April 30, 2025 • 32 mins
The Elephant in the Treatment Room
Jack Chew is back, diving headfirst into a controversial topic that’s stirred the waters on LinkedIn.
In this solo episode, Jack unpacks a bold statement made by a leader in UK physiotherapy regarding the undervaluation of quality care by private medical insurers — and the uncomfortable contradictions that come with it.
From public post to corporate ownership, Jack explores the blurred lines between truth-telling and virtue signaling, the influence of venture capital on care standards, and why leadership accountability matters more than ever. This episode isn't just a takedown — it's a rallying call for integrity, transparency, and deeper discussion in MSK care.
Join the conversation:
▪ Should clinic leaders speak out publicly or tackle issues internally?
▪ Are private medical insurers solely to blame for degrading care standards?
▪ What role does corporate consolidation play in patient outcomes?
Send feedback or thoughts to: info@physio-matters.com
Don't forget to like, comment, and subscribe for more unfiltered physio commentary every week!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Here at Physio Matters, we thinkphysio matters.
Become a member today and accessover 500 webinars.
Get free tickets to shows and access new content instantly.
Access at home, work or on the train to make sure your CPD is
on track. Physiohyphenmatters.com More
content than the all you Can eatbuffet cart.
(00:49):
Good afternoon folks, hope you're good.
I'm Jack Chew. This is chewing it over and
we're back. We only had a brief interruption
because of purely because the clinic Internet was misbehaving
and so I had a bit of a bit of downtime.
So I doubt you've missed me. I've certainly missed you and
it's been it's nice to get back stuck into doing this.
I've got some really cool episodes coming up with some
brilliant guests. Joe Elphiston and Joe Turner are
(01:11):
joining me shortly, as is Ash James from the CSP.
We're going to do a piece on AI as they've got some new gardens
out, which is really cool. But before we do that, I wanted
to jump on because we had a bit of a had a bit of a in, I want
to say interaction, but it's notreally an interaction on
LinkedIn. Just that was interesting.
And I want to talk you through it because I think it's quite
telling of the industry and alsoof something that I think we
(01:35):
need to talk about more or at the very least not hide from.
And so I will get stuck straightinto it.
So I want to show you a little bit about something that
happened on, on LinkedIn. So I've got some, I've got some
images here. I better, I better slide over
here. Shouldn't I slide over here and
read it to you? It's a bit weird, isn't it?
But I can get out of the way of the, of the image.
(01:55):
There's an elephant in the treatment room.
So I'll read it for those that are not watching, but on audio
as well on the podcast. So someone's posted on LinkedIn,
I'll explain who and, and, and, and that is relevant in a
moment. But there's an elephant in the
treatment room. Insurers are undermining and
undervaluing quality physiotherapy providers across
the UK. At six our mantra is don't
(02:16):
treat, cure. So just to give you some
clarity, this is someone from six.
When they say at six they don't mean 6:00.
Six is the name of the of the physio company.
I'll come to that in a minute. Our mantra is don't treat, cure.
And it's a commitment to not just patching people up, but
making a long lasting positive impact on their lives as someone
invested in getting people functionally better, not just
(02:38):
temporarily relieved. The persistent undervaluation of
high quality physiotherapy by private medical insurance
companies is a problem that needs addressing.
It's not just a matter of fairness, it's a direct threat
to the standards of patient care, expected, expect and
deserve. As it stands, it's a race to the
bottom. So I'll just pause for a second.
Not there's lots to like, isn't it there?
(02:59):
You can imagine me saying that on tuning it over.
And I have many times as as others have.
So yeah, this is this is all very exciting, isn't it?
You can imagine I'm I'm giddy toto jump on this bandwagon and
and celebrate this truth teller.The costs of running clinics and
the real impact on inflation, particularly over the past five
years, is undeniable. This isn't sustainable from a
(03:21):
patient's perspective. When clinics are financially
squeezed, the quality of care inevitably suffers.
That might mean shorter appointments, less experienced
therapists or focus on quick fixes rather than addressing the
root cause. We won't be doing that at six.
So before I bring the other image on, I just want to go back
up to the top a second and I should have given her a bit of a
sidebar. Insurers are undermining an
(03:41):
undervaluing quality physiotherapy providers across
the UK. Absolutely reasonable opinion,
but an opinion that is essentially then implying that
that is the thing rather than a thing.
And we will come back to that ina second.
But let me pull this one up as well.
This is following on the same post.
I don't think that, sorry. I don't think that is really the
(04:02):
value proposition anyone wants. The lack of appropriate
compensation isn't just frustrating for us on the
ground, it's economically. It's economically short sighted.
There's a mutually beneficial opportunity for collaboration.
High quality physio reduces the need for medication, imaging and
often surgery. It gets people back to work,
back to living fuller lives faster, and it's ultimately a
(04:24):
cost effective solution all round.
Quality physiotherapy isn't justan expense, I see it as an
intelligent investment in betterpatient outcomes and a key part
of a more efficient healthcare system.
We need a realistic reassessmentof reimbursement rates with that
reflect the true value and expertise of high quality
physiotherapy delivers. It isn't new news unfortunately.
(04:47):
The current trajectory isn't just unfair, it's illogical and
ultimately detrimental to the patients we all aim to serve.
Increasingly patients, whether they have insurance or not, will
need to pay to access the high quality physio service they
require. I'm sure you could get a haircut
in London for a fiver somewhere,but I don't think it would be
worth it. So again, you can imagine.
(05:11):
All good points. And you know what's not to like?
Sort of wish I was the sort of person that could just clap
along to that and celebrate it and repost it and invite him on
the show. But I couldn't.
I was a bit, it miffed me a bit.Not because of the substance of
(05:33):
it, which is fundamentally true,but the context matters.
And, and so, yeah, look at me. I had to, I had to pipe up and
I'll show you what I said. I'll lean over again.
I'm going to have to read this to you as well.
So I I then said I can't remember how soon afterwards.
I then said Eddie, sorry to be abuzzkill of what is
unfortunately Truish post, but you do realise that you work for
(05:56):
Six Physio, which is owned by Ascente, which is owned by BDC,
which is owned by two engineers turned venture capitalists who
are unlikely to give a shit about MSK care standards.
We won't be doing that at Six. I quote you will if you're told
to. Also, if you don't yet, you're
holding onto a premium product made premium by private medical
(06:20):
insurers and providers like Ascente, making routine care
barely functional. Anyway, rant over for now.
Your cute LinkedIn post probablydidn't deserve all of my ire,
but it got on my tits I'm sorry.Good news is that it has
inspired me to make some more content on the various causes of
the care quality issue that I sense you and I agree on.
(06:41):
And here I am. Well, obviously this is not not
exactly the content I would haveplanned without this post.
But yeah, it made me realise, look, I need to talk about this
more because quite short sightedUni, you know, uni dimensional
analysis like this might emerge and, and, and and so yeah, we
definitely need to talk about itmore.
So obviously a fairly provocative and confrontational
(07:05):
post from me. And, and this is the this is the
thing that's worth me just unpacking.
So the original post was from this lad Eddie Smith.
I don't know him. And I think I can't remember if
this is my screenshot or someonesent it to me because they sent
me the post afterwards. It's one of those comments
whereby to people then send you a load of text messages saying,
oh, this is spicy, thanks for saying this or whatever, or
can't believe you said this. So anyway, the elephant in the
treatment room post was from Eddie Smith, who is the managing
(07:28):
director at six Physio, who are a company I've known for a long
time and admire. I know Matt Todman less well,
but certainly Rupert Crowfoot, someone that I've interacted
with and I had on our show a number of times and someone
that, you know, it's like I really like 6 physio.
