P.O. Box 409095
Chicago, Ill., 60640
Length: 12 minutes, 25 seconds
Interviewer: Neil McLaughlin, managing editor, Modern Healthcare
Interviewee: Robert Crone, president and chief executive officer, Harvard Medical International
[00:00:08.04] Womans Voice: Welcome to this edition of Special Report Extra, brought to you by Modern Healthcare and powered by Martopia. With each edition of Special Report Extra, listeners hear directly from key healthcare executives involved in the major events shaping the industry.
[00:00:30.27] Neil McLaughlin: Im Neil McLaughlin, managing editor of Modern Healthcare. Were talking with Dr. Robert Crone, President and CEO of Harvard Medical International. Our topic is the subject of Modern Healthcares August 6th Special Report. Thats a new medical city being built in Dubai, in the United Arab Emirates. Harvard Medical is spearheading development of an international hub of medical services and research at the complex in the Persian Gulf. Doctor, lets start out by telling our listeners what is Harvard Medical International.
[00:01:04.06] Robert Crone: Harvard Medical International was established about thirteen years ago, by the Dean of Harvard Medical School, as a subsidiary, not-for-profit corporation of Harvard University and the medical school, that is focused on extending the mission of Harvard Medical School internationally in the areas of excellence in medical education, healthcare delivery, and biomedical research.
[00:01:30.21] Neil McLaughlin: How did Dubai officials pitch the Dubai healthcare city project when they approached you four years ago?
[00:01:37.06] Robert Crone: They came to us with the concept of establishing a new paradigm for the delivery of healthcare in the Middle East. There was an extraordinary appreciation on the part of the leadership of Dubai, that clinical care could not be delivered consistently and at a cutting edge, without it being supported and informed both by medical education as well as biomedical research. The challenge that has plagued areas such as the Middle East has been difficult to change the culture in such a way that practice of medicine would be done in an open, transparent and ethical fashion, without some of the less-savory business practices that have developed over the years in the region. So the opportunity here was, with the support of the leadership of the government, was to create what is termed an economic free zone. An advantage to this approach is that it made the opportunity to establish an environment that was completely new and in which the existing culture, and frankly, even the existing laws of the land did not apply to this geographic area called the economic free zone. Dubai has used this approach in the development of several other major projects, one of which was in the area of communications, and the other was in the development of a number of Internet-related activities. So they had some experience with this, and they thought this might be applicable to healthcare. So we saw this as an opportunity to create an entirely new regulatory environment, using basically best practices from around the world, to create both licensing as well as credentialing rules and regulations for both healthcare institutions that would wish to co-locate in the Dubai Healthcare City, as well as individual practitionersbe they nurses, physicians and allied-health professionalsin such a way that we could create an environment that would encourage high-quality, transparent, ethical practice in an environment that was self-supporting and self-governing, to some degree.
[00:03:56.00] Neil McLaughlin: Well, speaking of that, whats something surprising or challenging that came up during the process of creating regulations and licensing rules for that zone?
[00:04:06.07] Robert Crone: Well, I think the first thing that was quite surprising is in going to regulators from different places in the United States, as well as around the world, to ask them if you had this to do over and had the opportunity to do it right, what would you do different? And I must say, that we received enormous support and enthusiasm for new ideas that would support that kind of environment. And, with the opportunity to glue this together with an information technology platform, that would allow for the reporting of outcomes, as well as other quality benchmark data, that would support and continuously inform the regulatory process. So, the opportunity to create something from the ground up really created a great deal of enthusiasm by individuals from different places in Europe as well as Australia as well as the United States and Canada. In trying to think through this in a way that would move the whole industry forward in this kind of a demonstration project.
[00:05:13.29] Neil McLaughlin: Why do you think so many big name U.S. institutions and companies want to establish a presence in the United Arab Emirates?
[00:05:24.24] Robert Crone: Well, I would say that not only do they wish to do this in the United Arab Emirates, but elsewhere in the world. I think that there is a realization that for the first time, healthcare is truly globalizinglike many, many other industriesand there are many manifestations of this. Obviously, diseases have always crossed borders, but increasingly providers are crossing borders, both for training as well as practice. And then theyre moving on to other places as well. And, for the first time, really, institutions are globalizing in such a way that there is developing an international arbitrage, both of kinds of technologies and procedures that can be done in many places around the world. And, for the first time, there is the opportunity to actually compare cost and quality across institutions.
