Why a 20-Site Physio Group Has No Receptionists

Rhys Carter is a physiotherapist and the co-founder and group managing director of Carter & George, a UK MSK group he started with his friend of 25 years, England rugby international Jamie George.

The idea came from a conversation in a bar in Dubai, where Rhys was working as a physio and Jamie was recovering from a ruptured bicep with the kind of support elite athletes get. They wondered whether everyday patients could have the same experience.

The first clinic opened in Hertfordshire in April 2018, and Rhys had never run a business. He describes a first receptionist who started before the clinic existed, a lease that fell through, and a payroll that left £70 in the overdraft.

When COVID closed the clinic, he kept the whole team together, then bought a second practice from a physio who didn't want to reopen. He says it grew 300% in its first year, which taught him that growth didn't have to start from scratch.

Carter & George now has 20 sites, with two more opening early next year, a team of just over 80 and around 65,000 patients a year. Rhys puts the growth down to people: autonomy, progression and mastery, a dedicated lead whose only job is developing the physios, and pathways for clinicians to run their own sites.

He is candid about what went wrong when the group grew faster than its management, as leadership became more directive and experienced people left. The fix was to hand autonomy back and lean on a clear mission, vision and values, which he sees as what holds a single-brand group together.

On patients, his focus is the experience outside the treatment room: one consistent journey from the website and the phone call to reception, the physio and the follow-up. He takes cues from outside healthcare, from Ryanair's consistency to the ambition of becoming the M&S of physio, and argues for transparent pricing and for testimonials that speak to the patients a clinic actually sees.

He believes most clinics don't talk to their patients enough between visits, and that the answer is a planned cadence rather than more messages. Carter & George automates some check-ins between sessions and keeps people for everything else.

It moved away from site receptionists to a central team of four or five working from one customer support system across calls, WhatsApp, email and live chat, which took around eight months to integrate. He thinks AI receptionists can suit small practices with simple flows, but struggle with 75 clinicians and 150 services.

Looking ahead, the goal is 50 sites by 2030. For Rhys the number matters less than a playbook that scales, from onboarding and HR to how meetings run in Glasgow and in Sussex, and the harder task of keeping the underdog culture of the early days as the team grows into the hundreds.