When Singapore Paincare Holdings (SPCH) made its debut on the Catalist Board of the Singapore Exchange (SGX) in July 2020, its intention was to become a “disruptive force” in the healthcare sector.
Two years on, CEO Dr Bernard Lee says the journey thus far has been“exciting.” Apart from raising additional funds, the company has expanded its suite of services and treaments, which has led to improved earnings. For its 1HFY2022 ended Dec 3, 2021, SPCH reported earnings of $2.27 million, up 235.9% y-o-y from the $674,887 posted in the year before. Revenue in the same period was up 70.9% y-o-y to $8.3 million, thanks to the addition of two clinics to its network.
Besides the core business of offering pain management and physiotherapy services, SPCH has also been kept busy with administering the Covid-19 vaccinations under the national vaccination programme. It also benefited from a pick-up in foreign patients when the vaccinated travel lanes (VTL) were announced.
For the coming year, Lee maintains a conservative stance as the pandemic continues. However, he is “cautiously optimistic” of better business with the aggressive roll-out of vaccinations in Singapore as well as the launch of VTLs to more countries.
More doctors on board
Lee has also been keeping an eye out for suitable growth opportunities. As of Dec 31 2021, SPCH has spent $2.4 million, or 67.8% of the $3.54 million raised during its IPO, to expand its business operations locally and regionally.
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Aside from the balance of $1.14 million in IPO funds, SPCH has amassed $3.95 million from a private placement done on Nov 27,
2020, which has yet to be utilised. It also had cash and cash equivalents of $15.6 million as at the end of its 1HFY2022, which puts the company in seemingly good stead to explore opportunities to grow.
SPCH shares, which were offered at 22 cents when it debuted on the SGX on July 30 2020, closed at 19 cents on March 23, valuing the company at $34.13 million. At the current price, the company’s P/E ratio stands at 8.56 times. In contrast, other locally listed clinic chains like Q&M Dental Group, Talkmed Group, Singapore Medical Group and HC Surgical Specialists, were trading at 16.1, 20.3 and 10.1 and 9.56 times historical earnings respectively.
As at Dec 31 last year, SPCH’s net asset value stood at 14 cents, up from 13 cents as at June 30, 2021.
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At present, SPCH’s services operate under two specialist clinics — the Singapore Paincare Centre and Singapore Paincare Centre @ Novena — and 10 primary healthcare clinics: The Lian Clinic, Horizon Medical Centre, AE Medical Clinic, New City Clinic, The Family Clinic@ Towner, Express Medical Clinic, Medihealth Bishan Clinic and Surgery, Dr+ Medical Paincare Clinic, Binjai Medical and Paincare Clinic and Centre for Screening and Surgery.
The latter is the latest addition to SPCH’s network: Run by surgical oncologist Dr Kum Cheng Kiong, the centre offers screening and treatment for breast, colon, stomach and thyroid cancer. On Feb 28, SPCH announced plans to pay $3.26 million in cash for a 51% stake in the clinic, with Kum retaining the remaining 49%. Additionally, SPCH has interests in the physiotherapy and post-operative treatment space through a 51% stake in Ready Fit Physiotherapy. The remaining 49% is held by physiotherapist and centre manager Daryl Li.
The model of acquiring controlling stakes in other clinics as an option to grow is a common strategy. Lee is happy to note that since SPCH’s listing, the number of doctors in its network remains high, for everyone is “still within the same family”. From just himself initially, the company has added two more specialists — Drs Yoong Chee Seng and Kong Chee Seng — since it went public. The number of general practitioners (GPs) under the group, meanwhile, has increased by four to 10.
Having more clinics under its fold is a step towards positioning SPCH as the first line of defence for patients suffering from pain, says Lee. Currently, most patients tend to seek out “organ specific specialists,” to treat the pain they are experiencing.
Take for example a patient suffering from chronic pain in the finger. The patient’s first course of action would typically be to go to an
orthopaedic specialist. “If there was a finger or hand doctor, [the patient] would literally go to the hand doctor,” he adds. “SPCH [is usually] the final stop for many patients who have been unsuccessful in finding relief for their difficult chronic pain conditions.”
