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The Canberra Business Podcast
A podcast about all things Canberra Business.
The Canberra Business Podcast
From Small Practice to Healthcare Leader: Dr. John Deery's Entrepreneurial Journey
What does it take to build a thriving healthcare business in an underserved market? Dr. John Deery, CEO of YourGP and chair of the Australian GP Alliance, reveals the fascinating intersection of medicine and entrepreneurship in this eye-opening conversation.
From his competitive drive to enter medicine to building a healthcare network that now employs 45 doctors and 60 staff across multiple Canberra locations, Dr. Deery shares the remarkable journey of YourGP since its humble beginnings in 2012. He dispels common misconceptions about general practice, explaining how four out of five GP clinics in Australia operate as small businesses with independent doctors working as tenants rather than employees.
Canberra residents might be surprised to learn their city faces a significant GP shortage comparable to regional Australia despite its metropolitan status. Dr. Deery unpacks the complex factors behind this shortage and his strategic approach to addressing it through doctor training and recruitment initiatives.
This episode is supported by CareSuper.
Hello and welcome to the Canberra Business Podcast. I'm Greg Harford, your host from the Canberra Business Chamber, and today I'm joined by Dr John Derry, the CEO of YourGP and the chair of the Australian GP Alliance, which was formed in 2016 to represent the interests of GP practice owners nationwide. John, welcome to the podcast. Thanks, greg, appreciate it. So let's just start with a bit of background. Your background is as a GP and you're a relatively recent founder, I think, of your GP. Tell us how that's gone and what's the business aiming to do.
Speaker 2:Tell us how that's gone and what's the business aiming to do? We started your GP in 2012, and our original aspiration was really just to have about a 10-room practice. We'd come from a. We both worked at another surgery in town, which was about eight rooms, and so our greatest aspirations at that time were maybe we'd do something a little bit bigger than that, and so we bought some land and we, through God's grace, built a lovely facility at our Christ premises, but before that time, we actually had to. When my old boss found out about our plans to run our own practice, he asked us to leave, so we had a 30-day notice period, and so 31 days later, we'd started your GP at Lynham.
Speaker 1:Right, so a little bit earlier perhaps than you'd intended.
Speaker 2:It was always going to be a difficult separation and we were very blessed to open your GP at Lynham. It was a small trainer practice. It was a three-room practice that was really waiting for us to open the door, give it some paint and like a few computers down and I'm employee one staff member, and so my wife and I started that and in 2014 we developed a the craze side, and that's a, now a 20 room facility, but it started off as a nine room facility and in 2019 we opened another practice in in Denman prospect, which is a nine room facility, and in 2019 we opened another practice in Denman Prospect, which is a nine room facility.
Speaker 1:So, yeah, so quite strong growth over that time. There'll be some people listening to this who kind of think, well, why have we got a doctor here? A GP is not a business. But really it is a business just like any other, right.
Speaker 2:So four out of five general practices in australia are run by small business owners. Um, and that goes from. You know small practices that are one or two doctors up to. You know we have 45 doctors across our group and there are other larger. You know still family-owned businesses that are gps as well.
Speaker 1:So you know we're a small business or medium-sized business, like anyone else and you started the Australian GP Alliance back in 2016 to represent the interests of general practitioners. What was that all about?
Speaker 2:the AGPA is actually, it's more about representing the owner, the interest of GP practice owners, so there was no one. We we have a professional body that represents the interest of GPS, the Royal Australian College of GPS, and there's also at the AMA, which represents on the interest of doctors as a whole, but there was no specific organization to help gp owners like myself to stay in business and also to advocate at a political level as well, and so in 2016, there was a little crisis affecting some of one of the funding streams, one of the streams of revenue for practices, and so agpar was born out of that, and so, and you know, we've found a need to keep that going over the years, and so we have about and we've found a need to keep that going over the years, and so we have about just over 80 members in our organisation, representing just north over 100 practices across the country.
Speaker 1:Fantastic. And are the issues facing GPs around the country different from state to state?
Speaker 2:When you say GPs, I'll take that as being GP owners.
