By Anwar Anis, Director, TE Asia Healthcare
Modernisation since the start of the 20th century has seen an increased adoption of specialisation in line with the predominant economic thought of the era. As was first espoused by eminent British economist David Ricardo, the virtues of comparative advantage gave birth to focused industries and lean production leading many sectors of the economy to be more specialised.
Within the global healthcare sector, demand for such focused healthcare operations is fast catching on. This new wave of decentralised, customer-centric treatment options is evident from the mushrooming of multi and single specialty hospitals, specialised units within general hospitals as well as free-standing ambulatory sugical centres.
While the global COVID-19 pandemic led to disruptions in the healthcare industry, it also acted as a catalyst to revisit conventional operational strategies to ensure industry sustainability. Once again, several Asian markets including Malaysia rose in response by integrating technology and healthcare to provide digital healthcare services to ensure continuity in patient care.
The pandemic has also opened discussions around better patient management and addressing urgent patient needs in times when most hospitals are already overburdened. This has shifted the conversation around patient management to focus on single specialty hospitals as effective delivery models to address patient needs.
Arriving at an era of focused healthcare operations, single specialty hospitals allow for a healthcare delivery structure that is nimble and efficient, thus enabling hospital networks to optimise their performance. They help to ensure continuity of patient care and that urgent medical care is available for all those in need, without overburdening the existing healthcare infrastructure.
Addressing the gaps in Malaysia’s current healthcare delivery
Malaysia operates an internationally renowned healthcare system, with both government and private healthcare facilities offering quality treatment to patients. However, the pandemic has led to several challenges within this ecosystem. This includes paranoia among patients to visit multi-specialty and government facilities, overburdening of hospital resources, the need for timely action to respond to patient needs, and fatigue among healthcare workers.
In the post pandemic era, single specialty hospitals can provide focused and superior services in healthcare. Single specialty hospitals are designed to cater to specific patient types and are fitted with the right resources and operational strategies to address urgent patient needs, without the hassle of long waiting periods and competing for resources with other specialties. This is especially crucial in the current healthcare scenario where medical care needs to be accessible, convenient, and efficient. For patients suffering from non-infectious diseases, single specialty set-ups therefore provide a fast and safe option for treatments, without having to further delay medical care.
Between general and specialised healthcare
Multi-specialty hospitals cover a vast spectrum of medical specialties, from childcare to geriatric care, orthopaedics, cardiovascular diseases, dermatology, women’s health, and reproductive services – just to name a few. It is not entirely a new phenomenon, but single specialty hospitals have in recent decades increased in popularity and are commonplace in major cities around the world. This has stirred a heated debate between specialised and general healthcare.
Proponents argue that single specialty hospitals are more efficient and can deliver operational advantages relevant to the specialisation compared to general hospitals. Multi-specialty hospitals on the other hand, can sometimes deliver far too broad a range of healthcare services leading to conflicting goals at an operational level. This can ultimately result in mediocre performance in health outcomes and costs.
Through the increased focus and specialization of services, single specialty hospitals not only deliver healthcare services with greater efficiency but also promote innovation. This is motivated in part by such hospitals behaving like “focused factories.” Because of the focused approach of specialty hospitals, it permits a standard of care which can be embedded and controlled along the entirety of the healthcare sequence – from patient admission, to care and finally discharge.
This allows facilities to deliver predictable, high-quality outcomes across the clinical hierarchy to junior doctors and even nurses, thus lowering costs without compromising quality. It also enables a steeper learning curve for staff creating a dynamic learning environment for them which is congenial for innovation and sustained improvement. Similar developments have taken place in other industries which have successfully undergone a transition towards more specialised production units, such as in manufacturing, transportation, education and even banking. Studies comparing different types of healthcare delivery units have also shown significant advantages for specialized facilities.
Services offered in single specialty hospitals can often be easily detached, independent, planned, repetitive, predictable and with a low degree of patient comorbidity. Patients at these hospitals have access to extraordinary expertise, resources and therapy programs that aren’t often available anywhere else. Single specialty hospitals often have physicians or surgeons with decades long experience of treating individuals within their specific field of specialisation. These hospitals then have the necessary dedicated facilities for patient and family support to help them overcome and navigate through their medical trauma.
In contrast, the multi-specialty or general hospital model can be highly capital intensive, given the need to cater to multiple specialities. As such, they accrue high fixed costs which can inflate the costs for treatment across the board. This also leads to added bureaucracies that are more doctor-centric rather than patient-centric. On top of that, co-locating different specialties within a fixed space and limited staffing options makes it a challenge in ensuring smooth hospital operations. The complexities that ensue result in the fundamental inability for these hospitals to tightly link input costs to output value. Consequently, patients are potentially left to deal with higher hospital bills.
A potential gamechanger
As single specialty hospitals continue making waves throughout the region, more emphasis is now put on the healthcare consumer per se. The striking difference of how patients are treated today compared to a generation ago is in the quality of care and attention provided. The pandemic has also ushered in a major shift in people’s perception towards doctors and hospitals with many now realising that getting the best care for their ailments necessitates a focused environment which a single specialty hospital engenders.