Altering mindsets
Lee wants to alter this mindset so that patients seek out treatment at a pain care GP or specialist first, before visiting other specialists if there is still a need for them to do so. “Our motto is to be able to reduce a minimum of 70% of pain, otherwise we will not touch the patient. We are very confident that we have always achieved that and will always be confident to give patients a satisfaction of [reducing] at least 70% to 90% of their pain.”
Doctors, he adds, use a “unique diagnostic approach that builds on our knowledge of the multiple pathways leading to chronic pain, [so as to] eradicate the pain generator and provide lasting pain relief”.
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In the example of the patient experiencing pain in the finger, it could be triggered by a bigger problem like rheumatoid arthritis, says Lee, adding that the group’s pain care GPs are trained to address around 70% of pain conditions. These GPs are required to undergo 30 hours of training and lectures as well as 16 hours of practical sessions by SPCH’s Singapore Paincare Academy, before they can administer any pain care procedures.
One procedure that pain care GPs are trained in is myofascial pain injections, a specialised injection administered into specific tender points and fascia to stop muscle spasms and inflammation, while improving healing. The procedure is typically administered to treat a wide variety of conditions like neuropathic, mixed and nociceptive pains.
Patients will subsequently be referred to specialists like Lee or the other two SPCH specialists if further treatment is needed. While “no pain is too difficult to treat,” Lee says he is always humbled when patients — like those with cancer — have to undergo surgery to get respite. With some 20% of SPCH’s patients requiring such procedures, Lee is looking to have a presence in this space through its recent acquisition of Centre for Screening and Surgery.
East meets West medicine
In a bid to offer a more comprehensive ecosystem of solutions to pain management, SPCH has added traditional Chinese medicine (TCM) to its network of services. Inherently, TCM and Western Medicine address injuries very differently, says Lee. Western medicine is very mechanical and reductionistic in that it looks at the pain generator and then tries to alleviate that. Conversely, TCM is based on the philosophy that discomfort is caused by a blockage in the flow of qi, which loosely means “energy” in Mandarin. Thus, TCM practitioners will look at ways to improve or unblock the qi through methods like acupuncture. By including a TCM practice in SPCH’s ecosystem, he hopes to achieve a more holistic way to pain management.
Recently, SPCH added TCM to its capabilities via shareholder Sian Chay Medical, a charity organisation that can trace its history in Singapore to 1901. In November 2020, SPCH issued 18 million new shares at 22 cents each to Sian Chay for a stake of 10.02%. Besides raising $3.96 million from this deal, the move drew the two entities closer thus giving them both a broader range of expertise to offer. Sian Chay — whose chairman Toh Soon Huat was formerly the head of Novena Holdings (which has been renamed Viking Offshore and Marine) — has subsequently increased its stake in SPCH to 16.3%. Lee’s stake stands at 27.01%
while listed clinic chain HC Surgical has 3.31% and medical consultancy Medinex has 1.27%.
SPCH has also incorporated a wholly-owned subsidiary Singapore Paincare TCM Wellness to provide traditional medical services at a 2,347 sq ft centre in Marina Square. The facility hosts three of SPCH’s brands: TCM wellness for Eastern treatment Dr+ — a paincare GP clinic and Ready Fit Physiotherapy for post-treatment rehabilitation. The other treatments available there include a foot soaking therapy called Wellness Herb Ionto, a paediatric wellness experience to stimulate acupoints in children and Qi’Nergy Tuina for overall rejuvenation.
The centre also offers a skin conductance response test on patients to test their pain sensation through real-time skin resistance and sweat response. The data from the test will be represented graphically, allowing for the tracking of the intensity of a patient’s pain and improvements in their condition as their treatment progresses.
As Lee looks to establish a comprehensive ecosystem for pain management, he believes that demand for quality medical services — like what SPCH offers — will grow amid rising income levels and a resultant improvement in the quality of living. Additionally, he notes that the decentralised treatment that the company offers will also allow it to reach out to Singapore’s ageing population who are less mobile. Pain care may be a relatively new specialisation here, but Lee believes that SPCH will continue to make its mark.
Cover image of Dr Bernard Lee: Albert Chua/The Edge Singapore
