Women carry out many roles in their lifetimes, varying from mothers to wives to caretakers and protectors. However, few take the risk and consider entrepreneurship with a select few making it past a decade in operation. Today’s Corporate Profile highlights Image Plus Consultants Limited and its co-founders Dr Lilieth Ann Robinson Bridgewater and Dr Karlene McDonnough who formed a business in diagnostic imaging.

In 1986 McDonnough had just completed a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree at The University of the West Indies, Mona and went on to specialise in radiology with a sub-speciality in nuclear medicine. She completed her doctorate in the area of nuclear medicine in 1992 before becoming the head of the nuclear medicine department at the University Hospital of the West Indies a year later. She held this role up until 1999.

Similar to her other colleagues at the time, everyone had some practice time in government service before they branched out into private practice. Based on her passion to improve the lives of patients through improved services, she reached out to fellow radiologist Dr Robinson Bridgewater about the possibility of starting a private business in the diagnostic imaging space. Her husband believed in the business opportunity.

“We probably weren’t thinking too much about that at the time, but an opportunity came up and I don’t really believe in turning my back on opportunities. So, we looked into it seriously and contacted my colleague Dr Ann Bridgewater. She also took the leap of faith and we decided to get started right here at this location,” said McDonnough in an interview on Monday at the company’s Molynes Road, St Andrew location.

But taking the plunge to become entrepreneurs in the late 1990s, they faced an uphill task in securing the capital needed to start the business and get it off the ground. This was also at a time when interest rates on loans were comfortably in the double digits and the financial sector began to experience liquidity and solvency issues. However, collaboration and assistance from other people they knew allowed them to build out their concept.

McDonnough met with Dr Gordon Bradshaw at 2a Molynes Road, which was a space where he wanted to work with other medical doctors to form a diagnostic centre offering a range of medical services for the general public. Although he was a dental surgeon forming his own private practice, he believed in investing in his colleagues which resulted in him being a founding shareholder in Image Plus Consultants Limited. The company was incorporated on February 16, 1996.

The radiologist duo also received assistance from Roy Curtis who was an accountant that assisted them in drafting their first business plan, putting the company documents together and establishing the general accounting systems. P Clyde Cunningham, who was the principal of Meditron Limited and an agent for Siemens in Jamaica, assisted with setting up the technology and also became a shareholder in the business. Dr McDonnough also received a stamp of confidence from her personal banker Dalvern Williams who took a leap of faith in providing financing to her in assisting with the formation of the business.

McDonnough’s sister, Karen Gauntlett, was the first employee of the company, assisting with several activities while trying to setup her own fledgling company.

“We had to pound the pavement to get financing and, of course, we were new to all of this in starting a business. I have to give credit to my father Karl McDonnough as well as Joyce Robinson who were there for us from the very beginning, giving solid advice and helping to make connections for us. He [Clyde Cunningham] decided to forego his commission at the time as part of his investment in the company and became a shareholder. All of these things helped us to get going and all of the founding shareholders had to borrow money and take mortgages on their properties to help us get there,” McDonnough explained about the early days of the business.

In order to not put additional pressure on cash needs, they brought in ultrasound services as their first modality and subsequently added X-ray services a few months later. One difficulty they encountered though was receiving referrals from doctors who had the challenge of recognising their presence as a young diagnostic centre and preferred to stick to the established services of other imaging centres.

Despite this hurdle, the duo worked extra hard to build up the clientèle which involved one-on-one conversations, office visits and networking. This also presented the opportunity for the company to find a novel approach to build partnerships. At the time, the Government was giving discounts on import taxes for equipment. Image Plus would receive a write off and would have an arrangement where it would pay for these discounts through services to patients from the public health-care system.

“It was just that when we got here, there were other independent businesses established and the complex was Apex Medical Centre. So, although our company name was Image Plus Consultants Limited, we thought that for better recognition of what we do, we started the trade name Apex X-Ray & Ultrasound Services,” McDonnough said in explaining why the trade name it has used throughout the years is different from the company name.

With the company steadily growing, it looked for new opportunities to expand and added another branch. Portmore was a rapidly developing space, but it had no imaging centre. The Urban Development Commission was selling commercial land at the time and Image Plus was constrained with space limitations at its current location. After proving themselves to their bankers, they were able to secure a mortgage and opened their Portmore location in February 2003 at the Portmore Town Centre.

The company opened its third branch at 3A Winchester Road in November 2006 and expanded its services to include nuclear medicine and multi-detector computed tomography (CT) scanning. Image Plus’ steady growth and work over the years saw it begin to garner more interest from other doctors planning to setup private practice. This culminated with the 30 per cent stake in Winchester MRI during 2013 which resulted in the company breaking ground into MRI (magnetic resonance imaging) services.

“A couple of doctors who also had their private practice in obstetrics, gynaecology and surgery at this location wanted to invest for themselves in a building similarly to what we did. They acquired the property at Winchester, and they then asked us to setup a diagnostic centre there. Again, it was connections with colleagues who were confident in our services and asked us to follow them on their path,” McDonnough expounded on the benefits of collaboration and relationships.

