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Far from Australia's centres of economic power with a scarce offering of private specialist healthcare options, for almost a decade Darwin-based entrepreneur Dr Dev Tilakaratne has been building a hub of businesses that are challenging old norms in the sector, including what he claims to be one of the largest tele-dermatology services in the country.
Since 2016 the dermatologist and his wife, gastroenterologist Dr Kirsty Campbell, have been on a mission to do away with "patronising" notions of private healthcare access.
Together they founded Ologist, a play on the suffix found for most medical specialist titles, which has since expanded its range to nephrology (associated with the kidneys), general physician, and geriatrics services. With Adelaide-based dermatologist Dr Christopher Ross, Dr Tilakaratne also developed telehealth service DermoDirect catering especially to remote patients or those requiring discretion, such as celebrities.
"We used to have this phrase here - 'when in pain, get on a plane’ - and as a kid it was funny, but on the other side of it it's a little bit patronising, a little bit offensive," he tells Business News Australia.
"Maybe there was some justification back in the day when we were short on services, but nowadays we are training our own workforce, we're building capacity," he says.
"There are so many more things that we can do here. Hopefully we'll hear that phrase less and less."
He says Darwin has traditionally had only a "smattering" of private medical practices given working regionally is a very big commitment, although the number of private general practices has been on the rise as medical rebates have failed to keep up with inflation and practice costs.
"What we have been focusing on is first starting with commitment to the place, and then using the stability of being committed to setting up an enduring service," says Dr Tilakaratne, who grew up in the NT capital.
"We're confident now that the service that we have started will carry on in the ultra long-term, even once we’re gone, because it’s well and truly entrenched in the landscape now.
"I think it's very useful having so many disciplines under the one umbrella, being able to work collaboratively in the private sphere."
Dr Campbell, who hails from north of Cairns, says that having specialised medical practices opens up new opportunities and inspiration for doctors starting out in their careers.
"We both believe we do the best medical specialty there is, but we like to show the junior doctors that we're passionate about our specialty and what our specialty offers, inviting them to come and join us for placements or sit in on clinics so that they can get exposure that we didn’t receive, and they can think about this as a realistic career pathway for them," she says.
The two Ologist co-founders met at James Cook University in Townsville, and when they decided to set up a business in Darwin the pair needed not only to overcome their lack of prior business knowledge, but also growth constraints in an industry where specialist training is generally required interstate.
"I was the only gastro living in the Northern Territory when I started. Dev still is the only dermatologist living in the Northern Territory," says Dr Campbell, who alongside her partner was a finalist in the 2024 Australian Young Entrepreneur Awards.
"What’s unique about our population here is that they’re quite used to having to travel for medical care – they know that we can’t do everything here and we can’t service all of their needs here, so they have to travel.
"If they’re in public the default is that they go to Adelaide, so we trained in Adelaide - we were well connected there."
It was also in Adelaide that Dr Tilakaratne met Dr Ross, who would become part of his visitor physician network for the Darwin dermatology practice, and later the technology Diagnode which underpins DermoDirect.
"We set that up basically as just a way of following up patients when we were travelling around doing clinics," Dr Tilakaratne said, adding the Diagnode tech is also available to other doctors wishing to emulate Ologist's success.
"We effectively made a hodgepodge of video calling software, payment portal, scheduling software, practice software – even though it worked, in order to be optimally efficient time-wise, we had to build the whole system again so that it could be fully customised, sending out forms, making sure that we’re integrated with Medicare to claim rebates."
"Over a few years, Chris and I enlisted the support of a web developer to make the service and technology from the ground up. We own that, and we’re in the process of integrating it with other medical practice software so that it can be an add-on subscription that clinics can use to run their telehealth activities.
He says DermoDirect is now doing several hundred consults a month, with the platform able to organise urgent appointments within two days and sometimes same-day bookings.
"These are mostly people who are all around the country who want discrete dermatologic care, such as celebrities who don’t want to be gawked at in a waiting room," he explains.,
"Or they're people who really are in the bush; miners in the cab of their work ute, teachers in their lunchbreak in the middle of nowhere, who need access to medications and services."
He says the technology has taken the friction out of processes for both the patient and the clinic.
"For every element that goes into doing a telehealth consultation we've made it as fast as it can possibly be, simply because we've just been iterating, iterating, iterating every night after hours with our developer for years now, and basing that feedback on actual consultations," he says.
"In terms of volume of consultations, you wouldn’t think it but we’re one of the largest tele-dermatology services in the country. No one would ever believe it that this thing started in Darwin and is run out of Darwin. That brings me no end of pride."
Dr Tilakaratne likens the DermoDirect dashboard to working like Uber for dermatologists that are currently on board.
"We've been able to match our availability with dermatologists accordingly, because we’ve got a lot of dermatologists who are on maternity leave, they want more control over their hours," he says.
"There's no front-of-house to deal with; we operate that online service with virtually no overheads, because now we own the software that runs it as well.
"The unique thing is I’m probably one of the few people who understands the costs of running a bricks and mortar practice, and now also the cost of running a purely online service. It’s a very unique, enlightening thing, because increasingly we are changing our bricks-and-mortar processes to match the service that we've got online."
Whilst most medical practitioners are honing their skills in bricks-and-mortar practices, Dr Tilakaratne envisages a dichotomised industry where more practices and professionals will be drawn to digitally-underpinned services.
Dr Campbell also sees society moving in a more digital direction, even for specialties like hers that are more difficult to undertake over the phone or online.
"The younger generation, they don’t want to have a half a day off to attend an appointment if they can just duck out of their offices and sit in the car or go downstairs for 20 minutes for their appointment, and then their script or blood form is emailed to them, and they have another follow up in four or six weeks’ time," she says.
"Whereas the older generation, that's the type of medicine that they're accustomed to, so they're happy to have the day off work or they're retired so they can come in and they're flexible.
"I think we are going to see a paradigm shift because the demand for the services like this is going to significantly increase. Obviously, you can't do colonoscopy via telehealth, but you can do pre-care and after-care."
She adds that whilst the industry shifted towards telehealth during COVID-19, Ologist and DermoDirect were embracing it well before the pandemic.
"The rest of Australia picked up telehealth in COVID times but we've been doing it for years before that in the Territory just because of the tyranny of distance," she says.
"With DermoDirect, one of the important points is the average wait time to see a dermatologist in Australia is months and months and months, even if you live in Sydney, Brisbane, Melbourne; the average time to see a dermatologist on DermoDirect is something like 48 hours."
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