But, and also, I then mentioned in that, that LinkedIn reply,
don't I, about how they are now owned by a stream of people of
(07:50):
which then ends up being essentially commercial venture
capitalists. That, that then probably, you
know, it's, there's always a risk of me looking like some
raving commie who's got this massive problem with, you know,
corporate ownership or somethinglike that.
When fundamentally I think thereis something to be said for the
fact that that that chain is relevant.
But the big thing that I want tounpack a little bit more of and
(08:12):
the, and the main irritation that I have is fundamentally
within that chain and directly owning and, and, and running 6
physio now is that they're now owned by a centre who for
various reasons are responsible in part for what, what Eddie's
describing. And so I'm sympathetic to what
he's describing. But, you know, it just ends up
being a situation where I look on and I'm just sort of
(08:34):
frustrated at the fact that someone in this position, right?
I wouldn't be doing this if it was some random associate at six
had posted that it'd be like, that's what the sort of thing
you'd celebrate, right? Or someone who's just in, in
clinical practice, frustrated that speaking out and stuff,
there'd be something brave to that.
But in a position of leadership at six physio, you're kind of in
a position where I'm like, well,I'd rather you weren't
essentially virtual signal on LinkedIn.
(08:55):
And you could probably just speak to your boss.
You can get someone on the phone, get the guys who actually
own your clinic to say maybe we should not degrade standards for
a bit. How about that?
Should we do that as a bit of a treat for the industry?
So for those that don't know Ascente, this isn't from the
Ascente's website. If you don't know them, they're
(09:16):
a, a, a, a company that that operates both NHS practice NHS
sort of Commission services as well as then they, they have
private clinics. I don't know if they do pay as
you go as well, but it's just, you know, essentially they, they
bid for business. So from their website, again, I
keep forgetting that people aren't necessarily always seeing
(09:37):
this. So I'm just pulled up something
from the website. Philosophy and values.
We are passionate believers in our distinct clinical philosophy
because we know it works and seefirst hand how it helps people
every day. Our knowledge comes from over 25
years of successfully treating more than 1.5 million people
from office workers to top athletes.
I'll just pause for a second forthem to be referenced in 25
(09:58):
years. They have not been trading this
Ascenti for 25 years, but it's interesting that they want to
name that. And if they're willing to name
25 years, they're clearly proud of their entire past, of which
I'll come to in a second. Our philosophy Ascenti
Physiotherapist take a results oriented approach to treatment,
combining hands on techniques with cognitive strategies and
progressive digital health services, then repeat
(10:19):
themselves. For some reason this means using
manual therapy such as soft tissue massage alongside
cognitive therapies that addresshow the mind and lifestyle
factors can influence your physical well-being.
OK interesting there. I don't understand why it's
describing hands on techniques and cognitive therapies, right?
It's a big jump there. Obviously a big rehab advocate
(10:39):
as I am, right? I think you should probably
should do some functional rehab there or some at least physical
exposure to, to, to activity, which I don't know, you do some
manual therapies and then cognitive therapies is like
persuade them that that you're OK.
And, and hopefully they'll go forth and do the functional
rehab that might get them betterthemselves.
I don't know. But anyway, and nitpick, that's
needless, but it was worth me just showing you they are, you
(11:01):
know what they're doing. And so 25 years, 25 years
they've been in the game. You might not have heard of
Vicente from 25 years ago. You might have heard of them
now, the big fish, massive company and you know, good on
them, they've grown. I've no, I've no real problem
with that. You might know of them from
their previous names. So there's a lad called Neil who
(11:23):
started it out. I don't think he's on the scene
anymore. I think he retired.
But back in Birmingham from whatI recall, and some of my mates
worked for them in the early iterations of this First, first
glance, you're thinking, why is the two companies of the same
name at the bottom? But look, he spelled his name
wrong at the at the start there.So then quickly became Physio
world. You might have heard of Physio
(11:43):
World 2006 to 2015. I think they were then acquired
or or maybe even just a name change.
And though for three years they were then trading as tics, which
was the injury care clinic, I think, or clinics.
So tics. So these are these are the
previous company names of Ascenti.
They were Physio world, then they were tics, then they became
Ascenti. And so they're referencing 25
(12:04):
years, I think. I think my masks are right in
that they're kind of casting it back from the different
iterations of the company, right.
So that's, that's Assenti who operate physiotherapy practice
across across the country, as far as I'm aware.
And so they have MSK clinics andservices, they're commissioned
for NHS business, but they also do occupational health work.
(12:27):
They'll then do, they'll get a tender for some whiplash care
with an insurer or they will then see patients that are
insured with various different private medical insurers, right,
Buprax or etcetera. Aviva, I think, I don't know for
sure that they're, they're who Ithink, you know, I'm pretty sure
I've been on their website recently on this.
So it's like they're, they're with all major insurers is what
they say. And so I'd be surprised if the
(12:47):
ones I've just named aren't, aren't true as well.
But one of the things that's really relevant here is that
Ascente, this is on the, the, you know, the scoop that I
managed to get from doing some really, you know, sharp
journalistic digging, due diligence that I did by going to
ascente.com. Ascente partners with Bupa.
So, and you know, this was, thiswas pretty big news last year.
(13:08):
And Ascente has launched a new strategic partnership with
leading health insurance provider Bupa.
This partnership provides Bupa members with access to Ascente's
network of directly employed physiotherapists, Right.
So Boopers and and and and Ascenti have done a deal.
It's often known as vertical integration.
I don't know if that's perfect phrasing of that, but
essentially that's then Ascenti physios using a combination, I
(13:31):
think a physio line, which is their direct phone based
telephone triage type service. Kevin Doyle quoted here, he's
their chief commercial officer at Ascenti.
I remember him from Physio Worlddays.
So he's still in the big in the biz.
We are delighted to partner withBupa and provide their members
with rapid access to high quality musculoskeletal care.
(13:52):
So this is interesting. So Bupa members are being
provided high quality care, musculoskeletal care from
Ascenti according to, to to Kevin here.
So unless Eddie was not mentioning, you know, our mate
Eddie was, was he not meaning Bupa?
(14:12):
He could have not been meaning Bupa, right?
And a lot of Bupa patients are seeing Ascente, right.
So is, is Eddie referring to a draw a drawback in standards
that come from the private medical insurers driving prices
down? A lot of them are then seeing
Centi, right? So is it poor quality, Eddie's
(14:33):
opinion, which I share, or is itwhat Kevin's describing over
here when he's sent to do this landmark deal with Bupa to see a
load of their patients? I, I don't know.
I don't know. This seems like the difference
of opinion here, right? And that that happens across,
across the businesses, right, across the industry, right?
Difference is opinion. I love it, right?
It's a debate. We do all sorts of debates and
stuff like this. Exactly what is your matters
(14:55):
about? I absolutely love it.
I love nothing more than a day. However, the interesting thing
about this is these are essentially colleagues.
In order for that difference of opinion to occur and to have
that out right, For someone to say I think that the standards
are being dragged, which I agreewith, right by the private
medical insurers, which I agree with.
(15:16):
They're certainly contributing significantly to that and
driving it down. But then the person who in part
is responsible for the service that that person runs.
So Eddie says this Ascent, he owns 6 Ascent, he's chief exec,
he's responsible for six. It's sort of it's well
integrated like that. These aren't separate entities
(15:36):
in any clean fashion at all. On a corporate governance level,
the day-to-day, you know, it maywell be I've no idea.
