Dr. Rafi Kot was interviewed by BusinessWoman Magazine
An instinct for business

Rafi-Nu%20Doanh%20Nhan1.jpgWith all his eagerness and enthusiasm, Dr. Rafi Kot shared some of his opinions on Vietnamese businesswomen and concerns about the health care industry in order to bring the best health services to all patients.

No fancy words

Another three clinics and a hospital of yours is planned to be opened by 2016. I wonder how the project is going and if there have been any obstacles so far?

The project is going well, and there is no doubt that they will be launched within the first half of 2016. The obstacles are still lingering, though. On the one hand, there are quite prompt directions from the Ministry of Health and Ministry of Investment to attract overseas investors to upgrade the private clinics and hospitals, introducing Vietnamese people to improved treatment services without having to leave for other countries. On the other hand, interested investors will probably be reluctant due to the excessively complicated paperwork and administrative procedures. Renting a piece of land for the hospital, for instance, took ages to be approved by the authorities of different levels and requires countless types of documents. As such, investors will be discouraged and even doubtful of the feasibility of the project. Luckily enough, I remained positive and got over some of the obstacles. All this which brings me to wonder sometimes if the healthcare needs of the Vietnamese public should be addressed at a hospital level, or at a very well equipped day-care clinic. In other words, maybe we need less hospitals and more high-level out-patient facilities which are an easier answer,  quicker and cheaper to build.

What disadvantages do the above-mentioned obstacles bring to Vietnamese patients who would like to use medical services in high-class hospitals?

There are several disadvantages for sure. The completion of the hospital set us back approximately US$43 million (30% of which came from my personal budget), twice as much as it cost in Bangkok, Thailand. Particularly, the imported medical equipment in Vietnam is very expensive, up to 200% in some cases. The fact that Vietnam does not allow refurbished equipment by the producer (cheaper by 30%) makes the process of equipping hospitals very expensive. As the expenditure on paperwork, renting land and equipment purchase rises and service users have to pay higher as a result. Unfortunately, the hospital will have the patients “pay” for that in their bills later on… They do not have the opportunity to be cured by skillful, experienced doctors and to enjoy the best facilities.

Additionally, I find the money from tax revenues which is saved for health investment too limited. So, the citizens can hardly make use of the best treatment services, as what they benefit from the health investment budget is marginal. There has not been proper attention given to health facilities and equipment, together with the poor serving manners of doctors. This results in numbers of Vietnamese patients heading to Thailand or Singapore for medical treatment more as a result of losing trust in domestic doctors rather than searching for better facilities. I think, we have accumulated a massive amount of medical equipment in Vietnam. Our equipment is on a par with Thailand and Singapore. Yet, people go there. Why? It’s the confidence in the medical treatment, the fact that the doctors explain what  is  happening  and  what  is  the  next  step and the results  are accurate. These create confidence among the patients. I think we have to look more into bedside manners of the doctors and better communication with patients. And of course a better level of care. “Good Doctors do Good medicine.. not machines..”

Family Medical Practice Viet NamFamily Medical Practice Viet Nam
As you just said, a number of patients are afraid of doctors despite being paying customers. I think personally, they should change any such thinking. What do you think?

I think it’s all about manners, bedside manners and communication skills. Too much pride, too little time, no will to explain, all lead to a bad experience. I think that education and manners starts at home. It continues through medical schools, and is refined to the specific relations of doctor-patient. If you don’t have these, no matter what you do, no matter how correct your diagnosis is, your patient will go home disappointed, angry, and not really understanding what he has. All in all a bad experience. I usually sit down with my Vietnamese patients and ask them after the consultation if they have questions. Many times I see the surprise in their eyes. The answer is always a quick “no”. That’s when I say “ok, so now I have some questions, tell me a bit of what you understood from what I just explained”…. And a dialogue begins… Very quickly a patient-doctor discussion becomes a partnership in treatment and understanding.. that’s how it should work.

Based on your observations, how do the Vietnamese feel about high-class and expensive clinics like Family Medical Practice?

For US$25 for each treatment session, patients can be treated or consult with competent doctors who have the best equipment. They choose us because we are an international clinic. It is like someone buying a Louis Vuitton bag despite it costing more than a Mango or a Zara one. What I mean is the value of the brand and quality.

Have you offered positions to any Vietnamese doctors so far?