Speaker 1:Yes, guys, that are small business owners.
Speaker 2:Payroll tax has become a big issue across the country. It's not affecting WA and Queensland Queensland legislated last year that any payments to GPs wouldn't be liable to payroll tax and that's always been West Australia's point of view and but the other states are trying to navigate what is a very large it'll be a very large revenue cut to owning the business of general practice.
Speaker 1:Now, of course, here in Canberra, we have the highest payroll tax in the country, which is a badge of dishonour, perhaps, for the territory. But there'll be some people listening to this who sort of think well, you know, gp practice is a business like any other. Why should there be exemptions for you, notwithstanding the fact that we need to bring payroll tax rates down across the?
Speaker 2:board. So the GPs that work within my facilities are not my employees. They're tenant GPs. I'm not their boss and in a lot of ways I provide a facility like Westfields does for its shop owners. I provide services and facilities for the GPs to be able to help their own patients and I certainly don't tell the doctors what to do patients and you know I certainly don't tell the doctors what to do.
Speaker 1:So that's an interesting point because many people probably don't think about general practitioners like that. Is that kind of the common business model around Australia?
Speaker 2:Almost 100% of GPs that are working within facilities are tenant GPs providing a service to their patients independently.
Speaker 1:So, at the back end, you're sharing facilities, you're sharing systems, presumably, but the customer relationship is with the doctor.
Speaker 2:Yes, yes, In the same way. It's a very similar model to Westfields. We want to attract patients to the facility and we want to provide service to the GPs so they can provide service to the patients.
Speaker 1:So how did you come to get into medicine in the first place?
Speaker 2:I was a competitive child and so I really just wanted to win at everything that I did, and the classroom was just another sporting field, and so I used to be a professional athlete and I just took that same attitude into the classroom and I enjoyed beating everyone there.
Speaker 2:And so medicine was at the top of the tree in terms of the hardest thing to get into, and so I set myself to do that was at the top of the tree in terms of the hardest thing to get into, and so I set myself to do that. And well, you know, I had a lot of opportunities that others don't get as well. My parents sacrificed so that I could get to go to boarding school and have good education. So, yeah, so anyway, I got in the medicine and I've enjoyed that. I knew, you know, enjoy. It's a wonderful occupation being a GP, because it's very privileged, you get to enjoy relationships with your patients over decades, and the pay's not too bad either, and so it's very easy to draw a line of sight between what you do and how you're making a difference in people's lives.
Speaker 1:Yeah, and clearly some really positive outcomes in many cases. Hopefully, all you said recently to Region Canberra that the number of GPs per capita in Canberra is probably similar to the rates elsewhere in regional Australia, despite this being a metro zone area.
Speaker 2:Can you?
Speaker 1:elaborate on that. Is it really right that we're underserved in terms of the number of doctors per capita?
Speaker 2:Well, in a metropolitan setting we are. Clearly, you know, there's a vast disparity between the number of GPs per person in Canberra versus any other metropolitan city, bar Hobartra versus any other metropolitan city other than Darwin, and really the number of GPs per person in Canberra is very similar to regional Australia. It's a little bit more, but it's certainly an underserviced population.
Speaker 1:What drives that? Do you think?
Speaker 2:That's a very tricky problem. Several things have been. I'm not really sure, really Most. Until the last 15 years most medical centres were in, not in Canberra, so we now have a medical. I'm sorry you couldn't do medical training to be a doctor and in camera, and so they would have to come to camera from somewhere else.
Speaker 2:And then the strongest determinant of where someone ends up as a, as a doctor, is a who they get married to right and so you know a lot in in the past most of those people, those relationships are being formed when people are at university and so they would tend to stay that place. I was originally thought that I would go back to more regional Australia, as I was. I'm born in water and they've been more in treatment for a while and but my wife's from camera and here I am fantastic.
Speaker 2:Well we're so sorry to answer your question. There are now medical students produced in camera, but a lot of them are choosing to leave camera because they're just not happy working in the health service here and once they leave I it's difficult to get people back. I think Canberra is a wonderful place to live and grow a family, but it's problematic to get people to move here.
