About this episode
Neuro physio is not MSK with a different label. It is a different universe entirely. In this episode, Michael Schumacher talks with Adam Poulter, founder of Foundations Physio, about the realities of running a neuro clinic, why staying clinical actually strengthens a business, the truth about neuro pricing, and why innovation means more than buying shiny tech.
Show Notes
Neuro physiotherapy looks glamorous from the outside: higher fees, long-term patients, stable caseloads, and none of the MSK hamster wheel chaos. Reality is far more complex.
In this episode of No Appointment Necessary, Michael is joined by Adam Poulter, founder of Foundations Physio and one of the few clinic owners who still treats nearly full time. They break down why neuro is a different beast, how Adam built a highly successful service while staying hands-on clinically, and why genuine collaboration beats the usual “scale fast” nonsense pushed at MSK clinics.
They dig into innovation that actually works: VR, gamification, tech that improves outcomes instead of draining bank accounts, and how to use partnerships to make private neuro care accessible without destroying your margins.
The conversation also hits the uncomfortable topics no one touches:
• Why anyone can call themselves a neuro physio (and why that is a problem).
• The gap between clinical competence and what patients assume they’re getting.
• Whether neuro clinics exploit high lifetime value patients.
• The “haves and have-nots” divide in brain injury rehab.
• Why giving things away for free can still be the most profitable marketing strategy.
This one gets into the weeds of innovation, ethics, business, and what good care actually looks like when money is involved.
What You’ll Learn
- Why neuro physio is fundamentally different to MSK from a marketing, clinical and operational perspective.
- How one clinic owner stays clinical five days a week while still running a successful and growing business.
- The real role of caregivers, families and case managers in neuro marketing and why most agencies get it wrong.
- How to identify neuro tech that genuinely improves outcomes vs neuro tech that just helps someone hit revenue targets.
- Why partnerships with charities can outperform paid acquisition for neuro clinics.
- The financial reality of neuro vs MSK: lifetime value, volatility, and profitability.
- How to balance ethics and pricing when patients face huge long-term rehabilitation costs.
- Why offering “free help” strategically can generate more trust, more referrals and more long-term revenue than hard selling.
- How authenticity, culture and staying close to your “why” can outperform every business-hack trend circulating on LinkedIn.
Who This Episode is For
Neuro physios, MSK clinic owners considering expanding into neuro, practice owners interested in innovation that actually works, and anyone trying to grow a clinic without losing the clinical soul of the business.
Guest Details
Guest: Adam Poulter, Founder & Lead Neuro Physiotherapist at Foundations Physio
Specialisms: Stroke, brain injury, complex neuro, community rehab, innovation in neuro tech
Website: https://foundationsphysio.co.uk/