Our clinic has only one Vietnamese doctor who once worked for Bạch Mai Hospital in Hanoi. He was trained in the US for three years, so he’s quite open-minded and well-matched with our workplace. The biggest weakness of Vietnamese doctors is their language skills. Most of the doctors who would like to work here fail to meet the language requirement.

While the majority of doctors are foreigners, how can Family Medical Practice approach Vietnamese patients?

The input of Vietnamese patients is still insignificant. We do not focus on advertising as people will surely set high expectations and then are very likely to feel disappointed once their expectations are not met. Instead, we try to work towards word-of-mouth advertising, i.e. patients who have come and used our services will recommend us to their friends and families if we offer them a professional service beyond their expectations. As a rule we like to improve quality rather than just saying glamorous words.
We employ translators for Vietnamese patients, most who are actually our nursing staff. By the way, this is according to the regulation of the Ministry of Health in Vietnam.

Vietnamese businesswomen look ahead

Having lived and worked in Vietnam for over 26 years, I’m sure you know quite a few Vietnamese people, especially women, who come to hospital only for emergencies rather than for regular check-ups. What do you think can be done to change that habit?

Seven years ago, I was the first person to import a breast imaging machine that helps  the search breast cancer inVietnam. A very hi-tech piece of equipment. Some time later, an influential woman friend asked me to help sponsor an event for 500 guests. All were influential women  most  of  whom  were  office  workers,  businesswomen or housewives. I  made  thorough preparations of documents on why I was searching for breast cancer. I sponsored by offering 200 free breast mammography checkups. How many of them took interest in the medical issue, can you guess?

Around 50%, am I right?

I was taken by surprise that none of them took interest in it although they were smart, knowledgeable, and pretty. I asked them one by one, and the answers were either they felt good or they did not have time. Some said that they are pretty sure that they will never get breast cancer. I find what you just said true, that is, they won’t seek medical treatment until they feel pain. Breast cancer survival rates today are fantastic…. But it depends on early detection. Coming late… well.. that’s another story. And, payment can also be an issue as insurance policies are usually signed for children and the elderly. They prefer hospitals to clinics because they feel more assured. Such thinking has been embedded, no matter who they are. It will take around two or three decades, or a few more generations to change this belief. Still, fortunately enough, quite a few patients opt for us instead of hospitals, which is a remarkable change. It is noted that beauty remains the top concern among women. Botox techniques can attract them more than breast cancer searching can. (Grinning)

Besides the fact that most Vietnamese businesswomen pay insufficient attention to health care, what other impressions do you have of Vietnamese businesswomen and leaders that you have met?

I find Vietnamese women really keen on doing business. They can do business much better than men. They seem to have an instinct for business. There are some women who do not have formal training and C-management certificates or who start with a low base but are still able to do a good job in leading positions. They have a good vision, which is one of the virtues of leadership.
Second, I rarely find Vietnamese people who are innovative. Viber, for example, was invented by an Israeli person while Vietnamese people tend to follow and develop the existing ground. The time when Vietnamese women were supposed to cling to traditional roles of housewives is over, and men should be aware that Vietnamese women can do more than just staying around the home. I do hope that once escaping from such traditional beliefs, more Vietnamese women can make innovative things and lead the world.

High achievers

How do you evaluate the contributions of female employees at Family Medical Practice?

Over 80% of our employees are female whose contributions have made the clinic what it is. As a fast speaker, I find my female employees are able to get the points more quickly than their male counterparts. They are also committed to being part of the clinic for longer periods. Even when leaving for another workplace, they are normally offered higher positions. This has proven that Family Medical Practice has created an environment that provides its employees with firm foundations and excellent skill development.

What qualities of your female partners do you find the most pleasing?

They speak perfect English, have extensive knowledge, and look confident. Their confidence enables them to communicate smoothly and facilitate the interaction with foreign doctors and customers.

You once said that you are quite direct and outspoken. Are you like that towards anyone, or is there any exception, for female employees, for instance?

I’m not hot-tempered; rather, I am quite direct and outspoken. It is not my management style to ever ignore my employees’ mistakes. That means those who can’t stand pressure will not work here. I point out frankly and offer them a chance to do it better. It seems many times they either are not assertive as they sound, or the work modality is simply not for them.. (Grinning)

Thanks for sharing with us.