Spotlight Interview: Gene Thompson, Project Director, Aster Cayman Medcity, & David T. Boucher, MPH, FACHE, Corporate Chief of Service Excellence, Aster DM Healthcare, Dubai

About Gene Thompson

Gene Thompson is a fifth-generation Caymanian of a family of entrepreneurs, and is a director of Thompson Development Ltd, one of the first and premier development companies in the Cayman Islands. His family are considered pioneers in property development and many other business ventures.

Thompson Development has varied business interests, including commercial development, tourism, retail, real estate and resort development. Although the Thompson family has diverse business interests, their stellar reputation in business began in development over 50 years ago. Gene has been involved and/or led various types of development projects, including commercial centers, residential projects and resort developments. Gene was a founding director and project director for Health City Cayman Islands and led the project from inception to completion and operations for the first three years and is now the project director for Aster Cayman Medcity, another major healthcare project. Gene is also a cofounder and chairman of TechCayman, a technology innovation platform that is designed to set the Cayman Islands apart as a tech hub.

About David Boucher

David Boucher has worked in healthcare for over 40 years and currently serves as chief of service excellence at the corporate level for Aster DM Healthcare. In this capacity, he is guiding the 26-hospital chain through its service excellence journey. Prior to Aster, David served for two years as chief business transformation officer at Bumrungrad International Hospital in Bangkok, Thailand. Previously, he served 18 years as an executive of BlueCross & BlueShield of South Carolina. From 2006 through 2016, he also served as president of Companion Global Healthcare, Inc. – the world’s only medical tourism facilitator owned by a major health insurer. Prior to 2000, David served as CEO at several hospitals in the U.S.

David earned his B.S. from Slippery Rock University (PA) and a Master of Public Health (MPH) from the University of South Carolina—and been named a distinguished alumnus by both institutions.

He has been quoted in over 250 newspapers and journals, including The Wall Street Journal, New York Times, The Economist, U.S. News & World Reports. He has been interviewed on NBC Nightly News and Fox Business News. He has delivered lectures on disruptive innovation in healthcare at Harvard Business School, Yale School of Management and Harvard Medical School. He currently resides in Dubai, United Arab Emirates.

About Aster DM Healthcare

Aster DM Healthcare Limited is one of the largest integrated healthcare service providers operating in multiple GCC states and is an emerging healthcare player in India. Through its network of 26 hospitals,115 clinics and 224 pharmacies, the organization provides the complete of care to all segments of the population. With an inherent emphasis on clinical excellence, it’s one of the few entities in the world with a strong presence across primary, secondary, tertiary and quaternary healthcare through its hospitals and clinics. Aster has over 21,000 plus dedicated employees across the geographies where they are located, delivering a simple yet strong promise to its different stakeholders: “We’ll Treat You Well.”

Medical Travel & Digital Health News (MTDHN): Why did Aster choose to make its first inroad into the Western Hemisphere through the Cayman Islands?

Gene Thompson (GT): The Cayman Islands are well-positioned to be a mecca of healthcare for not only the Caribbean, but also for the region. First, we’re known for being in healthcare and medical tourism and it’s a big part of their government’s focus. Also, we’re well located, in the middle of the Caribbean, and provide good access from North America, South America and the rest of the Caribbean.

We’re considered a very advanced First World Country. It’s a great place to visit and do business. Healthcare is a big part of the focus of our economy and building that third pillar of our economy. This made it the natural choice when they reached out to me about building a presence in this part of the world. This will strengthen Aster’s presence as a leader in healthcare in the region.

MTDHN: Do you want to touch upon the COVID-19 situation in the Caymans?

GT: Cayman has been COVID-free, I’m pleased to say, for basically one year. I think the last local transmission, if I’m not mistaken, was April 18, 2020. Imported cases have all come in with travelers, who go directly into quarantine, so there’s no way to spread it. We are operating at completely normal levels, but with fewer tourists. Restaurants and stores are open.

The government took a very aggressive approach to this, and they were very successful in the program and locking the island down early.

MTDHN: What is the vaccination rate?

