Around the World

Rick Johnson, for HealthLeaders News , November 15, 2007
Some physicians loath administrative responsibilities and seek to practice medicine unburdened by bureaucracy. But others view leadership positions as a calling to bring the experience and point-of-view of the medical practitioner into administration.

Moreover, placing doctors in leadership roles appears to create a culture in which patient-centered care is more than just a rallying cry, but is embodied in the actions of the organization's members. Perhaps it is a chief reason why some hospitals are now working to adopt the Mayo Clinic model in which physician leaders head-up service lines.

I considered this when I was researching a story about the globalization of healthcare, which appears in this month's HealthLeaders magazine. Hospitals and systems in the world's emerging economies are reaching out to well-known academic medical centers like never before. These foreign hospitals are not short of cash or technology, but they need administrative and clinical guidance to truly become state-of-the-art.

I had the chance to talk with Kenneth Ouriel, MD, who had spent 15 years as the chairman of Cleveland Clinic's division of surgery. He's one of those physician leaders who took a liking to administrative responsibilities. So much so that he aspired to become a CEO of a health system. Earlier this year, he got his opportunity to run a system--but it was about 8,000 miles from home.

Ouriel took charge in June as CEO of Sheikh Khalifa Medical City following a deal with the Health Authority of Abu Dhabi. Cleveland Clinic agreed to manage the healthcare network that includes a 552-bed acute-care hospital, 121-bed behavioral sciences pavilion, an 88-bed rehabilitation center and more than 20 outpatient clinics and primary-care centers.Now Ouriel is adjusting to a very different cultural climate that calls for his personal attention in all phases of Sheikh Khalifa Medical City's operations.

"Here everything is hands-on," he said after finishing an hour and a half of negotiations to get better housing for the system's employees. But with his staff of six C-suite executives--all veterans of the clinic--Ouriel is trying to create an empowering environment that more closely aligns with Cleveland Clinic's organizational model.

Sheikh Khalifa Medical City represents just one of several recent global projects that a handful of American academic medical centers are taking on. Now that entry into the United States is much more difficult than it was prior to Sept. 11, world-renowned U.S. health programs are seeing fewer international patients.

But at the same time, emerging regions of the world are seeking ways to enhance the quality of healthcare by emulating many elements found in U.S. health systems."Every industry is going global. The world is getting smaller because of a facilitation of communication," Ouriel said. "For the next decade or so, there's a real need for outside management teams."

Rick Johnson is a senior editor with HealthLeaders Media. He can be reached at

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