Antoine Gharios, Managing Director; Roula Gharios Zahar, Deputy General Director and Honorary President Dr. Elie Gharios at MLH sat down for a cover interview with BUSINESS LIFE magazine at Mount Lebanon Medical Center.
Antoine Gharios is the Managing Director of Mount Lebanon Medical Center. He is a professional responsible for the successful leadership and management of the hospital’s business. Antoine supervises and stirs all the hospital’s operations, people and ventures in order to maintain and grow business.
He is reputed for having keen observation where Antoine analyses the results of employee actions and take notice of any shortcomings that could be detrimentally affecting overall productivity. He also possesses a strong competitive drive that makes him more productive. He takes his business more seriously, thereby leading him to greater levels of success. He simply gained from his late father Mikhael Gharios the answers to the most common problems that arise when owning and running a business.
When it comes to keeping clients happy and keeping employee morale high, Antoine’s communication may be the most important factor in his leadership skills.
BUSINESS LIFE reporter conducted an exceptional cover interview with : Roula Gharios Zahar co-founder and Deputy General Director of Mount Lebanon Hospital.
A little bit of kindness goes a long way in the business world, especially when you’re dealing with patients disgruntled employees and/or clients. Having a strong sense of ethics enables a director to treat people with respect, and in turn that respect is given back. On the other hand, a director who is overly stern, inconsiderate of people’s feelings, and lacking basic morals and courtesy, will likely produce animosity and hostility in the workplace, both of which can greatly hinder collaborative efforts.
Roula Gharios Zahar co-founder and Deputy General Director of Mount Lebanon Hospital has supported many patients and has implemented business rescue solutions such as company voluntary arrangements as well has invoice discounting and asset based finance solutions for her medical center.
She has built a very credible reputation over the past years in corporate insolvency working alongside her brothers.
Her responsibilities included strategic planning, financial and resources management, implementation of Hospital Information System (HIS).
She has been working in the quality field since 2002, and is member of the National Committee for Hospital accreditation since 2009. As a board member in the syndicate of private hospitals in Lebanon, she contributed in the improvement of the accreditation process for Lebanese hospitals.
Roula Gharios Zahar holds degrees in economics from the American University of Beirut and hospital management from Saint-Joseph University, Paris-I Pantheon Sorbonne, Paris-Dauphine University in Paris. She earned a degree in mediation from Saint Joseph University and has contributed in several activities in family and delinquent youth mediation.
She is a fellow of the International Society for Quality in Healthcare (FISQua) since in March 2014 and has been selected by ISQua’s board for the Emerging Leaders Program for 2015/2016.
In 2016, Mount Lebanon Hospital - Gharios Medical Center was accredited the GOLD SEAL by the Joint Commission International (JCI).
Dr. Elie Gharios, Mount Lebanon Medical Center Honorary President sat down for an interview with BUSINESS LIFE magazine.
Mount Lebanon Hospital – Gharios Medical Center was founded in 1995 by Mikhael Gharios. In response to a growing regional need, his ambition was to lead and deliver excellence in the healthcare sector. True to his vision today, with the international recognition awarded by the most prestigious American accrediting body The Joint Commission International, MLH is now one of the leading health care organizations and has become a reference in the Middle East.
Mount Lebanon Hospital provides a wide range of clinical services. Its mission is to become a trusted provider of compassionate, superior healthcare services that enhance quality of life and provide medical or psychological advice, diagnosis or treatment.
As a pioneer in the region it safeguards the acquirement of latest medical technologies, with patient care and comfort in mind. As such it was the first to introduce the PET CT in the Middle East, thus utilizing state of the art technology to offer the most precise diagnostic and preventive tool for patients.
At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. We must move away from a supply-driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need. We must shift the focus from the volume and profitability of services provided—physician visits, hospitalizations, procedures, and tests—to the patient outcomes achieved. And we must replace today’s fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health-delivery organizations and in the right locations to deliver high-value care.
As a leader in Oncology services, MLH brings together the best specialized physicians in the world known for their extensive expertise and distinctions from renowned world cancer institutes with the newest diagnostic tools, treatment platforms and surgical services in addition to individualized psychological support for both patient and his family, to provide and facilitate the access to a complete treatment plan for patients.
Throughout the years MLH has widened its services to include Critical Care Units, from well-designed, state of the art Emergency Unit, Neonatal Intensive Care, Cardiac Surgery, and Cardiac Electrophysiology Laboratory, all of which are professionally and technologically equipped to respond and attend to all life threatening situations.
