Latest / Becker’s Healthcare Podcast / Expanding Cedars-Sinai’s Global Care Model with Heitham Hassoun, MD

Transcript

Expanding Cedars-Sinai’s Global Care Model with Heitham Hassoun, MD · Becker’s Healthcare Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
• 0:04
  leaders together to unpack the most pressing issues
• 0:06
  facing the industry.
• 0:08
  And every year, those conversations shift in profound
• 0:10
  and unexpected ways.
• 0:12
  This April, more than 3,500
• 0:14
  healthcare executives will return to Chicago for Becker's
• 0:17
  sixteenth annual meeting. Seven ninety five elite speakers
• 0:21
  will offer new lessons, new case studies, and
• 0:24
  predictions about what comes next.
• 0:26
  Join us April 13 through the sixteenth.
• 0:29
  For the agenda and event details, visit beckershospitalreview.com
• 0:33
  and click on the events tab in the
• 0:35
  upper right.
• 0:38
  This is Scott Becker with the Beckers HealthCare
• 0:41
  podcast.
• 0:42
  We're thrilled today to be joined by a
• 0:44
  brilliant physician leader.
• 0:46
  We're joined today by doctor Haitham Hassoun.
• 0:49
  And doctor Hassoun is the
• 0:52
  president
• 0:53
  of the Cedars Sinai International
• 0:55
  effort. You'll explain to us in more detail
• 0:57
  what exactly that is, but a brilliant career
• 1:00
  as a surgeon, professional,
• 1:02
  and as a leader. Doctor Soon, can you
• 1:05
  take a moment to introduce yourself and tell
• 1:07
  us about Cedars Sinai and Cedars Sinai International?
• 1:11
  Absolutely. Thank you, Scott. And, it's a pleasure
• 1:14
  to be with you, and
• 1:15
  I enjoy your podcast. I enjoy your,
• 1:18
  meetings, and I enjoy
• 1:20
  all the provoking,
• 1:22
  thought pieces that you put out and
• 1:24
  looking forward to your upcoming book in the
• 1:26
  summer.
• 1:28
  I,
• 1:29
  yeah, I've been at Cedars Sinai for,
• 1:32
  just over seven years now. I came from
• 1:34
  Johns Hopkins where I spent better part of
• 1:36
  my
• 1:37
  career as a surgeon, academic,
• 1:39
  surgeon and scientist.
• 1:41
  But along that journey,
• 1:43
  and it's been almost twenty years now, honestly,
• 1:46
  I got involved
• 1:49
  and became quite passionate about our formal global
• 1:53
  sort of program at Hopkins, which was, you
• 1:55
  know, at the time and still is a
• 1:56
  leading one. And, you know, I I was
• 1:59
  as a faculty member. It was very organic,
• 2:01
  starting with going overseas and doing cases,
• 2:04
  at some of our partnerships and hospitals. But
• 2:07
  that morphed my career morphed,
• 2:09
  into
• 2:11
  more of an hospital administrator and an executive
• 2:14
  and,
• 2:15
  sort of leading our strategy and
• 2:17
  business and operations around,
• 2:20
  international
• 2:22
  and everything we do that's in the global
• 2:24
  context.
• 2:26
  And so, yeah, I've been doing that at
• 2:28
  Cedars Sinai, like like I said, for the
• 2:29
  past seven years, and we've grown a lot.
• 2:32
  It's really exciting. I continue to be bullish
• 2:35
  and,
• 2:37
  quite ambitious,
• 2:38
  despite
• 2:39
  any of the turbulence and headwinds we are
• 2:42
  facing. And so, yeah, happy to dive into
• 2:44
  any details around that.
• 2:46
  And so Cedars Sinai, one of the great
• 2:49
  institutions in the world, I think ranked the
• 2:51
  last few years in the top five. I
• 2:53
  think one year maybe top one or two
• 2:54
  in US News and World Report. Fantastic
• 2:58
  institution.
• 2:59
  The international
• 3:01
  tell us about the focus of their international
• 3:04
  effort. Tell us your exact title so our
• 3:06
  audience gets that right, doctor Hassoun.
• 3:08
  And then talk to us about the international
• 3:10
  effort and the core priorities in in there.
• 3:14
  Yes.
