Episode 39 · With Geoff Gamble · 18 Jun 2026 · 43 min

    The Clinic That Almost Closed, Then Turned It Around

    Growth is rarely the smooth climb it looks like from the outside. Sometimes a clinic has to nearly break before it learns how to scale.

    Featured guest

    Geoff Gamble

    Chiropractor & Co-Founder, NHRC
    Geoff Gamble is a chiropractor and the co-founder of NHRC (Niagara Health Rehab Center), a large multidisciplinary clinic in Canada. He opened it in August 2012 with his business partner Paul, a kinesiologist, starting with four practitioners in around 4,000 square feet. NHRC now runs to about 7,000 square feet with roughly 27 staff, and is Coherent's first Canadian partner.

    Show notes

    Geoff Gamble co-founded NHRC in 2012 with four practitioners and about 4,000 square feet of space. It is now a 7,000 square foot multidisciplinary clinic in Canada with around 27 staff, and Coherent's first Canadian partner. On paper it reads like a clean growth story; in practice, as Geoff admits, it has been anything but a straight line.

    For the first seven years the clinic grew steadily and Geoff assumed he had it worked out. Then he and his business partner started taking their hands off the wheel, and within 18 months they had lost most of their staff, watched growth flatline, and begun weighing up whether to close. The recovery started with an uncomfortable admission: they did not actually know how to run the business.

    Coaching, learning to read a P&L, tracking the numbers weekly rather than monthly, and hiring for attitude over CV all followed. Geoff is candid about the habits that held them back, from decisions made on napkin maths to a control freak's reluctance to delegate, through to a costly expansion built on a hunch and reactivating a dormant patient list as much for good care as for revenue.

    Key takeaways

    • Growth is not a straight line: seven steady years lulled them into easing off, then a heavy loss of staff over 18 months nearly closed the clinic.
    • The turnaround began with admitting they did not know how to run a business; seven years in, Geoff did not know what a P&L was.
    • Review the numbers weekly, not monthly.
    • Hire for attitude, not the CV.
    • Expand on evidence, not a hunch.
    • Reactivating lapsed patients is about care as much as revenue.
    We undervalue how important our admin team is. They are the lowest paid people in the clinic, yet they see every single person who comes through the door, and they are the first and last person that patient sees.
    Geoff Gamble
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