To provide comprehensive care, MLH added to its medical spectrum a broad range of specialized units in various fields such as a Psychiatry Unit, Fertility, Renal Dialysis, Otolaryngology, Ophthalmology, Diabetes and Epilepsy.
Making this transformation is not a single step but an overarching strategy. We call it the “value agenda.” It will require restructuring how health care delivery is organized, measured, and reimbursed.
Saying the above, BUSINESS LIFE reporter asks Antoine Gharios the following questions in an exclusive interview:
BL: What qualities make a good managing director?
Antoine Gharios: The Willingness to Do More, The Ability to Adapt and Adjust, Diligence and Persistence, Creativity and Innovation, Adept Learning and Researching Skills, Keen Observation, Competitive Drive, Communication Skills.
Therefore, although one person may possess an advantage over another initially, there’s always room for improvement, and ultimately you are in control of the traits and characteristics you choose to develop or neglect.
BL: How was Mount Lebanon Medical Center established and when? What is the purpose of its creation?
Antoine Gharios: We started working in November 1997, when the first patient came to the hospital with a radiotherapy surgery. Then, it was expanded by having more services.
Now, the hospital includes about 200 beds and we continue developing to have nearly 150 to 170 extra beds.
Mount Lebanon Hospital accounts for 850 employees, hoping that it continues developing especially with the current bad economic situation caused by the current political situation.
BL: Do you think that the economic situation will recover soon, especially after announcing the petroleum extraction in Lebanon?
Antoine Gharios: Definitely, everything in life will have an end one day. But I hope its results will not be more disastrous. All these problems are caused by the political situation. All the troubles that Lebanon faces have resulted from the political situation. Lebanon in an economic and political mess.
The economy in our country is 100% more linked to politics than other countries, and we hope that there will be sufficient awareness and comprehension about these matters.
Certainly, awareness is important in the current difficult period.
BL: What do you think of the Lebanese Liras and the US$ exchange rates? Will there be a currency protection or are we heading towards the unknown?
Antoine Gharios: The Lebanese Lira cannot be solid without having a big support from an income coming from the industry or export but unfortunately that is not the case in Lebanon. The government should not neglect its national currency and leave it to currency merchants.
BL: Lebanon's oil will be extracted this year, will this wealth lead to an appropriate solution to address the economic crisis that we are witnessing?
Antoine Gharios: Well, the economic crisis that we face might be tackled by the petroleum extraction but it seems that the Lebanese will not have a big share of these resources income.
BL: Mount Lebanon Hospital founded in 1995, has advanced and became one of the most prestigious hospitals in Lebanon and in the region, is this due to its experienced and wise management and to the efforts made by its distinguished doctors?
Antoine Gharios: First, it is the management that has chosen the professional staff to work at the hospital and all its achievements are a result of their hard work and consistent and exerted efforts.
BL: You were working alongside your late father Mikhael Gharios in many areas, such as contracting, Danish Iceberg and Maccaw and the rest of the family business, in addition to the hospital management. How did you manage these various skills and excel in all these tasks?
Antoine Gharios: The field of management is the same whether it is in a service company or a contracting company, and the hospital is considered a service company because the work that I have done is more administrative than technical.
We started Maccaw in 1973, and naturally I have that long experience in management.
Concerning Liban jus, the manufacturer of Iceberg and Maccaw, I am a silent partner, we are now working on producing first class quality dairy products such as natural milk, fine cheese and its derivatives and I wish them great success in their work as well.
They are very successful, because Danish Iceberg is a very popular brand and it is in great demand.
BL: What are your challenges and future plans for Mount Lebanon Medical Center?
Antoine Gharios: I just mentioned that we are seeking to increase the capacity from 200 to 400 beds. The hospital had sections for pregnancy and health care but later on Mount Lebanon Medical Center was modernized until it expanded and included other departments.
BL: What are the future plans in developing the hospital's work?
Antoine Gharios: The future plans that we seek to achieve and develop the hospital's work are to follow modern technology through the use of the latest mechanisms and equipments such as: (Robotics, Radiology and Imagery ..) as the hospital seeks to purchase those valuable and useful equipments. We have started making plans now but the market does not absorb much and the equipments are still very expensive, and its performance is constantly evolving, so we will wait while it becomes more sophisticated, as we cannot bring these mechanisms currently at exorbitant costs of approximately two or three million dollars and then after a short while there will be more advanced mechanisms nearly two years after they are purchased. Accordingly, we have to wait a little longer as surgical mechanism develop very quickly.
My future plans for developing the hospital are being up to date and to the latest technology by using modern, valuable and professional equipments, such as Robotics, Radiology and Imagery.