• 3:16
  So my my exact title is chief executive,
• 3:20
  Cedars Sinai International,
• 3:23
  and,
• 3:24
  that is a senior vice president,
• 3:26
  level position in the, health system, if you
• 3:29
  will.
• 3:31
  It has morphed. When I arrived here, it
• 3:33
  was,
• 3:33
  you know, I was recruited as a vice
• 3:35
  president and medical director, and the titling is
• 3:38
  purposeful in this change
• 3:40
  in the context that, you know, I have
• 3:42
  responsibilities
• 3:43
  over you know, really, if you think of
• 3:45
  all of our mission, vision, values as a
• 3:47
  as a complex academic medical center today,
• 3:51
  Cedars Sinai,
• 3:53
  looking at all the things we do in
• 3:55
  a global context, patient care, of course, we
• 3:58
  have a brilliant culture of a very highly
• 4:01
  patient centric approach,
• 4:04
  and I think that remains
• 4:07
  center
• 4:07
  central to our ethos and our operations,
• 4:10
  is everything we do truly is about patient
• 4:13
  care and how do we connect with patients
• 4:15
  and then as an extension to our communities.
• 4:18
  Now Cedars Sinai, you know, has been
• 4:21
  you know, it it's very different than at
• 4:23
  Johns Hopkins, and I could speak to that
• 4:24
  freely because I spent so much of my
• 4:26
  career there. But I'm very familiar with some
• 4:28
  of the other top academic medical centers, of
• 4:30
  course.
• 4:31
  I think, you know, historically, a differentiator for
• 4:34
  us is we truly are a community hospital
• 4:36
  here in West Los Angeles. It was born
• 4:38
  that way, and even today still has,
• 4:42
  much of that carved into our, sort of
• 4:45
  infrastructure and into our DNA
• 4:47
  as as as a community hospital. But, obviously,
• 4:50
  we are a top 10 funded,
• 4:53
  hospital when it comes to research.
• 4:55
  We have incredibly
• 4:56
  talent incredibly talented trainees,
• 4:59
  residents, and fellows,
• 5:01
  PhD
• 5:02
  scientists,
• 5:03
  and students, and doing masters.
• 5:05
  You know, really our complex,
• 5:07
  we actually now have the Cedars Sinai University,
• 5:10
  though we don't have schools. We don't we
• 5:12
  don't give out degrees for medicine or nursing
• 5:15
  or pharmacy or any of that type of
• 5:16
  thing. So it's a bit unique. I think
• 5:18
  Cedars Sinai has developed its own path as
• 5:21
  an academic medical center.
• 5:24
  And, you know, my my job has you
• 5:26
  know, when I arrived, we were doing an
• 5:28
  excellent job at taking care of, patients that
• 5:31
  would come to us and try to,
• 5:34
  kinda grow the the brand and and awareness,
• 5:36
  but only really focused on the medical travel
• 5:40
  enterprise and patients to come to Los Angeles
• 5:42
  and get care. The reality is to, you
• 5:45
  know, in my view, to be a a
• 5:47
  a top program today,
• 5:48
  you need to be do far more than
• 5:50
  that, and you need to be bringing not
• 5:52
  only direct care closer to patients where they
• 5:55
  are, but also improve the the continuity of
• 5:58
  care and the care delivery in those communities,
• 6:01
  whether it's our neighboring countries. You know, like
• 6:03
  most of us in US, we're dealing with
• 6:06
  a a good bunch of people coming from
• 6:08
  Mexico or Canada.
• 6:09
  Of course, decades, we've been sort of a
• 6:12
  the trusted place for, the Gulf countries to
• 6:15
  the government sponsored patients to travel and get
• 6:17
  care, very complex care here.
• 6:20
  Certainly,
• 6:21
  you know, ten years ago, it was heavy
• 6:22
  on on China as a as sort of
• 6:25
  the the East Asia
• 6:27
  kind of, because of the population, etcetera,
• 6:30
  and India and South Asia. But I think
• 6:32
  a lot of that is dynamic today, looking
• 6:35
  I mean, we we're we're almost all over
• 6:37
  the world in terms of, strategically finding where
• 6:39
  opportunities are and building communities.
• 6:42
  But, you know, we still stay focused and
• 6:44
  strategic in our approach.
