August 28th 2017 In the next weeks/ months I will share my experiences about being an entrepreneur in the Healthcare in the Netherlands. From 1984 untill 2010 I worked in a Regional Hospital, in 2010 I started in Private Clinics. It was not going to be an easy ride 😉 I will share some of my stories, experiences and lessons learned, from a perspective as a doctor and from a MBA perspective. Healthcare is a special business……;) Allan Vafi, MD MBA vasc surgeon
How To Start A (Private) Medical Clinic In The Netherlands
The Story Of The TwenteHof Clinic In Hengelo
August 30th 2017 2. So at the beginning of 2015 we often came together and made nice plans about how the new clinic should look like. Actually, our new clinic could be seen as the logical continuation of the Spatader Clinic where my two colleagues were still working. At that moment I was still working in another medical organisation leading the department for venous insufficiency and had set up the endovenous laser treatments at their clinic in Doetinchem. It seemed possible for me to combine this with the new clinic, maybe in the form of a collaboration between the two clinics.
We sought contact with a consultant to build the clinic. Issues like establishing a formal structure, regulations, WTZi permission etc were being taking care of. My colleague already had practice space in Hengelo where we would establish the new clinic. On the same floor some extra rooms were rented and a treatment room was prepared for the surgical procedures. His own staff would be employed by the clinic, later supplemented with two staff members from Spataderkliniek. Money had to be supplied, which proved to be problematic for my two colleagues because of the lack of financial resources or hesitation with transferring. The financing was therefore on my shoulders, which from the start created a financially inbalanced situation. In July 2015 the WTZi permission was granted and the clinic could start. The ‘dream team’ from the Spataderkliniek, which my colleague had worked closely with, started working in Hengelo in the same way. Shortly after the start of the clinic our other colleague (surgeon) did not appear to be in agreement with the ideas and plans on how the clinic would shape and the role he would play. We talked and we all agreed it would be better for him to leave and to repay his investment. I realized that the team was quite autonomous and barely controlled, and regarding actions and decision making they were only depending on my colleague, just as they used to do in the previous situation. Attempts to restore the governance balance had little results, for my colleague it was not really an issue, so he didn’t matter. In retrospect, the team got too much space to go their own course without accounting for it. In fact, it seemed as if my participation in leading the clinic was seen as an unnecessary and undesirable interference.
August 28th 2017 1. The start of my report of the journey I went through when I was asked, at the beginning of 2015, whether I felt about starting a medical clinic in Hengelo in the area of phlebology, dermatology and proctology. Perhaps I was a little naïve or too enthusiastic when I agreed and as a result I worked together and trusted somebody, which I would regret later. Let me start at the beginning: In 2012, I left another medical clinic, the Spataderkliniek Enschede, which was a successful initiative that I, together with the former founder R, had expanded into a well-functioning clinic in two years. At the time of the agreed 48% equity transfer in March 2012, R suddenly backed off without giving a reason for it and I was being confronted with a not unsympathetic but smooth lawyer. I had no option but to leave and transfer the matter to a lawyer. With the Spataderkliniek it did not go well, R has disappeared from the scene, the three hired advisors could not save the clinic, left the sinking ship, taking ‘good care’ of themselves, and the clinic finally had to close in September 2015. From the Spataderkliniek I knew the person who asked me to start the new clinic. I had worked very well with him uptill 2012, he stayed after my departure and kept on working there until just before the end of the clinic. At the beginning of 2015, we decided to start a new clinic in Hengelo, together with a former colleague surgeon who had also worked in the Spataderkliniek. I knew him a long time ago from my surgical training in The Hague. He started at the Spataderkliniek in February 2012, in fact I even had worked him in (just before my unexpected departure).
-to be continued-