Unifying force

Seven years. That’s the average amount of time between the onset of symptoms of endometriosis and the provision of a formal diagnosis. It’s an unacceptable amount of time for any condition, even for one that is so difficult to detect with regular sonography. But for obstetrician and gynaecologist Dr Lauren Hofmann, the whole situation was made much worse by the siloed nature of healthcare in the public health system.

“What I was seeing in my training and as I was going through my fellowship was that everything was quite disjointed,” she explains. “Often in women's healthcare, you get the best outcomes if you have more of a collaborative approach. For example, I look after lots of women with pelvic pain. And we know that women do very well when they have collaborative care between pelvic floor physiotherapists, reproductive dietitians, reproductive endocrinologists, gynaecologists and then gynaecological surgeons. But I couldn't find anywhere that was bringing these people together.”

As she continued her training, an idea of a practice started to form in Dr Hofmann’s mind. “My goal was always
to make a practice that could improve women's access not just to surgery, but diagnosis,” she says. “And to try to improve their pain.”

The need for collaboration

The pain of endometriosis is physically debilitating, but it’s further compounded by the psychological stress for patients navigating doctors, specialists and allied health services. A number of times, while she was training at Westmead Hospital in Sydney, Dr Hofmann would encounter frustrated patients whose treatment was hampered by poor communication between the different teams looking after their health. Every time they saw a new specialist, they had to tell their whole story all over again. On top of that, as a surgeon, she knew there was a strong correlation between good-quality ultrasound in detection of endometriosis and then having high-quality surgery, but often patients or other teams were unaware of, or unable to afford, the correct sonography.

“In the last two years of my fellowship, I did another qualification, my Diploma of Diagnostic Ultrasound in women’s ultrasound as well,” she says. “Because I could see that there was this gap. Sometimes we would take women for operations, and it was almost like you were going in blind because they couldn't afford the proper deep infiltrating endometriosis ultrasound that we use. That is the mapping ultrasound that then guides what surgery you're going to have. I was seeing women come for surgery who were potentially not worked up as well as they could have been because access to deep infiltrating endometriosis ultrasound was so limited.”

The solution was clearly having a team of doctors and allied health professionals collaborating closely on each case, but in practice this hardly ever happened. “Sometimes, you can feel really lonely as the practitioner in this space,” she says. “Because you think, as well as the correct ultrasound, what my patient probably needs is either psychological support, for example, or physiotherapy. We can't be all things to our patients, so you need the team. And you also need the team to have a clear vision and a clear goal, and to communicate beautifully so that the patient can feel well-supported and well taken care of.”

Finding the finance

Then one day, while working at the Sydney Adventist Hospital at Wahroonga in Sydney’s north, she drove past the new Parkway development there and saw a sign that read, ‘One suite remaining’. By that stage, she had been dreaming of and planning what would become Sydney North Women’s Health for about a decade.

So, when she called the number on the sign, it was “like a sliding doors moment. I had colleagues working in the same building and they were really happy with the space. So I called Avant Finance and that’s where it started.” 

About a year before that she had ‘discovered’ Avant Finance when she and her husband, Ben McAlpin, had needed to buy a bigger house to fit their growing family. She had just finished her training, and they weren’t feeling a lot of love from the banks, when a colleague suggested they try Avant’s (then) new mortgage broking service. The broker also steered them towards Avant Law for all the legal aspects of the mortgage, and within a few weeks they were in their new home and delighted with the result.

Those same colleagues recommended JDV Projects, who had already delivered 18 suites for other specialists in the building, for the design and fitout of the space. They interpreted her vision with warm timbers, soft finishes and an attention to detail with the joinery and integrated technology.

Just as she was settling on the property at Parkway, one of her colleagues at North Shore Private decided to sell his rooms and offered her the opportunity to purchase them. Space there was highly sought after, and so for the third time in a short period, she was on the phone to Avant saying, ‘Just wondering how crazy it would be if I purchased another property, and will you guys help me with this, too?’

“I feel like I've come to Avant almost every time with kind of a plan, and a goal, and a hope,” she says. “But I'm 35 and at the beginning of my career. I didn’t always have the strong finance numbers to back my plan. But the Avant team’s approach was always, ‘We've got to get behind her and try and help’.

“We’re all good at the thing that we're good at, but I'm not good at any of this, right? I'm good at being a gynaecologist and that's what I also enjoy. I don't really enjoy looking at 40 plus page contracts of company constitutions and all the other stuff. And so, I put a lot of trust in my team. I lean heavily on their expertise because I know what I'm good at, but it's none of this kind of stuff."

A large part of that process involved calling on the expertise of others at Avant when it came to drafting employee contracts, consent forms for the practice to use AI scribes when taking patient notes, and the formation of self-managed super funds and companies. The help provided by Avant Law proved invaluable here.

“And when things are also expanding quickly, it's a really quickly moving ship. I'm trying to do all this stuff, but I'm also the mum of two little kids. This is a lot of moving parts, and so it was really helpful to know that you had really, really good people in your corner.”

Branching out

The combination of her expert team inside the practice and the support of Avant alongside them makes the future look bright for Dr Hofmann and Sydney North Women’s Health.

“I got into this because I'm really passionate that women's health gets the short end of the stick a lot of the time, and that I want it to be better,” she says. “And that I felt like there was no financial backing in the public sector to be able to do that, so I've moved it into the private sector. And that means that it's going to look different, but I don't want to lose the core culture of what's important to me. But then sometimes, I feel like we have
so many ideas and I'm so excited to see the business grow.”

For example, currently she’s starting an early pregnancy clinic within the practice where patients can be seen by a women's health GP and have care for bleeding in early pregnancy or miscarriage management, a service that is currently only available in acute care in the public sector. “I don't love using the terminology but I also am now a business owner, so that also means essentially looking at the market, and what the market needs for women's health,” she says. “My experience is that women are engaging in their health in a really positive way, and a lot of women are happy to pay for care. They just want really good care.

“We are looking for opportunities to help. And because we are young and flexible and keen, we're able to pivot into different spaces and to learn whether that is something that women want. And so that's where I see our business going, looking for opportunities to help in those ways.” 

“Even though Dr Hofmann had gradually formed her vision for her practice over many years, when it started to actually happen there were a lot of moving parts, says Avant Law’s Ben Ryan. “At Avant Law, we're here to make sure that each step of a practice setup is covered,” he explains, “because there is a lot of background legal work that needs to be covered off to make sure that you're planning for the future as well. There is inevitably going to be something down the track that throws you off, whether that’s not having your employment contracts or privacy material right, or the lease wasn't done correctly. So really our job across our different teams in Avant Law is just to make sure all those aspects are covered.”

For example, he says, one of the key legal aspects of commercial property purchase—as Dr Hofmann was doing—involves ensuring due diligence is done properly. “That involves making sure the property is fit for purpose, for example. It's making sure your business structure is set up ahead of time as much as possible. Setting up the right foundations take time. But getting them done early means you can jump on an opportunity when it pops up.”

Ben Ryan - Partner, Avant Law