• 6:47
  Fantastic. And talk about as you head into
• 6:49
  this year, and we're already in 2,026,
• 6:52
  what are you most focused on and excited
• 6:54
  about? And, doctor Arsoon, do you end up
• 6:55
  doing a lot of travel with the CEO
• 6:57
  job of of international? Do you end up
• 6:59
  going to the Gulf countries a lot and
• 7:01
  and talk to us a little bit about
• 7:02
  that? Is that fascinating?
• 7:04
  Yes. I I think I definitely have a
• 7:07
  fascinating job. It involves that you know, I
• 7:09
  I don't I don't think you could do
• 7:11
  this job without traveling
• 7:13
  and being sort of heavy traveling because you're
• 7:15
  really building relationships and and you need to
• 7:17
  really understand,
• 7:19
  you know, what's happening in the communities that
• 7:21
  that we serve, that we partner with.
• 7:25
  I think, you know, for us today, I'll
• 7:26
  tell you what I'm I'm most excited about,
• 7:28
  and we've been on a journey of of
• 7:30
  I feel like we're building the the the
• 7:32
  modern railroad for health care. And,
• 7:35
  you know, I think that requires,
• 7:38
  you know, I think the big Achilles' heel
• 7:41
  in my view has been this continuity of
• 7:43
  care, like truly creating. And and and on
• 7:46
  the one hand,
• 7:47
  if you're a technical
• 7:49
  thinker and and IT and all this, it
• 7:51
  is true that, you know, if we had
• 7:53
  all hospitals and everyone on one system on
• 7:56
  Epic, for example, like what we use, and
• 7:58
  we can have access to information and imaging
• 8:00
  and follow-up and continuity of care, it's very
• 8:03
  helpful.
• 8:04
  But that's not realistic in the world we
• 8:06
  live in, both from an from a commercial
• 8:08
  aspect but also from a regulatory aspect.
• 8:11
  And so, you know, you can do affiliations.
• 8:14
  And one of the great things at Hopkins,
• 8:16
  you know, what I learned to do because
• 8:17
  I was the global medical director, which was
• 8:20
  we had about a dozen
• 8:22
  plus
• 8:23
  affiliations that had the brand
• 8:26
  that came with sort of requirements to place
• 8:28
  medical directors and then have quality sort of
• 8:31
  infrastructure
• 8:32
  and share KPIs.
• 8:33
  And that starts to allow you to create
• 8:35
  sort of a structured approach to,
• 8:37
  you know, having an equal playing field for
• 8:40
  the hospital. But it doesn't necessarily address that
• 8:43
  continuity of care direct to the consumer, direct
• 8:45
  to the patient.
• 8:47
  And so I think today we're very I
• 8:49
  mean, what excites me is, you know, we're
• 8:50
  opening our clinic in London, our first wholly
• 8:52
  owned asset overseas. This will be in the
• 8:54
  Harley Medical area.
• 8:56
  And we we have two clinics, actually. A
• 8:57
  smaller one in partnership with the guys in
• 9:00
  St. Thomas
• 9:01
  is already open, but our flagship, it will
• 9:03
  be opening later in the springtime.
• 9:06
  But that's just the beginning.
• 9:07
  You know, we are working on our on
• 9:09
  our partnership in Singapore where we have an
• 9:11
  office, but we want to extend that into
• 9:13
  an actual, again, a a clinic.
• 9:16
  I call these concierge clinics. You know, the
• 9:18
  the semantics can be highly variable. What it
• 9:21
  really is is primary care, like, you know,
• 9:23
  for the community that we serve. And strategically
• 9:26
  for us, that's we have to be in
• 9:28
  London, we have to be in Singapore, we
• 9:29
  need to be in Dubai, and we need
• 9:31
  to be in Mexico City.
• 9:33
  We have a long history of patients and
• 9:36
  and activities there, but I also think those
• 9:39
  are international cities with crossroads,
• 9:41
  modern crossroads of of the the globally traveling,
• 9:45
  patient and consumer that would want to access
• 9:47
  Cedars Sinai and who knows Cedars Sinai. And
• 9:50
  also we'll have our doctors, physicians there who
• 9:52
  are very good at 20 fourseven high touch
• 9:55
  care and make sure that these,
• 9:58
  these patients and these customers always have access
• 10:01
  to at a primary level that can immediately
• 10:03
  connect into our specialty care model. So this
• 10:06
  is why I think it is kind of
• 10:07
  this rail where we're building the tracks. Of
• 10:09
  course, those there's a lot of gaps between
• 10:11
  those cities, but
• 10:12
  through organically
• 10:14
  partnerships
• 10:15
  like we have at the View Hospital in
• 10:16
  Qatar now, beautiful hospital, and it's really coming
• 10:19
  into its own, kind of growing into its
• 10:21
  shoes as a from a workforce and and
• 10:24
  capability
• 10:25
  perspective.
