Building a Thriving Business with Intuition and Strategy

These transcripts are AI-generated, and spelling may not be 100% accurate (especially for names, places, and methodologies).

 

you have to actively be involved in your own holistic well being

and sitting and just discussing how bad your pain is

amongst a group of people

who are also just ruminating about their pain

it kind of reinforces that victim complex of you’re a passenger

it’s like no

you’re not a passenger you are the boat

you’re not just a captain you are the boat

Hello everybody and welcome to The Healthy Business Lab Podcast

where we interview awesome allied health business owners

sharing their learnings their experiences

and their insights for fellow allied health businesses

and professionals in

growing their practices and just being all around learning machines

so today I’m super excited to have on the call today

Nicola Michell from City Physio here in Sydney

local to me Nicola

welcome to this episode

Hi, thanks for having me so I’m Nicola

I took over City Physio

which is in Martin Place in 2017

and since then we have tripled it in size

and so now it has a team of 12 at the moment 

up to 12! that’s amazing growth even so we always have a

bit of a pre chat with our guests

and learn a little bit about them

and I think when we were speaking then

he’s about 9 as a few months ago that we spoke

so continuing to grow

yep here we have it

it’s kind of it’s become its own little beast

love it a bit

a nice piece from everything that the discussions that we have had

I’d love to unpack that growth

it was 2017 that you took over

it was an interesting

process that you shared with me

and then also

that living in the centre of Sydney during the covid times

a lot of learnings, a lot of challenges that you face. 

