By Megha Merani
How do you do things by the book, provide proper quality healthcare to patients and make money? Mohammed Ali Al Shorafa Al Hammadi has an answer
Healthcare in the UAE is 'oversupplied' is not what you expect to hear when you sit down to interview the top man of a rapidly expanding healthcare group in the emirates.
But Mohammed Ali Al Shorafa Al Hammadi, CEO and managing director at Abu Dhabi-headquartered United Eastern Medical Services (UEMedical), doesn’t beat around the bush.
“I think there’s definitely a lot of oversupply,” Al Hammadi tells CEO Middle East. “The problem is it’s like herds. When they (healthcare companies) see a group developing projects that are commercially viable, everybody starts copying. But if you have a lot of one thing, everybody is going to lose at the end of the day.”
His investment strategy when establishing UEMedical back in 2005 was simply to go against the herd. Of course it helped that his experience prior to venturing into healthcare included nearly a decade of strategic planning, policy implementation and financial investments at Abu Dhabi Investment Authority (ADIA), and managing other family companies.
Reading the market right, the CEO steered clear of general hospitals - a trend followed by the majority - and instead zoomed in on underserved specialisations such as maternity, pediatrics, fertility and diabetes.
“The main drivers of our strategy from the very beginning is to be specialised, quality driven and offer unique services, [as well as] integrating the facilities to work in tandem with each other within an integrated health system,” Al Hammadi explains.
“We see a lot of players in the market where they are a jack of all trades and masters of none. But if you take a step back and look at the number of how many general hospitals are there, there’s plenty. I’m not saying it’s wrong but I think the market cannot sustain all of these general hospitals, which is being tackled by the regulator now.”
It’s why, he notes, a lot of general hospitals are currently trying to create speciality centres.
“Healthcare is not just building a building,” he says. “You can get funding and equipment from anywhere, and you can recruit from anywhere, but the market is the market. There are a number of people that I think made bad decisions and invested in areas that we believe are oversupplied. Some of them have closed down because they cannot meet the quality KPIs.” And confidently, he adds: “They haven’t read the market properly.”
Oversupply isn’t just a commercial concern however. For patients, having a choice of many facilities may even sound good in theory. But the bigger worry, Al Hammadi says, is the impact on quality of care.
“Is this facility really seeing the proper number of patients? If it’s a very low volume, they might try to cut corners,” he says. “[When] quality goes down, patients are not going to be diagnosed or treated properly, and you’re just over-billing [and] over-diagnosing to compensate. [And] For example, if you have a top notch cardiac surgeon that only does 10 open heart surgeries a year, he loses his skills, and he loses interest in the market.”
Now the regulator and insurance companies have implemented measures to control the unnecessary services and overbilling.
Asked about whispers about hospitals setting sales targets for their doctors to order tests leading to increased financial reimbursement from patients and their insurance providers, Al Hammadi confirms: “It’s true. That’s what I mean. If you don’t have the right volumes, and mindset, you will try to find ways to compensate for what you might be losing. You will over diagnose, over treat, all of that.”
It’s an issue that Abu Dhabi’s Department of Health is taking serious actions on, he says, insisting that the UAE capital has “really changed the playing field” by implementing several new measures, checks and balances.
Al Hammadi, who is also a board member in the Strategic Partnership Council of the Department of Health in Abu Dhabi, says the regulator has set the “first line of defense” for patients. In maternity cases for instance, he explains, the regulator says doctors are not allowed to order more than three-to-four ultrasounds before delivery. The number is based on international guidelines for clinical pathways.
“We know that some [doctors] used to do 10 to 12 ultrasounds before delivery and the insurance company used to pay that,” Al Hammadi says. “First of all, from a patient safety point of view, you shouldn’t be doing it. Secondly, you want to regulate the market so the insurance companies can survive.”
The healthcare leader adds that the regulator is always “more than willing” to meet with potential local or international investors to “tell them where the gaps are” – an opportunity he believes providers should take advantage of before building. Meanwhile, UEMedical’s live technology dashboard, which Al Hammadi shows us he always has running on his screen, is designed to help ensure quality of care and make it part of the culture. The system flags anything that is “out of the ordinary”, even a patient’s appointment delay.