• 10:27
  I I think that, you know, clearly, The
• 10:30
  Gulf, we wanna have more presence in Saudi
• 10:32
  and UAE and and and but we're we're
• 10:35
  picky. Picky not in a bad way, but
• 10:37
  in a good way. We're not looking just
• 10:38
  to jump into partnerships for the sake of
• 10:40
  that. It's not a revenue,
• 10:42
  game. It's a it's really, you know, having
• 10:45
  the right minded partners and,
• 10:47
  trying to be able to connect the dots
• 10:49
  and deliver top care.
• 10:52
  I'm really also and I'll stop here because
• 10:54
  I know I don't wanna keep sort of
• 10:56
  belaboring some of the same issues, but I
• 10:58
  I am also very bullish on the the
• 11:00
  private sector development in other areas such as
• 11:03
  even Western Europe. Very, very and I'm really
• 11:05
  excited about that. We're putting a lot of
• 11:07
  effort.
• 11:08
  I do think that there will be a
• 11:09
  Cedars Sinai Hospital.
• 11:11
  You know, we have been talking with,
• 11:14
  you know, great potential partners in Spain and
• 11:17
  Germany,
• 11:18
  Very traditional areas that our our partners don't
• 11:21
  necessarily I mean, our excuse me, our colleagues
• 11:23
  at, you know, wherever, Hopkins, Mayo, Cleveland, don't
• 11:25
  traditionally go because of the obvious dynamic of
• 11:29
  the government based systems and then the the
• 11:31
  private sector challenges, but that's all changing.
• 11:35
  And I think now is a good time
• 11:37
  to invest in. And and then when we
• 11:39
  invest, we don't go alone. We go in
• 11:40
  partnership. So you gotta build the right partner
• 11:43
  and be able to provide for those developing,
• 11:46
  markets, you know, really that high touch, high
• 11:48
  quality, care,
• 11:50
  offering.
• 11:51
  And how do you assure
• 11:54
  the quality,
• 11:55
  the reimbursement,
• 11:57
  the recruitment?
• 11:58
  I I guess, actually, in a different way.
• 12:01
  What are the
• 12:02
  most interesting challenges as you go into another
• 12:05
  country to provide care and to develop clinics
• 12:08
  and develop hospitals?
• 12:10
  Is it the recruiting talent? Is it reimbursement?
• 12:13
  Is it maintaining the CDR signing quality in
• 12:15
  another place? What what are the big issues
• 12:17
  you you think about?
• 12:19
  Yeah. Great question and and very, insightful one.
• 12:22
  You know, I think
• 12:23
  the the reality is it's all of those
• 12:25
  things.
• 12:26
  And I think the main thing to to
• 12:28
  know and understand is number one,
• 12:31
  you really take your time to understand
• 12:34
  the market, not just from a business or
• 12:36
  regulatory,
• 12:37
  on paper,
• 12:38
  but to know the people and to see
• 12:40
  how because culture, as we always talk, right,
• 12:43
  eat strategy for lunch every day of the
• 12:45
  week. And I think,
• 12:47
  I I think that's a critical piece to
• 12:49
  it, and you just have to take the
• 12:50
  time
• 12:52
  and, you know, really understand,
• 12:55
  what's happening, the dynamics, the physician practices.
• 12:59
  You know, I think revenue is a challenge
• 13:01
  because there aren't many places that have revenue
• 13:04
  streams like we have at Cedars Sinai in
• 13:06
  LA.
• 13:07
  So you it's impossible
• 13:08
  to transplant our our system. It'll immediately be
• 13:12
  rejected. If nothing else, there's not enough, you
• 13:14
  know, oxygen or supply chain of what the
• 13:17
  fuel needed to to to do the work.
• 13:20
  So you have to build a global workforce.
• 13:22
  You know, we, when I and it's I'm
• 13:25
  not talking about the clinical operations, just the
• 13:27
  administration of my team. We've when I arrived,
• 13:29
  we were 11 people. Now we're 65.