So again,

we always talk about experiments here at 

The Healthy Business Lab

and love to hear some of your experience in those learnings

of that process of how and where you started

absolutely, so I was working at City Physio for two and a half years

and I think about at the two year mark

I sort of had that conversation

everyone goes through this sort of conversation at some point in time

where you go if this was my business

I would not do it like that

I do it like this and

and so it just started playing in the background

oh I would definitely do it this way or this way

and then within a few weeks

I had actually built a business model

I had worked out roughly

how much business I could get through the business

doing it my way versus the way it was being done

and I approached my boss

who was actually finishing off his medical degree

to take over the clinic

it didn’t go as smoothly as I like to make it seem like this

but we’ll skip over that little part and I took over the clinic in

I think it was about July 2017

at that point in time it was myself and a receptionist

and I think I had another physio there for about a month or two

but she was finishing up anyway

I sort of had a bit of

a really rocky start into this sort of the vertical where

something pear-shaped went with the receptionist who

perceived some management as bullying

and we had a fair work intervention and she sort of sent herself off

so then for a little while it was just me

I did about six months just myself before I hired an admin 

I thought I was probably going to die and then I hired my first physio

by the end of that first year

I had an incredibly state learning curve

I was dealing with finances

my God, if I can’t work can’t keep the doors open

I can’t pay my admin if I have one sick day

I won’t make rent and so very

very quickly learnt that I am not scalable

and so I hired my first physio Matt who still works here today

Love Matt and he and I sort of built the practice up through 2018

by 2018 we had two more physios

so then there was three or four of us depending on the day and admin

and then by early mid 2019

I had paid down all debt completely

so within two years

I proved that my business model was an actual model

not just a theory and I love that

I love to delve into that

just that little bit more of the idea from idea to conception

to building a framework and then those first two years where again

certain parts were detours taken challenges faced

things to work through being that new business owner

what were your sort of biggest learning is during that sort of period

I think that the biggest learning for me was that people are key

you have to invest in your team

and that’s sort of something that continues through to now

without the amazing team that we sort of built

through the different seasons that City Physio were

sort of was going through

we would not have made it

you spend more time at work than you do at home sometimes

so it’s you want to make sure that at least

you’ve got a symbiotic relationship with your team

and everyone’s on the same page

and at the beginning when my admin sort of went pear shaped

it was a very very obvious that we were not on the same team

and that her values weren’t

sort of aligned with where I wanted to take the business

just little things like that and just having that alignment

not easy, but easier

 yeah, one hundred percent and love that the word alignment is just so

key and crucial as we’re sort of growing in that hole and

and getting on the same boat

so to speak

so there’s no point having everybody in different spots

and so then I guess that that sort of next phase

then the evolution and say

your business model and your plan of going through hey

you get over that point where you’ve got a financially sustainable

you’ve paid off basically

the purchase of a business in two years

which is impressive in itself

how did that next sort of step into the next phase go for you

2019, my goal was to make myself redundant

the only thing that I wanted to actually be able to do in the business

myself is have to run payroll

because that takes me 10 minutes and it’s like $400 to outsources

so if I only touched one thing

I wanted it to be only payroll and everything run

and I tested that theory by going on holidays and it mostly ran itself

there are a few little glitches

and i was like, nailed it we’ve actually got something going here

by that point in time I knew my numbers

I had a separate savings account for tax and superannuation

I had payroll down to a fine art

I knew exactly how many patients were coming in

and we could forecast cash flow

and that took us right to the end of 2019

you can see where I’m going with this

yeah yeah

well hold on there because this is

a big turning point for everybody in their business

and many great insights and learning

but what again I love this idea of

I sort of see that holiday that you took of kind of an experiment

and one of the books over my shoulder is a book by 

Mike Michalowicz called Clockwork

hundred percent the idea of systemising your business

getting that process is going on a four week holiday

see how the business goes

and you’ve obviously need systems in place to be able to do that

and to be able to go

and then it is exactly what you just sort of talked about there

of a few little things few learnings

but no doubt you then created systems around that on your return

so how long did you go for out of curiosity

I did four weeks in Italy

nice it was exactly as the book described

but yeah and it mostly worked yeah

cool brilliant

mostly and again

mostly but I’m guessing those things that weren’t

the fully which no business is always fully

there’s no such thing as perfect

