The clinical side is the part you are qualified for. The part that catches people out is that opening a practice is a property decision, a staffing decision and a cash-flow decision, in roughly that order of consequence, and nobody taught you any of them.
The lease is the decision. Everything else is adjustable
You can change your mind about a treatment bed. You cannot change your mind about a five-year lease.
Things to have answered before signing, ideally by someone who reads leases for a living:
- The term, and any break clause. A landlord's preferred term and a first-time practice owner's tolerance for risk are not the same thing. If there is no break clause, you are betting the full term on a location you have not yet traded from.
- Make-good. The clause requiring you to return the premises to their original condition. It is routinely overlooked and can be one of the largest single bills of the whole venture, payable at the worst possible moment — when you are leaving.
- Who pays for the fit-out. Plumbing for a sink in each room, partitioning, flooring, accessible access, soundproofing between rooms. Some of this may be negotiable as a landlord contribution or a rent-free period; none of it is negotiable after you sign.
- Permitted use and planning. Whether health services are permitted at that address at all. Find out before, not during the fit-out.
- Parking and getting in the door. Half your patients are in pain and some are on crutches. A first-floor room up a narrow staircase with no lift will quietly cost you referrals for the entire term.
The alternative worth taking seriously: renting a room in an existing practice, or a chair in a gym or medical centre, for the first year. Far less commitment, far less capital, and it tells you whether the catchment supports the practice before you commit to a term. A number of very good practices started exactly that way, and a number of empty shopfronts started with a confident five-year lease.
What you need on day one, and what can wait
The temptation is to open fully equipped. It is also the fastest way to run out of money in month four, when your income is still thin and the loan repayments are not.
Genuinely day one
Professional registration and indemnity insurance. Public liability. A business structure and a bank account that is not your personal one. One good plinth per treatment room. Basic assessment kit. Something to keep records in. A phone number that gets answered and a way to be booked. Hand hygiene and consumables. A sign, and enough of a web presence that someone searching your name finds you.
Can wait until the diary justifies it
The second and third plinth. Electrotherapy beyond what you actually use — much of it gets bought, used for a month and then moved to make room. A rehab gym fit-out. A receptionist. Branded everything. A custom website, when a single well-built page ranks perfectly well for your own name and suburb.
A reasonable test for any purchase before opening: can you name the patient you are buying it for? Not a category of patient — an actual person in your diary. If you cannot, it can wait a quarter, and waiting a quarter costs nothing.
Why we are not giving you a total
You will find articles offering a single figure to open a physiotherapy clinic. Ignore them. A fit-out in central London and a fit-out in regional Queensland are not the same number, and neither is registration, insurance or a month's rent. Anybody quoting one figure across four countries is guessing, and you would be budgeting against their guess.
What is useful is the list of things you will be quoted for, so nothing arrives as a surprise:
| Category | What sits inside it |
|---|---|
| Premises | Bond or deposit, first month's rent, fit-out, make-good provision, utilities connection, signage |
| Clinical | Plinths, assessment equipment, exercise equipment, consumables, laundry |
| Compliance | Registration, professional indemnity, public liability, contents and business interruption cover, waste disposal, first aid |
| Business setup | Company or partnership formation, accountant, solicitor for the lease, bookkeeping |
| Getting found | A page that ranks for your name and area, a business listing on the main maps, photographs, referrer introductions |
| Systems | Practice management software, card terminal or payment processing, phone, internet |
| Working capital | Three to six months of fixed costs, because month one does not pay for itself |
Get three quotes for each line that matters, in your own city, this year. That exercise takes a fortnight and is worth more than any article.
The last row is the one people cut, and it is the one that closes practices. A new practice does not fill its diary in the first month, and the rent does not care.
The first hire, and the employee-or-contractor question
The first person you bring in is usually not another physiotherapist. It is whoever answers the phone, because a missed call at 2pm is a patient who rang the practice down the road at 2.03.
When you do add a practitioner, the structural question comes first, and it is not a preference — it is a legal classification. Whether someone is an employee or a genuine independent contractor is determined by how the working relationship actually operates: who controls the diary, who sets the fees, who carries the commercial risk, whether they can send a substitute. Calling someone a contractor in a document does not make them one.
This is an area where the rules have shifted in recent years in both Australia and the United Kingdom, and getting it wrong is expensive and retrospective — back pay, superannuation or pension contributions, leave entitlements, penalties. Get advice specific to your country before the first practitioner starts, not after. It is a small bill against the alternative.
On pay models: a percentage split is common and has one requirement that people underestimate — it has to be calculable from the records every single month, without argument. If a practitioner cannot reconstruct their own payout from what the system shows, you will spend part of every month on it, and eventually you will lose someone over a disagreement about arithmetic. Decide how the split treats package payments, unpaid invoices and refunds before the first one occurs.
