Build your own blueprint: How David Birley started an Osteo clinic (twice)

David Birley (also known as Dave the Osteo) knows how to spot a good thing. He was one of the first graduates from Australia’s Victoria University Osteopathic degree 20 years ago, he was the first Osteo in Australia to complete Clinical Pilates training, he started one of the first (third to be exact) Pilates studios in New Zealand, and was one of Cliniko’s first customers (almost 10 years ago).

Although being forward thinking comes with benefits, it’s not without its challenges! We spoke to Dave about his career and what he’s learned along the way.

Starting out.

David was born and raised in NZ, and completed a Bachelor of Science, majoring in biochemistry and physiology at a veterinary school in Palmerston North. “I couldn't see myself really doing a lot with a) animals or b) test tubes. I had a bit more of a people focus,” he said. “I still completed that degree but I thought ‘what else can I do?’ and so I looked at physio, I looked at chiro, I looked at osteo and sort of settled on osteo as a flavour of manual therapy that I liked”.

The challenge of being in New Zealand 25 years ago  (and deciding that Osteopathy was the career path for you) was that there were no Osteopathy courses in New Zealand—only in the UK and Australia. David chose to study Victoria University’s newly founded Osteopathy degree in Melbourne, Australia. While living in Melbourne, David also completed formal (Physio-based) Clinical Pilates training—becoming the first Osteopath in Australia to do so.

Five years later, at age 27, David returned home to NZ and started his own business—an Osteopathy and Pilates practice—in Tauranga.

He reflects, “My family have always had their own businesses, so I knew it was probably going to be my own thing or nothing. You just need confidence to make it work.”

With his family experience in business behind him, Dave knew the importance of being frugal when starting out. Knowing it would take time to build up the customer base and begin earning, he found a location for his practice and negotiated the first four months rent free. He also took out a loan for the equipment to set up the practice appropriately.

He was flat-out busy within three weeks.

This brought David his first big challenge—it was impossible to hire staff for the same reason the practice was taking off so quickly. New Zealand didn’t train Osteopaths, and both Osteopathy and Pilates were rare therapies offered in New Zealand. On the upside, the unexpected and almost immediate growth allowed him to pay off the equipment loan just as quickly.

This early income also allowed David to invest $15,000 in Houston Medical (a server-based practice management software) to set up computers and licenses. Although the monthly cost was $500 (and it was a “nightmare” to update and maintain), it enabled cost-justifying efficiencies for David and his team.

Five years later, in 2006, the New Zealand government made a large portion of physiotherapy treatment free, which halved the business of New Zealand’s few Osteopathy practices almost overnight.

Starting up, again.

In 2007, David and his wife decided this was the right time for them to make the move to his wife’s hometown of Geelong—back in Melbourne (AU).

David set up his own practice for the second time: The Osteopaths - Geelong. This time the business conditions were markedly different—there were already ten Osteopathy clinics in Geelong. David went from thousands of clients to none, which is the hardest part of moving your practice as a clinician.

To limit his startup costs this time around, David decided not to re-establish his Pilates clinic (because of the extended opening hours), to focus on Osteopathy as a solo practitioner (without the overheads of people management), and forego the expensive practice management software.

Four years of paper client notes later, David was at the home of friend, also an Osteopath, who showed David the software that his friend and her partner had just developed. It was cloud-based practice management software called Cliniko, created by a software developer (Joel) and an Osteopath (Liora). David says that after being put off practice management software by the expensive server-based software he’d used in the past, he thought, “This is something I can use because it’s cloud based.” His only concern about cloud-based software was the security of patient details, but he says, “Security was always going to be a concern but the level of security [with Cliniko] is as good as you’re going to get.”

David worked solo, at capacity, and enjoyed the focus on practicing without the distraction of a lot of business management for another seven years, when he began to turn away too many new clients. This was despite the fact that competition in Geelong had never been greater—there were now 19 Osteopathy practices in Geelong (nine more than when he had started his solo practice in 2007). David credited the increase in demand to a change in how Osteopathy was being viewed: “Osteopathy is an ‘optional’ treatment but it’s grown as a top of mind practice as long as you provide a good service."

“It wasn’t until several years later that we took up space inside an allied health clinic, and had the opportunity to take on an additional three associates within a year (associates are like employees—but are contractors)."

“Within two years we needed a second location, enabling us to potentially expand from there."

“It was around this time that he had the opportunity to buy a location not far from the Naturopathy practice where he had rented a room since starting the Geelong business.”

This model allows David to maintain 25 hours practicing, and 5 to 10 hours managing. David has found that cloud-based practice software is an essential for him, allowing him to switch easily between practice locations—and also mitigating practice internet dropouts by being able to pick up his phone to access his practice software. David also marvels, “I don’t have to train staff [on the software], it’s unlike anything else you can get. One short training video and off they go.”

Nowadays, the marketing game has also evolved. When David started both of his practices, local marketing was reliant on the physical Yellow Pages directory. “If you missed the Yellow Pages booking deadline, you were doomed,” David reflects. So while being very digitally-savvy with his website and search engine marketing, David also uses the Cliniq Apps integration with Cliniko and triggers text messages and emails to his clients based on tags on their files.

Continuously learning

“It’s only in the last 20 years that ‘evidence-based’ [Osteopathy] has come into play,” David shares. “Certainly back then there was a lot more old school indoctrination. The word evidence based didn't even come across the radar. That's now pretty much a huge focus, so way back then there was a lot more grandfathering of technique and things like that.”

“What's really interesting for me is often all manner of courses, I've done a lot of physio courses that have let me in. I've done chiro courses, other bits and pieces. I've done kinesiology. To just sort of challenge the way that I look at things. I'm a huge fan of the saying ‘you don't know what you don't know’ and certainly osteo doesn't solve all problems but it does give you an excellent background.”