I've no idea and I doubt that that there's like any business,
especially of that size, it's going to be so integrately and
intimately intertwined. But it's just on a on a
commercial level, they are. And so then that difference of
opinion that we're describing, which literally can't, it's not
(15:57):
like there's an in between on this.
That's an interesting dispute that that essentially is between
two people. Then they could, they could have
that chat, couldn't they? They could, they could probably
get stuck into that and think, right, Well, you know, might we,
might we not do the degrading standards thing?
Shall we not do that for a bit? You know, as I mentioned
earlier. So I'm just setting the scene on
(16:19):
why little old me reads that on LinkedIn, nodding along
thinking, Yep, Yep, of course, Yep, fair play.
And then I kind of, it just irked me to then realise that
that's the sort of message that you could put on an internal
e-mail to provoke a boardroom conversation with some of the
people that by your own analysisreally are doing just what
(16:43):
you're describing, right? Some of the worst offenders.
Now, it could well be that Eddiejust doesn't consider them the
worst offenders. It'd be interesting, right?
They, he might feel that Bupa and Ascente in partnership are
actually, you know, it's nothing, it's nothing to do with
them, right? I'd be intrigued.
It'd be really interesting. I think.
I feel like I need some detail then, because by speaking about
(17:04):
private medical insurers writ large, right, it means that you
then you know your, your big ones are, are fairly well known
Bupa acts vitality Aviva. So and it, it, it could be that
he's not meaning them. I think you'd probably want to
be a bit more precise. So let's, I think it's
reasonable to assume, well, I'm looking forward to clarity that
that Bupa would be involved in that.
(17:25):
And in fact, it'd be probably a bit negligent for him to not
mention, of course, I don't meanBupa, right.
So I imagine the problems between Bupa and that Bupa are
then, you know, certainly vulnerable to this sort of
critique because they pay very little for fees, right?
It's sort of well known for that.
We certainly don't see them in our clinic and many others are
sort of moving away from that because they underpay and it's
(17:48):
not great, but I sort of understand it.
And those be market forces and it's a challenging thing.
And so essentially many clinics that are premium are going, are
going cash paid now really challenging.
And I really feel for and othersin London, in London, when I
speak to business owners in London, it's just like that's
the amount of the amount of people that are insured through
(18:08):
their workplaces and stuff like that mean that then they would
just be going to they would always be going through their
insurance. And so to then cut off private
medical insurance is more trickyin those central clinics that
are doing massive volume. So, and I think that that is
really interesting and really challenging, but I think that's
what I'm just explaining where some of my assumptions have come
(18:28):
from that when I read that from Eddie, of which I'm nodding
along to, I can still understandit.
The, the thing that the thing that really irritates me is, is
primarily what I'm describing. I need to repeat myself, right?
Is that essentially the the teamof which you're part of,
especially as you're managing director of 6, whether he's
directly reportable or whatever,but it's just that they are they
(18:50):
are at one with Assenti sufficiently for that to be
intertwined in terms of corporate governance at least
comfortably means that then thatconversation is an internal memo
and e-mail that that's a beef that I agree with that could
easily be taken up and you and imagine the influence it could
potentially could have having that opinion right.
There's an elephant in the room.You're in that room.
(19:10):
It's this isn't this isn't needn't be, you know, doing the
social commentary thing, OK, which, you know, fair play to
you and and you're doing as well, but it's just like just
have that, you know, you think to have that chat.
Now, the second thing is then where I am a bit more torn and
we're going to make some more content about this incoming,
incoming months really is this idea that then as this massive
(19:32):
amounts of mergers and acquisitions going on.
It's really tricky because I do think there is a a circumstance
where standards are being in part degraded because you're
getting more and more layers in which more and more margin it
gets squeezed. I think that then stacking it
high is is going to be somethingthat does compromise care
quality. But I also know the market
(19:56):
enough and know that absolutely many people, including many
friends of mine, deserve. Brilliant exits and if they get
a valuation on their business and and want to sell, then I am
super proud of them and their massive inspirations and stuff
like that, many of which have been on this show and we
collaborate with. And so it's not like I'm saying
this out of any sort of bitness.I don't have any skin in this
(20:18):
game. I'm not in in clinical
competition with any of these inany of these people or
companies. And it's not as if I'm sort of
in this situation where I just think that like essentially pull
on the thread and follow the money and therefore you just see
nothing. But like what immorality is that
It's not my point. I think that to some extent when
it comes to, you know, talking about who, you know, we we
really care. It's like, you know, at the end
(20:40):
of the day is that you will eventually do as you're told.
And that's the bit that was a bit a bit aggro from me, wasn't
it? Let's just pull up my reply
again. I think the bit that was
probably more snarky than I needed to be was when I quoted
him saying we won't be doing that at six.
And I said you will if you're told to, which is a bit, I don't
like myself for that. That were a bit too sassy even
(21:01):
by my taste. So I sort of, I can't say I was
going to say I take it back. I don't, I don't take it back
because I did mean it. And I still do mean it because I
think fundamentally I do. But it's unnecessarily aggro.
Bearing in mind, I don't know this person.
I have absolutely no problems with this person.
In fact, I'm describing the factthat I agree with him in
principle. So that was that was
unnecessary. But what I'm getting out there
and saying in in two sassier terms is that are we suggesting
(21:25):
that that BD capital, it might imply that Ascenti need to do
something and Ascenti suggests that actually 6 physio needs to
deliver this particular type of care model or that they're
literally anything to do with their structures.
Well, so you'd hope that those people wouldn't micromanage
Eddie and his team. Yeah.
(21:47):
Fundamentally, I I know what it's like to have ownership and
control and power in that way. And it's just so unlikely that,
you know, when Eddie says with his full chest, we will not be
doing that. And it's just like, just where
did he get those assurances? And if he got them from Ascenti,
then he could have a word with them about this beef, couldn't
he? You know, it's like, so which is
it? It feels like it was frustrating
because it felt like he was having his cake and eating it,
(22:08):
too. And.
And so, you know, posting something like that for, for,
for, for some of the fandom thatwould naturally come from it.
And because clearly I have no reason to believe that he
doesn't believe what he's saying.
This is the bit that got annoying.
And why I am doing this now is probably not what would have
happened if it wasn't for this next bit, which is that he then
he then didn't engage. No, no, I don't.
(22:31):
I'm not owed a reply by anyone, right, But he deleted the
comment, left the post up, blocked me on LinkedIn and then
just hoped twice he hoped, hopedI'd go away a bit ambitious
really, because this sort of my job, right?
Weirdly, compared to most peopleyou know, I do this.
I do this sort of commentary piece and Physio matters now for
(22:52):
12 years has done exactly this. And then I think friend and of
ours. So Julian had posted not long
afterwards after mine had been deleted and posted something on
there, which was again, sort of critical of the fact that then,
you know, some of the hypocrisy that I've mentioned.
And then her post was deleted. Whether she was blocked or not,
(23:15):
I don't know, but I haven't spoken to Sue, but I just know
that that was happening. And partly because people were
texting me this and, and, and sort of giving me, you know,
watching, watching the this unfold.
And so there was nothing else then done or said, right?
It was just like, right. I posted a bit on saying like,
this is what not to do. And I'll be making some content
about this. I didn't speak specific.
I didn't reference this specifically.
I was just meaning that essentially it's, it's not cool.
(23:37):
And so, and all it's done is he sort of flared me up to make
sure I sort of tell the story because I think it's important.
