…As Emi Membere-Otaji unveils solutions
Extramural medical strategy refers to where a doctor can get a space in another hospital to treat his patient and pay off the host-facility owner. In this case, the patient belongs to the doctor, and not the host hospital.
With the model, according to Emi Membere-Otaji, a University of Lagos-trained medical expert, medical investor, and maritime entrepreneur, the doctor who may be an expert is spared of the burden of setting up a clinic. He rather, buys a space for a time to deliver his expertise to a patient.
He also revealed a number of solutions to medical practice, especially in times like we are in.
Reeling out the remedies, Membere-Otaji, chairman, Princess Medi Clinics Limited, presented a paper on various strategies especially extramural practice and shutting down of clinics to help medical practitioners swim out of the hard times.
He gave the tips in a lecture he presented at the 2023 end-of-year seminar at the Association of Nigeria Private Medical Practitioners Lecture Series in Port Harcourt, where he insisted that the extramural method is the way out.
Explaining further, he noted that with the strategy, doctors and medical experts, especially in government facilities, can take their patients to private facilities with better equipment to treat illnesses instead of setting up their own clinics.
The model allows them to render their medical expertise without owning the facilities or facing the operational, administrative, and associated risks in setting up their own practice, with the attendant business headwinds and stress.
The model works with pre-agreed fees; including fees for diagnosis service, nursing care for in-patients, among others.
“With this, strong hospital or healthcare infrastructure capacities can be built and private medical practitioners can also have reasonable life beyond patient-care private practice.
“For instance, a medical practitioner can arrange with a well-equipped medical centre to bring in his or her own patients and treat them and pay off the owner of the medical facility. This allows the patient to get the expertise he/she desired without becoming the patient of the location clinic.
“This way, the patient gets the best of medical attention and best of medical equipment at same time,” Membere-Otaji disclosed.
Explaining further, he said that the model offers win-win for the three parties; patient, doctor, and facility owner.
The major aim of the strategy, according to him, is to stop medical experts from insisting on opening their own clinic even when some of them do not have enough funds to do so.
He also said this would help the investors and entrepreneurs to focus on building, equipping, and managing medical centres, while experts offer out-sourced services to those centres.
Mentioning other medical practice survival strategies, Membere-Otaji said this is premised on developing good strategy by making clear cut choices on how to compete, by understanding the supply and demand sides of the business, knowing and creating competitive advantage, knowing and managing associated risks.
“However in times of turbulence in the business environment, the key ingredients of survival are not necessarily plans and aspirations but agility, capability, and the operators thinking outside the box”.
He said that leadership and corporate capabilities worthy of note would help an organisation to survive turbulence, adding that it is not necessarily to create stability, but the ability to learn fast, adapt and respond to changes and uncertainties thus always adding value, no matter what comes along.
Other strategies include; building a corporate culture of agility that keeps organisations stronger and makes them survive shocks.
He said Bill Gates put it succinctly thus; “Success today requires the agility and drive to constantly rethink, re-invigorate, re-act and re-invent”.
As leaders in the private health service industry with thorough understanding of the complexities, he went on, with the disruptions and turbulence that medical outfits are facing, it is pertinent to ensure top notch culture of agility in the system.
He also quoted McKinsey: “Agility is the ability of an organization to renew itself, adapt, change quickly, and succeed in a rapidly changing, ambiguous, turbulent environment.”
Taking on repositioning the business in times like we are in, the CEO of Elschon Limited, who is a marine and maritime investor, urged entrepreneurs and medical investors to review and re-strategize the business, improve client and employee relationship management, employ efficient cost control measures for short term sustenance and long term viability, and revisit the strategic plan, clarifying the business strengths and weaknesses, considering what used to work may not again, so adjust, to remain competitive.
Others are service innovations that should be put in place, executing well and making quality a key ingredient to the business growth; and exploiting existing capabilities and exploring new business opportunities and new markets, customers, product lines, and diversifying the service offerings to increase income.