A diary per practitioner, and why it matters early
One shared diary works for exactly as long as one person is using it. Add a second practitioner and everything becomes a question: whose patient is this, whose room, who gets paid for it, who can see the note.
Sort this out while there are two of you rather than five. Specifically: each practitioner sees their own day, someone can see the whole practice, records make clear who wrote what, and the financial side splits by practitioner without a monthly spreadsheet. Retrofitting that once four people share a diary is a genuinely bad fortnight.
One practice, a diary each
Physioly practice plans give every practitioner their own diary, shared patient records, consolidated finances and payouts calculated per practitioner. From US$95 a month for up to three.
Create a free account → No credit card. The first 7 days have no limits at all.Five numbers to read every month
Not a dashboard with forty tiles. Five things, same day each month, written down so you can see the trend.
- Occupancy. Appointments booked against appointments available. This is the number that tells you whether to hire, whether to market, or whether to sit tight. Everything else is downstream of it.
- New patients. And where they came from — GP referral, a search, a recommendation, a fund's directory. If you cannot answer the second part, you are marketing blind and paying for it.
- Average sessions per course of treatment. A quiet, powerful number. If it falls, people are dropping out early, and that is a communication problem long before it is a marketing one.
- Rebooking rate. What proportion of patients leave with the next appointment already booked. Improving this is usually cheaper than acquiring new patients, and it is almost entirely about what happens in the last thirty seconds of a session.
- Missed appointments as a percentage of bookings. Per practitioner. A rate that is double everyone else's is almost always about booking habits rather than about patients. There is a whole article on that.
Revenue is deliberately not on the list. It is the outcome of those five, it lags them by weeks, and watching it tells you what happened rather than what is happening.
What Physioly covers for a practice, and what it leaves out
Physioly's practice plans cover a diary per practitioner, shared patient records, group classes billed per participant, session packages and overdue payment tracking, consolidated finances, and payouts calculated per practitioner so the monthly split is not a spreadsheet exercise. Pricing runs from US$95 a month for up to three practitioners to US$239 for ten and US$399 for twenty.
What it is not:
- Not payroll. Physioly calculates what each practitioner earned. Paying them, and the tax and superannuation or pension that goes with it, happens in a payroll system or with your accountant.
- Not rostering or HR. No staff scheduling, leave tracking or timesheets.
- No stock control. Consumables and retail are counted somewhere else.
- No health fund claiming. You can record a fund and its fee schedule and issue an invoice; lodging the claim happens through your terminal or the fund's own portal.
- No accounting sync. Nothing that talks to Xero, MYOB or QuickBooks. You export and hand it over.
- Twenty practitioners is the ceiling on the published plans. Beyond that it is a conversation, not a pricing page.
- Billing is in US dollars, so expect your card issuer's exchange rate and possibly a foreign transaction fee on top.
For a practice of two to twenty physiotherapists that wants records, diary and money in one place, that is a fair fit. For a practice whose central problem is claiming or payroll, it is not, and you would find that out in week one anyway.
Questions we get asked
How much does it cost to open a physiotherapy clinic?
There is no honest single figure — it depends on your city, the premises, how much fit-out the landlord contributes and how much equipment you buy on day one. What is reliable is the list of categories: premises and fit-out, clinical equipment, registration and insurance, business setup, being findable, systems, and three to six months of working capital. Get three local quotes for each and build your own total.
Should I rent a room before opening my own clinic?
It is worth taking seriously. Renting a room in an existing practice or a space in a gym or medical centre for the first year costs a fraction of a lease and fit-out, and it tells you whether the catchment supports a practice before you commit to a multi-year term. The trade-off is less control over the space and the brand.
Should my first physiotherapist be an employee or a contractor?
That is not a preference — it is a legal classification determined by how the relationship actually works: who controls the diary and fees, who carries the commercial risk, whether a substitute can be sent. The rules have changed in recent years in both Australia and the UK, and misclassification is expensive and applied retrospectively. Get country-specific advice before the person starts.
What KPIs should a physiotherapy clinic track?
Five are enough: occupancy (booked against available), new patients and where they came from, average sessions per course of treatment, rebooking rate, and missed appointments as a percentage of bookings per practitioner. Revenue is the outcome of those five and lags them, so it is a poor early warning signal.
Can Physioly handle a clinic with several physiotherapists?
Yes — practice plans give each practitioner their own diary, shared patient records, consolidated finances and payouts calculated per practitioner, from US$95 a month for up to three, US$239 for ten and US$399 for twenty. It does not do payroll, rostering, stock control or health fund claiming, so those stay in whatever systems you already use.