• 13:32
  But of those, you know, almost, a little
• 13:34
  less than half, probably about 35 to 40%
• 13:37
  are are deployed somewhere globally, either employed by
• 13:40
  us or working in a consultant role. I
• 13:42
  think you need to have the and and
• 13:44
  we obviously need to continue to grow. But,
• 13:47
  you know, I think one of the things
• 13:48
  that US hospitals
• 13:50
  that are active international have been leery to
• 13:52
  do, which is to get comfortable,
• 13:55
  you know, outside of your local market. Certainly,
• 13:58
  some have. You know, I'm always been intrigued
• 14:00
  and impressed,
• 14:02
  by Pittsburgh and my colleague who who runs
• 14:05
  the international now, Joel Nelson. You know, I've
• 14:07
  gotten to know him a bit and understand
• 14:09
  how they think and do things. I mean,
• 14:10
  they
• 14:11
  they have over 3,000 employees.
• 14:14
  Everything they do overseas is is,
• 14:17
  you know, really, they own and operate any
• 14:19
  anything. They don't get into consulting or advisory,
• 14:21
  and it's almost opposite to what all of
• 14:23
  us. We all tap tap put our foot
• 14:26
  in the the the water, so to speak,
• 14:28
  and we buy consulting and advisory and education
• 14:31
  things before we tackle management and ownership. But
• 14:34
  I think there's something to be said about
• 14:36
  that because that is obviously,
• 14:38
  maybe the easiest way to control the operations
• 14:41
  and the quality,
• 14:42
  but it's also very difficult to stand up,
• 14:44
  the workforce. And and it's
• 14:46
  so no wonder they operate mostly in Europe
• 14:49
  where you might be a lot more alike
• 14:51
  than if we were operating in Southeast Asia
• 14:53
  or deep in South America or what have
• 14:55
  you.
• 14:56
  But I I think, you know, of course,
• 14:59
  I think for us, I think the main
• 15:01
  thing is you need to be very strategic,
• 15:04
  you need to build the relationships,
• 15:06
  and you need to be realistic about what
• 15:08
  you can and cannot do. And and, I
• 15:10
  I think we're steadily,
• 15:13
  moving, and that's why for us, doing these
• 15:15
  primary clinic nodes,
• 15:17
  where you might be looking at a $10,000,000
• 15:20
  investment initial or $20,000,000
• 15:22
  as opposed to a 200 or $1,000,000
• 15:25
  hospital or something,
• 15:27
  is easier and to get and that's how
• 15:29
  you start to build the relationships and understand,
• 15:32
  you know, through your doctors on the ground,
• 15:35
  the specialty market and what we can actually
• 15:37
  do and can't do. And how much of
• 15:38
  that how much does the future
• 15:41
  involve
• 15:42
  this medical travel or or or traveling to
• 15:44
  The US for for
• 15:46
  spine surgery and for transplants and for cancer
• 15:49
  care,
• 15:50
  or how much of that is actually gonna
• 15:51
  be localized? I mean, clearly,
• 15:54
  private health care is being regionalized
• 15:56
  with centers of excellence in in different parts
• 15:58
  of the world.
• 15:59
  I don't think,
• 16:01
  though, that patients are gonna stop traveling,
• 16:04
  to other countries or even The US. It's
• 16:07
  gonna be a mixture, and I think the
• 16:09
  survivors will be the ones that are able
• 16:10
  to blend the two models,
• 16:12
  and that's what we're trying to do.
• 16:15
  100%.
• 16:16
  And and the shortages that we have in
• 16:18
  The US
• 16:19
  are much larger in some specialties overseas,
• 16:23
  which at least if we're able to keep
• 16:25
  on producing great specialists here,
• 16:28
  there will be some continued travel here for
• 16:31
  care.
• 16:32
  I'm gonna ask
• 16:34
  two or three questions.
• 16:36
  And and one I'll ask you, I had
• 16:38
  a chance to visit our podcast with doctor
• 16:41
  Mehmet Goh,
• 16:43
  doctor Faith Mehmet Goh. Is is he with
• 16:45
  you in in Cedars Sinai, Qatar?
