Hiring Your First Few Staff Could Leave You Poorer, Clinic Data Suggests

HMDG's 2026 barometer of 715 UK MSK clinic owners found that those with two to five staff typically take home less than they did working alone, a stage the report cheerfully calls the "Danger Zone" - this includes practices like yours if you run a clinic or treatment centre with a small team.

Page updated: 13 Aug 2026

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Clinics thinking hiring equals earning more might want to look at the numbers before they look at CVs.

Original Research	A pay and pricing survey of UK musculoskeletal clinic owners, showing a dip in personal income once staff numbers reach two to five.
Source	https://hmdg.co.uk/private-practice-barometer/
Overview	HMDG surveyed 715 clinic owners on pay, pricing, retention and growth to build a set of industry benchmarks.
Year	2026
Publisher	Industry body, HMDG
Relevance to Wellbeing	Directly relevant to any clinic, centre, or multi-practitioner practice weighing up whether to bring on staff.
Our Verdict	Too early to tell a solid sample size, but it is one company's own survey of its own audience, so treat it as a strong hint rather than gospel.
Our Summary	Owners with two to five staff earned a median of £45,000, less than many solo operators reported. It gives a name and a number to a pattern many clinic owners already suspect but rarely discuss out loud. The survey covers MSK clinics specifically, so results may not map neatly onto every kind of wellbeing practice. Methodology details beyond sample size are thin, so the figures deserve a raised eyebrow, not blind faith.
Our Geo View	Figures are UK-specific; pay and pricing benchmarks won't translate directly to other countries' markets.

Abstract of wellbeing niches and revenue flow

Recognise how this might impact your practice

Why this might matter to you

Coaching: this matters because bringing on your first associate coach without sorting fee splits first can quietly eat your own income.
Therapy: this matters because growing a small therapy practice by headcount alone, without fixing pricing, tends to reward the new hire more than the founder.
Training: this matters because adding trainers to cover more classes doesn't automatically mean more money lands in your pocket.
Alternative Healing: this matters because scaling a healing practice with extra practitioners can dilute your earnings if the business structure isn't ready for it.
Clinical: this matters because MSK and similar clinics are the exact group this survey studied, so the Danger Zone is a live risk, not a theory.
Retreat/Centre: this matters because centres hiring a small core team often hit the same dip before things stabilise, and it helps to know it's coming.

Where this came from

HMDG asked hundreds of UK MSK clinic owners about pay, pricing and staffing, and found a rough patch for those with two to five staff.

HMDG, "UK Private Practice Barometer 2026", published on HMDG's own site.

Credibility flags: survey-based, 715 respondents, methodology beyond sample size not disclosed, industry body publisher.

How we scored this

A relevance score out of 100, built from three things: how well it fits the six practice types, how recent it is, and how solid the methodology behind it is.

93%

Practice fit, 100How new, 100How solid, 75

Marked down slightly on how solid the method is, given limited transparency beyond sample size, but scores well on practice fit and recency since it sits squarely within clinical practice and reflects current 2026 data.

It's worth considering changes to your marketing practices

What this means for your marketing

Put your pricing structure in order before you put a hiring ad online.
Say "we've fixed our fee splits" before a prospective associate asks about pay.
Brief your team on the fact that growth by headcount alone isn't the same as growth in income.
Use the "Danger Zone" phrase yourself when talking to other clinic owners; it's memorable and it's not yours to invent, so credit HMDG.
Hold off announcing "we're expanding" until the sums behind expansion actually work.

Who this is most useful for

Practice type	Relevance	Recommended action
Coaching	Medium	Review associate pay structures before adding staff.
Therapy	Medium	Check pricing supports a second practitioner before hiring one.
Training	Medium	Model income per trainer before expanding the team.
Alternative Healing	Medium	Plan fee splits ahead of bringing in extra practitioners.
Clinical Practices	High	Benchmark your own pay against the Danger Zone figures directly.
Retreats/Centres	High	Build a staffing plan that accounts for the early-growth dip.

Best before

Best before: revisit this when HMDG publishes its next barometer, and check figures directly against HMDG's original report before quoting them again.

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