Just imagine a patient in need of an orthopaedic surgery having to compete for medical attention from doctors who themselves have to deal with patients of varying medical conditions. Under a single specialty hospital environment, that patient would get everything under one roof – multiple doctors who are specialised in orthopaedic function as well as an end-to-end suite of services including post-operative care. They are seen to deliver better amenities for its patients and also achieve a higher percentage of patient satisfaction.
This patient-centric approach is already gaining currency in places where people are opting for increased comfort alongside expert treatment and care. For some healthcare procedures, it is often more comforting for patients to enter a single specialty centre which is less intimidating than a multi-specialty facility. The patient can rest easy knowing that the resources available in a single specialty hospital will be catered to his or her condition and this in effect improves the chances of positive medical output.
These hospitals also put greater management responsibilities on the doctors that help to improve quality as well as productivity. This is exemplified in the physician ownership structure which most speciality hospitals operate on.
The value of physician leadership and collaboration in hospital design, management, and operations to improve quality and efficiency must be recognised. An article by the Harvard Business Review (HBR) concluded that the best hospitals are indeed ones which are managed by doctors themselves. They make the best leaders simply because they have a deeper understanding of their fellow physician’s motivations which then better inform their leadership and managerial decisions.
If a manager understands via their own experience the requirements to complete a job to the highest standard, they are able to inculcate a high-quality work environment, set appropriate goals and accurately evaluate colleagues. Having an exemplary physician at the helm of a hospital also sends the right message to external stakeholders including patients, new hires and investors on the hospital’s organisational priorities and methods of operation.
Optimising healthcare delivery with a focused approach
Moving beyond the narrative of the COVID-19 pandemic, single specialty hospitals are acquiring a unique position of accountability, affordability and agility in operations thereby garnering greater interest from healthcare professionals and patients alike.
Without the operating costs of a larger multi-specialty hospital and other administrative expenses, single specialty hospitals can drive down costs and improve outcomes (Value Driven Outcomes), thus increasing accessibility to affordable and quality care for patients.
In a single specialty hospital, seamless patient care also becomes a reality as the healthcare professionals working within this set up are trained and equipped to cater to the needs of patients. Preliminary checks, follow-ups, post-surgical assistance, and other similar patient requirements can easily be managed through a central system, making personalised attention and care possible, giving patients more control on their overall health outcomes.
On the operative front, lower costs allow hospitals of this nature to invest more in technology and equipment, and be more efficient in the Operating Rooms, and more agile in the decision-making process. In the long run, this allows for better optimisation of overall processes and improved patient outcomes.
With a focused approach on specific conditions, single specialty hospitals also allow specialists and healthcare professionals to fully develop their professional knowledge and expertise. They also act as a platform for doctors to work on their niche specialties and dedicate time to research which improves the overall delivery of treatments.
For example, at ALTY Orthopaedic Hospital, our dedicated healthcare professionals from consultants to nurses are trained to cater to patients suffering from orthopaedic conditions throughout their treatment journey, from patient registration to post-surgical care. Providing dedicated care for joint and spine health, we are also able to invest in world class imaging and diagnostic techniques,partner top doctors and specialists and create an overall infrastructure that ensures each patient we work with experiences the best in-class patient care. As a group practice, the patients also have access to top specialists in the country where complex cases are discussed weekly within the group to make the best management plan for the patient.
While single specialty hospitals are not novel to healthcare systems, their growth in Malaysia is inevitable. This also resonates with the changing preferences of consumers and the way healthcare services are consumed. In a country like Malaysia, with a growing ageing population and the rise of affluent income households, there is a continued demand for healthcare services that are fast, convenient, affordable and accessible. The rising popularity of Malaysia as a healthcare travel destination also contributes to this growth, attracting more capital to the single specialty model of healthcare delivery.
The single specialty model of healthcare delivery will ultimately continue to grow, even post pandemic, and offer a long term alternative to relief the overburdening of healthcare systems and improve medical outcomes for both patients and healthcare professionals.
Single-specialty hospitals – the choice moving forward
The popularity of specialty hospitals over the past few years has increasingly raised significant opportunities for emerging healthcare businesses across a gamut of subspecialties. This is especially the case in the Asian region which is now facing the ancillary effects of a global pandemic and a spike in elder population.
From the viewpoint of an insured consumer where elective care is feasible, the advantages of single specialty centres are aplenty – from observable amenities such as rooms with specialty specific design elements and more convenient locations to the quality of care demonstrated by a higher nurse-to-patient ratio. This results in higher overall patient satisfaction.
Such organisations have continuously set a fresh benchmark for healthcare service providers by leveraging associated economies of scale and scope, by concentrating expertise with increased specialisation in augmenting patient choices. The result, lower healthcare costs and further enhanced quality of care. Therefore, it is no surprise that single speciality hospitals are fast becoming the primary choice for many.