• 16:48
  Yeah. So,
• 16:50
  doctor Goh is is a very experienced,
• 16:52
  and seasoned,
• 16:54
  hospital executive in the region there, and he's
• 16:57
  hired by our our partners to be as
• 16:59
  a CEO of the hospital. So he's an
• 17:01
  employee of, technically now, they call it Apex
• 17:03
  Health, which is owned,
• 17:05
  it's under a sort of the holding company's
• 17:07
  Power International. But it's a leading it's a
• 17:09
  leading,
• 17:11
  you know, development company in Qatar, and and
• 17:13
  he works for the health care, group. And
• 17:15
  I think now he actually recently had an
• 17:17
  expanded,
• 17:20
  sort of responsibility beyond the View Hospital, which
• 17:23
  is the Cedars Sinai affiliate and their sort
• 17:25
  of flagship, but also all the operations in
• 17:27
  Qatar because they're they're going fast. They move
• 17:30
  pretty fast, those guys. We got Let's try
• 17:32
  it. Keep the tiger by the tail as
• 17:34
  I always joke. But, we love them, and
• 17:36
  and I think the partnership's been amazing.
• 17:39
  No. He's a ridiculously gifted person and leader,
• 17:42
  and it's so interesting to be for me
• 17:44
  to be able to check dots because I
• 17:45
  had a chance to speak to him on
• 17:47
  his podcast not long ago and get to
• 17:49
  know him some. And I've visited with him
• 17:51
  over the years, but what what a fascinating,
• 17:53
  brilliant
• 17:54
  person.
• 17:54
  Yeah. Another question is this. And and
• 17:58
  if this is too complicated a question,
• 18:01
  doctor Hassoun, don't answer.
• 18:03
  Mhmm.
• 18:04
  Okay? So here is the question.
• 18:06
  Johns Hopkins,
• 18:08
  better
• 18:10
  today or back in the day,
• 18:12
  better in soccer or lacrosse? Which one has
• 18:15
  a stronger program at Johns Hopkins?
• 18:18
  I know it's a tough question. Give us
• 18:20
  your thoughts.
• 18:21
  Oh, you got me there. I thought I
• 18:23
  was I was bracing myself for where you're
• 18:25
  gonna put me to talk about Hopkins International
• 18:27
  or Medicine or something in the spot. That's
• 18:29
  an easy one. I mean, I played Hopkins
• 18:31
  soccer, and I still follow and they so
• 18:34
  if you if we look at it in
• 18:35
  this context, which I'll choose to do,
• 18:37
  is Johns Hopkins soccer, since the time I
• 18:40
  played there, between 1989 and 1993
• 18:44
  to today,
• 18:45
  has grown and developed
• 18:47
  tremendously
• 18:49
  compared to lacrosse team, which may have gone
• 18:52
  mostly the opposite direction,
• 18:55
  I will say that Johns Hopkins soccer
• 18:57
  is the team to support. That that is
• 18:59
  a fair statement, and I love the analysis.
• 19:02
  And thank you. And I did see that
• 19:04
  you played soccer
• 19:05
  at at Hopkins. I I have one more
• 19:07
  question for you. When when you work with
• 19:11
  surgeons internationally
• 19:13
  and, obviously,
• 19:14
  in our country,
• 19:15
  we are the huge beneficiary
• 19:17
  of surgeons that come from other countries to
• 19:19
  hear, and thank god for it because our
• 19:20
  health care surgery would be so much worse.
• 19:22
  And and the surgeons that we work with
• 19:24
  are are are so well trained from other
• 19:26
  countries. I I I literally have two questions
• 19:28
  here, so bear with me. What are the
• 19:30
  shortage look shortages look like in some of
• 19:31
  the other markets that you're in of
• 19:34
  surgeons, procedural specialists? What are the shortages look
• 19:37
  like compared to here? That's one question. And
• 19:39
  I guess the second question is, some countries
• 19:41
  are doing a tremendous job of producing doctors
• 19:44
  that are out truly practicing
• 19:46
  after college, med school residency at 27, '28,
• 19:49
  and we somehow have made it to people
• 19:51
  are not out really practicing till thirty, '31,
• 19:54
  '32,
• 19:55
  and more and more of them practicing part
• 19:56
  time. Is there something we could learn from
• 19:59
  medical education in other countries?
• 20:01
  I mean, we produce great doctors, but not
• 20:03
  quickly and not efficiently. Is there something we
• 20:06
  could learn from other countries on that? And
• 20:08
  and what does the I assume the doctors
• 20:10
  that you work with in other countries are
• 20:12
  great.