Speaker 1:Yeah, and look, it seems to me, as a relative newcomer to Canberra myself, that Canberra has a bit of an image problem around the rest of the country. We've really got to work pretty hard to get the message out there that Canberra is an amazing place to live, work and play. And often, you know, I talk to people around Australia who kind of sneer at our beautiful city a little bit, but actually they haven't been here, or if they have been here, it was 20 or 30 years ago and they really don't have a good sense of what's here. Yeah, so so are you trying, how are you trying, to fill that gap with your GP?
Speaker 2:oh we, we just try to try to try to provide incredible services facilities, you know well. Now, first, our first pillar of strategy is really having our staff being really well trained and enjoying their work so that they can provide incredible you know facilities and services to the GPs working there. We figure that if our staff are providing excellent service, that the doctors will enjoy working with us and they'll provide incredible facilities and services to the patients serving them and that then drives better patient outcomes, better business outcomes and so yeah, we are quite well known in the GP community in Canberra as being a you know, place of choice for GPS to get training to be, to be trained to be GP and also even, even
Speaker 2:even in a more national spectrum. Um, you know our brand is known as well, so that's you know. Yes, so attracting GPS the Canberra is really our next um sort of focus as a business goal. Um, you know, we understand that canberra is underserviced and so, um, we've decided to focus on train. We train doctors, we want to market to and, um, attract doctors from around australia to canberra. Um, and they're also starting to put together a strategy around how to get them to come from overseas as well yeah, and that can be a little trickier right in terms of getting qualifications recognized it depends on the country that you decide to market to.
Speaker 2:So Australia has quite close relationships with Ireland, uk, new Zealand, south Africa, and the level of training at those in those countries is very similar to Australia, and so we've recently had a UK GP join us, and there he's an excellent doctor, but he still had to learn the whole system of providing health care in Australia, which is quite different even from the, and so we spent a fair bit of time, invested a fair bit of time, just training him about just navigating the particular health system differences here and so, yeah, oh, it's good that you're able to sort of put that investment and the time in.
Speaker 1:I'd like to come back to your point about getting your staff to be well trained and enjoy their work, and that's often a challenge that many business leaders have is how do you, what is it that you do that helps encourage enjoyment in the workplace and and and build that that great sort of team engagement um, we, um, about 18 months ago we started.
Speaker 2:We realized that, uh, so about 18 months ago we realised that mostly how employees Employees want to know three things, and I got this from a book called Drive by Dan Pink, and if you want to just watch the YouTube video, it's 10 minutes a lot faster.
Speaker 2:But people want to be paid enough so they're not looking for another job and so they can afford to live where they are.
Speaker 2:And then I want to have mastery, autonomy and purpose, and so you know, we, we want to train our staff really well so that they can have a sense of mastery once they're trained appropriately well. You know we're not going to stand over the top of them and tell them how to do it, you it, so they can have autonomy and a sense of purpose is something that I was grappling with for a while, and so we actually started having a series of All of our staff should have at least one one-on-one with their coach. We don't call our managers managers, we call them coaches. They should have at least one one-on-one with their coach every month, and that's an opportunity for that coach to help them, to see, you know, the work that they're doing, how let's impact these people's lives, so helping them to see a sense of purpose as well, and and then we measure we measure how engaged our teams are and how well trained they are, and because we want to.
Speaker 2:You know, I really want to make. If you're turning up to some place for 40 hours a week and you're earning a wage and you're hating your life, I'm not interested in that. You know, I really want people to be able to sense a greater purpose and to see how they're impacting the lives of others.
Speaker 1:Yeah, so how big is your team overall? So you've got 29 consulting rooms. Yeah, sorry, we've got 33 consulting rooms.
Speaker 2:Yeah, sorry, we've got 33 consulting rooms and we have 45 GPs and I think we've got about 55 to 60 other staff.
Speaker 1:Right, so that's quite a big team overall. Is that sort of ratio of support staff to GPs about standard in the industry?