BL: What makes Mount Lebanon Hospital the most professional medical center among all the other pioneer hospitals in Lebanon? Who is your competitor?
Antoine Gharios: What distinguishes Mount Lebanon Hospital from others is that it is not commercial, as it includes large humanitarian aspects and the patient is never exploited, so Mount Lebanon Medical Center gained the Community trust so quickly.
In BUSINESS LIFE special cover interview, Dr. Elie Gharios aims to depict how healthcare facilities may look in the near future.
BL: As a recognized medical center in Lebanon, how do you maintain ML standing out among other hospital?
Dr. Elie Gharios: Mount Lebanon Hospital is famed to be more humanitarian than seeking profit only and this made other well known hospitals to compete on these basis.
For sure, we aim to generate profit but we care a lot on the humanitarian aspect and we do not differentiate between socio-economic class, nationalities, race, gender or sect.
Saying the above, that Mount Lebanon Hospital is recognized for its skilled and highly specialized doctors, nurses and dedicated team.
BL: What is your mission?
Dr. Elie Gharios: My mission is a humanitarian one to help patients in need for excellence in healthcare by producing evidence to make healthcare safer, higher quality.
My target is to provide “more for less”—more value, better outcomes, greater convenience, access and simplicity; all for less cost, complexity y, and time required by the patient.
BL: Why did you choose to become a doctor?
Dr. Elie Gharios: I chose to be a doctor because during my childhood I suffered from diabetes and that is why I was keen to be a doctor to help patients and the society from such diseases.
Diabetes is a disorder where the body does not produce insulin or does not use it efficiently.
BL: What is the latest information on obesity?
Dr. Elie Gharios: According to the World Health Organization (WHO), there are approximately 500 million obese adults and 42 million obese children under the age of five.
BL: Why is this hospital important to the Lebanese?
Dr. Elie Gharios: Our current health care system can be defined by its rules, policies, regulations, enabling technologies, operating models, customs, and patient and provider preferences; together, these elements comprise the frontier of what is possible. They also serve as the constraints to what can be achieved. For far too long, the health care industry’s performance, despite attempts to spur progress, has remained at the edge of this frontier. The industry needs to break current constraints and expand the frontier to achieve true breakthrough performance. While the constraints are many, the traditional, dominant, fee-for-service (FFS) payment model, in particular, does not align provider incentives with the goal of achieving more for less.
At Mount Lebanon Hospital, we try to give more for less.
BL: What are your future plans?
Dr. Elie Gharios: Our plans is to expand Mount Lebanon Hospital from almost 200 beds to 400 beds and to make superb facility and modern hospital that matches the demands of Lebanon.
BL: How do you compromise between your stressful career and your family?
Dr. Elie Gharios: I try to allocate my time wisely.
BL: Do you as a doctor have any weakness or strength?
Dr. Elie Gharios: My strength is to absorb work pressure and resolve obstacles for the welfare of our patients.
BL: What do you think of robotic surgeries? When will you use it in Mount Lebanon Hospital?
Dr. Elie Gharios: Surgeons who use the robotic system find that it enhances precision, flexibility and control during the operation and allows them to better see the site, compared with traditional techniques. Moreover, fewer complications, such as surgical site infection. Less pain and blood loss.
In fact, it is a matter of choosing the proper time when such surgeries will take place in Mont Lebanon.
Until now, all robotics and medical technologies are still too expensive and economically inefficient since you need very specialized professionals and huge work load to be feasible.
BL: What is your ability to face the challenges both medical and personal?
Dr. Elie Gharios: During my career, I Learnt how to turn my challenges into opportunities for growth. I do my best to tackle these challenges very carefully and intelligently rather than getting hyper. Dealing with challenges faced by a doctor, if not handled properly can lead to big problems.
BL: What are your comments on Coronavirus in Lebanon?
Dr. Elie Gharios: All I can say that cleanliness and precautions are crucial. We should always clean our hands and surrounding and keep away from infected patients.
If we can hold our breath for 20 seconds then it is a good sign that our respiratory system is good.
BL: How does the present political and economical situation impact the medical industry and hospital?
Dr. Elie Gharios: In fact, Lebanon's current and past corruption is impacting everybody.
At Mount Lebanon Hospital, we see a lot of medical or psychological or drug edicts cases that are attributed to the imbalance in the Lebanese social system.
The Lebanese people are entitled to have social welfare system, social security system and a good system that prevents poverty in old age. There are no simple solutions towards achieving these goals soon. Currently, the system is bankrupting health and pension programs.
