For Sale: Best (Canadian) Medical Practices

"We don't recognize until we get outside Canada how respected Canadian health care is. Our sense is that we have really a moral imperative to use that expertise to the benefit of the Ontario taxpayer."
Dr. Robert Bell, CEO, University Health Network, (UHN),Toronto

"Despite trying to take our public health care systems into a new domain, I think it's for the betterment of our institutions.
"We have a lot of expertise that a lot of people would like to have, and I think we undersell ourselves, we really do.
"Canadians are seen as bringing everything that is good about North America, without being American.
"We've always been more low key and I think in general they like that."
Dr. Michael Churchill-Smith, Montreal Medical International, (MMI), McGill University Health Centre

Canadian health-care professionals, including the organizations they are associated with, have long provided educational and humanitarian aid to people living in deprived conditions within countries with emerging economies unable to care for the neediest in their populations. Canadian health professionals donate their time and experience with missionary zeal, and have done so for decades.

It is far more lately that health professionals and the hospitals they serve in Canada have offered outreach programs to countries with health care systems less well endowed with professional expertise, at a hefty price, to help them establish more advanced methods of treatment, introducing them to the latest in technologically-advanced equipment as well.

Where previously the altruistic outreach has concentrated on what was once called Third-World economies, this new dollar-centric approach, though it has a decided helping component, is geared toward those capable of paying handsomely for the privilege. Those would be countries with immense wealth, but in some ways, Third-World living conditions as far as medical science, or any kind of in-depth national, home-grown science may be concerned.

This new type of outreach-for-profit activity has been characterized as medical professionals and their hospital administrations behaving like globe-trotting entrepreneurs, even though they represent government-funded health institutions. The facilities have always, apart from their government funding, engaged in fund-raising through various types of enterprises such as lotteries to bring in those additional dollars required to operate hugely expensive institutions.

Sunnybrook Health Sciences Centre, Toronto

In Doha, Qatar, a children's health centre is being designed, built and staffed with the assistance of organizers and professionals from Toronto's highly internationally respected Sick Children's Hospital. In Kuwait, Montreal and Toronto-based hospitals are assisting in the building of world-class cancer-care and heart-treatment programs. B.C. health-care facilities have rented out consulting services to clients as far removed as China and Slovenia.

Alwakra Hospital ,Qatar,Doha

The functional arrangement whereby Canadian hospitals dispatch experienced medical professionals through remuneratively-handsome contracts for consulting and education via this marketing scheme has given Canadian medical centres the opportunity to earn millions yearly, and that funding is then plowed back into patient services in Canada.  UHN is partway through a five-year, $100-million contract developing a cancer-treatment centre in Doha, Qatar.

The earnings from that contract has seen fruit, enabling the funding of an impressive expansion of the clinical-trials program at Princess Margaret Hospital in Toronto, an affiliate of the UHN network. The concern was that to fulfill the contracts experts would have to be extracted temporarily from facilities within Canada, and the spectre of taking needed resources from home to an international destination appeared as a detriment.

As it happens, however, there has recently been a bit of a glut on the medical-professional market as medical schools were admitting larger numbers of medical students to meet the challenge of insufficient numbers of doctors in Canada to serve the public; those shortages referred mostly to general practitioners, but encompassed the realm of more diverse medical professions.

Sick Children's Hospital in Toronto advertises itself and rightfully so, as one of the world's top four children's hospitals. UHN and Sunnybrook present as the fifth and sixth largest cancer centres in all of North America. Their credentials are impeccable, the results they can guarantee equally so.

Gulf doctors in large numbers have taken their training in medical specialties at universities in Toronto. 300 such Gulf doctors completed residencies at McGill University alone, making for a natural fit. Many of those Canada-trained doctors now occupy senior hospital positions, their time in Canada having gained their loyalty as well as the needed expertise to serve their countries well.

In a sense the missions represent a huge dollar figure benefiting hospitals in Canada and by default the patients whom they serve, Canadians throughout the country. On the other hand, Canadian expertise is being sold to fabulously oil-wealthy countries.

What about other, less well financially endowed countries of the world? Montreal's MMI focuses as well on Eastern Europe, with its growing economies, hampered by health-care systems well behind those of more developed nations. An agreement with a Warsaw medical school is in the works, and potential clients in Poland and the Czech Republic are being negotiated.

Sunnybrook International, the overseas business arm of the hospital in Toronto has been courting contracts in Jamaica and even Kazakhstan.

Some British Columbia hospitals which have gone the route, including the University of British Columbia medical school and the province's Health Ministry are less enthused about these ventures. They were involved in work for drug companies in China, a Saudi hospital, the government of Taiwan, among others, but the profit realized wasn't sufficient to warrant the venture.

Competing for contracts on the international scene against such well known American medical centres like the Mayo Clinic, Cleveland Clinic, Harvard and Johns Hopkins, along with British and Australian hospitals, all venturing into the same competitive market, is time-consuming and costly. Clearly not suited to all medical communities everywhere in Canada, after their initial ventures.

"Any time you're in a business where it costs more to get into the business and to bid and get work, you have to get a certain number of contracts ... to stay ahead of the deficit line", commented Steve Kenny, Canadian Advanced Medical Services International, B.C.