MEDICINE OR BUSINESS?
This was the career decision Dr Heah Sieu Min faced - and made - more than three decades ago, after a night with little sleep while on guard duty in the Singapore army.
Today, Dr Heah, 53, who grew up in a family of rubber estate owners, experiences the best of both worlds - the successful colorectal surgeon is also the founder and chief executive officer of SGX-listed HC Surgical Specialists.
"It was 1984 and I was 20 years old, in national service, when I had this eureka moment," recalled Dr Heah, who graduated from the Royal College of Surgeons in Ireland (Dublin) with a Bachelor of Medicine and Bachelor of Surgery degree in 1990. He started his medical career as a houseman in Ireland, then returned to Singapore in 1991 to complete his national service.
In 1992, he was awarded traineeship in general surgery, and took on the role of medical officer at Tan Tock Seng Hospital. After obtaining his Fellowship of the Royal College of Surgeons (Edinburgh) qualification in 1994, he held various positions at Singapore General Hospital - including medical officer specialist, registrar, associate consultant and consultant of the department of colorectal surgery - till 2004.
He then spent just under three years as consultant in colorectal surgery at Pacific Colorectal Centre (Pacific Healthcare) before starting his own practice - Heah Colorectal Endoscopy & Piles Centre - in 2007 at Mount Elizabeth Medical Centre.
When Dr Heah began his private practice, he considered endoscopy, which would offer a stable income due to demand as well as provide him with opportunities to treat patients with conditions such as haemorrhoids and colon cancer, further supplementing revenues.
Having trained as a surgeon, Dr Heah prefers to be in the operating theatre. "However, to be successful in private practice, one needs to strategise. I decided from the beginning I would focus on endoscopy. Since I don't see any credible substitute for this service, demand should be sustainable over the long term."
VALUE FOR MONEY
Venturing into the heartland to set up clinics was also a deliberate plan. "If you have only a centrally located clinic, you end up competing with the majority of surgeons for the same pool of patients. The likelihood of attracting patients from the heartland is low, because they invariably have the impression that you are expensive," he said.
"But when you have a presence in the outlying residential estates, your catchment area is much wider, and there's no one else in private practice who provides the same service. As a result, you can cater to patients who would otherwise be destined for restructured hospitals. Generally, we can streamline our service for patients to offer shortened waiting times."
Dr Heah has since expanded his practice to five other locations - Bukit Batok, Hougang, Tampines, Farrer Park and d'Leedon condominium. This year, two more centres with endoscopic facilities will open in the heartland.
His motto is to offer patients quality healthcare at their doorstep. "In the heartland, you can help more patients by being next door to them and offering affordable prices, particularly for those with tight budgets. All our centres are, or will be, Medisave-accredited, and we're on the panel of many major insurers... Rentals are also cheaper, and it's easier to control your overheads."
Ironically, a specialist's reputation in the heartland rests on the success of his centrally located clinic, he pointed out.
"It's not good, image-wise, if you were to head straight to the residential areas without first setting up shop in Orchard Road, or Mount Elizabeth Medical Centre. Patients will tend to think you're based in the heartland because you couldn't succeed in a central, competitive environment."
In September 2015, Dr Heah founded HC Surgical Specialists with Dr Chia Kok Hoong, who was appointed the group's chief operating officer. The company, which derived its name from the founders' initials, was listed on the Catalist board last Nov 3, via a placement of 30 million shares at 27 cents apiece.
The group includes colorectal surgeon Lai Jiunn Herng and general surgeon Charles Tan as well as general practitioners Malcolm Lim and Tan See Lin.
HC Surgical has a market capitalisation of more than $85 million. Its shares more than doubled on their trading debut, closing at 55 cents, up 103.7 per cent from their initial public offer price. In the year-to-date, the stock has declined 5.7 per cent to 58 cents, but is still 115 per cent above its issue price.
The group offers endoscopic procedures, including gastroscopies, colonoscopies and general surgery, with a focus on colorectal procedures. Common conditions treated include haemorrhoids, gallstones, hernias, colorectal cancer, stomach cancer, as well as thyroid conditions.
It has a network of 12 clinics that spans central Singapore and the heartland, with some situated within major private hospitals.
Between the financial years ended May 31, 2014 and 2016, HC Surgical Specialists averaged a revenue of $7.2 million and an attributable net profit of $3.1 million. It intends to pay out at least 70 per cent of its profit after tax as dividends for FY2017, FY2018 and FY2019.
Following its listing, HC Surgical continues to look out for opportunities to strengthen its local presence. To grow the patient pool and increase the range of speciality treatments available, Dr Heah plans to collaborate with other GPs through joint ventures, as well as acquire specialists in other fields.
In February, HC Surgical completed its acquisition of Julian Ong Endoscopy & Surgery for $2.2 million. The inclusion of Dr Ong in the group's stable will enhance its capabilities.
But finding the right talent for the group may be a challenge, as physicians by nature are hard to manage, Dr Heah admitted. Some of that experience came from managing doctors in his role as commanding officer of 1 Combat Support Hospital from 2008 to 2013, during his NSman days.
Singapore as a medical tourism hub is also facing stiff competition as costs escalate.
HC Surgical is increasing its exposure in Asian markets. In January last year, it entered into an agreement with an independent party to provide consultancy and training services at the Transport Hospital in Hanoi, Vietnam.
The group will assist Transport Hospital in establishing a day surgery and endoscopy centre, where its specialist surgeons will have exclusive rights to perform surgical and endoscopic procedures for a stipulated period of time.
"Because Vietnam is less saturated than China, this market offers a lot more opportunities," Dr Heah noted.
WALK THE TALK
Having a heart for patients is another must. "The patient always comes first," he pointed out. "Do no harm, cure often, and comfort always."
While many doctors have the skills to perform scopes and operations, the degree of attention to patient welfare is a key differentiator.
To this end, staff training and morale are key. "I challenge my staff to provide service standards that exceed most patients' expectations. It may sound difficult, but difficult is not impossible," he added.
Dr Heah, whose wife is a doctor with her own practice, has a daughter, 22, and a son, 20.
Working 12-hour days, starting with early morning visits to hospitals to check on patients, followed by clinic appointments with endoscopy and surgical procedures, often at different locations across the island, is his usual routine. He ends the day by catching up on administrative matters and business meetings with company personnel or other doctors.
"We're a close-knit community, and we usually come together to talk about partnerships, acquisitions and the latest industry developments," he added.
• This is an excerpt from Singapore Exchange's Kopi-C: the Company Brew, a regular column featuring C-level executives of SGX-listed companies. Previous editions can be found on SGX's My Gateway website www.sgx.com/mygateway