totally believe in that

what did you do on your return from and working through those

the only things that sort of didn’t work were like

sort of left field people issues

which some of my team didn’t feel that they had

the authority to actually

act on my behalf I don’t agree with that

I think I would have trusted them implicitly

but they didn’t feel that it was their place to act

so those things were managed okay with a time zone difference

so it was all all fine and sort of on the return from that holiday

there was a few sort of things we had to work out

some things that weren’t done that people are waiting for me

so there was obviously a few glitches that haven’t been accounted for

but I don’t think you could know what they are until you leave

hundred percent

one of those processes actually going through that process is spot on

and the other one I think touching upon there

which probably set you up for what would he share at a moment

from a chronological order of things

was you tell that you’re very early on

you’re across your numbers at the end of the day

obviously we love our numbers here

and so I know when we’ve had our chat really

you’re like you’re super clear on hey, where you sit

putting buckets of money aside for certain things

but then even just knowing the numbers as to what you need to hit

the goals and the

you know the ties in with your model no doubt

it’s really nice to hear that you think I’m really across my numbers

because I will proudly say that I got 51% in my finance module

in my commerce degree

so my big thing with numbers is if I can’t see it

they don’t exist so I have to pay myself as an employee

not via a trust I can’t find I can’t see it

I’m not tangible enough so when someone is owed superannuation

I put it in the account name superannuation when I’ve got tax

I put it in the tax bucket the savings

I put it in the savings bucket because that way I can see the numbers

during my commerce degree

which I’ve got under my belt as well

I really struggled with these hypotheticals because

I couldn’t see where the money was coming from and so for me

it’s going to be there 

visible, tangible, one hundred percent 

yeah and it’s this idea that we talk about

even though got the accounting background and all the rest of it

hundred percent that idea of the theory

the theory and the practice hundred percent are totally different

and what you’ve done there is very much give

given your money a purpose and then you’ve actually made it real the

it’s the cash that’s moved over there

rather than financial reports there

they can be confusing they can be ambiguous

you got all these numbers

and the reality is you kind of need to know three different reports

to truly know the finer details

which accountant spent years and years mastering

business owners don’t have that time

they’re running businesses

it’s like let’s make this tangible

so again you’ve found a way that works for you

leverages in the natural way that you think

which is brilliant

 yep, so I spent a lot of time

in those books and I just did little things like

every month I would look at a different metric

and then the next month I’d look at the next metric and go

what is the how does that link with the previous one

and sort of work my way through

love that again

taking your time biting off little bits and pieces as you go

what’s the one thing what’s the next one big thing

no doubt there’s like oh

that has the biggest impact of well

once I know and understand that hey

how does that interrelate to the

next piece of the puzzle

absolutely and that allows me

to build what we called our

dream boat which was our savings account

at about early mid 2019

I decided that we were hamstrung by the size of our premises

and we needed to save

for a fit out

in the Sydney CBD

so at that point in time I quoted out a fit out of a bigger premises

to be about 25 or 35% of what it actually cost it five years later

so our dream boat very very quickly in reality

five years later was a canoe ha ha

a life raft just a bit smaller one there

yeah so we just started chipping away with the savings yeah

but again

having numbers out there putting a goal out there and saying well

he’s what it is and then watch the practical things happen

that’s always part and parcel of again

whether it’s the people whether it’s the finances

there’s always things that our engine flows in

that river of the boat that

goes along oh I guess we’ve touched on that period but and again

the financial side of things leading into 2020

and that sort of period

or learning your evolution and your changes around the time of Covid

basically my motto has always been I’ve got two mottos one

it’s always going to be fair two fail fast

so I can tell you intimately what day and what hour Covid started

it was a Wednesday in March and on that Wednesday

what’s the worst that could happen

and I think I cried for like 12 hours I went

oh my god if I can’t pay my team

they can’t pay their mortgage if they can’t pay their mortgage

then they have to like this is not viable

what are we going to do and by from the Wednesday

when there was an incline that this is going to go down

people started flooding out of the CBD by Friday

I had a bank loan secured because I still had cash flow

my motto was fail fast so I locked in a loan

I had forecast out for the next 12 months on how many patients a week

and our savings our dream boat

which became our covid life raft

how many patients a week exactly how many needles

how much sorbolean how many towels could we use or not use

or cut back on to extend that dead

dates in that spreadsheet

so I still have the spreadsheet

it sits on my desktop of my computer but every time 

we saw a patient

