Why Most Physio Businesses Fail

Why do so many well-meaning, skilled physiotherapists struggle when they step into business ownership? It’s not a lack of care, talent or effort.

In this honest interview, Michael Dermansky sits down with Shane Gunaratnam to unpack the most common pitfalls allied health business owners fall into — and how to avoid them.

The Financial Blind Spots Physios Can’t Ignore

Most physio business owners are passionate clinicians but disconnected from their numbers.

Shane shares that the first question he always asks is: “What was last month's revenue?”.

Almost everyone has to look it up.

Which tells you a lot straight away.

👉 Learn more about what else I ask in Physio Business Coaching.

Know your finances, especially basics like weekly revenue.

Without it, you’re flying blind.

Michael and I discussed this with regard to unit economics as well.

The key with revenue is it breaks down, across every layer.

You can look at it yearly, monthly or weekly, and compare across your business(es).

You can also take it deeper, and look at it on a per-practitioner basis.

In fact, that's the core of what I teach in my Number's Don't Lie video.

👉 Numbers Don't Lie - work out your gross profit margin -> watch the video here

And then things got a little bit Gross

That's write, us two financial perverts started getting our egghead on, and dived into gross profits.

Specifically, gross profit margin.

If you learn nothing about finances, and understand revenue and GP margin, you can basically run a successful practice.

Honestly, it's the most critical lever in your practice.

Especially now, with wages going through the roof and practices struggling to stay afloat.

Gross Profit Margins are the cornerstone of profitable clinics.

I've actually made a stack of videos on this topic and more, including the proposed FairWork Changes which will likely hit post FY26.

This is all available for a one-time-fee on the Culture Of One Circle Platform.

"If you don’t know what your gross profit margin is, you’re guessing with every decision you make." – Shane Gunaratnam

Growing Without Differentiation Is a Dead End

Opening a clinic just because you’re a good physio is not a strategy.

Without an unfair advantage, you’re just another clinic on a crowded street.

Differentiation doesn’t mean being the cheapest — it means being relevant and distinct.

That could be your model, niche, culture or service design.

Owning a Clinic Isn’t Just Another Job

Many owners go into business to “work for themselves,” but end up in a cycle of burnout.

Shane reminds us that treating full-time while managing everything else is unsustainable.

“If you’re working in your business all the time, you don’t own your business — your business owns you.”

The Real Reason Young Physios Should (or Shouldn’t) Start a Clinic

Shane’s advice: if you’re a new grad considering a clinic, be bold — but be prepared.

You’ll need to learn fast, stay curious, and build something different.

Want to build a practice that works for you — not the other way around?

👉 Watch the free Numbers Don’t Lie webinar

👉 ChatGPT Lean Canvas Generator

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