'We did it in the end': Spectrum Health MD on how clinics chain took on the recession - and won
How often have we heard the mantra 'your health is your wealth'? Yet, when cutbacks have to be made, luxuries such as private health insurance, as well as the frequency of doctor and physio visits, can quickly face the chop.
For someone in the private medical profession, deciding to expand their business in the middle of Ireland's most recent recession (between 2008 and 2014) was a bit of a brave move.
"It was either reinvest and really try to make a go of it, or stop. And we didn't want to stop," Anne McGoldrick, co-founder and managing director of Spectrum Health, says.
She qualified as a physiotherapist herself, but the company's clinics provide private patient care in areas like psychology, podiatry, speech therapy and dietetics.
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The group also provides in-house services for corporate clients.
"We reinvested, took the risk, and when we came out of the recession, we had 12 clinics," the Trinity College Dublin graduate says.
The husband and wife-founded company, opened its first clinic in September 2007.
It was - naturally - not all plain sailing, and despite the expansion, revenue fell by around 30pc-40pc during the recession.
"We started to see a drop-off," McGoldrick says.
"Even though health is something people need, it is a necessity item, people were letting go of their health insurance.
"Where people may have come to us five or six times, they were starting to come to us three or four times."
Along with expanding its physical presence, the company realised it needed to diversify beyond physiotherapy.
Key to keeping afloat, during what was a brutally hard time for all kinds of businesses in Ireland, was relationship management.
"We were very careful, there was an awful lot of communication and relationship building during that time, not just with our GPs, but with our suppliers and our landlords. I would be very strong on communicating with them if there was a problem, trying to give them as much forward notice where possible," she says.
"There was always a fear we couldn't pay our staff, and leaders eat last, so you have to wait," the Dublin native adds.
The hardest part during that time, she maintains, was "being afraid to not realise the dream".
"Was the recession the worst thing? I suppose it probably was, but we did it in the end," she adds.
The company did benefit from falling rents, she notes.
Spectrum lived to tell the tale, and today the company has 37 clinics, mainly in Dublin, but also in Kildare, Westmeath, Kilkenny, Waterford, Cork, Limerick and Galway.
The group is chaired by McGoldrick's husband, Stuart, whose background was in aviation.
As well as direct patient care, a new departure is providing wellness services to corporate clients, from on-site physios, to seminars and webinars.
It has become a big undertaking. "Corporates were asking us to create their (health and wellness) programmes for the year, for their employees," McGoldrick says.
"That worked really well to the point where in 2018 we decided to split out the companies."
The complexity of multiple business strands, locations, clients and programmes was all getting too much.
"We had a lot of business centres under the one umbrella, and we were all very thinly spread. So I went from anything from product design to clinical governance, to operations," she says.
"We felt if we split out the entities and had a managing director in each position, then we would be able to exponentially grow, with each MD focused on the growth of their entity."
Today, there is Spectrum Health, Spectrum Mental Health, Spectrum Life, and a number of smaller entities.
McGoldrick oversees a team that provides services including physiotherapy, diet and nutrition, podiatry and chiropody.
"This has really changed how we look at things," she says. "I became a managing director at that point. This meant a load of new skills to learn, and I was able to just focus on our clinic footprint. And since January 2018, we have added seven more clinics, so we are up to 37."
Over the next three years, the company has planned to have as many as 50 clinics, creating 60 to 100 jobs in the process.
Most of the growth will take place in areas where the business is not already present, such as Wicklow, Louth, Clare and Laois. The biggest challenges that McGoldrick sees will be recruitment and staff retention, plus the increasingly high commercial property rents.
Staff retention and recruitment is a "huge issue" right around the country, she says. "We have had to turn to other countries to recruit; we are banking on homeward-bound employees from the likes of Australia, New Zealand," she notes.
In addition, the company is looking at South America, in particular Brazil, where McGoldrick says the training is "fantastic" for most of the professions required by the business. "And we are also looking at the UK."
Longer-term, Spectrum has started a scholarship programme with Galway University for graduates in the area of podiatry.
The business is also active in the colleges here that teach physiotherapy.
Under the graduate programme, Spectrum pays a student's final-year tuition fees. The graduate then gets a 12-month contract with the company on completion of their degree. Successful applicants are provided with a full salary, as well as "a huge amount of hand-holding" in their first year.
Despite these efforts, McGoldrick maintains recruitment "is going to be difficult for the next few years".
All the while, rents are rising. "Rents are not going to stop going up. A lot of very good deals we got during the recession are now coming to rent review stage; we have to be very careful around our long-term leases and how they are structured," she adds.
On a more positive note, as the economy improves, a lot of people are increasingly focused on their health.
"We need to harness that opportunity and help people achieve their health objectives," McGoldrick says.
Looking forward, the qualified physiotherapist envisages a swing from reactive to preventative physio, "as patients get more educated in health".
Podiatry and chiropody are other areas where she expects growth to occur.
In addition, mental health will be a key area for the business.
"It has always been there but I think people were afraid to have the conversation," she says.
"We see a huge trend in people and corporates wanting to have that conversation."
Meanwhile, having first started out dividing her time between private practice and working in orthopaedics in a hospital, McGoldrick says she would love to see more private-public cooperation and partnership.
"I think the private sector has a huge amount to give in the way of innovation, ideas. I think the public sector should achieve a lot from more collaboration," she says, adding that "both sectors have a lot to learn from each other".
Like a lot of family-run businesses around the country, McGoldrick works alongside her husband, something she says "was definitely difficult in the early days".
She adds: "We are very different people when we are at work, so it took three or four years for us to figure out how to work together.
"It is fun and interesting at times, but it can be tricky."
In overcoming the difficult aspects of this, the parents of two young children made "a lot of rules" around working together.
"What we did at work had to stop when we got home, and if we couldn't stop at home then we had to go for a work dinner just to have that discussion," she highlights.
"When you are going home to two children, you don't need to bring your work back; it is something we are quite strong on. We have really worked hard to ensure work doesn't cross into our personal life."
As the business has grown, the two no longer work as closely together.
"It is much easier now because we work in very different parts of the business, don't really see each other any more at work, and I think that's probably good," she laughs.