Emerging Market Health Care Staffing: “Buy American” may not be the answer…

It is tempting for U.S. or European health care organizations planning new health care ventures in emerging markets, or assuming the management of existing facilities, to build their business and organizational plans around importing a sizeable cadre of well-trained physicians and professional staff from their home countries.

However, based on our experience, “Buy American” or “Buy Euro” may not be the best policy to follow.

The pool of potential North American staff willing to relocate to a developing country is limited, and the cost of such foreign postings – both in pay to make it attractive enough, and in additional expenses for housing, transportation and family schooling – can raise the per-capita cost by approximately 50 percent annually. Among those who make the move, turnover is a constant challenge.

Likewise, depending largely on the strictly native population can be a challenge. For example, in some oil-rich Gulf states in the Middle East, allied technical and nursing professions, in particular, are not seen as particularly attractive or well-paid careers. Physicians and allied health professionals (nurses, radiology technicians, respiratory therapists, etc.) from emerging economies such as India – a past mainstay of Middle East health care organizations – are increasingly choosing to stay at home, as their own health care industry is booming.

One innovative solution is for an incoming U.S. or European health care organization to establish an affiliated technical and/or nursing school to expand the staffing pool in the host country by drawing students from throughout the region, or to partner with another organization to do so. This is a model that has not yet been tried.

Failing that, the solution to the emerging-market health care staffing challenge is to cast a very wide net, globally. For an American-run hospital in the United Arab Emirates, we built a medical team with physicians from 50 countries. Among them were a significant number of U.S.-trained doctors from Jordan, Syria, Egypt and Lebanon, to whom a return to their native Middle East was attractive. Our allied professional staff hailed from 63 different countries.

The bottom line is that a creative, detailed plan to meet the staffing challenge must be built into the initial emerging-market business plan, including the cost and effective in-house management of recruiting initiatives and companies around the world – both for initial hires and ongoing replacements to deal with turnover issues. Details on staff sourcing and any requirements for a given percentage of American or European vs. local staff also should be clearly spelled out in government, regulatory or management contract language.

Staffing an emerging-market health care organization is not easy, or inexpensive, but it can be done cost effectively with proper planning and management expertise.

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