Meet Mo Alvi: a physiotherapist and business owner with a passion for working with people

A budding entrepeneur in his teens

Now with 16 years as a physiotherapist under his belt, Mo first dipped his toes into the business world as a teenager in Lancashire, supplying cut-price fashion ‘package deals’ – pairs of locally-produced Kickers shoes coupled with pairs of Joe Bloggs jeans – to schoolmates.

‘My father had always been in business and I think it was inevitable that I would be something an entrepreneur too,’ he told PhysioUpdate.

In his teens, Mo also travelled regularly to markets in Lancashire – even venturing as far as north Wales – selling items of clothing known as ‘factory seconds’ from a stall. He recalls arriving at pitches at 4.30 am to prepare for the first customers. At closing time, the stall would need dismantling and any remaining items re-packing before the journey home.

Learning to work hard, make deals and mix with people from all walks of life have all stood him in good stead in his career, Mo believes. However, he admits his schoolboy business ventures did not make him rich – much of his earnings went on buying meals from food stalls in the market.

Human physiology degree: a 'first', despite distractions

Despite the distractions from schoolwork – Mo was also a keen sportsman at school, playing football and cricket at a fairly high level – his A-Level grades enabled him to study human physiology at the University of Newcastle, where he gained a first in 2002.

‘I was always fascinated by how the body worked, and physiology broke things down: not just at a cellular level, but at an ionic one.’

Mo admits he was far from being a model student, frequently skipping classes to pursue other interests. ‘In truth, the lectures often bored me, and I discovered that I preferred studying by myself, learning the topic almost from scratch before an exam, and taking my self-directed studies as far as I wanted to.’

Next step: a degree in physiotherapy

Though Mo’s career path wasn’t constructed as carefully as it might appear in hindsight, his grounding in human physiology provided an ideal stepping-stone into his next venture: a three-year physiotherapy degree at King’s College London.

Though grateful for the financial cushion offered by an NHS bursary, meaning no tuition fees, Mo still grafted outside the course. He recalls, for example, being a physiotherapy assistant in London’s East End on a weekday or two, while co-ordinating a team of delivery and collection drivers in the West End over two consecutive 12-hour shifts at the weekend.

‘I almost fell into physiotherapy at the time, and, though I did want a vocational career, it wasn’t a hugely calculated move. But now, in my early-40s, I realise it was the ideal career for me,' Mo explains.

There’s an aspect to physiotherapy that’s not often articulated. Yes, there’s a mechanistic side in, say, MSK work, but you’re not dealing with a mechanism: you’re dealing with a person, an organism [Mo Alvi]

People are 'organisms, not mechanisms'

‘I have an analytical, scientific side, but there is another part of me that’s always been aligned with nature. I was a keen gardener from a young age, for example, and loved animals.

‘There’s an aspect to physiotherapy that’s not often articulated. Yes, there’s a mechanistic side in, say, MSK work, but you’re not dealing with a mechanism: you’re dealing with a person, an organism.

‘Combining that with the fact that I love being around people and communicating, physiotherapy’s been the ideal profession for me.’

On graduating, Mo says there was a temporary ‘glut’ of people like him – with openings in the NHS at a premium. ‘I was relatively lucky, in that my last placement had been with a respiratory team at Kent and Canterbury Hospital [some 60 miles east of his base in London]. The trust was very keen for me to join them and my application was successful.’

Despite feeling relieved, Mo – in a move that perhaps reflects his youthful self-confidence and resourcefulness – asked for a six-month break to recharge his batteries. ‘I had done back-to-back degrees and held down three part-time jobs at the same time. I was tired,’ he recalls.

China-bound for a 'rest' before taking up first NHS post

When his request received the green light, Mo moved to the Chinese capital Beijing, where he taught English to university students studying to become airline pilots.

‘Having an Asian background, I found there was no culture shock. It was brilliant: I loved the difference and learned to speak some Mandarin – at least to the extent of being able to order a meal in a restaurant or ask for directions on the street.’

Duly refreshed, Mo fulfilled his commitment to the NHS and moved to east Kent to take up a rotational post as a junior physiotherapist in the mid-2000s.

‘Within 18 months or so, when I was still in my late twenties, I was appointed as an MSK specialist physiotherapist at the Queen Elizabeth The Queen Mother Hospital in the seaside town of Margate.

‘At the time, the hospital had a cohort of outpatients from areas with a lot of social deprivation where there were also a lot of mental health issues. Treating people with persistent pain all the time can be emotionally quite draining, especially as there was limited guidance available then.

‘You were not really prepared for this kind of work at university but, luckily, I had some amazing colleagues to discuss things with. One was a physio called Mike Stewart, who has, among other things, gone on to run international training courses on dealing with persistent pain. See: https://www.knowpain.co.uk/

A physiotherapy business is born 

Mo was also struck by a growing realisation that MSK outpatients had to follow a ‘very long-winded, bureaucratic process’ before actually seeing a physio. ‘As a result,’ he says, ‘I put together a presentation – or “business case”, I suppose – for local GP practices, the first being the Park Practice in Herne Bay.

