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In the first of a four-part series looking at the trials and tribulations of setting up practice in the Middle East, Medical Times goes back to basics to discover how to create a business plan that can survive and succeed in a high-risk, high-reward market.

Despite a reputation as a recession-proof economy, setting up a practice in the Gulf region has been largely the preserve of those with the biggest names and the deepest pockets.

But as the dust settles around brands such as Moorfields and the Cleveland Clinic, fewer patients appear to be leaving the region for treatment. When you combine this trend with a growing expatriate population, market demand is at an unprecedented high.

And now that the big names have blazed a trail through the GCC, there has never been a better time for physicians to set up practice in the region.

But as with many things in the Middle East, knowing the bigger picture means very little - getting down to the nuts and bolts of creating a business plan is far from easy.

Striking out on your own (or in a small group) in the Gulf can seem daunting, but the potential rewards are substantial. Saving lives shouldn't all be about profit, but if you get it right in the Middle East you could make a killing.

Minding your business

Creating a business plan is a fundamental process for any start-up, yet industry consultant Ziad Fares is always surprised by how flawed many medical proposals he reads actually are: "I see a lot of business plans from abroad written by analysts sitting at some desk writing them for a living - they talk about starting healthcare businesses here without even visiting the region personally and 90% of them are completely unrealistic."

It seems like stating the obvious, admits Fares, but the best piece of advice potential start-ups can take on board is to develop and catalogue local knowledge. "It is especially important in this part of the world where extreme differences can occur within a few months," he explains.

"The landscape is changing tremendously almost weekly so it's extremely important that the first step is on-the-ground reconnaissance."

Despite the changing regulatory landscape - or perhaps because of it - the region still has a reputation for unwieldy bureaucratic processes.

Whether they are already working locally, or considering moving here from abroad, many physicians are put off by the GCC's reputation for red tape and mute ministries before they even get started.

It is a stereotype that no longer holds water, insists Fares, at least in his dealings with Health Authority Abu Dhabi (HA-AD).

"There has been an obvious shift in the mentality of the Health Authority in entertaining questions, in addressing concerns, and in responding to issues," he states.

"The licensing process is not impossible. I have submitted quite a few business plans online and I can't say I have had a significant problem - you don't need an infinite amount of signatures any more."

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