3 minutes
Melbourne-based gastroenterologist Dr Luke Crantock finds plenty of meaning in a quote from the famous American motivational speaker Tony Robbins: “Every problem is a gift, without a problem, we don’t grow.” With that in mind, the process of building his own private hospital with his colleagues Dr Rusli, Dr Sorrell and Dr Mahindra must have been like Christmas—a series of ‘gifts’ culminating in the ultimate ‘gift’ of a global pandemic as they prepared to open the doors.
After 25 years working in and around Victoria’s public health system, he was frustrated. “On a personal level, I didn't accept the culture of the public system,” Dr Crantock explains. “It didn't sit with the way I felt patients should be managed. We all need to place ourselves in our patients’ shoes and respect the care our patients expect. Health systems don’t always do this very well for many reasons.
“To be honest, I think the chaos and enormity of public health was doing my head in, and I know I'm not alone. I think most people feel that way when they've been working in public health for a long time. They end up not being able to practise the way they would like to. There are many invisible constraints.”
Dr Crantock had seen plenty of examples of hospitals working well for both patients and practitioners. After completing his undergraduate training and fellowship in Tasmania, he took on advanced training in gastroenterology in Brisbane. Then he headed overseas to Edinburgh, Scotland and Oxford, England as well as visiting the Edouard Herriot Hospital in Lyon, France, where he encountered endoscopic ultrasound.
“It was a bit before that technology found its feet in Australia,” he explains. “Other specialists were doing endoscopic ultrasound in France, and they were very good at lots of procedural stuff. It was a fascinating hospital.”
For him, the appeal of gastroenterology as a clinical specialty, was how it covered the full experience of being a hands-on physician. “It offers diagnostic, patient intervention and consultation, and also the potential for research,” he explains. “You have the opportunity of seeing patients, talking with them, getting to know them and their problems, but also have the opportunity of diagnosing through endoscopic evaluation and doing therapeutic interventions. Those are all sorts of things that we do that makes it an interesting and rewarding clinical specialty.”
He returned to private practice in Melbourne in 1993, while also working at Monash Health, known then as the Dandenong Hospital. In his private practice, Gastrointestinal Health (GIH), he consults from two main sites in Berwick and Mulgrave and works out of two medium size private hospitals as well. “There are seven other gastroenterologists in our group now which makes the environment very stimulating as we have diverse interests, some of my colleagues still work the majority of their time in the public system whilst others work with their major emphasis in private clinical practice.”
While Dr Crantock’s frustration with public health delivery was clear, access problems also exist with the larger private hospitals.
The problem, in a word, is expense. “The population has really expanded very rapidly in south-eastern Melbourne,” he explains, however private insurance rates are well below 50 per cent. “For patients who are not insured, it has become difficult for them to pay for private procedures. Our group recognised that many patients therefore weren't presenting for the investigative procedures they required, and we really couldn't offer them the clinical services they needed without opening our own efficient more affordable centre.”
Upon this realisation, Dr Crantock’s practice manager at the time noticed a development happening within 10km of the primary practice site. The opportunity it presented—being able to create a purpose-built centre that could provide a more affordable option for clinical diagnosis—was too good to pass up. But then came the problems—or ‘gifts’, as Tony Robbins would say. The first gift was the budget. “It was like watching an episode out of Grand Designs,” says Dr Crantock. “The budget always gets stretched, and it becomes quite a headache for everybody.”
Next, was the reality of building. “Trying to get a fit-out to the standard that's required for accreditation was a challenge. Educating the builders to understand what was necessary was also a challenge.” Then halfway through the process, one of the architects was diagnosed with leukaemia. “We had to start again,” he said. “So it did take a couple of years to complete the centre and finally get it up and running, but we very proudly opened … about a month before COVID.”
Directions from the Health Department during the pandemic meant they could only do very limited procedural work. “We had a pretty rough 12 to 18 months,” he says. “Things expanded after about 14 months, when the health directives allowed us to undertake category one and some category two patients, but not category three patients, which excluded many of our patients including some presenting for bowel cancer screening. As the COVID crisis waned and restrictions were finally lifted we were able to expand our scope of care and now we’re up and running to capacity.”
One constant in the process has been the group’s relationship with BOQ Specialist and particularly Melinda Goddard. “We've had a relationship with Melinda for a long, long time and she's been a key part of the financial side of our practice,” he says.
“She’s been there to provide us with assistance whenever we had to lease equipment as well as other aspects of the business. So, she was an obvious choice when it came to financing this centre.”
With the support of BOQ Specialist and his team, the future is looking busy for Dr Crantock’s new ventures, Officer Endoscopy and a joint service called GIH Access Endoscopy. He’s looking to expand the current roster of specialists, and he’s also exploring the idea of doing some research.
“One of the good things also about running your own clinic is that you can look carefully at issues such as polyp detection, you can assess patients with Barrett's oesophagus and Helicobacter pylori and start writing some of the clinical data up. So, we've got that aspect of it to look forward to,” he says.
And in the meantime, he takes heart from an observation by another famous, inspirational American.
“There was a quote from Steve Jobs that I quite liked; “an overnight success always takes a long time”. When we were developing the place, it was good to be reminded of that. The biggest challenge though was really with COVID, to be honest. That really was a massive handbrake, I mean for everybody of course, but that was our biggest challenge. Opening just when that hit couldn't have been worse timing in some respects. But we have overcome that, and I think it's made us stronger.”
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