The 2nd deputy national president of the National Chamber of Commerce, Industry, Mines and Agriculture (NACCIMA) as well as founder of the ‘Dr Emi Membere-Otaji Foundation, mentioned the ability to build a strong online presence and reprioritize an organisation’s marketing strategy as other strategies.
“Prioritise digital and mobile native experiences in every step of the way, for prospective buyers/customers to view your products and services, using email, apps, web-based and social media platforms, with frequent, analytics evaluation.”
He emphasized the use of social media influencers and Search Engine Optimization (SEO) as other approaches that would go a long way to get better results. “The digital space, also provides an avenue to improve inputs and spare parts procurements.”
He urged private medical practitioners to revise their budgets to account for new spending.
Answering questions from newsmen, the leadership guru and co-author of a biography, ‘Push Through The Wall….Way of Success’, said as part of survival plan, “You should have a clear idea of what you need to be budgeting for and what you can cut to make the most of the revenue, you do have coming in. Spend based on your budget.
“Diversify products and services lines and other sectors of the economy. Companies grow faster and also survive business headwinds better, when they have an array of products and services.
“Forward thinking companies would create other products and services to ensure they remain competitive in the market. Gaining more grounds with varied products would help the company in times of uncertainty, such as this.”
Here, he explained that a medical centre should be able to offer many services and diverse products to survive.
On cashflow management, the expert advised his colleagues that the cliché that cash is king has never been more apt than now, as the challenging business headwinds rage on. “Revenue pipelines are distorted and businesses are starved of funds, sometimes, almost tending to bankruptcy for some.
“In spite of this, out of pocket payments for medical services has remained a big challenge and health insurance practices have been frustrating to providers. Ensure improved cash flow by earlier payments for services. Minimize credits to clients.
“Adjust the business to deepening poverty, is key to survival. Hospitals are facing reduced sales as a result of fall in patient flow are better off restrategizing the services, to accommodate low-income earners to boost profitability. A winning strategy is to play cheap on offer.”
Giving the background, the University of Lagos-trained medical expert noted that the notion that Nigeria’s economy is weak is obviously not in doubt. “The nation’s mono-product and import-dependent economy has been struggling for some years, due to many reasons that include corruption, poor governance with fiscal and monetary policies quagmire, infrastructural deficits, insecurity, global economic and supply chain disruptions and overhang of the recent COVID-19 pandemic turbulence.
“The result that despite the advantage of the nations over 200 million, mainly youthful population, our economic indices have remained poor for over eight years.”
He quoted the National Bureau of Statistics (NBS) reports to show that the reality has been abysmal with the September 2023, inflation rate of 26.72 percent up from August 25.80 percent, sluggish 2nd Quarter Gross Domestic Product (GDP) of 2.51 percent (year-on-year). He said with foreign exchange rate of about N1000/1$, fuel price more than quadrupled in the past few months. The net results are increasing unemployment, underemployment, poverty and associated crime in the society.
Hitherto Nigeria was described as the poverty capital of the world with about 133 million people, multi-dimensionally poor, earning less than $2 per day.
“The summation of the nation’s miserable economic situation is that while human development indices with the attendant high morbidity and mortality in the population remains very abysmal, the huge healthcare financing deficit and insensitive ease of doing business have put medical practice and indeed health care business in quagmire. Worthy to note also is the mass emigration of Nigerian healthcare workers to other countries. A typical case of external business multiple turbulence.”
He said a medical practice in simple term provides preventive and curative medical help to the public. The core features are the physician, patients and the facility where the service is provided.
He named different forms of medical practice as Private Medical Practice; Group Medical Practice; Employed Physician Practice; Locum Practice where the doctors just act as temporary stop gaps in the system; and Multispecialty healthcare business in different scopes and sizes.
He warned that businesses in Nigeria including those in medical sectors are facing polycrisis or multiple turbulence hence sustainable business survival strategies are key, to even remain afloat much more, grow the business.
He concluded by saying, “In these days of volatile, unstable, complex and ambiguous operating environment, private medical practice and indeed businesses are going through, good business strategy, agility, capabilities and continuous innovations, hold the key to sustainable survival and indeed growth of our private medical practice.”