‘I said there is something really wrong here. Why can’t your patients see me here, instead of going miles to the hospital? The GPs and I can all work from the same medical record and cut down on paperwork.

‘I explained I could also screen patients in-house who would traditionally have been referred to orthopaedic surgeons. If it became clear this path was necessary, I said I could supply a much more detailed letter than the GP, as it’s not their speciality.’  

Eventually, Mo’s business case won approval from what was the primary care trust (PCT) at the time, and he began seeing patients in evening sessions outside his NHS post. When PCTs were replaced by commissioning groups, the funding was capped – despite the fact that his model was saving the NHS considerable amounts of money. For example, he points out, physio time costs a lot less than a surgeon’s. In addition, fewer MRIs were being conducted and less medication was being prescribed.

Returning to London and a surprise offer

But, after a couple of years in this role, Mo found himself itching to return to London, and landed on his feet at Northwick Park and Central Middlesex hospitals. He did, however, recruit physios to cover the GP surgery sessions in east Kent and kept his fledgling business venture ‘ticking over’. ‘At the time,’ he says, ‘it was more to do with wanting to help the practice than anything else – any profit margins were very modest.’

During this period, Mo married Dr Shabana Issa. The couple had met up in London, some years after briefly working together at the hospital in Canterbury. Then, out of the blue, the Herne Bay GP practice manager called to say the new NHS procurement model meant they now had funding to create an autonomous MSK service at the surgery. Would he consider running it for them?

Though it meant long commutes and staying overnight locally on certain weekdays, Mo accepted, and spent four days a week seeing MSK patients at the surgery. ‘Gradually, by virtue of being in the practice and nurturing strong relationships with the team – while my skills were also developing – it became clear that patients were getting a first-class service.’

One innovation was to combine record systems so that physios and GPs shared the same electronic notes (previously physios has used paper notes and body charts that would eventually have to be archived). ‘Templates were developed that made it easy to conduct audits and meant GPs were kept up-to-date.’

I became increasingly aware that I was seeing patients with mental health issues that were manifesting as physical health ones. If this wasn’t picked up and dealt with ... patients could be sent down a path that led to a spiral of decay [Mo Alvi]

A 'passion' for working with people

Mo has never been one to stand still. ‘Over the years, I became increasingly aware that I was seeing patients with mental health issues that were manifesting as physical health ones. If this wasn’t picked up and dealt with by the first contact clinician, patients could be sent down a path that led to a spiral of decay: the anxiety, the pain and the isolation would go up. Patients could be over-medicalised, over-pathologised and over-investigated. In short, they were treated as a mechanism rather than an organism.’

Mo says he has always been driven by ‘being passionate about something’, rather than developing a business for its own sake. ‘I realised that I felt passionately about working with people. As clinical professionals we are very fortunate: something very special is exchanged in one-to-one situations with a patient.

‘If you do your job with a level of openness, humility and vulnerability, then you have the privilege of being able to experience that connection. That is the joy of the job, though there can also be some ambivalence or sadness about the situation the person is in.’

Rebranding the company as Level Health

Mo’s company was initially called Primary Physiotherapy, a title he rebranded as Level Health in 2018 to reflect the holistic approach he espoused. He ran workshops on handling persistent pain and lower back problems for GP consortiums and clinical commissioning groups; gradually, through ‘word of mouth’ his business grew and now provides services in 16 practices.

‘For them, what I was offering was the best of all possible worlds: it is more efficient, saves money on consultant referrals and means patients get the best care.’

Mo is clearly someone who lives by the motto: ‘work hard and play hard’. ‘I’m generally in love with the business, but sometimes it does get challenging. It’s like an organism that always needs taking care of, but the great thing is that it gives you a chance to create a better work-life balance.’

Scaling new peaks

Mo and his wife, A&E consultant Shabana, live in an area of east London that offers easy access to pretty Essex villages and the vast expanse of Epping Forest. ‘If I want to work in the morning and take the afternoon off, I can. The forest is beautiful and it’s ideal for walks and bike rides,’ he says.

In his spare time, Mo is a keen mountain climber. To give a flavour of his skill level, Mo describes a relatively recent ascent of Ben Nevis (the UK's highest peak) as ‘a walk’. Once the Covid-related travel restrictions ease, he hopes to join an expedition to the Himalayas, providing physiotherapy back-up to Nepal-born climber Hari Budha Magar, who lost both legs above the knee while serving with the British Army in Afghanistan in 2010.

For more information, visit: https://www.levelhealth.co.uk

Author: Ian A McMillan