GT: The vaccination rate is number five in the world. Our total vaccination rate of people that are vaccinated with two vaccines is approaching around 58%.

MTDHN: David, what is your take on the appeal of this project?

David Boucher (DB): The Caymanian government has been very, very gracious. I think it’s going to be relatively easy for us to get U.S. board-certified physicians and other practitioners licensed in the Caymans, thanks to Gene and other people. The quality and the safety of medical care that’s offered is very high.

Also, the geographic proximity to the United States and Canada makes it an easy location that offers great hotels at reasonable prices. There are a lot of interesting activities, from swimming with the stingrays to fishing and shopping and so forth.

MTDHN: Gene, can you touch on the captive community?

GT: We’re the insurance, captive and hedge fund capital of the world. We have more captives than anybody else in the world for people looking at alternatives to save money. A few of those captives have reached out to us to find a way to embrace what we’ve done in Grand Cayman.

Many hospitals have funds and captives to protect their interest.

MTDHN: Tell us about the hospital’s features and services.

DB: As we contemplate the types of surgical procedures that lend themselves to people getting on airplanes, they tend to be common procedures which have low complication rates and ones where the recovery rates are relatively short. So think, cardiac surgery, orthopedics, cosmetic surgery, bariatric surgery, and oncology.

We will have one of the first, if not the first, neonatal intensive care units in the Caribbean. We will also offer dental, dermatology, ENT, endocrinology and general surgery services. We are still working out details for pharma or “medication tourism”.

We know that many American employers are paying outrageously high prices for many high-dollar medications and they are actively considering alternatives.

GT: There’s no real comprehensive cancer center in the Caribbean, so that’s going to be a big part of what we do. The other area is pediatric care, which is very much lacking in the Caribbean, as are neurosciences and neuro rehab, which is almost nonexistent in the Caribbean.

We’re going to offer comprehensive quaternary care in all areas of specialties, with five or six main specialties to start off in building the subspecialties, like endocrinology, nephrology and so on.

The goal is to be very comprehensive with four or five major specialties to begin and then grow from there over 13 to 15 years. We’ll start with about 165 beds and expand to up to about 500 beds. This gives us latitude to adjust to market needs.

MTDHN: This is well beyond elective cosmetic surgery procedures.

GT: Correct, although eventually that will be a part of what we do. In many cases, it is predominantly clinical or lifesaving type procedures that are needed.

The region’s spend on healthcare in the Caribbean is somewhere between $8 and $11 billion. So, there’s considerable opportunity to provide support for that level of care that is missing throughout the Caribbean region.

DB: We will be in the wellness business and offer anti-aging services, lap-banding and gastric bypass surgery, nutrition and lifestyle programs.

MTDHN: Will surgeries be less expensive?

GT: Our plan is to be substantially less than U.S. costs as a big motivator to attract medical travelers. The United States is spending $3 trillion on healthcare.

Many people in the region can’t afford the U.S. healthcare costs, so we would like to see our costs somewhere at least half or less than half of U.S. healthcare costs. We’re finding that our delivery model is working very well in the Cayman Islands at this time and well accepted with good uptake.

DB: We’ll have all-inclusive bundle prices that include professional fees, the price of the implants and so on. The educated consumer is our best customer. When the occasional complication occurs, there may be additional fees, of course. But patients will know they are in a quaternary hospital with intensivists in the building.

Our competitive prices will be attractive to employers, including the U.S. government.

GT: The model that we are going to offer is truly bundled. When we say the price upfront and you decide to have a knee replaced or a shoulder replaced, that is the price.

MTDHN: How does the employer work with your organization?

GT: We will handle everything. If somebody needs a passport in the United States, we will help them get a passport because we have connections. If they need help with travel to the island, we will help them with that, including transportation from the airport.

We have an arrangement with the government where we do a VIP pickup at the plane side, bring them in through customs and immigration and take them to the hotel or wherever they are staying.

We handle everything right to putting them on the plane home and doing follow-ups linked with their primary care physician back home. This makes both the employer and employee feel comfortable. We are here to remove all obstacles to better care and provide a wonderful experience and improved health.