every pump of sorbolean every hand sanitizer

every dry needle was accounted for in this model

and every time we added in we saw a patient

the date shifted on what day we would no longer be solvent

 what day could we no longer pay out the annual leave

what was the day we fell over

I paid myself zero for about I think it was 12 or 16 weeks

I’m not I can’t recall my husband and I sat down and forecast all that

I cut my team salaries back by a small increment

and that pushes out even further

so I tried all these little levers to see what we could do

with the metrics that I knew

I love that

and I love that idea of because you knew your numbers and 

I’ve now got a date it’s like

what are the levers and it’s the

experiments of this and it’s like the one client well

that gets you a bit further down the road or if we drop wages by

X Y Z a little bit what does that do to that number

and at the end of the day

that gives you a perception gave you visibility to go 

hey, we still need to experiment

we still need to tweak or actually that’s going to work

and then as that starts to play out

it just gives you more confidence at the end of the day

absolutely and the team thrived off those numbers because

they knew that they had a job

and the most common thing in the CBD

was people to cut their marketing spend

and cut their physios put sort of stand everyone down

if you don’t market in the CBD

you’re not visible

most physio practices like we were in on level 10 of it office tower

so there’s no the foot traffic and then if you cut your physios

you can’t get busy

you’ve got no one there and then they get other jobs

so the two things I maintained was I maintained marketing spend

but we reduced the amount because no one else was competing with us

we had a monopoly

and I keep kept the whole team on the entire time

I love that

and again, been out of show how you do that but it’s thinking ahead of the curve

which you go full circle back as to

you’ve already had that thinking process around

what’s the worst case scenario

and so that you nearly got your

your war plans

so to speak they’re ready to go

so that while everybody else is

their shoulders are up here and their stresses

and they’re not making the best decisions they’ve made

you’ve already done some of that thinking

you’ve probably stressed yourself out a little bit more

not as much as what people are

but you’ve done that a little bit earlier than anybody else

which is

yeah, it was it’s a running joke that I would freak out about

two days before anything was announced

I mandated masks in the clinic two days later

Glasgow clinically mandated masks for New South Wales Health

and that sort of the whole way through

yeah love that

and it’s like

we love sort of prophesying what’s going to happen in the future

you sort of a little

a  mini prophet there working through your business from having those

and yeah it’s great

also the delivery side of things

I guess through Covid

and you’re what a business model if we step through

I know when we first spoke

your model there that you’ve created for your clientele

being CBD based very specific type of clientele

he’s kind of like in nature

I love you to share a bit around that

and the experiments that you work with and where you’ve landed in the

model that is now working and thriving for you

so because we’re based in the heart of the Sydney CBD

our clients are very switched on

whether they’re academically sort of level up

or they’re just working in high sort of fast pace industries

our patients are switched on

they’re on time but they want the jargon

they want information

we run a really tight ship in terms of don’t run late

always on time for our appointments

that’s non negotiable and we really focus heavily on education

my big thing in the clinic is if the patient knows

if they understand comprehensively why or why not

they should do something then you’ve

built that trust implicitly for the journey

of their injury if I’m saying to someone look

I really don’t think you should run

I need to explain to them in depth why that decision will impact them

and then ultimately that the adult they could call

but if I empowered somebody with enough information to know why

or why not they should or should not do something

then they’re going to have more trust in the process

so within our clinic we have at the moment five physios

I’m a titled pain physio

my colleague Matt is a titled sports and exercise

and then three for the generalist physios

within that sort of model

we have a cross referral system

so I do chronic complex and oral facial pain

I have a specialty at oral facial

Matt does all of this for the sports things

and so we have a sort of network within our team that

if someone is not quite the right fit

will recommend a cross 

and sort of recommend them to the most appropriate physio

and patients love it they go

oh my God that’s amazing

I don’t need to see Nicola

I’m like no

you’re not chronic you’re not complex

you’re not dark and swirly

we don’t need to dig you out

you’re fine you’re doing well

stay with Dan stay with Elizabeth

stay with Claudia whatever is needed

and because our patients sort of really thrive off information

gathering the education part

and then explaining

why we should send them across to a different physio

it just sort of ties up with yeah

I love that well

the educating clients piece is what really stuck out at me

is being somebody who loves the idea of that

and different practitioners who have used

the ones that have explained certain things

like I my brain can now tell my body what it needs to do in some ways

and so, how long did it sort of take to really bed that in

from when you started and that idea of that model