And thats against the background, particularly here in the United States of post-9/11. When it is actually much more difficult for patients to come from other parts of the world to the U.S. to receive care. And, therefore, Id say since 9/11 we have seen the development of regional centers in excellence, utilizing individuals who potentially have come to North America for training and potentially have stayed for practice, but now have the opportunity to go back to their own communities to practice in a similar kind of environment that they might have found here in the United States, Canada, modern Western Europe.
So, I think most U.S. and European healthcare institutions have recognized that if theyre going to remain competitive globally, theyre going to have to have a presence globally. The advantage to locating in the United Arab Emirates is the fact that it is a pro-Western transit hub for a very large region of several billion people, if one includes the Indian subcontinent, North Africa, as well as Central Asia and Eastern Europe. As this area has become really a destination for tourism, it also has created the opportunity to be a destination for medical care as well.
[00:07:31.04] Neil McLaughlin: Whats your assessment of the existing hospitals and the healthcare system in the Arab Emirates?
[00:07:36.24] Robert Crone: Its spotty because individual practitioners can be excellent, but there has been a limited history of institutional quality, and creating a culture of quality that transcends individual providers. Lets say over the past five or six years, were just beginning to see institutions embracing that concept that quality has to go beyond individual practitioners. It has to become an institutional ethic that really cuts across virtually every department within the hospital.
[00:08:11.13] Neil McLaughlin: Is Harvards involvement in this project lucrative?
[00:08:16.02] Robert Crone: No. We are a not-for-profit, we are self-supporting, and therefore have to generate enough revenue to support ourselves. But by and large, these activities do very little other than support themselves. What little is left over at the end of the day goes back to Harvard Medical School to support its traditional activities. Harvard has always seen this as an opportunity for its faculty and its students to participate in, and therefore learn from, the rest of the world and its activities in healthcare, as well as to make a contribution. And so we generally use approximately 250 or 300 of the Harvard Medical School faculty to teach and to provide short-term consultations as well as providing students the opportunity to do short-term rotations to understand how healthcare is practiced in the rest of the world and to participate in some of these innovative programs and processes Ive just described.
[00:09:18.15] Neil McLaughlin: In line with that educational process and opening of international windows, what was your impression when you first visited Dubai and has your perception of the place changed since then?
[00:09:31.16] Robert Crone: I had several initial impressions that, for the most part, I must say, have been borne out. The first is there is extraordinary leadership at the top, in Dubai in particular. Sheik Mohammed (bin Rashid al-Maktoum), who is the ruler of Dubai, is an individual in his mid-50s who has truly committed his life to creating a vision of Dubai as not only a superficial destination for tourism, but is genuinely interested in human resource development of individuals from that region, to support that region. And so he has made an enormous commitment to education and research, to support, providing services that are clearly important for any modern city, such as healthcare.
The second point that is very obvious once one meets individuals from the region, and that is the true commitment that the people of Dubai have to sharing that vision. There is a true commitment and love for the leadership that is palpable.
The third component is many of the stereotypes of the Middle East that we all are faced with in terms of reading the newspaper on a daily basis, are turned upside down. There is a very strong program and commitment to promoting women into leadership positions in Dubai and in the United Arab Emirates. So that many of our counterparts are very, very well-educated young women who have lived and worked in the U.S. for a period of time, gone to university here, and then gone back to support these activities. Many have large families, and at the same time support full-time jobs.
Another important stereotype, which I found salacious with regard to dealing with Dubai and the United Arab Emirates, was the tolerance for virtually all religions and virtually all people from around the world. In Dubai, for example, the population is somewhere around 1.4 million, and about a million of those 1.4 actually come from about 120 different countries around the world, and they come with their religions, and they come with their cultures, and that they all are not only tolerated, but really encouraged in such a way that not only does one see mosques but also synagogues and churches of all denominations. And so, it is a much, much more tolerant community than I would have ever guessed from my superficial understanding of the region prior to my working there in some depth over the past four and a half years.
[00:12:10.08] Neil McLaughlin: Weve been talking with Dr. Robert Crone of Harvard Medical International about Modern Healthcares August 6th Special Report. Thank you, Dr. Crone.
[00:12:21.02] Robert Crone: My pleasure.
[00:12:24.19] Womans Voice: Thank you for listening to this edition to Special Report Extra, brought to you by Modern Healthcare and powered by Martopia. Listen to other editions of Special Report Extra by visiting the multimedia section of Modern Healthcare Online at modernhealthcare.com.