It is not easy to build a new clinical service. In 2010, I was invited to start a Gastroenterology service for a new public hospital in Singapore. At the time, the hospital did not have any Gastroenterologist, and nobody could perform advanced endoscopic procedures such as ERCP and EUS. 3 years later, I left behind a Gastroenterology Division, and an Endoscopy Centre with advanced capabilities.Yet, that challenge was dwarfed in private practice, which in Singapore is somewhat like the Wild West, with Gastroenterologists operating alone or in pairs. I realized this was not sustainable. Gastroenterology is a rapidly growing specialty, and even large departments are challenged keeping pace.I founded gutCARE with 2 key aims: 1. Build a team of Gastroenterologists with experts in each sub-specialty field, and with niche support services. We provide patients with a full spectrum of specialty expertise and services, which evolves as the specialty advances. We will be the private sector equivalent of a full Gastroenterology department.2. Build a practice that will last beyond my generation. We invest in quality assurance to demonstrate good clinical outcomes and cost sustainability to both patients and insurers. We embrace information technology to 'digitize' Gastroenterology for the next generation.I started with a single clinic in 2014. Within 6 years, gutCARE established clinics in all 6 main private hospitals in Singapore, and had a full team of Gastroenterologists, with renown experts in each sub-specialty area. I am blessed to have a family of like minded doctors in gutCARE. Together, we continue to help define the future of Gastroenterology in the private sector.