And I think it's important that for two reasons. 1 is that I
think it's a useful thing to talk about as a as a topic.
But then also, if you're going to put something like that out
elephant in the room, right? It's designed and framed as
being like the thing that peopledon't talk about.
Listen, you know, so then when people want to talk about it,
(23:59):
they just happen to disagree with you.
And they point out some quite, Iimagine quite awkward thing for
me to have to, to say to him is that you've still got fronted up
if you're in leadership, right? That's the nature of it.
You can't hideaway. You can't be a coward.
The difference between what you think and what you say,
especially saying publicly, is sometimes diplomacy.
Sometimes you'd like to say something, but you think it's
(24:19):
diplomatically unsound for you to do so.
So sometimes that's the difference.
But sometimes the difference between what you say but what
you think and what you say publicly is just cowardice.
And those things are hard to tell apart sometimes, including
inside yourself, right? So you want to say something.
You want to own something you'vesaid.
(24:40):
You could be thinking like diplomatically.
That's probably not wise to say it, but it could be that you're
deciding that actually, I'd rather say it should be said.
It would be useful to say it, but I'd rather not.
And that applies to me as well right here.
I, I could absolutely, and many would argue I should have
absolutely have thought it and not said it because for
(25:00):
diplomatic reasons that I'd be smart, right?
I have absolutely no major axe to ground here.
As I've mentioned before, a massive amount of time for six
in particular, it's founders andthe work it's doing.
I have absolutely no, no odd feelings and don't know this lad
Eddie from Adam. But it's also something that, as
you know, I certainly felt that way.
(25:21):
I've expressed it in a post. And so I share that as a means
of partly that's part of my work, part of my job, and also
why I have my independence as a means of being able to say such
such things. So then, yeah, deleting it,
blocking, not engaging and essentially hiding.
A few days have passed and certainly not heard anything.
And I'm fairly accessible, aren't I?
(25:44):
So that was a shame. And I think we need to make sure
that we kind of don't make that a precedent.
So that's one of the things thatmakes me then look at this and
why I kind of created this is partly to tell you a bit about
what happened to explain my feelings about that side of the
market is that absolutely you will find few people that don't
(26:06):
want to shake their fists at theprivate medical insurers, you
know, namely sort of Bupiracs, Aviva.
I'm probably missing some that are, that are then driving down
prices and essentially would want to pay for my care and time
and my team's care and time at half the price that that would
be on the cash rate. Because they're then doing it
in, in, in bulk, whatever. And then not appropriately
(26:28):
negotiating and, and, and such that it's frustrating and just
drive down standards in the waysthat Eddie's described it.
I should talk about that and I do talk about that.
But then for that to be the onlyanalysis is that part of that
analysis is the people that are then delivering that care and
are dragging prices down and arewilling to see people for a
tenner. He's he's alluding to that he
(26:49):
could get a haircut for a fiver in London.
I'm sure he's like, he's just meaning that there's people that
are willing to do that, be that individuals and companies.
Are we implying that they are just not they've they've got no
skin in the game. They've got no agency as
individuals and the individual clinician.
That's harsh, isn't it? If they're employed to do a job,
but the services, all the companies that are doing those
(27:11):
deals. So are we suggesting that
they're irrelevant to it, right.They're just they're just, oh,
if we've got to feel sorry for the providers and it's actually
all the all the insurers. It takes 2 to tango in that for
the based on the same logic. So I, it felt like it'd be
stupid to me to not create this to explain myself, my opinion on
that, what had happened as well as then.
(27:32):
And it's worth me saying LinkedIn, all, all social media
platforms have their upsides anddownsides and LinkedIn skews
sycophantic, right? It has this tempo to it where
it's sort of a virtual signalingmachine, particularly when it
comes to say business or corporate content content and
(27:52):
the certain things that can be said for that that will bait the
right reactions and emojis. And, and as I said, I, I
actually like, I like the point,but I, I think it's, it's just,
it's just feels. It feels hypocritical and, and
someone having their cake and eating it too, for it to have
come from where it did. And then unfortunately the
reaction by not engaging at all or not engaging with it.
(28:16):
I, I really do not mind tough guy had better things to do
anyway. I'm kind of glad they didn't in
some ways, but the delete it, blocking me and just crossing my
finger, crossing the fingers that it all went away is
frustrating. So part of the outcome of why I
wanted to do this is because oneof as often talk about decreased
virtue signaling, particularly on LinkedIn and the sycophantic
(28:38):
nature in which people will ham up that side of the industry.
We need more awareness of a fuller context of these sorts of
things, right? It's not just us finding our
favorite beating stick that becomes socially appropriate to
talk about. Like, for example, the elephant
in the room was easier to talk about that that part of the
elephant wasn't it for for Eddie.
(28:59):
Whereas if you had had a had a Bupa might want to make a
similar point. I mean, hopefully they'll have
the sense to keep their heads down.
But if had a Bupa wanted to makethat point and started to rail
against rail against dissenting,then it would be be interesting,
wouldn't it? And so you've got this situation
where we need the the full context and for leaders to if
you're aware of that and if you are aware of it, you'd have the
(29:20):
sense to not just keep your headdown, but also recognize that
the better place is for you to lobby for change like that.
And then finally is that if you end up caught in this sort of
situation, be that not just withme, but particularly with
someone that wants to engage andhas a point.
And granted, I've admitted that there was some sassiness Tower
made it, but it wasn't that outrageous and it's still an
opinion I hold. Then yeah, engage with it
(29:43):
somehow. Find a way, don't hide and don't
be a coward. I think it's a shame when
people, particularly people in of the ship mount will, will
just be pissy enough to to behave like that.
I don't think it's useful. And so we need to make that
consequential. And so here I am explaining what
happened. Now, this might be a bit of an
area of dirty laundry. I think it's not always, it
(30:03):
might be a bit uncouth for me todo so, but I think it's an
important topic. I think this is important stuff
that we all need to be better at.
And so as I come up to my half an hour mark there, I'm going to
leave it. Thank you so much, TuneIn for
tuning it over in the next couple of weeks with Ash James,
Joe Alfeston and Joe Turner. We've got some brilliant,
brilliant interviews coming and you won't have to deal with just
me doing piece to camera and pictures for for half an hour.
(30:25):
But yeah, hope that's been useful.
Great to be back on tuning it over and we will be back weekly
from now. Thanks to those that tuned in
this week to our pelvic health master class, hundreds of you
scaring me that it was going to stay up on the Internet and
whether we'd got enough bandwidth, which is amazing
after all these years for us to still be running master class
events. And still me being worried that
too many of you have turned up. That's a good problem to have.
And so thank you for that. Such a brilliant engaged
(30:46):
community. So do check out the links
because you've got, if you attended that or you are a
physiometrics member, then get on to the library and have a
little look because all of that has been updated and all the
links have gone out for you to get the content that you can
then obviously have on demand from now.
So anyway, thanks so much for for tuning in.
Love to hear from you on this. I've had to pre record this and,
and post it out because the, the, the live stream just didn't
(31:08):
tick over there. So I'm just going to post this
out. So any comments on on here or
any, feel free to e-mail info@physiohalfandmatters.com if
you'd prefer. I'd love to hear from you on
this, especially including if you feel like I've been banged
out of order with it or there's some, especially if there's some
inaccuracies. Apologies if there's any factual
inaccuracies on this or if you feel like I'm actually missing
the fuller context and, and, andstuff.
(31:29):
I'd be, I'd be gutted if that was the case because I want, I
want us to be more thorough. All right, thanks all.