It is very crucial and urgent that our governmental system stops all corruptions for the sake and the welfare of Lebanon and the Lebanese people because our current situation is totally unexpected and this is harming a lot the medical sector and hospitals.
BL: What are your comments on Lebanon's energy? Would it save Lebanon from the current financial crisis?
Dr. Elie Gharios: What I know that Total (the company in charge of Lebanon's natural oil and gas extraction) will not give cash in return. There is some sort of a deal that I don't know its full terms and conditions.
BL: What are your comments on the health care cost?
Dr. Elie Gharios: Around the world, every health care system is struggling with rising costs and uneven quality despite the hard work of well-intentioned, well-trained clinicians.
My aim is to achieve excellence at Mount Lebanon Hospital at a reasonable cost.
Finally, BUSINESS LIFE reporter conducted a special cover interview with Roula Gharios Zahar, co-founder and Deputy General Director of Mount Lebanon Hospital
BL: What are the financial obstacles that you face in Lebanon? All hospitals are complaining about the financial crisis, what is the solution?
Roula Gharios Zahar: Of course, our main problem, is our receivables from the government, and the public pairs. This issue has been there for quite some time. We have delays in payments for several years, this is one of the issues, regarding all our receivables from the government whether from the Ministry of Health or any payment from the Ministry of Finance. So, we have huge delays in the payments. This constitutes a very big burden on our cash flow and increased costs in terms of interests, payments, etc. Since October 17th, this has been again exacerbated by the situation.
We are facing problems in buying goods that are most of the time bought from outside Lebanon. Therefore, we need foreign currency and it is very rare and sometimes it is made unavailable nowadays. We are sometimes obliged to buy dollars into black market in order to buy our goods from outside.
It is true that the bank of Lebanon has subsidized the dollar for the medication purposes and the medical supplies but we still have lots of other purchases to do from food, detergents, paper and other supplies which are huge burden on us and we have to find dollars because most of the suppliers do not accept Lebanese Liras and they need cash money. So this a big and additional burden that we are having since October 17th.
BL: What about wire transfers?
Roula Gharios Zahar: We cannot transfer any money.
We do not usually transfer money ourselves as hospitals. The ones who transfer money are our suppliers and this is why they are asking for cash in dollars. It is very difficult to obtain US$ nowadays and it is very expensive. We bought dollars at 2600 Liras last week.
This will have a very direct impact on the profitability and the cash flow.
BL: Are there certain medications that are out of stock?
Roula Gharios Zahar: We have a problem nowadays in certain personal protective equipments like masks, gloves, etc. which are also not found easily and are very expensive. This is due to mainly the Coronavirus crisis and it has been the same worldwide. We are also facing huge issue in this matter.
BL: Don't you think that the gloves and masks issues, etc is an abusive way from the merchants to get more profits?
Roula Gharios Zahar: I cannot say so because the crisis in the Lebanese economy is done by demand and supply and it is very normal for the crisis to go out. The problem is that our prices as hospitals is fixed. We cannot change our prices with third party pairs and the government. Our prices are fixed because we believe that we are a regulated industry but the prices of goods and services fluctuate over time, but when prices change too much and too quickly, the effects can shock an economy. The things that we buy from the market fluctuate. It is normal they are fluctuate today.
Of course, there might have been abuses. I have heard some stories of abuses. I cannot say whether this is true or false but after all this is a free economy and this is a free market.
BL: How do you deal with controlling the financial aspects of the Mount Lebanon Medical Center?
Roula Gharios Zahar: It is not one person show. We have a team of financial controllers from people that are dealing with such an issue. We try to be as effective as we can. We try to follow up using the latest technology, information technology, in stock control and in cost control.
BL: How did you choose your software and equipments? How did you manage to get the quality certificate JCI?
Roula Gharios Zahar: JCI accreditation was very challenging to get. We really use very professional approach in dealing with this aspect. We have several teams that are dedicated to quality improvement in the hospital.
What helps a lot is to introduce a culture: You cannot work without introducing a culture of quality in the hospital. This culture of quality comes from the top, usually by motivating our employees to perform the best they can; by providing them with the right tools in order to work properly; by showing them the right values, we think this is the only way to lead forward and to implement any quality measure. Our policies and procedures were revised. Our implementation was done with the help of our own staff. We barely got some help from outside the hospital and this really has been the achievement of the staff of Mount Lebanon Hospital. They have the quality of culture really embedded. We did a lot of trainings; we really try to be as quality oriented as we can and this was really "the way to success". We really took very seriously this project and we were following up and giving it the maximum we can in order to achieve the maximum results.