and the evolution of fine tuning

that sort of process as the team grew as well

having the ability to do the cross referral of the right people

being able to serve the right clientele

depending upon the clients requirements

think it was ever a day I think it’s continued

I think that especially because

the influence of things like social media are so loud

these days it’s really

really easy to be swayed by someone’s opinion on the internet 

oh, the bacteria-polycotyl is the problem and being like look

it’s not actually it’s not that cut and dry

nothing is your human body not a robot

it’s a continual discussion with the team and every now and again

we have to sort of reset and kind of regiggle things back again

but it’s

more of an intrinsic feeling rather than an actual thing

so my big thing is it comes from here

not from here and kinda having to course not course correct

but to remind the team that you know okay

that’s fine

you don’t know everything you’re not supposed to know everything

but lean on the team

you’ve got the best examples of that are when things go wrong

if a patient’s not progressing well or if a patient is agro

not because of what we’ve done

but because they’ve they’ve brought into the clinic

I always have to say to the team

you are not alone you can say

you know what I don’t think I’m the right fit for you

I’m going to send you to Nicola because I won’t tolerate that

and personality wise sometimes it can be a better match

yeah awesome

and I love how you can and a lot of this is driven off

what I’m hearing or I’m feeling is that whole communication piece

and being able to have those open conversation across practitioners

and from the absolutely the

the system and the structure that you’ve set up around that

no doubt and no doubt the internal team training

that you’re doing as well

is that a fair comment absolutely

we actually split our internal training between soft skills

and clinical skills so there are different things we’re working on

particularly because I work with a lot of chronic and complex pain

that’s the way you describe something your hands

your face the tone

the intonation is really important if you’re saying

I think you have a big coping skill issue

or deficit in a psychological skill

that can set make someone feel like they’re crazy

so explain it in a way that biopsychosocial pain approach

the pain doesn’t mean I think you’re crazy

it’s it’s a new app and I’d going there

we love to share on this podcast as well

sort of tips and insights for business owners

we don’t often look after ourselves sometimes as good as we could

and we need to be looking after ourselves

to be able to look at our businesses

and as you were talking about

a lot of the C-suite executives that you see and the like

and some of the characteristics of those people

I was like yeah

that’s very similar to a lot of business owners out there

hundred percent very similar ideas so

I guess

some of the insights of some of the work that you do with your client

I love you to share a bit further into the insights

and even that idea of pain

I know myself it’s something that I went through at the moment

and I’m doing the brain thing with the cell memory of pain

and stuff like that

if you got a little insights and tips for people to think about

so that they can have their

body operating as you know

optimal as possible to

so that they can do the awesome things in their business

that they need to so

I’m probably the worst person to ask about this

because sometimes I feel like burnout would sort of

burnout was a long time ago

so I go in and out of sort of self preservation because

I kinda love it I just kinda want to keep running

and then then I will catch myself fall over and go

it comes something different

but for me it’s a very roller coaster approach

my big thing I always tell patients is that

your body doesn’t know where stress comes from

it doesn’t know if it is the high intensity Barry’s Boot Camp

boot camp pass you to this morning

or if it was a tragedy in the family or a workplace situation

stress itself is chemical it’s memory

it’s psychological and whether you are running as a good stress

it’s still stress on the body

so a lot of the times we have to tell patients okay

you’re adding more things to your plate what are you taking off

your plate’s not getting bigger

so you realised you’re stressed and now you’ve added meditation

and then you realise you’re a bit stiff

so you now you’re doing yoga as well

and you’re now exercising 14 times a week

what are we taking off and then

so that

the absence of something sometimes is better than adding more pieces

so so good

and I’m just letting that sit for people and also for myself

and that idea of even as I just I was writing down there

the body doesn’t know where stress comes from

in that simple concept of that

and thinking of plates analogies

we use plate analogies for a finance your

version there of the the separate buckets for your bank accounts

but it is it so I like plate can’t get bigger

and in life plates have got bigger over historical components

and they can go to a certain level in some ways

but there still is there still are limits to that

and taking that idea as a business owner of hey well

I got we usually got a couple of plates up in the air

but those plates aren’t getting any bigger

and how do we actually make sure that we don’t overload every plate

that we’ve actually got absolutely

and if people are still

instead of insisting on wanting to add a piece

and I typically say water

just add water it works for kids it works for adults too

so whether you can stick your head underwater in the ocean

whether you can go and float can you swim some laps

it’s got this carnative effect