“The team has good governance framework,” he says. “You’re not pushing physicians to generate volume, you’re pushing them to generate clinical KPIs.” For those who work with the sales volume modus operandi, he doesn’t mince words. “Their life is very short, they will close down.”
“This is the dilemma,” Al Hammadi adds. “As a provider, how can I do things by the book and still make money and still provide proper quality healthcare to patients.”
Being specialised and providing quality is the ideal way to succeed, he says.
With UEMedical’s investment in the healthcare sector reaching over $1.14 billion (Dh4.2 billion), the company’s portfolio in the UAE and the wider region, includes Danat Al Emarat Hospital for Women and Children, HealthPlus Fertility Centres in Abu Dhabi, Dubai and Saudi Arabia, HealthPlus Network of Specialty Centres and Family Clinics, Moorfields Eye Hospital in Abu Dhabi and Al Muhaidib Dental Group that includes over 60 dental centres across KSA.
Late last year, UEMedical announced a Dh300 million expansion project for the facility that will see the number of beds in its Neonatal Intensive Care Unit doubled to 40 beds. Pediatric subspecialties including pediatric orthopedics, pediatric gastroenterology, pediatric pulmonology and pediatric neurology, in collaboration with renowned The Hospital for Sick Children (SickKids), Toronto, Canada, in addition to other pediatrics subspecialties will also be further expanded.
Going forward, Al Hammadi says, the group is looking at further expanding other “highly demanded” specialisations including orthopedics, mental health, urology, and day surgeries. Further expansion in Saudi Arabia is also on the cards, he adds, as well as in the Levant area, Tunisia, Algeria, Morocco and Egypt. “Saudi Arabia is a huge market, the population is huge [and] there are gaps in the market,” he says. “Specialty care is highly needed in Saudi Arabia market.”
The company has also started investing in genetics, while the Danat Al Emarat Hospital has been authorised as an accredited scientific medical research centre in Abu Dhabi.
“We are the only local player that has a genetics lab that is 100 percent locally owned within our HealthPlus Fertility Centers,” Al Hammadi says. “From an IVF point of view, we had to have a genetics lab, otherwise we used to send our samples outside. There used to be a lot of family marriages in the region and there are a lot of genetic diseases, like thalassemia. The Middle Eastern population is different and we need to look at the causes.”
Meanwhile, effectively managing his more than 3,000 employees and growing all comes down to one thing: “Empowerment.” He swears by the strategy because it has resulted in “zero turnover” in his leadership team.
“They are well-paid,” he jokes. “But on a more serious note, I think it’s more of an open-door policy, respect and empowerment. We are managed in a very robust structure. Our operating facilities are managed separately and we are managed through committees. So it’s empowerment but with strong oversight from a corporate level. It’s not a dictatorship. It’s a matter of are you meeting the KPIs, yes or no? If no, why? Do you need help? Convince me.”
Looking into the future of healthcare, he agrees with recent comments made by his counterpart Dr. Azad Moopen. The founder and chairman of Aster DM Healthcare told Arabian Business in September that the healthcare industry is doing “sick care” and not healthcare.
“He’s absolutely right,” Al Hammadi says. “I think this is the next wave... prevention rather than treatment. Maybe initially it’s more expensive but in the long run it’s cheaper. You have a healthier population. This can only be done through primary care, which is why we decided to invest in that area seven or eight years ago. Eventually insurers and regulators will impose that you have to go to your family doctor first.”
Sure, he says. “But you have to be a robust organisation in how you can see value in and create value from prevention. Healthcare isn’t real estate. You’re not building something and getting money tomorrow. It’s a long term investment. Maybe I will close down a facility but develop it into a preventative facility. You cannot be stubborn; you have to be agile. The market is [always] changing. If you’re going to just stick to what you have, you are out of the playing ground. If you cannot change, you’re out of business.”For all the latest Business news from the UAE and Gulf countries, follow us on Twitter and Linkedin, like us on Facebook and subscribe to our YouTube page, which is updated daily.