And yeah, see you next week. Cheers.
Are you fed up with printing outexercise programs or horror
drawing them? Solve every exercise
(31:50):
prescription issue you can thinkof using Rehab My Patient.
Thousands of pictures, videos ofevery movement you can dream up.
Send by e-mail or WhatsApp. Translate into different
languages at the click of a button, but don't take our word
for it. Sign up for a three month free
trial now. Just go to
rehabmypatient.com/physio Matters.
Here at Physio Matters, we thinkphysio matters.
Become a member today and accessover 500 webinars.
Get free tickets to shows and access new content instantly.
Access at home, work or on the train to make sure your CPD is
on track. Physiohyphenmatters.com More
content than the all you Can eatbuffet cart.
(00:49):
Good afternoon folks, hope you're good.
I'm Jack Chew. This is chewing it over and
we're back. We only had a brief interruption
because of purely because the clinic Internet was misbehaving
and so I had a bit of a bit of downtime.
So I doubt you've missed me. I've certainly missed you and
it's been it's nice to get back stuck into doing this.
I've got some really cool episodes coming up with some
brilliant guests. Joe Elphiston and Joe Turner are
(01:11):
joining me shortly, as is Ash James from the CSP.
We're going to do a piece on AI as they've got some new gardens
out, which is really cool. But before we do that, I wanted
to jump on because we had a bit of a had a bit of a in, I want
to say interaction, but it's notreally an interaction on
LinkedIn. Just that was interesting.
And I want to talk you through it because I think it's quite
telling of the industry and alsoof something that I think we
(01:35):
need to talk about more or at the very least not hide from.
And so I will get stuck straightinto it.
So I want to show you a little bit about something that
happened on, on LinkedIn. So I've got some, I've got some
images here. I better, I better slide over
here. Shouldn't I slide over here and
read it to you? It's a bit weird, isn't it?
But I can get out of the way of the, of the image.
(01:55):
There's an elephant in the treatment room.
So I'll read it for those that are not watching, but on audio
as well on the podcast. So someone's posted on LinkedIn,
I'll explain who and, and, and, and that is relevant in a
moment. But there's an elephant in the
treatment room. Insurers are undermining and
undervaluing quality physiotherapy providers across
the UK. At six our mantra is don't
(02:16):
treat, cure. So just to give you some
clarity, this is someone from six.
When they say at six they don't mean 6:00.
Six is the name of the of the physio company.
I'll come to that in a minute. Our mantra is don't treat, cure.
And it's a commitment to not just patching people up, but
making a long lasting positive impact on their lives as someone
invested in getting people functionally better, not just
(02:38):
temporarily relieved. The persistent undervaluation of
high quality physiotherapy by private medical insurance
companies is a problem that needs addressing.
It's not just a matter of fairness, it's a direct threat
to the standards of patient care, expected, expect and
deserve. As it stands, it's a race to the
bottom. So I'll just pause for a second.
Not there's lots to like, isn't it there?
(02:59):
You can imagine me saying that on tuning it over.
And I have many times as as others have.
So yeah, this is this is all very exciting, isn't it?
You can imagine I'm I'm giddy toto jump on this bandwagon and
and celebrate this truth teller.The costs of running clinics and
the real impact on inflation, particularly over the past five
years, is undeniable. This isn't sustainable from a
(03:21):
patient's perspective. When clinics are financially
squeezed, the quality of care inevitably suffers.
That might mean shorter appointments, less experienced
therapists or focus on quick fixes rather than addressing the
root cause. We won't be doing that at six.
So before I bring the other image on, I just want to go back
up to the top a second and I should have given her a bit of a
sidebar. Insurers are undermining an
(03:41):
undervaluing quality physiotherapy providers across
the UK. Absolutely reasonable opinion,
but an opinion that is essentially then implying that
that is the thing rather than a thing.
And we will come back to that ina second.
But let me pull this one up as well.
This is following on the same post.
I don't think that, sorry. I don't think that is really the
(04:02):
value proposition anyone wants. The lack of appropriate
compensation isn't just frustrating for us on the
ground, it's economically. It's economically short sighted.
There's a mutually beneficial opportunity for collaboration.
High quality physio reduces the need for medication, imaging and
often surgery. It gets people back to work,
back to living fuller lives faster, and it's ultimately a
(04:24):
cost effective solution all round.
Quality physiotherapy isn't justan expense, I see it as an
intelligent investment in betterpatient outcomes and a key part
of a more efficient healthcare system.
We need a realistic reassessmentof reimbursement rates with that
reflect the true value and expertise of high quality
physiotherapy delivers. It isn't new news unfortunately.
(04:47):
The current trajectory isn't just unfair, it's illogical and
ultimately detrimental to the patients we all aim to serve.
Increasingly patients, whether they have insurance or not, will
need to pay to access the high quality physio service they
require. I'm sure you could get a haircut
in London for a fiver somewhere,but I don't think it would be
worth it. So again, you can imagine.
(05:11):
All good points. And you know what's not to like?
Sort of wish I was the sort of person that could just clap
along to that and celebrate it and repost it and invite him on
the show. But I couldn't.
I was a bit, it miffed me a bit.Not because of the substance of
(05:33):
it, which is fundamentally true,but the context matters.
And, and so, yeah, look at me. I had to, I had to pipe up and
I'll show you what I said. I'll lean over again.
I'm going to have to read this to you as well.
So I I then said I can't remember how soon afterwards.
I then said Eddie, sorry to be abuzzkill of what is
unfortunately Truish post, but you do realise that you work for
(05:56):
Six Physio, which is owned by Ascente, which is owned by BDC,
which is owned by two engineers turned venture capitalists who
are unlikely to give a shit about MSK care standards.
We won't be doing that at Six. I quote you will if you're told
to. Also, if you don't yet, you're
holding onto a premium product made premium by private medical
(06:20):
insurers and providers like Ascente, making routine care
barely functional. Anyway, rant over for now.
Your cute LinkedIn post probablydidn't deserve all of my ire,
but it got on my tits I'm sorry.Good news is that it has
inspired me to make some more content on the various causes of
the care quality issue that I sense you and I agree on.
(06:41):
And here I am. Well, obviously this is not not
exactly the content I would haveplanned without this post.
But yeah, it made me realise, look, I need to talk about this
more because quite short sightedUni, you know, uni dimensional
analysis like this might emerge and, and, and and so yeah, we
definitely need to talk about itmore.
So obviously a fairly provocative and confrontational
(07:05):
post from me. And, and this is the this is the
thing that's worth me just unpacking.
So the original post was from this lad Eddie Smith.
I don't know him. And I think I can't remember if
this is my screenshot or someonesent it to me because they sent
me the post afterwards. It's one of those comments
whereby to people then send you a load of text messages saying,
oh, this is spicy, thanks for saying this or whatever, or
can't believe you said this. So anyway, the elephant in the
treatment room post was from Eddie Smith, who is the managing
(07:28):
director at six Physio, who are a company I've known for a long
time and admire. I know Matt Todman less well,
but certainly Rupert Crowfoot, someone that I've interacted
with and I had on our show a number of times and someone
that, you know, it's like I really like 6 physio.
But, and also, I then mentioned in that, that LinkedIn reply,
don't I, about how they are now owned by a stream of people of
(07:50):
which then ends up being essentially commercial venture
capitalists. That, that then probably, you
know, it's, there's always a risk of me looking like some
raving commie who's got this massive problem with, you know,
corporate ownership or somethinglike that.