BL: How do you decide on your budget and how do you deal with the board?
Roula Gharios Zahar: Regarding the budget, we have procedures that are quite well known to everybody in the hospital. We really take the opinion and advice of all our specialists in the hospital in order to build our budget. It is really a collective work as we try to satisfy all the demands; from our staff; from our heads of departments; the nurses, everybody has a say in the budget and then within our possibilities, we have a lengthy discussion usually in January and February about how to best allocate our resources in order to come up with the suitable budget for the hospital.
BL: What is your ambition?
Roula Gharios Zahar: My vision for the hospital is that it becomes really a complete healthcare system for its community. I would really dream of a system where we can follow up all our patients and clients from their childhood till adolescence, adulthood and seniority. We will need to focus a lot on prevention of diseases.
We really want the hospital to be the home for everybody so that it becomes really a reference to every person in the matter of his health. We really would like to be the soul reference for any person living in our community. We do not want people to come only for surgeries or when they are really sick at a point that their illness is so acute and they cannot mange it. We really want to be there to accompany the patients and the clients in their everyday life and to be their health consultant to help them in any preventive treatment they should take and to help them to follow up in their everyday life needs.
BL: How much time does it take from you managing this hospital?
Roula Gharios Zahar: I usually work about nine hours a day- with five days a week; about forty five to fifty hours a week.
We have been growing a lot and each stage has been different and very demanding. We had to adapt very quickly to our environment and learn because I came personally from a different background and I had to adapt to the hospital's particular situation and the unique problems and to find solutions every time. I also tried to adapt different management tools of hospitals in order to reach the most effective one.
BL: Are you more comfortable with verbal or written communication?
Roula Gharios Zahar: Well, we come from a community where verbal communication is essential because we cannot communicate solely by emails.
We were very verbal. We are changing a lot because we are always supporting the verbal communication with written follow up. I think both are essential because our culture is very verbal and we have to be specific and accurate.
BL: How do you reward people for their hard work?
Roula Gharios Zahar: We have a system of motivation for employees that are very well developed by human resources department whereby productivity, efficiency and quality drive are very well motivated. We try to include bonuses each year for our staff. Reward is not only money, it is also recognition. We have several events where we try to recognize our team as well as their achievements.
BL: What are your impressions and your constructive criticism about the current political and economic situation that Lebanon is passing by? How do you help a needy person?
Roula Gharios Zahar: First of all, my recommendation is that we should criticize today. It is very important what has happened since November 17th and the criticism that allowed things to change but criticism alone is not enough. We should be constructive in our criticism and this is how we can help in building our country.
What is happening positively, we are in a phase of change. We hope for the better and I am confident that it will be for the better. We really need to stay positive and bring on positive criticism in order to help the people and the government to improve. We cannot be negative all the time. We cannot criticize just for criticizing. We have to do a lot of sacrifices; come up with new ideas and hold on to our country because I hope it will be better.
BL: What are your hopes regarding the energy of Lebanon?
Roula Gharios Zahar: I have no comment; no ideas.
I always tend to think that natural resources are at the same time a blessing and a curse for the country.
If you look at it, several countries have been cursed because they have natural resources. I hope that for Lebanon this is not going to be the case. It is too early to judge.
Of course, we need those resources in order to fill the gap in exports and the need for foreign currency. Let us hope that it will be ok. Still, it is really too early to judge.
BL: What did you learn from your late father Mikhael Gharios?
Roula Gharios Zahar: I think the greatest lesson is that you have to move on in life by accepting what you cannot change and always changing what you can change. Acceptance is very important in moving forward. There are things in life that you have to accept. It doesn't mean that you will have to give up on everything. What you cannot change, accept it. When you can change, you change it and you move forward.
BL: What are your comments on the environment?
Roula Gharios Zahar: Regarding the environment, I hope that the environment issue will be tackled in our society because I think we are heading to an ecological disaster regarding the pollution of the air, water, and the pollution that is due to the trash.
I think this is a priority and it has to be addressed very quickly and effectively and this is related directly to the electricity crisis because if we don't have a proper energy producing plans that are ecologically friendly and environmentally friendly and low cost energy then it will be a disaster. If we continue having generators in every street; this emissions will increase and consequently the pollution will increase and relative diseases will increase. This affects our health a lot. It affects also our hospitals because energy is very expensive to pay, it is not affordable; it is not available and at the same time this affects the health of people by creating lots of allergies, diseases, chronic diseases, asthma and pulmonary diseases will increase a lot.
