Alejandro Alfonso Díaz
ABC Hospitals and President of the National Association of Private Hospitals
View from the Top

Private Sector Approaches, Public Sector Principles

Sat, 09/05/2015 - 19:47

Q: To what extent are Mexico’s private hospitals now on par with the leading hospitals of the world?

A: We encourage hospitals and clinics in the private sector in Mexico to focus on improving the image of the country’s hospitals on a global scale. At ABC, we measure our performance against the institutional standard, which is based on data from our affiliated hospital in Houston, Methodist International.

The lack of indicators available in terms of Mexico’s hospitals is one of the things that must be addressed, and the situation is exacerbated by the lack of shared information between hospitals. Many hospitals fail to collate information in the right way and others are simply wary of sharing. As the first hospital in Mexico to share clinical results online, we were disappointed that other hospitals did not follow suit. Our affiliation with Houston’s Methodist Hospital provides access to data that we can use as a benchmark, which is complemented by regularly reviewed indicators.

We aspire to be on par with any leading hospital in the world and we are industry leaders in certain specializations, such as neurosciences, orthopedics, cancers, and surgeries. In order to achieve a high level of success, it is necessary to work over many years to change behaviors with the understanding that the hospital’s principal purpose is providing quality treatment to patients. One mistake in healthcare can change lives irreparably, so quality is non- negotiable.

Q: With access to data regarding hospital standards in Mexico so limited for patients, how has ABC gone about creating awareness of its quality and services?

A: Sadly, information on quality of hospitals, surgeons and procedures in the country is simply not available. ABC has been actively promoting transparency in this area for several years, but in terms of our own reputation we have so far been entirely reliant on first hand recommendations and word of mouth. However, access to required information is essential to both patients and professionals in order for the industry to evolve. The information is currently generated, and we are legally permitted to publish it, but many hospitals perceive a risk in making certain figures publicly available due to the possibility of damaging the hospital’s reputation with unfavorable data. The way forward is to share information within the private hospital association, a measure I have promoted for a long time.

Q: Mexico’s recent reforms have had a limited focus on the health sector. What opportunities for reform, if any, have been missed?

A: Although the healthcare sector has been performing well, it has not received intense focus and any reforms implemented require time to bear fruit. The demographic changes taking place in Mexico are going to have an impact economically. Soon, current specialists will retire and young professionals will be required to fill the vacuum in healthcare provision. Both the political gains and the real gains have to be examined when addressing this issue. Many politicians want to build big hospitals, because that creates immediate impact, but this must be complemented with a long-term focus on areas such as the creation of talent, addressing the lack of physicians, nurses, and other healthcare professionals. The private hospital association has been stressing the importance of action with both the local and federal authorities.

At ABC we have three times the number of installations in place compared to ten years ago, but paying for construction and new equipment is the easy part, provided that funds are available. The daily running of the hospital is the area in which most focus should be centered, especially staff training, quality standards, and provision of effective care. Fortunately, the current Minister of Health is aware of this issue and is working to address it.

At ABC we put a lot of money into education, with an investment of US$15 million every year. We recently began working in conjunction with one of the most prestigious schools of medicine in Mexico, Tecnológico de Monterrey, and we have built an entire student facility at our Santa Fe campus. This is one of the only organizations in Mexico to host a fully integrated teaching hospital.

Q: How can cooperation between the various governmental institutions help to prepare the entire industry for the challenges that lie ahead?

A: Policy makers in this country must recognize the important and previously overlooked role of private hospitals in improving the country’s healthcare situation. Private hospitals tend to be perceived as a manner of compensating for inefficiencies in the public sector, and the potential for referrals from public hospitals is not fully capitalized on.

Furthermore, too much installed capacity in the private sector is underutilized. In the private sector, we receive paying patients who are often only able to attend appointments at high traffic times such as mornings, evenings, and weekends, leaving considerable potential for the sale of services to the government at fixed costs that are lower than those we charge to the private segment. This will not impact treatment provided to our current patient base, but will enable optimization of the facilities we have in place.

Q: Which misconceptions create the view that private hospitals exist only to serve the wealthy?

A: This perception is something that really bothers me, but due to the exponential improvements in medicine, associated costs have been increasing. As an industry, we are in danger of outpricing medical access despite our highly developed medical services. We are working to reduce costs and refocus our attentions, allowing greater access to the services we provide. Premium services will always be available for those who can afford them, but wider services should be more accessible.

For the last 50 years, the premium segment, ABC Plus, has been our main focus in the provision of healthcare. However, having conducted studies on the population, we have found that the ABC Plus segment is expected to experience limited growth in the future, whereas the economy segment has more growth potential. We will continue to invest in being able to provide first-class services, but we have now also made the strategic decision to invest several billion pesos in more widely accessible services.

Q: What practical measures are you taking to increase access whilst maintaining profit?

A: For a long time, ABC has had a small quantity of patients paying a high cost for their healthcare, presenting the challenge of improving quality while reducing cost. In the last five to six years, we have been developing our relationships with insurance companies due to the

decrease in the average price per patient, meaning that our cost-benefit ratio has improved. Ultimately, insurance companies are our partners, with an inextricable link created by a mutually beneficial relationship in terms of patient numbers. We have also implemented welfare programs that run concurrently with our regular activities, the scale of which continues to grow as we become more profitable. We have learned that if our patients and quality are our focus, then profits will naturally see a positive impact.

Q: What is one of the most exciting long-term objectives for the hospital?

A: One of our biggest challenges is to promote our presence nationally and to provide access in previously untapped areas. In certain cities, populations lack access to the sort of healthcare quality that ABC can offer, which is a challenge we want to address. I would like to see ten hospitals opened in ten different locations in Mexico over the next decade.

Our attitude to competition means we want to provide an appropriate range of services across a variety of fields. One factor requiring attention is acquisition of talent, because with our current geographic spread, talent can be easily shared, but this will be made increasingly difficult with the procurement of more hospitals across widely- spread areas.

Q: How would you like to be able to define the legacy of ABC hospitals in the Mexican healthcare industry?

A: I would like young doctors to focus less on individual advancement in favor of peer collaboration. It is only through working collectively across various fields and institutions that patient care can be adequately prioritized. Simultaneously, by continuing to provide high-quality services across a wider demographic, we can make a real impact on the medical industry, achieving higher levels of success.

We currently have a program in place designed to tackle pediatric congenital heart disease in collaboration with a not-for-profit institution called Kardias. As part of the program, we have so far performed approximately 100 surgeries on patients who were previously on long waiting lists, using funds generated from ABC plus patients.