• 20:13
  Are there bigger shortages in other countries in
• 20:15
  here, or what does that look like?
• 20:17
  Sure.
• 20:19
  And I think all the questions you pose
• 20:20
  are all sort of interrelated. I'll start maybe
• 20:22
  on the back end a little bit in
• 20:24
  the sense that,
• 20:25
  yeah, absolutely, I've long we we can learn,
• 20:27
  and we should learn and adapt, you know,
• 20:29
  and the hardest part is to is change
• 20:31
  is very difficult,
• 20:33
  and it it requires
• 20:35
  sort of leadership and sometimes, you know, requires
• 20:37
  breakthroughs.
• 20:38
  I mean, I think, you know, when I
• 20:39
  was coming up, I just I knew I
• 20:41
  wanted to be a vascular surgeon
• 20:43
  before I went to med school, and I
• 20:45
  was, you know, Michael DeBakey. I'm a Lebanese
• 20:47
  American, and and in that in our community,
• 20:49
  there was no bigger icon,
• 20:52
  an American,
• 20:53
  than Michael DeBakey, especially since I grew up
• 20:56
  and I'm from Houston, Texas.
• 20:57
  And so, I mean, I knew I wanted
• 20:59
  to be a vascular surgeon, and and so
• 21:01
  I think,
• 21:02
  you know, you but you had to literally
• 21:04
  at that time, there was no way you
• 21:06
  can take a modular approach. At least today,
• 21:08
  there's some improvement. You can go directly from
• 21:11
  med school into vascular and do your surgical
• 21:13
  training in five years as opposed to back
• 21:15
  then when we and you had to do
• 21:17
  general surgery for five and then two of
• 21:18
  vascular.
• 21:19
  But the reality is I think if you
• 21:21
  just think about you know, I'm I'm a
• 21:22
  bit on the fence
• 21:24
  about the, undergraduate
• 21:26
  education.
• 21:27
  So, you know, the four years of college
• 21:28
  and the four years of medical school, I
• 21:30
  think it produces for us more mature people,
• 21:33
  more,
• 21:34
  broadly
• 21:35
  kind of, versed and,
• 21:37
  and and maybe more prepared to take on
• 21:40
  a very noble and challenging,
• 21:42
  occupation of being a physician, responsible for people's
• 21:45
  lives and light in some ways livelihoods.
• 21:48
  So I kinda like the system we have
• 21:50
  about becoming a doctor,
• 21:53
  having to go through that process and not
• 21:55
  not squishing it together, and even having to
• 21:57
  go to college first, then med school, because
• 22:00
  it forces you to grow up a little
• 22:02
  bit before you make these important choices.
• 22:04
  Having said that, though, I do think we
• 22:06
  need to do a better job of of
• 22:08
  making your journey, once you have your MD,
• 22:10
  a bit more modular and tailored to what
• 22:13
  you wanna learn and stackable
• 22:15
  as opposed to being so, you know,
• 22:18
  big commitments and then having to make big
• 22:20
  decisions when you're still trying to figure out
• 22:22
  exactly what you want to do in your
• 22:23
  career as a physician. I mean, for me,
• 22:25
  I would never have thought I would be
• 22:27
  where I am today. And it's so much,
• 22:30
  it all makes sense to me now having
• 22:31
  grown up as an American expat, you know,
• 22:34
  I moved to Saudi Aramco and Saudi Arabia
• 22:36
  and from Texas when I was young, and
• 22:38
  I went to boarding school,
• 22:40
  you know, on the East Coast, and I
• 22:42
  went to Hopkins, and then like my whole
• 22:44
  life was this
• 22:46
  mixture of of cultures and communities.
• 22:49
  And then it was easy for me to
• 22:50
  go into a developing field that was especially
• 22:53
  driven by Gulf countries and and the money
• 22:56
  there and the resources to build the health
• 22:58
  care. But, you know, you can't sometimes plan
• 23:00
  that. I was just a nerdy scientist and
• 23:03
  and and clinician.
• 23:05
  So, you know, getting back to the physicians,
• 23:07
  how they look worldwide, look, I think clearly
• 23:09
  the world is much smaller now with information
• 23:12
  sharing, and there's no doubt with, you know,
• 23:15
  AI and tools that are gonna be in
• 23:17
  the future that there is gonna be a,
• 23:19
  you know, you know, I I think the
• 23:21
  knowledge gaps are gonna close in different communities,
• 23:24
  and they're gonna get pretty tight
• 23:26
  to where most most of the knowledge we
• 23:29
  have,
• 23:31
  will be available to everyone.
