month of patients who didn't return the following month. And that would be that would include patients who have been discharged, who have recovered and don't need any further care. And you've got other patients that that were expecting to come in the the following week or a couple of weeks and never turned up. And it's interesting because you've got different staff members want to do different things. So some of them want to have complete control. And I think part of that is part of that is I think you get this in throughout medicine healthcare more broadly, that they're trained as autonomous people, they are the clinical decision makers, all contact they want protected, and the way they speak to the patient is how they speak to the patient. They don't want a or many of them don't want a a an administrator saying Dear Jared, just wanted to follow up, we just wanted to follow up on how your back was because you might not get their voice. And so they tend to want to keep that. But I think actually that's it's one of those things that if you if it's done properly and done that's exactly the sort of thing that they shouldn't be doing.

SPEAKER_00 18:25

So the caveats that are mixed the properly, yeah.

SPEAKER_03 18:30

I think it's their language, I think it's their voice. I what they don't want to do, there's that sort of fine balance. We have to safety net patience. I want to make sure that I'm here just checking up on how you're going. We're here if we need it, if you've got any questions. And you're not wanting to push that to I'm chasing up in order to book you another appointment. Even though that might be that might you might find that 25% of people do that, it's not meant to be an overt sales call. And I think often the clinicians resist that. So that that's why they want that sort of control. And again, probably it's probably maybe 70-30, the clinics, 30% of clinicians are happy for it to be done by the admin team, and 70 will still want control. Yeah, interesting. Um it's quite hard to shift.

SPEAKER_02 19:18

You use this this five-letter word, which we will we bang on about this word quite a lot. The sales word. And yeah, what are the things that I think is so interesting? And when we opened clinic, much like Gosfront Desk, and I handled the new inquiries, and actually, even at the very beginning of the co-searing journey with one of our early customers, I went in because we do a lot of that work now. I went in and acted as their front desk.

SPEAKER_00 19:41

And I it's so interesting.

SPEAKER_02 19:42

Because I remember in all the conversations I had with patients, personally, it was never a sales conversation. It was always around do you have a problem that we can help you with?

SPEAKER_03 19:52

If you do, that's exactly right.

SPEAKER_02 19:53

Great. Like we can help if I'm asking for uh a holiday in Tahiti, we like you've come to the wrong place. It's not a it's not the right thing. How how what was your experience like in in that respect?

SPEAKER_03 20:06

Similar, I had an initially background before I started as a physio, I worked in a record store and it was a record store, so you sold albums and CDs on one side, and we and there were stereos being sold on the other. And there's an older guy who was one of those stereo salesmen, and he would then have a chart on the wall of who was making the most sales. And this guy was ten times everybody else. Now, he'd been doing it for the couple of the decade. But there were two things that he did. One was he loved it, he was passionate, he knew everything about any stereo, any speaker, and he'd come in with a smile, and he loved it. But the other thing he did was you'd have, and this was a higher end, he used to sell a lot of higher end stereos. If he had a mum and dad come home with their 10-year-old son, and they'd say, Look, we're looking for a stereo, he'd talk to them, he'd gang you with a son, and he'd say to them, Listen, you don't want one of these stereos. You need to go to Kmart around the corner and just get one of these for Christmas, right? That's perfectly good for this kid here. And they would love it because he was honest and he'd send them away. Now, what he'd always and then he'd tell the story, he'd say, Well, you'd often find us, they'd go and do that for the kid, but then the dad would come back and buy a stereo. So it was that and I've always said all you're doing is having a passion. If you have a passion for whatever it is that your expertise is, and you and for us, it's healthcare. Look, we want to help people. We sit in a community, you want to be valued members of your community, contribute it to it in in whatever way you can. And if you can be passionate about doing that, that you don't need to sell anything. People will come because they've seen you. And when someone comes and says, Listen, I've got, like you said before, if someone comes to me and says, Look, I've got an ingrown toenail, I said, you're at the wrong place. Go and see go and see hex around the corner. And for me, that's what sales is it's just communicating what your competency is with some sort of passion.

SPEAKER_02 21:55

It's interesting when you put the two words I'm hearing is passion. And authenticity honesty. I think it's interesting because one of the things that I know for myself, even I was really struggling with was the front desk is often a place where those conversations happen, either new inquiries, generally patients, etc. And this is in no way judgment because many people who work front desk at work front desk, many people who work front desk are very passionate and very honest and authentic. And when those things come together, it really shows but sometimes that isn't the case. Or sometimes you have a front office team of, as you said, 50 people, maybe 15 of them fall into that category, and the other 35 are sitting just behind that. And so it really can compromise not only patient experience, also quite frankly, commercial performance. Uh if that is not really check interesting. When you think about your journey from one site to four, where did things you talk about the importance of SOPs, like efficiency operational infrastructure? Where did things break? What were the from one from site one to site two or site two to side three? Where did things really start to get hairy? What were the sort of things that didn't work as you started to scale when you think about that journey?