that’s sort of well documented in the literature

I often describe it as the exercise version of a weighted blanket

it just kinda brings things down a notch

and I’ve had a few patients who have gone

we just need to stick your head underwater just for a second

and they’ve sent me a picture from the beach and gone

I hate that you’re right

I hate it so good so simple but so good

it’s the just add water

it’s something that people think of just add water

it can be the go and take a break and have a drink of water

or like you say run your hands or your face or whatever underwater

that’s cool my brain is processing that

and it’s the X I version of your weighted blanket again

got some nice weighted blankets out there for the kiddies out there

in the lounge room and know the power of those as well

that’s great well

what I’d love to share to sort of round off the conversation

time is flown

I love to sort of hear of

a case study examples of stressed out client coming to you

and where you’ve been able to take them from this

this whole process that you got in the model

and your 30 minute sessions

educating people

and the sort of transformations that you’ve been able to achieve

you got an example there for me that speaks in your mind

oral facial pain is one of the most chronic

and debilitating areas of pain in the body

so we’re talking chronic TMJ

tooth grinding the trigeminal neuralgia

all the really nasty things

as well as sort of headaches and migraine types

one particular patient I was seeing a couple of years ago

and we did a lot of this work on the memory of pain and how

we start to have this reaction to what we think is a snake

but actually it’s a stick

and so making sure you look and go

is it a snake is it a snake

because your body can do this thing where

it thinks it knows what it’s doing so it reacts for you

it’s supposed to be protective

but actually it’s not a snake

it’s it was a stick

it’s the same theory behind Pavlov’s dog and that happens with pain

and she recently messaged me

a link to a national group

a TMJ support group that was meeting with ANZOFP

which is the Australian New Zealand Oral Facial Pain Group

which I’m a member of looking as it of a discussion

to create a discussion between this TMJ group and ANZOFP

ANZOFP are traditionally very clinical

they’re very high level discussions with Axol facial surgeons

test videos that sort of group

and the TMJ pain groups are typically very victim centred

and she said to me

I saw this thought you might find it interesting

I’m not going and I said why

why aren’t you going

and she goes because I don’t want to just sit and talk about pain

and I was like that that’s the win

that’s the win right there

you have to actively be involved in your own holistic well being

and sitting and just discussing how bad your pain is

amongst a group of people

who are also just ruminating about their pain

it kind of reinforces that victim complex of you’re a passenger

it’s like no you’re not a passenger

you are the boat you’re not just the captain

you are the boat and I was very impressed that she’d finally sort of

in her own journey with managing her own chronic injury

realised that, that was not helpful to her

and what is brilliant about that is that

I can see why that one’s resonated for you

when I’ve asked the example

because it ties back to that education piece

absolutely it’s the notion of hey

you’ve worked with this client over a period of time

and that’s enabled this person to be able to self reflect

self identify which is we’ve taught somebody to fish

it’s like that ripple effect

the transformation that can happen from that

and no doubt that well

filter down that she’s talking to others out there in her community

in her space

around that that that’s going to have pretty amazing impact

yeah it’s

it’s quite good to have a win that is forward looking in chronic pain

because sometimes they are sort of quite maintenancey type

physiotherapy appointments

and a lot of them don’t like being challenged on sort of beliefs

and behaviours and things like that

that can actually be detrimental

so when you kind of get that classical conditioning full circle

where someone goes no

I recognise that I this would be bad for me

it’s like brilliant

and even for that little tip of taking things off your plate

I was like I don’t need that on my plate

I can take that away and that frees up space

that’s great so many amazing insights

I’ve got a massive page full

I’ve been trying to cram on one page here

of insights and learnings and great little takeaways as well

thank you very very much Nicola

that’s been so amazing that

I’m sure other allied health

business owners out there are going to get so many ideas

insights that you’ve shared

if people want to connect with you

learn more about your practice or what you’re up to and the like

where’s the best place for people to find you and connect

probably anywhere LinkedIn, email

social media we’re responsive on all of them

so whatever whatever works whatever works for other people

we’ll obviously have the show links in here to all those places

the socials the website and the live show

feel free to connect with Nicola

and if you’re in Sydney

check out the video I know when I’m next in the city

I’m not always in there

I’ll have to make sure I make a bit of an effort to go check it out

yes thank you very much for your time today

it’s been brilliant and as always for our listeners out there

make sure you like, subscribe

and keep on following us

to get these amazing insights that we’re sharing

on The Healthy Business Lab Podcast

it’s over an hour from us

thank you very much Nicola

Thanks Craig

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