There’s an old adage in business about the importance of working on your business, not just in it. Easy to say. Much harder to do in practice, particularly in physiotherapy.
Most physios running practices are busy being physios. Clinics are full, patients come first, staff need support, and by the time the clinical day is done there’s very little space left to step back and look at how the business itself is functioning. As a result, many excellent clinicians are running businesses largely on instinct.
One of the most common gaps I see is around knowing your numbers. Not in a profit-at-all-costs sense, but in understanding whether the business is actually doing what you think it’s doing.
Often, people feel busy but don’t feel secure. They’re working hard, clinics look full, yet there’s ongoing anxiety about cashflow, staffing or sustainability. That disconnect is usually where the numbers haven’t quite been joined up.
Addressing key questions
A useful starting point doesn’t require a spreadsheet overhaul. It’s simply being able to answer a few questions honestly, such as
- do I know my true monthly running costs, including the things that creep up quietly over time?
- do I know what level of activity that actually keeps the business healthy, not just afloat?
- do I know which services, sessions or roles genuinely support the business and which I keep going out of habit or goodwill?
If any of those answers are ‘I’m not sure’, that’s not a failure. It’s incredibly common in physiotherapy. But it is a sign that the business needs some protected attention, rather than being managed in the gaps between clinics.
Physios are a values-driven group. We care deeply about our patients and our teams. The risk is that without a basic grip on how the business works, that care can slide into overwork, blurred boundaries and constant firefighting. Knowing your numbers isn’t about becoming an accountant; it’s about having enough clarity to make decisions with confidence rather than guilt.
Physio First’s focus
Physio First is, at its core, a business-focused organisation. Everything we do is about helping physiotherapists to develop, grow and thrive, because sustainable, well-run businesses are the foundation that allow good physiotherapy to continue.
That focus is reflected in our programme of business courses and in-person events running across the UK in 2026, starting in Glasgow. These sessions are led by Celia Champion, with me being very much involved, and are designed to be practical, honest and rooted in the real decisions physios face day to day, not abstract theory or generic business advice.
Importantly, these courses are open to all physiotherapists and other health professionals, not just Physio First members. Supporting physios to work on their businesses more confidently benefits the profession as a whole.
Because when physio businesses are able to develop, grow and thrive, clinicians are better supported, patients receive better care, and the profession is stronger for it.
Kate Knapton is the chair of Physio First
X: @physiokatiek
Image: Shutterstock
Order your free private practice guide
Physio First has just updated its popular publication titled ‘Private Practice – Essential Guide’. To request a copy of the practical guide to setting up, running and developing a private physiotherapy practice, click and follow the instructions. Copies are available to members and non-members.
Business Corner
‘Business Corner: The five must dos to optimise your LinkedIn profile’. This online session, to be held during the lunch hour on 16 February, is available free to members. It’s one of series of monthly Business Corner sessions for 2026 that offer members practical, real-world support on everything from finances and team dynamics to marketing, operations, and strategic planning. For more information, click
Business Essentials
To find out about Physio First’s ‘Business essentials for running a successful practice courses’, click
The fee for each course is £125 for Physio First members and £250 for non-members.
The venues and dates are as follows
- Glasgow: 19 March 2026
- Bristol: 15 May
- Birmingham: 10 July
- London: 18 September
- Manchester: 20 November