When fundamentally I think thereis something to be said for the
fact that that that chain is relevant.
But the big thing that I want tounpack a little bit more of and
(08:12):
the, and the main irritation that I have is fundamentally
within that chain and directly owning and, and, and running 6
physio now is that they're now owned by a centre who for
various reasons are responsible in part for what, what Eddie's
describing. And so I'm sympathetic to what
he's describing. But, you know, it just ends up
being a situation where I look on and I'm just sort of
(08:34):
frustrated at the fact that someone in this position, right?
I wouldn't be doing this if it was some random associate at six
had posted that it'd be like, that's what the sort of thing
you'd celebrate, right? Or someone who's just in, in
clinical practice, frustrated that speaking out and stuff,
there'd be something brave to that.
But in a position of leadership at six physio, you're kind of in
a position where I'm like, well,I'd rather you weren't
essentially virtual signal on LinkedIn.
(08:55):
And you could probably just speak to your boss.
You can get someone on the phone, get the guys who actually
own your clinic to say maybe we should not degrade standards for
a bit. How about that?
Should we do that as a bit of a treat for the industry?
So for those that don't know Ascente, this isn't from the
Ascente's website. If you don't know them, they're
(09:16):
a, a, a, a company that that operates both NHS practice NHS
sort of Commission services as well as then they, they have
private clinics. I don't know if they do pay as
you go as well, but it's just, you know, essentially they, they
bid for business. So from their website, again, I
keep forgetting that people aren't necessarily always seeing
(09:37):
this. So I'm just pulled up something
from the website. Philosophy and values.
We are passionate believers in our distinct clinical philosophy
because we know it works and seefirst hand how it helps people
every day. Our knowledge comes from over 25
years of successfully treating more than 1.5 million people
from office workers to top athletes.
I'll just pause for a second forthem to be referenced in 25
(09:58):
years. They have not been trading this
Ascenti for 25 years, but it's interesting that they want to
name that. And if they're willing to name
25 years, they're clearly proud of their entire past, of which
I'll come to in a second. Our philosophy Ascenti
Physiotherapist take a results oriented approach to treatment,
combining hands on techniques with cognitive strategies and
progressive digital health services, then repeat
(10:19):
themselves. For some reason this means using
manual therapy such as soft tissue massage alongside
cognitive therapies that addresshow the mind and lifestyle
factors can influence your physical well-being.
OK interesting there. I don't understand why it's
describing hands on techniques and cognitive therapies, right?
It's a big jump there. Obviously a big rehab advocate
(10:39):
as I am, right? I think you should probably
should do some functional rehab there or some at least physical
exposure to, to, to activity, which I don't know, you do some
manual therapies and then cognitive therapies is like
persuade them that that you're OK.
And, and hopefully they'll go forth and do the functional
rehab that might get them betterthemselves.
I don't know. But anyway, and nitpick, that's
needless, but it was worth me just showing you they are, you
(11:01):
know what they're doing. And so 25 years, 25 years
they've been in the game. You might not have heard of
Vicente from 25 years ago. You might have heard of them
now, the big fish, massive company and you know, good on
them, they've grown. I've no, I've no real problem
with that. You might know of them from
their previous names. So there's a lad called Neil who
(11:23):
started it out. I don't think he's on the scene
anymore. I think he retired.
But back in Birmingham from whatI recall, and some of my mates
worked for them in the early iterations of this First, first
glance, you're thinking, why is the two companies of the same
name at the bottom? But look, he spelled his name
wrong at the at the start there.So then quickly became Physio
world. You might have heard of Physio
(11:43):
World 2006 to 2015. I think they were then acquired
or or maybe even just a name change.
And though for three years they were then trading as tics, which
was the injury care clinic, I think, or clinics.
So tics. So these are these are the
previous company names of Ascenti.
They were Physio world, then they were tics, then they became
Ascenti. And so they're referencing 25
(12:04):
years, I think. I think my masks are right in
that they're kind of casting it back from the different
iterations of the company, right.
So that's, that's Assenti who operate physiotherapy practice
across across the country, as far as I'm aware.
And so they have MSK clinics andservices, they're commissioned
for NHS business, but they also do occupational health work.
(12:27):
They'll then do, they'll get a tender for some whiplash care
with an insurer or they will then see patients that are
insured with various different private medical insurers, right,
Buprax or etcetera. Aviva, I think, I don't know for
sure that they're, they're who Ithink, you know, I'm pretty sure
I've been on their website recently on this.
So it's like they're, they're with all major insurers is what
they say. And so I'd be surprised if the
(12:47):
ones I've just named aren't, aren't true as well.
But one of the things that's really relevant here is that
Ascente, this is on the, the, you know, the scoop that I
managed to get from doing some really, you know, sharp
journalistic digging, due diligence that I did by going to
ascente.com. Ascente partners with Bupa.
So, and you know, this was, thiswas pretty big news last year.
(13:08):
And Ascente has launched a new strategic partnership with
leading health insurance provider Bupa.
This partnership provides Bupa members with access to Ascente's
network of directly employed physiotherapists, Right.
So Boopers and and and and Ascenti have done a deal.
It's often known as vertical integration.
I don't know if that's perfect phrasing of that, but
essentially that's then Ascenti physios using a combination, I
(13:31):
think a physio line, which is their direct phone based
telephone triage type service. Kevin Doyle quoted here, he's
their chief commercial officer at Ascenti.
I remember him from Physio Worlddays.
So he's still in the big in the biz.
We are delighted to partner withBupa and provide their members
with rapid access to high quality musculoskeletal care.
(13:52):
So this is interesting. So Bupa members are being
provided high quality care, musculoskeletal care from
Ascenti according to, to to Kevin here.
So unless Eddie was not mentioning, you know, our mate
Eddie was, was he not meaning Bupa?
(14:12):
He could have not been meaning Bupa, right?
And a lot of Bupa patients are seeing Ascente, right.
So is, is Eddie referring to a draw a drawback in standards
that come from the private medical insurers driving prices
down? A lot of them are then seeing
Centi, right? So is it poor quality, Eddie's
(14:33):
opinion, which I share, or is itwhat Kevin's describing over
here when he's sent to do this landmark deal with Bupa to see a
load of their patients? I, I don't know.
I don't know. This seems like the difference
of opinion here, right? And that that happens across,
across the businesses, right, across the industry, right?
Difference is opinion. I love it, right?
It's a debate. We do all sorts of debates and
stuff like this. Exactly what is your matters
(14:55):
about? I absolutely love it.
I love nothing more than a day. However, the interesting thing
about this is these are essentially colleagues.
In order for that difference of opinion to occur and to have
that out right, For someone to say I think that the standards
are being dragged, which I agreewith, right by the private
medical insurers, which I agree with.
(15:16):
They're certainly contributing significantly to that and
driving it down. But then the person who in part
is responsible for the service that that person runs.
So Eddie says this Ascent, he owns 6 Ascent, he's chief exec,
he's responsible for six. It's sort of it's well
integrated like that. These aren't separate entities
(15:36):
in any clean fashion at all. On a corporate governance level,
the day-to-day, you know, it maywell be I've no idea.
I've no idea and I doubt that that there's like any business,
especially of that size, it's going to be so integrately and
intimately intertwined. But it's just on a on a
commercial level, they are. And so then that difference of
opinion that we're describing, which literally can't, it's not
(15:57):
like there's an in between on this.
That's an interesting dispute that that essentially is between
two people. Then they could, they could have
that chat, couldn't they? They could, they could probably
get stuck into that and think, right, Well, you know, might we,
might we not do the degrading standards thing?