SPEAKER_03 23:15

Well it didn't work. I think the attempt to centralize control didn't work. Um so actually what you need is a lot of these clinics, they're people really are there. They've chosen a career that where they're in the business to help people, they turn up, they want to see whatever it is, 10 to 15 people a day, do some good work and go home, and they feel they've contributed and they've done their job. And uh each clinic has its own culture. And so I remember the mistake I made in the second clinic I bought. I came in and I looked at it, and they were wearing they were still wearing they were wearing tunics, and there was a sort of a funny sofa in the entrance. And when you walked in the door, you couldn't see any receptionists. There was it was just an odd setup, and the patient journey was pretty bad. And I remember turning up, and I think on the day that we completed, I came in and with my clipboard and said, Right, guys, we're gonna go outside and we're gonna walk in and we're gonna go through the patient journey. And I stood there and told them this is how it should be. And and that was probably the biggest mistake, instead of having them walk the journey and tell me what they think a good patient journey would be like, because I was coming from South Kensington, the second clinic was in Canary Wharf, so you had different demographics, different clinicians, different cultures, and actually trying to centralize that and having one consistent culture at a clinical level, it's quite hard. I think it's easy to do if it's a green site where you open up fresh and it's a new clinic. But if you're taking existing clinics and you're trying to bend them to your will, I don't think that works very well. And it was fine in the end, but it but I definitely could have got there quicker, had we had I listened, probably the answer is listen to them, listen to them as much as you expect them to listen to you.

SPEAKER_04 25:06

Yeah, it's interesting.

SPEAKER_02 25:08

We've heard particularly from those on the buy side, we've heard that a few times, that the playbook and the experience for Greenfield is very different, and one of the places that it is different, as you're saying, is is in the almost the fabric of the clinic experience, probably the stuff under the hood, the the back room, the engine room, yeah. People are probably less sensitive to those things being centralized, standardized, etc. But I can completely appreciate why the place that people show up to do work and provide care every day almost takes on a life of its customer or a patient body. Yeah, so that makes sense. Interesting. Did you find that in that journey, the clinics that you were acquiring, did you find that they had the same sort of ambition to grow as you had, as the sort of the principle, or what was the sort of disconnect there in terms of the pay the pace of change?

SPEAKER_03 25:59

No, neither there was one of them was a struggling clinic that you that I probably wouldn't have thought would have had it continued on in a couple of years, it wouldn't have existed. Um and they just they didn't quite have a handle in their numbers and their deck and all that sort of stuff. And so actually they were sort of baling water out of the ship, so that there was no vision for growth beyond beyond a line somewhere saying we want to grow and it was just destroyed. So that was a turnaround job. So coming in there and turning around, making it sustainable. The other clinic, the other two clinics was someone getting to the end of retirement age, um, but they still had clinicians in them that were driven and still wanted they wanted to progress. And for some, that progression is clinical, you can progress and become a clinician uh or a better clinician, you can be part-time part-time academic, or you can be a bit more on the commercial side. And so if you can offer pathways for people, and that second group of clinics was you needed to build in some pathways because there was a drive there to grow, which we did. Yeah.

SPEAKER_02 27:04

Interesting. Well, one of the questions that that we usually ask guests, and I'll ask this of you now. You've been in market for a while, you've seen different chapters of the particularly private healthcare story. If we roll the clock forward 10 years, what do you think will change and what do you think will stay the same in terms of how, in your case, MSK provision exists in the world? Are you seeing the beginnings of the next sort of tidal wave? And also, what parts of that attorney do you think won't actually move?

SPEAKER_03 27:35

So I think on the demand side, the patient demand side is only increasing. I think in the UK, uh, I think in any countries where you have a large publicly funded health system, they're struggling. And they won't cut, they won't cut things like cancer services and heart disease, but they will cut pain and they will cut back pain and hip pain and those sorts of things and push that sort of more to the independent sector. I think we'll see that. So the demand will be there. The waiting lists in the UK are still crazy for a lot of these things. Um and so there'll be plenty of demand. Uh, I think what will happen from a the clinical experience won't change so much. I I still think people have a the need to have a human physio, human touch, someone to look at their knee and feel the knee, and so that's where I think we're a long way away from robots doing that. I think the AI stuff on the side of being a sort of a decision-making companion is probably hugely valuable in a lot of medical sectors. But I think that broadly the clinical side will stay the same. The huge change will be on the admin side. So I can envisage a scenario where you're you have a what we might call a receptionist today, just to simply be a concierge. So who sits there, all of the billing, the appointments, the intake, all of that will be automated. And there's I see no reason why it shouldn't be. And that the sort of front of house, if you like, is is it's a different skill set to an a process an admin process worker, someone forwarding invoices taking payments. That'll be somebody who is acting more as a sort of concierge, who might help the patient book their appointment with the consultant or might help them book their MRI for them, might have a conversation with their health insurer for them. Some of those are human things that are necessarily human. And the admin stuff should, I suspect, will just disappear.

