The Asian financial market crisis hasn't stopped two major U.S. academic medical institutions from choosing Singapore as their starting point for establishing an international presence.
Baltimore-based Johns Hopkins Medicine and San Francisco-based UCSF Stanford Health Care have signed separate contracts to collaborate with the government of Singapore to build and operate specialized facilities that will provide a combination of clinical care, research and medical education. Both projects are set to be operational by year-end.
The deals show major healthcare institutions can afford to take risks in financially volatile Asian markets.
It makes sense "for those that have the money to be able to take the risk," says Martin Light, president of International Health Resources, a North San Juan, Calif.-based healthcare consulting company that focuses on international business. "Your average hospital can't do it."
Light says he expects to see a growing number of ventures abroad as major medical centers seek to cultivate referrals back to their U.S.-based operations.
Both Johns Hopkins and Stanford, which are venturing into this type of international collaboration for the first time, were approached by the Singapore government to create the two pioneering medical centers.
"Singapore looks to become the medical hub for all of Southeast Asia," says James Bair, director of international medical services at UCSF Stanford. "The government's alignment with academic medical centers in the West helps to further this objective."
Johns Hopkins will create an oncology clinic, scheduled to open in September, while UCSF Stanford will establish an advanced radiologic imaging center, set to open in December.
In January Johns Hopkins began its partnership with Singapore's National University Hospital, the National University of Singapore, and Singapore's Economic Development Board and National Science and Technology Board to develop for-profit Johns Hopkins Singapore Clinical Services. The partners haven't decided how they will split the estimated $10 million in start-up costs. The clinic will concentrate on research and care for patients with cancers prevalent in Southeast Asia.
"We identified an unmet need in the oncology arena in the region," says Steven Thompson, chief executive officer of Johns Hopkins Singapore and vice dean of Johns Hopkins Medicine.
Physicians from Johns Hopkins will provide all patient care. Three to six of them will permanently relocate to Singapore, while another 10 to 20 will have stays there of six months to a year. The Johns Hopkins doctors, two administrators and an unspecified number of other staffers will oversee research and training.
Johns Hopkins Singapore also will recruit people from Singapore and around the world to work at the clinic, Thompson says.
Singapore doctors will be exposed to training programs and can collaborate on research, he says.
For the time being, Johns Hopkins Singapore will lease a space at the National University Hospital but hopes to build a facility in the future, Thompson says.
Stanford, which in November 1997 merged its medical centers with those of the University of California at San Francisco, joined the Health Corporation of Singapore in 1995 to establish Stanford-HCS Imaging Center. The HCS is a government body that controls the restructured public hospitals in Singapore.
Another partner in the joint venture is Pontiac Land Private Limited, a Singapore real estate development company. Pontiac Land will build an 18-floor multispecialty medical office building called Camden Medical Center, and the imaging center will occupy its bottom two floors.
Bair would not reveal the total start-up costs for the radiologic imaging center but says UCSF Stanford will contribute 17.5%.
Stanford doctors will provide medical direction, including training of Singapore radiologists. In addition, Stanford will transfer hardware and technology capabilities from the U.S. The HCS will manage the facility.
"We were drawn to the Singapore joint venture because it was managed and controlled by a government entity with a good reputation," Bair says. "It didn't require us managing an operation on the ground. . . . So we can do what we do best: science and clinical operation of radiology."
Both Johns Hopkins and UCSF Stanford say they are open to forming similar international affiliations in the future. However, like most healthcare institutions in the U.S., they say they remain focused on bringing foreign patients to their hospitals.