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The Skin Institute Looks Back on Two Decades of Ground-Breaking Work
Skin Institute
March 15, 2015

The Skin Institute has spent 20 years fundamentally changing how New Zealanders think about skin care, skin cancer and skin surgery.

When Dr Mark Gray first moved into a small room in a shared clinic at 398 Lake Road, Takapuna, in the early 1990s, he didn’t know whether his venture would make it past five years – let alone two decades. But what he did have was a revolutionary way of looking at his combined disciplines of anatomic pathology and dermatopathology from his study in the United States at Harvard Medical School/Massachusetts General Hospital and Cornell University/New York Hospital, and he knew he could stand out from the crowd in New Zealand.

We sat in the same room from where it all started, he points out the cramped space in which he used to operate (it’s now a stairwell) and remembers the group of other physiotherapists, sleep specialists and consultants he worked among.

Right from the get-go, he says, he was busy with a “constant stream” of patients and started to gain a reputation he knew he could build on with careful marketing. He also realised that he could mould a business for which Kiwis were quite clearly crying out for.

By 1996, Dr Gray was still working on his own in what was then known as Dermatology Lake Road when he decided to make a major investment, which changed the way he would work. “I’m certainly less conservative than most dermatologists out there in what I’ve been prepared to explore in my career – I’ve always gone as far as I could to the edges of anything I’ve worked on,” he says.

“So I bought a laser for surgery, which was the first in the country, and I bought a machine out of Germany, which was New Zealand’s first mole map machine.” Those purchases meant he was now committed to clinical work marrying together cosmetic surgery with the more conservative field of traditional medical surgery.

“That was a really difficult time because cosmetic surgery was seen as superficial but at the same time you were saying `I’m a serious oncologist’,” Dr Gray says.

First to come on board was GP Dr Marcus Platts-Mills and then UK-trained surgeon Mr Mark Izzard – now there are 18 medical staff and dozens of nursing staff across 17 different clinics. Dr Gray says he’d always wanted to create a group practice – and he’s proud that his colleagues showed an “amazing leap of faith” in joining a unique and ground-breaking business model.

So where did the inspiration come from to create a multi-disciplinary team of doctors, surgeons and specialists? Dr Gray was born in Uranium City – a once thriving Canadian mining town in sub-Arctic north-west Saskatchewan, which has now collapsed to just 200 households after the closure of the mines – to a family steeped in medicine.

His father, brother and sister all became doctors, but, after moving to New Zealand in 1967 and becoming determined to be the best in his business, Dr Gray travelled to the United States to study and learn a different approach to marketing his skills. “I always felt that doctors – and my father included – worked very hard but they just perpetuated the model whereby you go into general practice and then work until you’re 65 and then someone opens up next door and you have nothing of value left. I wanted to change that,” he says. “I really wanted to change that so that all the value you create in your work somehow gets amplified as it does in other businesses – and the only way to do that is to operate with proper business principles.”

Having the sort of entrepreneurial spirit also led Dr Gray to set up the Skin Institute’s corporate structure. From there they also developed the “hub and spoke” model whereby central clinics such as Takapuna and the new Remuera clinic offer the company’s full range of cosmetic and surgical specialist procedures while the “spokes” offer cut-down services but refer the more complex cases to the central hub.

The result is a series of clinics where you can be guaranteed consistent service and style – where a system of specialised GPs and nurses can direct patients to the best surgeons in the business, whether you want cosmetic work or need specialist medical surgery.

“So many of our services evolved as new people came on board so we had to really zero in on what our core services are – and appearance medicine, skin cancer surgery, varicose veins and clinical dermatology is where we sit now,” Dr Gray says. “The structure is built around what the customers need and the fact that most of our procedures are carried out in day surgeries.”

So, just at the point at which the Skin Institute is looking to expand further throughout the North and South Islands, what does Dr Gray look back on as his watershed moments throughout the past 20 years? First of all was the setting up of the corporate structure.
Then there was the expansion out of Auckland, from the first partnership with Dr Hans Raetz in Queenstown, to having clinics as far afield as Taranaki, Whanganui, Alexandra, Dunedin and Invercargill. And, of course, simply being able to celebrate 20 years of changing the way Kiwis understand and think of cosmetic surgery and improving their understanding of skin cancer.

Quite apart from setting up a successful and ground-breaking business, it’s quite clear that Dr Gray derives most pleasure from the individual work he performs on patients. He describes hisMohs surgery (a complex technique which combines his pathology and surgical skills by requiring him to test tissue samples during skin cancer surgery) as his “most challenging, complex and satisfying” work.

“So often these people have had recurrences and recurrences and recurrences and the next recurrence is going to be very bad – they could lose a nose or half their face and you want to put a line in the sand and cure these people. You can really change their life and reconstruct them in such a way that an observer wouldn’t know they have had surgery done. It’s really scary to have someone operate on your face but then when it’s reconstructed and you look normal again it’s a pretty amazing thing.”

But amongst all those operations and all that planning and building a business, Dr Gray still thinks the most exciting stage is just around the corner. “There are defining points around what constitutes a big business and what constitutes a small business and we’re right at that tipping point now,” he says.

“So this next stage is the realisation of the 20 years it has taken to get there. Now we can create really strong branding that has a nationwide footprint and which has outreach into the overseas market.”

“I guess it’s a legacy thing for me so when we finish here, we can still enjoy watching the Skin Institute evolve and grow.”

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