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The heavy healthcare burden of the UAE has few perks for physicians. But for those with an entrepreneurial eye, industry experts agree, the growth in patient load means there has never been a better time to branch into business.

"Currently the whole of Dubai is underserved for healthcare," admits Dr Ottmar Schmidt, director of marketing at Welcare World, one of the UAE's leading healthcare corporations. The healthcare market is just one of the Emirate's industries that has failed to keep up with Dubai's soaring growth rate,. And while this gap in services is bad news for patients, it's great news for investors.

Part of the explanation for the lack of healthcare provision in the emirate is the population's reluctance to use the system properly. Just last month, Dr Juma Bilal Fairouz, director of disease prevention at the Ministry of Health (MoH), conceded that there is widespread ignorance about primary healthcare. The majority of patients, he revealed, still see the emergency room as the first point of entry into the health system. Schmidt agrees that the current culture is placing too much pressure on the hospitals and leaving primary clinics underdeveloped. "People who need to see a doctor think that they should go to the hospital because that is where the best care will be," he says. "The clinic concept is not that accepted over here."

But as mainstream hospitals slowly start to relocate patients to more appropriate primary health facilities, current facilities will be found lacking. This market gap, reports Dr Mohanakrishnan, of Dubai-based consultancy firm Eurohealth Group, is ideal for physicians yearning to be their own boss. "According to the latest statistics, there is only one primary care centre for around 60 to 70,000 people in the UAE: that is thoroughly inadequate," he explains.

Even in an underserved healthcare market, however, patients are picky in their choice of provider, and physicians looking to launch their first clinic should take time to research the options. The right practice site is key in ensuring the success of a venture, and location decisions should not be taken lightly, Mohanakrishnan warns: "There is definitely a niche here and anyone can open a clinic. But that does mean it should not be done professionally or that it is simple."

Physician, know thy market

Before deciding where to establish a clinic, physicians must have a clear idea of the patient base they hope to target. Most residential areas have a defined economic and social order, and the first choice facing would-be practice owners is which of those groups they wish to attract. This decision, Mohanakrishnan advises, should dictate the content of the business plan.

"The person or the group should have a clear idea of what sort of clinic they want to open. Will it be a premium clinic? Or will they be going for a middle level clinic? Or are they going for a clinic aimed at the lower socioeconomic level of society?"

This choice is not based on any type of snobbery, just cold economic reality, insists Mohanakrishnan. "If you recruit a very highly qualified doctor from, say, America to serve a middle income group, the return on investment will not work out financially. Once you have made a decision on who to target, then you have to find the areas where that group of people is demographically concentrated."

Welcare's recently opened Ambulatory Care Centre is a prime example, suggests Schmidt. The centre is based in Knowledge Village, Dubai, selected for its close proximity to affluent residential areas. These estates provide a ready source of upper-middle class residents - Welcare's lucrative target patient group. "We care for Dubai Marina, the Springs and the Meadows (local housing complexes)," Schmidt says. "There are a lot of people to target."

Conducting demographical analysis for healthcare locations normally amounts to a rough calculation of population divided by service providers. If the sum is high enough - you have a business. The reality, however, is a lot more complex. Physicians - particularly specialists - must establish whether communities can realistically support a new practice. Parking a cosmetic clinic in a predominately senior community, for example, is a recipe for disaster. If your own research fails to come up with answers, local hospitals can be a good source of demographic data. Ask where the majority of the referrals in your field come from, and what degree of growth is anticipated over the next few years. Alternatively, Mohanakrishnan believes that the best way to analyse an area's healthcare needs is to go there and talk to its residents. It's as much about finding what people want from healthcare providers, he tells clients, as it is about telling them what you can provide. "You have to look at demographic statistics, but we also try and go into an area and talk with the people who will eventually be using the facility," he says. "We have a structured questionnaire [for residents] and that can help us get an idea of what is needed from a hospital or a clinic in a specific area."

The money trap

Reconnaissance visits have another boon. They offer a chance to check out the competition. An important strategic trap to avoid is setting up shop in an area where your service is already overprovided. No matter how aggressively you market your clinic, you will be resigned to splitting your patient base with established providers. Schmidt says the formula for launching successful clinics is simple: provide niche services in areas that are currently underserved.

"The main considerations are the size of the population and the number of suppliers already operating in the market. It doesn't make sense if you have 10 clinics in one plot to open another one. You have to bring medical services to an area that can feasibly support them. We are not a charity organisation and you have to be able to turn a profit."

But that's not to say that physicians should be scared off by rival practices. Your odds are better as a sole provider but, even in a saturated market, a practice can flourish if it can trump the quality of the service currently on offer. For specialist physicians, one way of testing the water is by contacting practices that you hope to establish a referral relationship with. Who do they send patients to now? Are they happy with their current provider? There may be areas where you could offer an improved service. Dr Jamil Ahmed of the Prime Healthcare Group has found that the greatest selling point to patients can be convenience. If you can provide that, he says, your practice will be in demand.

"We have had many years of experience with our other centres. We are seeing more than 1,000 patients a day in Dubai, and that gives us a good idea about what services to offer," he explains. "Basically what we try to offer is almost everything under one roof. We have an operating theatre, we have beds, a pharmacy inside - a complete range of solutions."

For primary care physicians, pose as a patient and call your competitor to request a routine check-up. How quickly can you get an appointment? Typically, a long wait indicates a thriving, established practice popular with local residents.

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