Speaker 2:Yeah, it depends on the model of care you want to provide. Things can be done much more efficiently, but that's with much less. It depends what you want. We want to provide a really caring environment for our staff and for the GPs and for the patients, and we invest a lot in that, and so you could definitely do this a lot more efficiently than the way that we do it, and we have some profit goals that we want to achieve as well, but really, for us, profits it's a component of having a sustainable business. It's not our reason reason for existence, though. The business is profitable, and because we want to, we have to invest in more facilities and more services for more doctors and keep providing excellent care in other locations so so what is the vision for the business expansion here in Canberra, or are you looking to go national?
Speaker 2:oh, I think we'll just start with keeping on expanding. You know, you know, camera first, we still several operational things to solve before we start growing. We really we want to, meaning our vision, I suppose, is to meaningfully impact health outcomes and and so we have some metrics around that as well. But you know, we are in the process of looking at. I've got we have a DA application in and it's six year for another side in Amaru and we're having some trouble purchasing air rights from the ACT government, and but we're looking at two other sites in town as well currently six years for a day or some of it was our own.
Speaker 2:I was happy to pause that over COVID.
Speaker 2:And then we've we've had some internal you know, we had a tremendous growth that wasn't healthy over the COVID period. You know we did 60,000 COVID vaccines, we did 30,000 or 40,000 COVID assessment visits and that caused a rapid expansion in the team and that unbridled growth. We're still working that out. And there were some poor decisions made by myself as well. We decentralised some of our services and that was in hindsight a mistake and so we're bringing those services back into the businesses now, into the, into the actual practices, as opposed to um having a separate site and um that's taken some time for us to get to. The, you know, root cause of those operational issues and so um cause of those operational issues.
Speaker 2:But those operational issues are rapidly. We're obviously looking at more sites, so those operational issues are very close to being solved now.
Speaker 1:Fantastic. Well, we wish you luck as you progress those new sites over time. In medicine and, I guess, in general practice, there's a lot of talk about the future of technology. There's talk about telehealth as a solution to some of the GP shortages. Ai, of course, is on everyone's lips at the moment. What's the role that you see in the foreseeable future for new technology coming in to help you drive productivity?
Speaker 2:Sure Telehealth is. You know it's a helpful accessory tool that will never, never take the place of face-to-face care. You know obvious. You know you obviously cannot examine a patient if they're not in the room with you, or you can do a very limited version of that. And and also, to be frank, the GPs really don't enjoy providing telephone care to patients. It's much more enjoyable to do that and sustainable for them to do that in a face-to-face manner.
Speaker 2:Yeah, look, as with any other business, if you weren't starting to take stock of the changing role of technology and how it's going to impact your business, then you better start thinking about it now. And how it's going to impact your business, then you better start thinking about it now. We are already utilising AI within our business all the time. You know it's excellent at helping with. You know formulating draft documents, you know taking minutes, that sort of stuff. We are putting into place some tools to help our reception team to be more efficient and over the next few months we'll be rolling out some AI receptionist to take simple phone calls. And if you, um, actually we haven't got this in place yet, but um, one of my sideline businesses is I provide most of the vasectomies in canberra, and so, um, we have a ai receptionist in the works. His name is snippy and, um, and snippy is full of banter. When people call to make a appointment with john, he's not available yet, but, um, that's not too far away and that won't be.
Speaker 2:That won't be replacing our receptionist. Um, that'll be just taking away the a lot, of, a lot of calls on the phone. You know I'd like to make an appointment, and so you don't need a highly trained receptionist to be able to do something as perfunctory as that. Yeah, and so that's one of the ways that things that were changing at work. Then there's the role of the doctor as well. You know I I will certainly be a decision assistance support tool in the future. It probably won't ever be licensed to be used as a doctor replacement. That's a big deal, and AI has an error rate. It hallucinates between 1% and 5% of the time and medicine is a no-error zone. You don't want to get things wrong in other businesses. You can afford to have some errors.
Speaker 1:Um, you know healthcare, uh, finance, financial, um services, um, you can't afford mistakes and so I will certainly help doctors to make less mistakes in the future do you think your customers, your patients are ready to ring up and talk to an AI receptionist?