• 23:33
  The reality is, though, is that we don't
• 23:35
  have enough knowledge about truths and and the
• 23:39
  biological sciences,
• 23:40
  and I and I think it's it's different
• 23:42
  than physical sciences and other disciplines.
• 23:45
  And I think, that's where experience matters,
• 23:48
  real world tangible experience, and I think where
• 23:51
  culture matters.
• 23:52
  And I still stand heavily behind, you know,
• 23:54
  The United States. We are, you know, people,
• 23:58
  especially from the European side, but others will
• 24:00
  like to kinda poke holes of our expensive
• 24:03
  system. We do leave patients and people behind.
• 24:05
  Those are not things that,
• 24:07
  we'd like or proud of.
• 24:09
  But the reality is,
• 24:11
  the depth of our regulatory
• 24:13
  system,
• 24:14
  our peer to peer review system,
• 24:16
  and our social structure allows us to and
• 24:19
  I believe when you get out and start
• 24:21
  practicing health care, you're practicing at at the
• 24:23
  highest level you can, and we don't have
• 24:26
  a tiered system within the physician. So all
• 24:28
  these things lead to a very high level
• 24:30
  of professional level of of care delivery.
• 24:34
  I'm I I wouldn't say I'm concerned, but
• 24:36
  but I wonder how it'll evolve in the
• 24:38
  future.
• 24:39
  I think it should be hard to become
• 24:41
  a doctor and to become a surgeon,
• 24:43
  and I think we should carry,
• 24:45
  you know, that,
• 24:46
  sort of profession and field at a higher
• 24:48
  standard than just simply knowing certain things and
• 24:51
  having certain knowledge or the experience matters.
• 24:54
  And,
• 24:54
  so, you know, it'll be interesting to see
• 24:56
  how this all evolves over time. The last
• 24:59
  thing I'll say is, you know, between I
• 25:00
  mean,
• 25:01
  I I think
• 25:02
  there are differences in physicians'
• 25:05
  skills in different parts of the world based
• 25:07
  on what they see. I mean, some of
• 25:08
  the things that for example, within my field
• 25:10
  in China, an aortic dissection is so common
• 25:13
  to get such high volume. Or if you're
• 25:14
  in India and you're a cardiologist in the
• 25:16
  amount of coronary artery disease and the amount
• 25:18
  of Stansing cats. I mean, from a technical
• 25:21
  perspective, you aren't they're incredible.
• 25:24
  But then you need to have you know,
• 25:26
  most of the technology and the research and
• 25:29
  the and all that goes into the clinical
• 25:31
  trials
• 25:32
  are coming more from American and US minds
• 25:35
  and money. So I I think today we're
• 25:37
  in a different world than when I was
• 25:38
  growing up in the field. There is an
• 25:40
  internationalization
• 25:41
  or globalization of science and investment.
• 25:44
  And it's it's very interesting. It's harder and
• 25:46
  harder to draw clear lines
• 25:48
  despite what when you live and and and
• 25:51
  see in the media and our and our
• 25:53
  leaders today and and sort of the movements
• 25:55
  that are happening kinda retracting to within boundaries
• 25:59
  and borders. The reality is on the ground
• 26:01
  that I see is it's from an economic
• 26:03
  perspective and maybe even a social one, it's
• 26:06
  kinda hard to pull that back, and we
• 26:07
  are living in a world that truly is,
• 26:10
  more integrated than not.
• 26:12
  A 100%.
• 26:13
  Doctor Soon, thank you so much for joining
• 26:15
  us. I love the reference to doctor DeBakey.
• 26:18
  You went to Baylor College of Medicine or
• 26:20
  did your residency in a magnificent program.
• 26:24
  Fantastic.
• 26:25
  My daughter spent last summer in Beirut, so
• 26:27
  I got a chance to learn more about
• 26:28
  Lebanon than I thought I ever would in
• 26:29
  my life. Thank you so much for joining
• 26:31
  us today on the Beckers Health Care podcast.
• 26:33
  What a pleasure. Amazing. Thank you, and I
• 26:35
  can't wait to see you in Chicago next
• 26:37
  time at the meeting.