FROM THE INSIDE

Iran 2011 | HEALTH & EDUCATION | INTERVIEW

TBY talks to Ramin Fallah, Managing Director of Fanavari Azmayeshgahi.

Ramin Fallah
BIOGRAPHY
Ramin Fallah is currently Managing Director of Fanavari Azmayeshgahi.

What sort of products and services does your company provide to the medical industry?

We mainly supply Siemens imaging products to hospitals and imaging centers, including systems such as MRI, X-ray, and ultra-sound. In addition, we provide machines necessary for endoscopy, though these are supplied by Olympus, a Japanese company. Also, we supply surgical products like staples and sutures for open and laparoscopic surgery, and we source these from different parts of the world. These are examples of some of the advanced surgical products that we supply to hospitals—both private and state. We also supply products from Getinge and Maquet, their products cover CSR, operating room equipment, and ventilators.

What is the percentage of private institutions in the healthcare system, and what is the relationship between the Social Security Organization (SSO) and the public and private hospital systems?

In the past it was mainly the government who took care of health care, but it is almost 10 years since the government decided to transfer part of the responsibility for health care to the private sector. Based on the figures we have, 10 years ago 90-95% of our turnover was coming from the public sector and the rest was coming from the private sector. Now it has changed, with maybe 50-55% coming from the public system and 45-50% from the private sector. These are our figures; I don't know the figure for the total market. In Iran, we have three different types of medical services. One is government owned and run, which is covered by the medical science universities. We have in each province a medical science university that covers a few hospitals. They also provide training for doctors and nurses. In addition to that we have the SSO, and it owns very good hospitals in each city. It's not strictly governmental, although very close.

The private sector has invested a lot in the last 10 years, and in the last five years the number of private hospitals has doubled. Parsian Hospital, for example, is a very good hospital with modern, high-tech equipment. Not that long ago we had a ceremony over there and opened a new integrated operating theater, which was a very nice combination of Olympus and Getinge technology. It's a new type of operating room where everything can be done by remote control.

“There is now active competition between private hospitals to invest more and more in their equipment..."

In Iran, high-income earners invest a lot in their own health, and they represent maybe 10% of the population, which is not a small number, maybe 7 million. There is now active competition between private hospitals to invest more and more in their equipment and on the quality of services they provide.

How do you think the quality differs between them?

For sure, the private hospital sector is the best because you have to pay and when you have to pay they have to offer you better services, that applies to the nursing system and the general attitude of the people. Then it goes to the medical science universities, because they are teaching hospitals they have good instructors and good expertise, although most of the operations are performed by the students and residents.

So if you go to a private hospital, does the SSO cover the services you receive?

If you have complementary insurance besides governmental insurance you can go to any hospital and private insurance will cover at least part of the fees. But if you are not covered by a complementary policy, and if you want to use government insurance only, many hospitals won't accept you.

Do you have special agreements with the Ministry of Health or with the SSO to sell your products?

It depends, any medical company who wants to work in Iran has to have a license from the Ministry of Health. It's quite a complicated process; we have to register for each company and each product. For the sale of products sometimes a tender is announced and then we participate in the tender and provide and supply the requested items. Sometimes it's not like that, with each organization, hospital, or medical science university buying a limited amount for itself by inviting a few companies to submit offers. Every few years or so the government decides to announce a large tender, for instance three years ago there was a tender for 25 hospitals. It bought all of the products it needed for these 25 hospitals from one supplier, and the contract was won by us. But I do not think this is a good way of doing business, because then the other companies complain a lot, and it also scares us because this means that in the next tender we may be put in a similar position.

Medical tourism is beginning to increase in popularity in Iran. Where do you think the most medical tourists come from, the Middle East or Europe?

There are different figures, but between 3 million to 4 million Iranians live outside Iran. They come back to visit frequently and plastic surgery has become very popular. Maybe one in five women has their nose redone. It's still not very popular for men, though. Many non-resident Iranians are coming from Europe and the US to have their operations done here. The other thing is that some people from Iran's neighbors, such as Kuwait and Bahrain, come here because they prefer to be treated in an Islamic country. Concerning the knowledge and equipment, we have no problem, but there are some other things that should be sorted out in order to absorb more tourists, such as relaxed visa requirements, social activities, and similar things. Because when you go to a city you go for a specific reason—but at the same time you look for social activities and other touristic attractions.

How would you evaluate the quality of medical staff in Iran?

After the Revolution the state trained lots of doctors and medical staff, so in numerical terms we are comparatively well off. Qualitatively it's also comparatively good because they have training and what they receive is good quality. The worst point is that we don't have the medical ethic. Medical staff do not obey the ethics of treatment as they do in other parts of the world. For example, those who work in hospitals should think differently from others, and if they see somebody sick and you are a doctor, no matter if he pays or not, you have to treat him. But here it's not like that and everything is related to money. The way that they approach the patient is not very professional. That's something that in many discussions with ministers and doctors we discuss because we need to improve this situation.

Do you experience any problems with shipments?

Fortunately, nothing very serious. The customs in Iran are very bureaucratic for any product that you want to release from the customs house. You have to have the permission of the Ministry of Health, the Ministry of Commerce and then go to customs to obtain its release. In other parts of the world, for example in Armenia, the products are shipped to companies via DHL, and then the day after that you receive it at your office, not in the customs house. Siemens has established a huge warehouse in Frankfurt and they told us that we would not need one in Tehran because of this huge investment. Yet, due to problems at customs we have to have a warehouse in Tehran. We aim to get rid of it, because it's an unnecessary cost for us, though we cannot do that at the moment.