One hundred years of the Hawthorne Clinic

‘We’d always had a dream, from when we first got married, that one day we would own a practice together.’
 
Little did businessman Lucas Down know that not only would he and his wife, GP Dr Carmen Main, realise that dream, but become part of a storied and celebrated history in the process.
 
Since 1925, the Hawthorne Clinic in the Brisbane suburb of Balmoral has weathered challenges ranging from the Great Depression to COVID-19.
 
Even during the post-World War II housing boom, when the classic Queenslander was temporarily remodelled into apartments, it continued to operate as a clinic – just from a newer smaller building at the front of its Riding Road location.
 
The clinic rooms have long since been reinstated in the original rambling home, where ceiling roses remain and patients speak of the ‘family’ feel of the building, says Mr Down, who took over the practice with Dr Main in 2016.
 
‘The patients still get the feel of the old family home when they come to visit,’ he told newsGP.
 
On Friday, the feel will be party mode, as the Hawthorne Clinic officially celebrates an astonishing 100 years of continuous service to the local community.
 
In attendance will be some 80 people, including local politicians and business people, former staff and members of families who have been cared for at the clinic across four generations.
 
It has been a challenging time for general practices in recent years, with rising costs and GP shortages forcing many practices to close their doors, yet the Hawthorne Clinic has continued to defy the odds, with an active patient base of well over 10,000.

The property was originally built as a family home in 1921.
 
Originally built as a family home in 1921, the heritage-listed house was bought in 1924 by a young doctor named Antony St Ledger and his wife Kathleen.
 
The following year, Dr St Ledger placed a notice in the Courier Mail newspaper announcing he had opened a medical practice.
 
Dr St Ledger ran the practice until 1951, when he sold it to another doctor.
 
Since then, the Hawthorne Clinic has seen just a couple more changes of hands, several transformations and additions, including three enormous practice rooms remodelled into eight, but what has never changed is its location, nor its continuous service to the community.
 
Mr Down attributes its survival to the very qualities that first drew his wife to join the clinic, which at the time was owned by Dr Giuseppe ‘Beppo’ Pagliaro.
 
Dr Pagliaro joined the Hawthorne Clinic in 1966, and became a community favourite across generations, seeing patients he had delivered become grandparents themselves.
 
‘Carmen had been working there for a couple of years and said, “you know, I really love this practice. It’s got a really good feel to it, a really good culture. And Dr Pagliaro, who’s been here for nearly 50 years, is not getting any younger”,’ Mr Down recalls.
 
‘So, she said “how do we go about putting it to him that we’d like to buy it one day?”.’
 
The couple decided to write Dr Pagliaro a letter, asking if they could be ‘first in the queue’ if he ever decided to sell the practice.
 
‘It turned out that was music to his ears, because he wasn’t sure how he was going to go about exiting the practice,’ said Mr Down.
 
‘He said, “not now, but let’s reconvene in another 18 months or two years, and we’ll reassess it then, but I won’t sell it until I’ve ticked over 50 years here”.’
 
They took the practice over from Dr Pagliaro in 2016, the day after he celebrated 50 years at the clinic.
 
‘He ticked over 50 years on the Thursday, and we did the deal on the Friday,’ said Mr Down.

The first Courier Mail newspaper advert for the practice in 1925.
 
He is now the Hawthorne Clinic’s managing director, and Dr Main the principal GP. And maintaining a strong and supportive culture within the practice has remained a priority.
 
‘Carmen worked in some practices in her earlier days as a GP, where the culture wasn’t ideal,’ said Mr Down.
 
‘So going into owning our practice, she knew ways that she didn’t want things done, how she didn’t want people treated.
 
‘It’s really about trying to create a work environment where it’s like a work family, so that people actually feel empowered and respected, and like we’re all pulling in the same direction.
 
‘Not only is it a good culture and it makes them want to come to work, but it’s a pretty good business because they hang around. When we bought the practice, there were staff that had been here for 30–40 years.’
 
Mr Down has put his years of business experience to good use in meeting the same challenges faced by practice owners all over the country – remaining up to date and viable while providing high-quality patient care.
 
‘It’s really embracing the technology in terms of websites and online bookings and telehealth and e-scripts and e-referrals, all of that kind of thing,’ he said.
 
‘For us, we know that we’ve got the quality of care. We know we’ve got the right team and the right people and the right patients. It’s about, how do we make sure we stay viable?
 
‘Where’s the technology going and how will that affect general practice, and what are the trends in the funding? What will happen with Medicare in five years? What will that look like?’
 
Then, of course, there is having enough doctors at the clinic to meet demand.
 
‘The biggest challenge for us is actually getting enough good GPs to work here, because as soon as we get a GP on, the demand from our patients is huge,’ said Mr Down.
 
Sadly, Dr Pagliaro did not live to see the Hawthorne Clinic celebrate its centenary, passing away in 2022. But he doubtlessly knew he was leaving it in safe hands.
 
‘We’re proud, but we also know we’re only nine years of the story,’ said Mr Down.
 
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Brisbane general practice milestone Hawthorne Clinic