Shall we not do that for a bit? You know, as I mentioned
earlier. So I'm just setting the scene on
(16:19):
why little old me reads that on LinkedIn, nodding along
thinking, Yep, Yep, of course, Yep, fair play.
And then I kind of, it just irked me to then realise that
that's the sort of message that you could put on an internal
e-mail to provoke a boardroom conversation with some of the
people that by your own analysisreally are doing just what
(16:43):
you're describing, right? Some of the worst offenders.
Now, it could well be that Eddiejust doesn't consider them the
worst offenders. It'd be interesting, right?
They, he might feel that Bupa and Ascente in partnership are
actually, you know, it's nothing, it's nothing to do with
them, right? I'd be intrigued.
It'd be really interesting. I think.
I feel like I need some detail then, because by speaking about
(17:04):
private medical insurers writ large, right, it means that you
then you know your, your big ones are, are fairly well known
Bupa acts vitality Aviva. So and it, it, it could be that
he's not meaning them. I think you'd probably want to
be a bit more precise. So let's, I think it's
reasonable to assume, well, I'm looking forward to clarity that
that Bupa would be involved in that.
(17:25):
And in fact, it'd be probably a bit negligent for him to not
mention, of course, I don't meanBupa, right.
So I imagine the problems between Bupa and that Bupa are
then, you know, certainly vulnerable to this sort of
critique because they pay very little for fees, right?
It's sort of well known for that.
We certainly don't see them in our clinic and many others are
sort of moving away from that because they underpay and it's
(17:48):
not great, but I sort of understand it.
And those be market forces and it's a challenging thing.
And so essentially many clinics that are premium are going, are
going cash paid now really challenging.
And I really feel for and othersin London, in London, when I
speak to business owners in London, it's just like that's
the amount of the amount of people that are insured through
(18:08):
their workplaces and stuff like that mean that then they would
just be going to they would always be going through their
insurance. And so to then cut off private
medical insurance is more trickyin those central clinics that
are doing massive volume. So, and I think that that is
really interesting and really challenging, but I think that's
what I'm just explaining where some of my assumptions have come
(18:28):
from that when I read that from Eddie, of which I'm nodding
along to, I can still understandit.
The, the thing that the thing that really irritates me is, is
primarily what I'm describing. I need to repeat myself, right?
Is that essentially the the teamof which you're part of,
especially as you're managing director of 6, whether he's
directly reportable or whatever,but it's just that they are they
(18:50):
are at one with Assenti sufficiently for that to be
intertwined in terms of corporate governance at least
comfortably means that then thatconversation is an internal memo
and e-mail that that's a beef that I agree with that could
easily be taken up and you and imagine the influence it could
potentially could have having that opinion right.
There's an elephant in the room.You're in that room.
(19:10):
It's this isn't this isn't needn't be, you know, doing the
social commentary thing, OK, which, you know, fair play to
you and and you're doing as well, but it's just like just
have that, you know, you think to have that chat.
Now, the second thing is then where I am a bit more torn and
we're going to make some more content about this incoming,
incoming months really is this idea that then as this massive
(19:32):
amounts of mergers and acquisitions going on.
It's really tricky because I do think there is a a circumstance
where standards are being in part degraded because you're
getting more and more layers in which more and more margin it
gets squeezed. I think that then stacking it
high is is going to be somethingthat does compromise care
quality. But I also know the market
(19:56):
enough and know that absolutely many people, including many
friends of mine, deserve. Brilliant exits and if they get
a valuation on their business and and want to sell, then I am
super proud of them and their massive inspirations and stuff
like that, many of which have been on this show and we
collaborate with. And so it's not like I'm saying
this out of any sort of bitness.I don't have any skin in this
(20:18):
game. I'm not in in clinical
competition with any of these inany of these people or
companies. And it's not as if I'm sort of
in this situation where I just think that like essentially pull
on the thread and follow the money and therefore you just see
nothing. But like what immorality is that
It's not my point. I think that to some extent when
it comes to, you know, talking about who, you know, we we
really care. It's like, you know, at the end
(20:40):
of the day is that you will eventually do as you're told.
And that's the bit that was a bit a bit aggro from me, wasn't
it? Let's just pull up my reply
again. I think the bit that was
probably more snarky than I needed to be was when I quoted
him saying we won't be doing that at six.
And I said you will if you're told to, which is a bit, I don't
like myself for that. That were a bit too sassy even
(21:01):
by my taste. So I sort of, I can't say I was
going to say I take it back. I don't, I don't take it back
because I did mean it. And I still do mean it because I
think fundamentally I do. But it's unnecessarily aggro.
Bearing in mind, I don't know this person.
I have absolutely no problems with this person.
In fact, I'm describing the factthat I agree with him in
principle. So that was that was
unnecessary. But what I'm getting out there
and saying in in two sassier terms is that are we suggesting
(21:25):
that that BD capital, it might imply that Ascenti need to do
something and Ascenti suggests that actually 6 physio needs to
deliver this particular type of care model or that they're
literally anything to do with their structures.
Well, so you'd hope that those people wouldn't micromanage
Eddie and his team. Yeah.
(21:47):
Fundamentally, I I know what it's like to have ownership and
control and power in that way. And it's just so unlikely that,
you know, when Eddie says with his full chest, we will not be
doing that. And it's just like, just where
did he get those assurances? And if he got them from Ascenti,
then he could have a word with them about this beef, couldn't
he? You know, it's like, so which is
it? It feels like it was frustrating
because it felt like he was having his cake and eating it,
(22:08):
too. And.
And so, you know, posting something like that for, for,
for, for some of the fandom thatwould naturally come from it.
And because clearly I have no reason to believe that he
doesn't believe what he's saying.
This is the bit that got annoying.
And why I am doing this now is probably not what would have
happened if it wasn't for this next bit, which is that he then
he then didn't engage. No, no, I don't.
(22:31):
I'm not owed a reply by anyone, right, But he deleted the
comment, left the post up, blocked me on LinkedIn and then
just hoped twice he hoped, hopedI'd go away a bit ambitious
really, because this sort of my job, right?
Weirdly, compared to most peopleyou know, I do this.
I do this sort of commentary piece and Physio matters now for
(22:52):
12 years has done exactly this. And then I think friend and of
ours. So Julian had posted not long
afterwards after mine had been deleted and posted something on
there, which was again, sort of critical of the fact that then,
you know, some of the hypocrisy that I've mentioned.
And then her post was deleted. Whether she was blocked or not,
(23:15):
I don't know, but I haven't spoken to Sue, but I just know
that that was happening. And partly because people were
texting me this and, and, and sort of giving me, you know,
watching, watching the this unfold.
And so there was nothing else then done or said, right?
It was just like, right. I posted a bit on saying like,
this is what not to do. And I'll be making some content
about this. I didn't speak specific.
I didn't reference this specifically.
I was just meaning that essentially it's, it's not cool.
(23:37):
And so, and all it's done is he sort of flared me up to make
sure I sort of tell the story because I think it's important.
And I think it's important that for two reasons. 1 is that I
think it's a useful thing to talk about as a as a topic.
But then also, if you're going to put something like that out
elephant in the room, right? It's designed and framed as
being like the thing that peopledon't talk about.
Listen, you know, so then when people want to talk about it,
(23:59):
they just happen to disagree with you.
And they point out some quite, Iimagine quite awkward thing for
me to have to, to say to him is that you've still got fronted up
if you're in leadership, right? That's the nature of it.