Speaker 2:We're going to trial it. So we've actually trialled having an AI receptionist several years ago and the AI was fairly poor and our patients kept persisting with it. We trialled it for about six months and just the product wasn't ready. That was two or three years ago and so if they would, you know they've, they've their time. Patience, time is valuable and so they'll make a decision. I've had really ridiculously good conversations with AI over the internet that lives in America about the NRL and and.
Speaker 2:I figured wow, we're talking football as if you can't take, was it take? Take, take some phone calls for me. So some patients will never want to speak to an AI. But um, online, online appointments never used to be a service and now that's about 45% of our appointments are made via someone booking through an app on a phone or through a web portal, and I think there'll be a similar option with AI receptionists in the future.
Speaker 1:Yeah, it's interesting. Do you think that your customers like, if you're introducing an AI tool to take those bookings, you're going to free up something somewhere? Do you think it's going to be migration from your online booking tools? Or do you think it's going to be migration from your online booking tools? Or do you think it's going to be migration from the real calls that you're getting at the moment?
Speaker 2:I think we'll be tracking those numbers. I think it'll be mostly the people calling in, but that's a good insight that you've had, greg. I think that the online booking tools, the platforms that are out there, might face some significant challenges themselves in terms of people won't be utilising their services as much because it's going to be so easy to ring and make an appointment over a phone.
Speaker 1:Oh well, we'll have to get you back in a few months and find out how Snippy's going and check in on how the AI is working. Certainly, the technology I know has improved streaks and bounds over leaps and bounds, I should say over the last couple of years. So it's interesting to hear about real-life situations where they're being implemented.
Speaker 2:Another our doctors are all utilising about 15,. I think 20% of our GPs are now utilising AI to assist with note-taking, and so the patients will give consent for this to occur, and the AI is listening and on the conversation and it does an excellent job at summarizing the console and the various issues that have been addressed, and it's so much faster than to generate a possibly a referral letter or a list of actions for the patient to follow through after the consult as a result of that, rather than the GP sitting there typing with two fingers.
Speaker 1:Yes, yeah, and we're seeing those sort of note-taking tools rolling out increasingly right across the business community. So my guess would be many people are becoming quite used to them as a commonplace thing. If you could change one thing about how general practice works here in Canberra, what would it be?
Speaker 2:Oh, if I could change one thing about how general practice works in Canberra. I think affordability for patients is becoming more and more problematic at the time, and the payroll tax issue that's occurred within Canberra recently has also definitely led to increasing out-of-pocket expenses and yeah, so some sort of mechanism to you know keep seeing a doctor affordable would be wonderful.
Speaker 1:And finally, I guess just to close. You obviously built a successful business through your GP, but what advice would you have for those who might be wanting to follow in your footsteps and take on ownership of a general practice?
Speaker 2:Well, stephen Covey said, start with the end in mind. And so you know, have a good think about you, know where you want to end up first, and then numb. You know, because what does the glass say? You know, if you, if you aim at nothing, you hit it every time, and so having a good idea of where the end is will help you to work backwards to where one of the first steps you need to take in that journey. You know, most people just do what I did and they just open the door and hopefully with no thought about where they want to be, and they hope that people will come in and see them. So that would be my number one takeaway.
Speaker 1:Excellent, dr John Deary. Thank you so much for joining us here on the Canberra Business Podcast. It's been great hearing a little bit about your business and about the model that applies kind of in the general practice sector, but, most importantly, fascinating to hear about the role of technology and AI as that evolves over time. Thanks for joining us. It's been great having you here.
Speaker 2:It's a pleasure Thanks.
Speaker 1:Greg, and just a reminder that this episode of the Canberra Business Podcast has been brought to you by the Canberra Business Chamber with the support of Care Super and Industry Super Fund, with competitive fees and returns, exceptional service and a focus on real care. Don't forget to follow us on your favourite podcast platform for future episodes of the Canberra Business Podcast, and I'll catch you next time.