DB: Also, we have got over 800 telehealth providers in all the specialties, which is important for both pre- and post-service. The patient can talk directly to the physician or surgeon pre- and post-surgery.

MTDHN: Are the electronic health records coordinated and integrated for the patient?

DB: We will have an electronic medical record and patient portal so they can get records and communicate with us in a secure format that is HIPAA and HITECH compliant.

MTDHN: We know that Aster DM has a big presence in the Middle East and in India and has been recognized for helping underserved populations, particularly incredible miracles on behalf of children. Do they plan to do this in the Caymans as well?

GT: Absolutely. We run a program here with one of the other providers here called Have a Heart.

We’ve performed upwards of 500 free or heavily subsidized primary heart surgeries for children that would have otherwise not been possible. We plan to expand for other needs, such as musculoskeletal needs, club foot, plastic surgeries and so on.

A big part of Aster’s culture is about giving back.

DB: Aster Volunteers have touched over 2 million lives already through these different initiatives — everything from blood donations to homes, flooding and COVID-19 relief.

We have over 27,000 Aster Volunteers around the world, which will be expanded into the Western Hemisphere.

MTDHN: What does this new hospital represent? For instance, if I go to Aruba and get sick, what does that mean for me?

GT: You’d have a super special quaternary care hospital to go to for, say, a stroke, heart attack, brain bleed or major trauma. There’s a company called Daggaro that will offer emergency and recovery services through the whole Caribbean.

They will have helicopters and airplanes for transfers to Aster Cayman Medcity, with Cayman as their base of operation. This is a great comfort for many people.

MTDHN: For retirees looking to settle somewhere, healthcare is always an issue. Tell us about retiring in the Caymans and access to healthcare.

GT: The goal is to build a retirement community here eventually for active retirees. Right now, on average we have an estimated 60 new retirees or residents coming to the island per week to live. Healthcare is a big factor.

In fact, the owner of the biggest development, Watermark, told me once Aster was announced his sales went up 30%.

We are very well-positioned to embrace a significant retirement community. I think we can be a regional hub for retirees who want quality health care.

MTDHN: David, could you give us a project timeline?

DB: We plan to break ground in June and have the project finished in the next 18 to 20 months.

MTDHN: For now, employers can start planning and talking to you about opportunities?

GT: Absolutely. We have already had outreach not only from employer groups, but also from the region. We have a clear path forward on our pricing model, services and structure.

MTDHN: Could you both comment on the medical travel industry—where it’s going post-COVID and a return to normalcy?

DB: I think that the case for medical travel continues to become increasingly more compelling as the days go by. Americans are traveling for safer, high quality care that is also cost-effective.

We will be Joint Commission accredited once the hospital is open. One of the biggest buyers of hospital care is the U.S. government. Eventually, they may want to offer great, safe quality care at accredited hospitals for a fraction of the price. Paraphrasing Winston Churchill during WWII, ‘You can always count on the Americans to do the right thing…once they’ve tried everything else and failed.”  I believe that the value in medical travel is increasingly too compelling to ignore.

Again, we are conveniently located for multiple nonstop flights each day from multiple American and Canadian cities. It’s just a matter of time before medical travel takes off, given that healthcare costs continue to go up in a compounding four to eight percent every year.

Larger employers, like Walmart, PepsiCo, Lowe’s and so on, have embraced domestic medical travel over the last several years.

GT: I think that the pent-up demand will be very significant in multiple ways. First, Canada had a pent-up demand, especially in orthopedics and GI. As a result, we’re seeing strong interest out of Canada.

Second, the United States has for many months seen greatly reduced elective surgeries and procedures. That has built up demand. Costs will have to go up to cover some of these costs and there will be lack of access in terms of cost and availability.

MTDHN: Is there anything else you would like to share with our readers?

GT: Everything we do will be transparent, not only on price, but also outcome data and process. This is important to company executives considering medical travel for their employees.

DB: We are making sure we do this right. It’s an exciting time, and I think it’s going to be one of those projects that is really going to help a tremendous number of people, from the whole Caribbean to Central America, South America, the Unites States and Canada

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