SPEAKER_02 29:32

It's interesting this idea of what parts of care should remain intact, what part what parts shouldn't. Obviously, for us at Coherid, we do a lot of stuff on the patient administration, so I'd be called patient operations, but a lot of things you're talking about intake, question handling, retention, patient support, so on and so forth. One of the things that we think people, and we see this in the clinics we work with, they are investing very aggressively in preserving exactly the word you just used, concierge. This idea that the front door of the clinic should be very empathetic, very human. And to enable that experience for patients, you actually need to pull away a lot of the gunk that currently lives network. So it's interesting to hear that that you think that will that part will actually maintain, but some of the distraction for that role may fall away. It was very interesting.

SPEAKER_03 30:26

I would have thought so, I would have thought so. Most of these things, the invoicing the payments, the those sorts of things, those the frequently asked questions, there's no need, there's no need for a human to answer the same question 50 times. Uh there's a whole bunch of questions that come up consistently. Yeah. That doesn't need the human there to be there for that sole purpose. So I I would have thought a lot of that will we'll we'll go. I'm just not sure. I just I just that what you said there is interesting. That open that door, what you want is if you can open that door and have that sense of human warmth, because there's obviously something intangible about the human experience. If you if you stand against a wall and your shoulders against the wall and you have the same pressure and compare that to a human just touching the shoulder, the difference between meeting a friend who shakes your hand and meeting a friend who has a hug, there's a different intangible quality feeling to that. Um that you it's very hard to define what that is. But I think when you come into a clinic uh and you open the door and there's a some sense of warmth and de-risking. And I think that's for patients, it's an intimidating place, particularly at the start. When a patient opens a door and they're going to see a new healthcare person, are they going to ask me difficult questions, embarrassing questions? Are they going to make me take my clothes off? Do they know what they're talking about? Do they smell all sorts of things that are these risks? And if you can get that right environment as they open the door, that sort of de-risks things a little bit, lowers our anxiety, and then they're more open to this sort of collaborative experience, which is largely what healthcare is.

SPEAKER_02 32:03

It's it it's interesting to hear you describe it that way. And I hadn't thought about leaning up against a wall versus leaning up against a hand. And I think those I can very quickly without even doing it, understand in an embodied manner the difference, the temperature for one. But yeah, there's a connection, there's definitely a connection there. Cameron, I want to be respectful of your time, and you've been very generous so far. I think for for those listening, particularly on that journey of I'm transitioning from uh clinician to entrepreneur, I'm thinking about expansion, I'm thinking about site expansion, I'm thinking about infrastructure that grows and also what tomorrow looks like. I think there are some things that are probably worth pulling out. One of them is SOP for everything. That that sounds like a non-negotiable. And then the other one, if I can try and wrap together, it it sounds like this idea that at some point the clinician needs to not be the single point of failure, needs to not be the single point of control for all the things that happen downstream. And the question is how do you get the right people and how do you put those things in place? But it sounds like that's a really important part of the transition that that you experienced. Is that right? Yeah.

SPEAKER_03 33:09

Yeah, yeah. I think that's that's there's a great book that I read kind of years and years ago. Uh it's called The E Myth. I think it's Michael Gerber. And it's it's basically the same story as a lady makes the best pie, she's a great pie maker, but she but she's overwhelmed as a huge cue, and so she needs to figure out how she can make more pies for more people. And so that that probably changed my or helped with my thinking at the start. Was how what are the processes you put in place to replicate what you do? But in healthcare, we don't want exactly the same pie, but we want broadly the same patient experience, and you then you know you gotta go step by step through what all those systems are. Um makes sense.

SPEAKER_02 33:50

Kevin, thank you so much for sharing a bit of your journey. I will make sure to let everyone who might be listening give them your personal details so they can reach out to you directly. Yeah, pleasure. And and I'm sure they might find themselves in in that journey as well. So I really appreciate the time and wish you lots of luck with the continued growth or offloading of your different clinic engagements over time. Uh, really appreciate it.

SPEAKER_03 34:15

Brilliant. Thanks, Joe. That was fun. So I just stopped the recording. Cameron, thank you.