Physiotherapy market leadership was the first round of the Fysios’ game

Sports, sauna and the development of business ideas. This was the programme for a weekend outing for Heikki Tiitinen, Pasi Syrjä, and their old student friends.

The friends had met at the University of Jyväskylä's Faculty of Physical Activity and Sport Science, and since they enjoyed each other's company so much, wouldn't it be nice to work together? One of the sauna evenings’ ideas had been to set up private schools in Finland. The idea was even pitched to venture capitalists, but a concrete wall of bureaucracy stalled the project. But the entrepreneurial desire to work together remained alive.

Tiitinen worked as the CEO of companies owned by the Miina Sillanpää Foundation. The Foundation organises, promotes and supports, for example, the rehabilitation of the adult population, and as part of this task, the struggling physiotherapy company Fysiosporttis became part of the Foundation group. Syrjä stepped in to pull the loss-making Fysiosporttis out of the red. The reform was brutal, but it worked. The problem company turned into a firm with healthy business operations.

At the same time, Tiitinen and Syrjä began to understand physiotherapy better. Less than ten years ago, physiotherapy was a poorly known form of rehabilitation that doctors referred people to, but the two of them believed there was potential for more.

Could this be their joint project? The thought jumped into action: What if they built a physiotherapy chain covering the entire Finland?

At Vaaka Partners, the creation of service business chains had been followed. Terveystalo, Mehiläinen, and Oral Hammaslääkärit had spread rapidly by buying up local operators.

The logic was clear. A small company in a fragmented industry employed a few professionals, someone or some of whom owned the company. The company was run alongside the main job, and administration was a necessary evil.

In a chain, the chain leaders could concentrate their efforts on thinking about the smartest way to organise things. Experts, on the other hand, could focus on their professional work instead of the routine tasks of financial management. The chain could market itself in a completely different way than a small firm with a few people in a building in the yard of an apartment building. Some customers clearly wanted a partner that would operate all around Finland.

When Tiitinen and Syrjä came to meet the people of Vaaka with their new idea, they all seemed to speak the same language. The plan quickly took shape. The plan was to collect a few physiotherapy companies as a platform and then connect with other companies. Fysiosporttis, based in the metropolitan area, could serve as a starting point.

In March 2015, less than a year after the first discussions, Fysios was established. It consisted of Fysiosporttis, which was bought from the Miina Sillanpää Foundation, and six other companies operating in Finland's largest cities. The total turnover of operations was just under nine million euros.

"We have an experienced team of professionals at our disposal at all times, who share our goals as owners and whose services cost us nothing," says Heikki Tiitinen, CEO of Fysios. Vaaka’s experts can be asked for advice when there are questions concerning company management.

One of these main issues was the reform of the management system of Fysios in 2019. It was then decided to double the number of supervisors. Another example is digital marketing: when a customer searches for a solution to their problem on a search engine, they need to be brought to Fysios’ website and offered available appointments for the current and subsequent days.

Shin splint. Click. Initial 45-minute appointment available in an hour and a half, 75 euros. Click.

The private equity investor also has ready-made processes for completing business acquisitions. Since then, the company's operational management has also gained experience. By summer 2021, 66 companies will have joined Fysios in addition to the original seven. Turnover has increased to EUR 50 million, and the number of clinics has risen to over two hundred.

Physiotherapy is a local service: the client wants easy access to treatment. Therefore, the network of clinics must be dense and easily accessible.

"At the heart of it all is a good therapeutic relationship that delivers value to the client and the therapist," says Pasi Syrjä, Deputy CEO of Fysios. "The rest is a consequence of that."

Supporting the work of therapists and keeping them satisfied is essential to the success of an expert company. The company has its own Fysios Academy, which, despite its fancy name, not only educates therapists but also creates a common culture.

"We provide therapists with the platform and the tools."

While Fysios has grown, the value of physiotherapy has increased in different directions. On the one hand, it has emerged as an alternative to surgical treatment and helping elderly people out of their chairs. On the other hand, people who are active in sports are exchanging tips about physiotherapists in the same way as they used to do about massage therapists. Fysios, which has become a market leader, has been instrumental in implementing this change.

Interestingly, Fysios is fulfilling the mission of the Miina Sillanpää Foundation, Tiitinen and Syrjä's former employer. Under the Foundation's ownership, it is unlikely that business would have expanded at this rate or that the market would have changed. Sometimes an effective way to do this can be to sell operations to enthusiastic developers.

According to Tiitinen and Syrjä, Vaaka has given them the courage to do things with an open mind. For example, when the coronavirus emptied physiotherapists' treatment tables and booking books in the spring of 2020, several competitors stopped marketing. Fysios increased it.

Vaaka's partner on the board of Fysios, Antti Salmela, says that in Fysios, the PE investor has sometimes had to put on the brakes, whereas usually the opposite is true.

Vaaka and operational management have jointly defined and focused. It has been a step-by-step process: first, becoming number one in physiotherapy, then expanding to other therapy services.

"Increasing turnover from just under ten million to fifty million has been the first round. The second round is to increase it to 150 million euros. The organisation believes that the second round will be easier than the first," the men say.

With the transactions made last year, Fysios played out the first round. It is the number one in physiotherapy in Finland.

The second round has begun, with the final whistle set to 2025.