The Reckoning Is Here: The Big Are Getting Bigger, The Small Are Going Solo & A Nasty Storm Is Brewing In The Middle

The allied health industry is at a tipping point.
Right now, we’re in the middle of a storm — a relentless, unforgiving grind that’s forcing clinic owners and practitioners to make hard choices. 

Recruitment is a nightmare.
Retention feels impossible. Leadership challenges are exposing cracks in business models. And let’s be honest — many of us are asking the same question: “Is this worth it?”

For some, the answer is no.
The hard truth is that some people shouldn’t be running clinics. Others need to close their businesses because they’ve lost sight of what matters: treating their staff with respect and building a workplace worth being part of. But for many, the real challenge is the middle.

The Sh*t Storm in the Middle
I’ve been in business for 24 years, and I can tell you this: The first two years are full of optimism. The last two years — if you’ve made it that far — are full of rewards. But those middle years? They’re brutal. This is where most clinic owners either give up, burn out, or rise above.

We’re again at the bottom of what I believe will be another five-year climb for our industries. The big clinics are getting bigger. The small clinics are choosing to go solo. And those who persevere through the middle will be the ones enjoying the most lucrative views at the top.

But let’s get real about what it takes to get there…

The Harsh Reality
The numbers don’t lie:

• 84% of healthcare professionals report ongoing stress and burnout, with mental health concerns like anxiety and depression affecting more than half of the workforce.
• 82% of health professions face critical gaps in staffing.
  Many clinics struggle to meet patient demand, and recruitment challenges are leaving new grads without adequate mentorship or private practice opportunities

The storm we’re in isn’t just personal — it’s systemic.
And while it’s tempting to throw in the towel, this industry desperately needs leaders willing to step up, adapt, and drive change in the middle. I’m scared for a future of sub-par solo practitioners or endless contractors working from GP rooms, saturating the market and leaving new grads without valuable mentoring and dynamic team opportunities.

Stop Sugar-Coating It
Running a successful allied health clinic isn’t about being a great practitioner. It’s about being a great leader, a savvy businessperson, and a resilient human being.

If you:

• Can’t mentor, empathise, support, and communicate with your team…
• Aren’t willing to learn the business acumen required to manage a P&L…
• Don’t have the grit to weather the tough years…

…then you might need to rethink your path. And that’s okay. Success doesn’t only come from owning a clinic. For some, going solo or working as a contractor is a better fit. But if you’re determined to build something bigger, then you need to stop complaining, start leading, and get to work.

The State of the Industry
The allied health profession is facing a reckoning. For many, the choice is between stepping up or stepping out. And while this reality is harsh, it’s also an opportunity. Clinics that rise to the challenge now will not only survive but excel as leaders in the next wave of healthcare.

What’s Next for Allied Health?

Here’s what I see for the future:

1. The Big Get Bigger:
   Clinics with strong leadership, scalable models, and cohesive teams will dominate. They’ll consolidate, expand, and thrive.
2. The Small Go Solo:
   Many practitioners will choose simplicity over scale. They’ll focus on patient care without the stress of running a team.
3. Leadership Is Non-Negotiable:
   The middle five years of ownership are make-or-break. Your ability to lead—not just manage—is what will determine your success.

The Opportunity Ahead
For those willing to stick with it, the future is bright. Allied health private practice can provide not just a good living, but an exceptional life.

The key is navigating the storm with

• Vision:
  Know where you want to be in five years.
• Leadership:
  Invest in your ability to inspire, mentor, retain your team, and give back.
• Business Acumen:
  Learn the skills that weren’t taught at university. Lean on mentors or seek out a good business coach.

Our industries still have incredible potential for scale and are some of the few in healthcare that are resilient in this fragile economic climate. But it requires determination, adaptability, and, most of all, clarity about what you really want. Stop focussing on what is broken and be part of the solution.

So, what now?

To those feeling the weight of the middle years, I feel you. It’s real — it’s bloody hard, but let me leave this with you:

Success doesn’t come from avoiding the storm — it comes from learning how to navigate through it. Whether you choose to scale, go solo, or pivot entirely, make your decision from a place of vision and strength, not frustration, avoidance, or fear. Nothing good comes from making choices during heightened emotions.

For those who stay with it, the next five years will separate the leaders from the rest.The big will get bigger, the small will find freedom, and those who persevere will reach heights they never thought possible.

So, what’s it going to be? Stick with me for a few more years, and I’ll see you at the top.

Bringing you my best,

Jade Scott. xx

References & Links:

1. Mental Health Australia
   Mental Health Australia Annual Healthcare Professionals Survey (2022):
   - 84% of healthcare professionals reported increased stress and pressure.
   - Burnout rates: 84% (2022), 86% (2021), 80% (2020).Available at: mhaustralia.org
2. Australian Institute of Health and Welfare (AIHW)
   - AIHW Health Workforce Report (2023):
   - 82% of health professional occupations face workforce shortages. Available at: aihw.gov.au
3. Royal Australian College of General Practitioners (RACGP)
   - Response to Burnout Among Australian Healthcare Workers:
   - Anxiety (59.8%), burnout (70.9%), and depression (57.3%) among healthcare workers. Available at: www1.racgp.org.au
4. National Disability Services (NDS)
   - Allied Health Workforce Shortages and NDIS Underutilisation:
   - Access challenges lead to underutilised NDIS funds. Available at: nds.org.au

 

Contributed by Jade Scott

Jade Scott is a leading identity within Australia’s allied health community. Having successfully established a number of osteopathy clinics in Victoria Jade recognised an opportunity to create meaningful change and innovation within the Allied Health Industry.