Based on the company’s rapid growth and vision, general radiologist Dr Marian Allison-Vaughan joined the company in 2009 and became a director and shareholder in the following year.

While imaging services demand was climbing in Kingston and St Andrew, the same could not be said for the Portmore location where most of the residents had commerce in the capital and accessed the services there. As a result, it closed its location in 2014.

Although some would have seen this as a loss, McDonnough was ecstatic about the new opportunity which occurred in November 2016 when it opened its newest branch at 129 Pro in Liguanea whose owners invited them to provide imaging services at the location.

With Kingston having a solid presence by the team, Image Plus explored other parts of the country to provide imaging services. It opened its fourth branch at Pineapple Place, Ocho Rios, St Ann, in 2019 which had several limitations regarding space. With the company firmly establishing the brand in Ocho Rios, it made the decision to move to White River North Commercial Complex this year.

Despite the business breaking records and achieving new highs, the board realised the limitation it faced with different board members/shareholders taking on the role of managing director when they themselves had full-time practices in different areas as well. In order to meet the growth targets they desired, they made the decision to search for a permanent chief executive officer who had professional expertise and passion for the role.

Kisha Anderson had succeeded in developing JMMB Group Limited over her 23 years, including the opening of a commercial bank in 2017. Despite spending most of her career at the institution co-founded by Joan Duncan and Dr Noel Lyons and being one of its earliest employees, Anderson wanted a break from the demanding life which was no easy feat. Thus, she turned in her papers on March 31, 2019, as the JMMB country chief executive officer (CEO) of Jamaica in order to seek new opportunities in the ‘new’ Jamaica which was undergoing a period of significant transformation.

Anderson said she was driving into church one day when McDonnough reached out to her about finding a permanent CEO for Apex Radiology. Anderson initially gave it some thought later that day and accepted the challenge. The board confirmed Anderson as CEO in January 2020.

“When I got here, I saw the amount of potential that the business had and one of the last things that I remember we were doing at JMMB was how we could tangibly help SMEs because we think that’s the engine of growth in Jamaica. I saw it as an opportunity to test what I knew from JMMB. The company was like a diamond in the rough with so many opportunities and possibilities. In the beginning, Joan Duncan’s vision was that every Jamaican could have a financial plan and realise their dreams,” Anderson added.

However, just as Anderson was settling into her role, the COVID-19 pandemic struck which had different implications for demand related to its services. This issue became pronounced during the lockdown of St Catherine in April 2020 and the revolving curfews and lockdown days which impacted the operational hours of the company. As a result, services like X-ray dropped considerably, CT scans were consistent while ultrasounds kicked off as more persons became close at home.

In spite of this hurdle, the company took the strategic decision to expand during the pandemic and invested in two ultrasound machines along with investments in biomedical equipment and operating platform. Image Plus also added more interventional studies during 2020 and offered on-call services from its Ocho Rios location in November 2021. It currently has 11 full time and part time radiologists as part of its staff complement.

With the company stepping into third gear, the board saw it fit to move ahead with an initial public offering with the ultimate aim of listing on the Junior Market of the Jamaica Stock Exchange (JSE). In a time when $1 and lower IPOs were all the rage for 2022, Apex chose to have their subscription price at $2 with the company seeking to raise $495.78 million in order to acquire a new property, add new equipment at its Ocho Rios location and expand the offering off interventional procedures.

When asked why it didn’t consider listing earlier, McDonnough pointed out that the board didn’t feel it was in the right position to make that step. However, they did attend JSE sponsored events and educated themselves along the way. After Anderson joined the team, they felt they were in a better position to consider going public and revisited that goal.

“We’re relocating our largest Kingston branch and we also have to purchase equipment to offer more modalities. The Ocho Rios location actually would allow us more space to offer different modalities. We’re also looking at direct purchasing of some our supplies so we manage our costs and taking care of any little issues opportunities that maybe there to manage the patient experience,” Anderson said about the 2023 plans.

One of McDonnough’s greatest memories over the 26 years was at the 10th anniversary where a long service award ceremony was held with most staff members receiving an award. It reinforced the benefit of having great staff members and she is thankful for the impact of the younger radiologists over the years. Williams and Curtis were able to join the ceremony with her father dancing up a storm with Bridgewater which made it felt like a huge family affair.

“As women, Dr Bridgewater and myself were mothers, wives and also caretakers of aging parents. It was just through grit, hard work and long hours that we were able to achieve what we did. We had to do everything for everybody. My advice is that you have to focus on the mission and dig deep in yourself to find the strength to keep those blinders on, put your emotions aside and stay true to yourself while you’re trying to accomplish that dream. Whether you’re a doctor or whatever, you have to understand your limitations, seek advice from trusted advisors and listen to them,” McDonnough closed as advice to other entrepreneurs including medical doctors.