You can't hideaway. You can't be a coward.
The difference between what you think and what you say,
especially saying publicly, is sometimes diplomacy.
Sometimes you'd like to say something, but you think it's
(24:19):
diplomatically unsound for you to do so.
So sometimes that's the difference.
But sometimes the difference between what you say but what
you think and what you say publicly is just cowardice.
And those things are hard to tell apart sometimes, including
inside yourself, right? So you want to say something.
You want to own something you'vesaid.
(24:40):
You could be thinking like diplomatically.
That's probably not wise to say it, but it could be that you're
deciding that actually, I'd rather say it should be said.
It would be useful to say it, but I'd rather not.
And that applies to me as well right here.
I, I could absolutely, and many would argue I should have
absolutely have thought it and not said it because for
(25:00):
diplomatic reasons that I'd be smart, right?
I have absolutely no major axe to ground here.
As I've mentioned before, a massive amount of time for six
in particular, it's founders andthe work it's doing.
I have absolutely no, no odd feelings and don't know this lad
Eddie from Adam. But it's also something that, as
you know, I certainly felt that way.
(25:21):
I've expressed it in a post. And so I share that as a means
of partly that's part of my work, part of my job, and also
why I have my independence as a means of being able to say such
such things. So then, yeah, deleting it,
blocking, not engaging and essentially hiding.
A few days have passed and certainly not heard anything.
And I'm fairly accessible, aren't I?
(25:44):
So that was a shame. And I think we need to make sure
that we kind of don't make that a precedent.
So that's one of the things thatmakes me then look at this and
why I kind of created this is partly to tell you a bit about
what happened to explain my feelings about that side of the
market is that absolutely you will find few people that don't
(26:06):
want to shake their fists at theprivate medical insurers, you
know, namely sort of Bupiracs, Aviva.
I'm probably missing some that are, that are then driving down
prices and essentially would want to pay for my care and time
and my team's care and time at half the price that that would
be on the cash rate. Because they're then doing it
in, in, in bulk, whatever. And then not appropriately
(26:28):
negotiating and, and, and such that it's frustrating and just
drive down standards in the waysthat Eddie's described it.
I should talk about that and I do talk about that.
But then for that to be the onlyanalysis is that part of that
analysis is the people that are then delivering that care and
are dragging prices down and arewilling to see people for a
tenner. He's he's alluding to that he
(26:49):
could get a haircut for a fiver in London.
I'm sure he's like, he's just meaning that there's people that
are willing to do that, be that individuals and companies.
Are we implying that they are just not they've they've got no
skin in the game. They've got no agency as
individuals and the individual clinician.
That's harsh, isn't it? If they're employed to do a job,
but the services, all the companies that are doing those
(27:11):
deals. So are we suggesting that
they're irrelevant to it, right.They're just they're just, oh,
if we've got to feel sorry for the providers and it's actually
all the all the insurers. It takes 2 to tango in that for
the based on the same logic. So I, it felt like it'd be
stupid to me to not create this to explain myself, my opinion on
that, what had happened as well as then.
(27:32):
And it's worth me saying LinkedIn, all, all social media
platforms have their upsides anddownsides and LinkedIn skews
sycophantic, right? It has this tempo to it where
it's sort of a virtual signalingmachine, particularly when it
comes to say business or corporate content content and
(27:52):
the certain things that can be said for that that will bait the
right reactions and emojis. And, and as I said, I, I
actually like, I like the point,but I, I think it's, it's just,
it's just feels. It feels hypocritical and, and
someone having their cake and eating it too, for it to have
come from where it did. And then unfortunately the
reaction by not engaging at all or not engaging with it.
(28:16):
I, I really do not mind tough guy had better things to do
anyway. I'm kind of glad they didn't in
some ways, but the delete it, blocking me and just crossing my
finger, crossing the fingers that it all went away is
frustrating. So part of the outcome of why I
wanted to do this is because oneof as often talk about decreased
virtue signaling, particularly on LinkedIn and the sycophantic
(28:38):
nature in which people will ham up that side of the industry.
We need more awareness of a fuller context of these sorts of
things, right? It's not just us finding our
favorite beating stick that becomes socially appropriate to
talk about. Like, for example, the elephant
in the room was easier to talk about that that part of the
elephant wasn't it for for Eddie.
(28:59):
Whereas if you had had a had a Bupa might want to make a
similar point. I mean, hopefully they'll have
the sense to keep their heads down.
But if had a Bupa wanted to makethat point and started to rail
against rail against dissenting,then it would be be interesting,
wouldn't it? And so you've got this situation
where we need the the full context and for leaders to if
you're aware of that and if you are aware of it, you'd have the
(29:20):
sense to not just keep your headdown, but also recognize that
the better place is for you to lobby for change like that.
And then finally is that if you end up caught in this sort of
situation, be that not just withme, but particularly with
someone that wants to engage andhas a point.
And granted, I've admitted that there was some sassiness Tower
made it, but it wasn't that outrageous and it's still an
opinion I hold. Then yeah, engage with it
(29:43):
somehow. Find a way, don't hide and don't
be a coward. I think it's a shame when
people, particularly people in of the ship mount will, will
just be pissy enough to to behave like that.
I don't think it's useful. And so we need to make that
consequential. And so here I am explaining what
happened. Now, this might be a bit of an
area of dirty laundry. I think it's not always, it
(30:03):
might be a bit uncouth for me todo so, but I think it's an
important topic. I think this is important stuff
that we all need to be better at.
And so as I come up to my half an hour mark there, I'm going to
leave it. Thank you so much, TuneIn for
tuning it over in the next couple of weeks with Ash James,
Joe Alfeston and Joe Turner. We've got some brilliant,
brilliant interviews coming and you won't have to deal with just
me doing piece to camera and pictures for for half an hour.
(30:25):
But yeah, hope that's been useful.
Great to be back on tuning it over and we will be back weekly
from now. Thanks to those that tuned in
this week to our pelvic health master class, hundreds of you
scaring me that it was going to stay up on the Internet and
whether we'd got enough bandwidth, which is amazing
after all these years for us to still be running master class
events. And still me being worried that
too many of you have turned up. That's a good problem to have.
And so thank you for that. Such a brilliant engaged
(30:46):
community. So do check out the links
because you've got, if you attended that or you are a
physiometrics member, then get on to the library and have a
little look because all of that has been updated and all the
links have gone out for you to get the content that you can
then obviously have on demand from now.
So anyway, thanks so much for for tuning in.
Love to hear from you on this. I've had to pre record this and,
and post it out because the, the, the live stream just didn't
(31:08):
tick over there. So I'm just going to post this
out. So any comments on on here or
any, feel free to e-mail info@physiohalfandmatters.com if
you'd prefer. I'd love to hear from you on
this, especially including if you feel like I've been banged
out of order with it or there's some, especially if there's some
inaccuracies. Apologies if there's any factual
inaccuracies on this or if you feel like I'm actually missing
the fuller context and, and, andstuff.
(31:29):
I'd be, I'd be gutted if that was the case because I want, I
want us to be more thorough. All right, thanks all.
And yeah, see you next week. Cheers.
Are you fed up with printing outexercise programs or horror
drawing them? Solve every exercise
(31:50):
prescription issue you can thinkof using Rehab My Patient.
Thousands of pictures, videos ofevery movement you can dream up.
Send by e-mail or WhatsApp. Translate into different
languages at the click of a button, but don't take our word
for it. Sign up for a three month free
trial now. Just go to
rehabmypatient.com/physio Matters.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!