The new mix of healthcare facilities –Medical Cities as a cornerstone of a successful healthcare system ( ? ) Fried Oelschlegel – Healthcare Development Holding Co. ; Jeddah01. December 09.40 am

Healthcare Cities – a business case

■ Developing large-scale healthcare projects to meet various healthcare needs

■ Identifying and selecting the right service provider to meet new demands

■ Lesson learnt from regional medical cities ???

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Medical cities – are they truly cornerstones ?

Painting of Allyn Cox (1896-1982) depicting the ceremonial laying of the building's first corner-stone in 1793. During his presidency, George Washington (1732-1799) performed the Masonic ritual over the Capitol ‘s and read the inscription on a silver plate that was laid in place with it.

The cornerstone (or foundation stone) is derived from the first stone set in the construction of a masonry foundation , important since all other stones will be set in reference to this stone, thus deter-mining the position of the entire structure.

Do have Healthcare Cities such directing importance ?

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Sales slang is dominating our language and is inflating “ bubble terms “

Healthcare Cities Medical Cities Centre of Medical Excellence Cutting edge approach State of art One stop shop Integrated healthcare Holistic approach Eye catcher Large scale projects

“Healthcare City” is showing about 54,300,000 results (0.17

seconds) “Medical City” is showing about 120,000,000 results (0.16 seconds)“ Hospital “ is showing about 367,000,000 results (0.38 seconds)  

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What makes the difference ……What is the difference between Healthcare / Medical Cities and Large scale Hospitals which are attractive enough for physicians for setting up their offices close located to the hospital; creating by this way a cluster of healthcare facilities in different kind and level of services ( in our management slang “ an integrated solution ; “ a holistic approach, a one stop shop ….”

It seems – there is no any real difference – but the difference is in regards of

Healthcare/Medical City: the design and planning of such processes “ at the green table “ based on more or less as realistic evaluated assumptions but with the strong driver of being “ prestigious”

Healthcare Cluster : self sustained organic grow over a long period of time without a previous designed and directing strategic business & development plan

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Land donated( US$ 7 Mio) by Johns Hopkins in 1883;construction finished 1889 at costs of 2,050 Mio US$

Founded 1782 by Dr. John Warren; the last relocation and construction in 1906 ; total costs incl. land less than 3 Mio US&

Founded 1656 by Ludwig IVX; 1789 the world biggest hospitals; Construction Cost 1684 less than 500,000 US $

Founded 1980; start with 200 beds (now 554 beds; > 1 Mio Patients per year); total investment 90 Mio Baht = 2,975 Mio US$; since 1989 stock listed

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Four of the worlds “Top Ten”; also of top 50… No one of them is considering themselves as a “ Healthcare /

Medical city;

non one of them was growing through real estate business and engagement of 3rd party service providers

The most of them in Europe and US are 200 years old or older; in Asia older than 30 years

All of them have start under very modest conditions , with 200 beds or less and with total investments below 3 Mio US $

All of them have changed the shape, size and location more 3 times

The most of them are legality Non-For-Profit Organizations

All of them have passed thought times and difficult periods as wars, civil wars, finance crisis, natural disasters

All of them” breathing” a strong ethical code of being committed to patients first

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HDH – ............. 8

It needs a lot of time , pressures, fire, passing bad conditions , recognizing changes & opportunities, courage to fight ( if necessary ) before a hospital will go the way from an ordinary stone to a shining a diamante

Hard facts

Market Study Feasibility Study Due Diligence Business Plan Master Planning Strategy Plan 100 Consultants 1000 Meetings > Billion of US$

LEADERSHIP

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Major drivers for Healthcare/Medical City Projects ■ National / Individual Prestige■ National ( regional ) and International Competition ; driven by

promises of a high profitable Healthcare Tourism Business■ the lure of developing “ new “ Real Estate Business fields – beside

Golf Clubs also Healthcare ■ the Healthcare Industry – the project developer, architects, the

contractors, the medical device & equipment industry■ to meet various and rare healthcare needs for citizens & residents

who can afford such services provided by these “ large scale healthcare projects

■ at least: closing the gap between existing healthcare capabilities and the necessity of offering high advanced care – in particular tertiary & quarterny care to make the region more attractive for further national & international investments

These drivers don’t match this spirit and culture which has made the mentioned hospitals to world class centre of excellence ;

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Service providers The simple question is : Do it or let it do it ? And why ?

● This question indicate the core difference between the mentioned world class centre and the theory & practice of Healthcare / Medical Cities which developing the projects based on real estate business practices.

● In the Real Estate Business is not so much important what kind of service will be provided but what will be the leasing rate and the profitability. Ayurveda & SPA might be more profitable than – for example – Geronto-Psychiatric Medicine which would be urgent necessary but no any provider can be identified or attracted to do this hard job.

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Medical Cities - cornerstone for successful healthcare systems – ( a hypothesis )

Worldwide are many healthcare systems successful established without such projects and with no desire to follow this idea which came up in the 90ths of the last century .

A cornerstone gives mandatory the direction how the building should be erected. If we would follow these already laid cornerstones in different countries we would run in a fatale direction.

Medical Cities are o real-estate option for developing large scale healthcare facilities - not more & not less

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My clear answer is : NO ! Medical Cities ( or however named ) are neither Cornerstones for successful health-care systems either necessary for developing healthcare .

A WORD OF THOUGHT…

It is not the strongest of the species that survives, not the most intelligent, but the one most responsive to change

Charles Darwin ( 1809 – 1882 )

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Do You Have Any Questions?

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