Dr Rakesh Suri, chief executive of Cleveland Clinic Abu Dhabi, speaks during a press conference in February. Dr Suri says Mubadala Healthcare, which Cleveland Clinic is managed by, is working on a referral system which involves having family doctors on the frontlines. Chris Whiteoak / The National
Dr Rakesh Suri, chief executive of Cleveland Clinic Abu Dhabi, speaks during a press conference in February. Dr Suri says Mubadala Healthcare, which Cleveland Clinic is managed by, is working on a refShow more

Health system that allows patients to send themselves to costly specialists needs to end, top medics say



Family doctors need to be put at the heart of the UAE's healthcare system to catch illness earlier and build a culture of check-ups and healthy lifestyles.

That's the message from the heads of the country's major hospitals as they cautioned against the long-time approach of specialists being at the frontline of healthcare.

For too long clinics and hospitals have allowed patients with sore ankles to see consultant orthopaedic surgeons and those with aches and pains to top specialists, senior medics said.

"I've had patients asking me for all sort of things from abdominal pain, from headaches to eye pains,” said Dr Rakesh Suri, chief executive of Cleveland Clinic Abu Dhabi and one of the world's foremost heart surgeons, specialising in robotic surgery.

He said current habits become most evident after an operation, when patients are asked who their family doctor is, in order to share records and ensure they receive regular check-ups.

“They respond, 'but you are my doctor' and while it is heart-warming … I still know that that this is not the best way to have them followed up.

"The expertise and availability of a general practitioner and a family doctor is what will keep that patient healthy for years, so I am as equally motivated to develop the network of referral."

Mubadala Healthcare, which Cleveland Clinic is managed by, is currently working on a referral system which involves having family doctors on the frontlines and sending patients with complex needs to specialists if needed.

And last year, Health Authority Abu Dhabi, now called the Department of Health, said it would clampdown on patients referring themselves to costly specialists, or 'doctor shopping', to bring down insurance costs.

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Read more:

Abu Dhabi medical authorities introduce reforms to stop 'doctor shopping'

Billions lost in healthcare fraud and waste

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The shift is not just focused on controlling costs, but also ensuring patients get regular check-ups, which is crucial to the early diagnosis of cancer, heart disease and diabetes, which the UAE has high rates of.

“In an integrated health network, you see patients routinely when they are well — they routinely get yearly health care check-up, they get the screenings when they need it and if we detect disease earlier, we prevent disease more effectively."

The intention is to "allow people to live happier, healthier and longer lives,” Dr Suri said.

Stephen Maclaren, a senior executive at Dubai insurer Al Futtaim Willis, said it is not uncommon to see patients go for "second, third and fourth opinions from specialists".

"If people are going from consultant to consultant without seeing a GP first, that is time consuming and expensive," he said in an article with The National last year.

Healthpoint in Zayed Sports City already employs a GP and family doctor system. It then refers patients up the chain, including to its own three centres of speciality — sports injuries, spine and orthopaedic surgery — or to other hospitals.

"The combination between primary health and specialised health is welcomed by patients," said Dr Mai Al Jaber, acting medical director and a public health specialist.

"They come to outpatient clinics for primary healthcare services and then are referred to the specialised centres either here or Cleveland Clinic."

Dr Al Jaber acknowledged the scale of the challenge, which is regarded as the product of an insurance-based private healthcare system that allows patients to choose their own treatment.

“In the UAE, the concept of primary healthcare didn’t exist until recently," she said.

"Now the community is gradually getting more oriented on the importance of primary health care and of having a family physician who can solve the majority of their issues."

Despite growing awareness about lifestyle diseases and the prevalence of cancer today, very few people go to the doctor unless something is wrong.

A Cancer Research UK study from 2014 found 46 per cent of cancer patients were diagnosed at a late stage. For lung cancer just 23 per cent were diagnosed at stage one or two.

"For a long time we have talked about the need for mammograms and the importance of breast screenings, but still we see cases diagnosed at the later stages," she said.

"We are constantly running campaigns but we still see cases who presenting late.

“Our culture of awareness should start from the school and focus on the importance of a healthy lifestyle, the importance of screenings and the importance of preventive screenings."

About 80 per cent of Healthpoint's patients are Emiratis, many with diabetes and high blood pressure.

It is urging this group of patients in particular to have regular check-ups with a family doctor, but it remains a “challenge,” officials said.

Another benefit is the traditional role of GPs and family doctors giving patients a reminder about their diet and weight, not something they may hear from others.

Dr Kawthar Al Ameri, a family medicine specialist at Seha’s Al Rowda Healthcare Centre, said there is a need to replicate the system seen in the UK and Canada.

"The role of a family physician is clearly identified and well practised by patients and healthcare providers, which reflects the family medicine scope of services. Whereas in the UAE there is a lack of awareness [of the need for regular check-ups].

However, Dr Al Ameri did say the number of Emirati family doctors is increasing, which may help more conservative families open up about complaints and ailments.

"This will hopefully overcome the obstacles that healthcare facilities are facing," he said.

Despite being used interchangeably, experts point out that there is a distinction between GPs and family doctors, the latter being a speciality that would look into the family history of a patient, particularly important in a country where genetic diseases, particularly in Emiratis, are common.

How being social media savvy can improve your well being

Next time when procastinating online remember that you can save thousands on paying for a personal trainer and a gym membership simply by watching YouTube videos and keeping up with the latest health tips and trends.

As social media apps are becoming more and more consumed by health experts and nutritionists who are using it to awareness and encourage patients to engage in physical activity.

Elizabeth Watson, a personal trainer from Stay Fit gym in Abu Dhabi suggests that “individuals can use social media as a means of keeping fit, there are a lot of great exercises you can do and train from experts at home just by watching videos on YouTube”.

Norlyn Torrena, a clinical nutritionist from Burjeel Hospital advises her clients to be more technologically active “most of my clients are so engaged with their phones that I advise them to download applications that offer health related services”.

Torrena said that “most people believe that dieting and keeping fit is boring”.

However, by using social media apps keeping fit means that people are “modern and are kept up to date with the latest heath tips and trends”.

“It can be a guide to a healthy lifestyle and exercise if used in the correct way, so I really encourage my clients to download health applications” said Mrs Torrena.

People can also connect with each other and exchange “tips and notes, it’s extremely healthy and fun”.

Profile of Hala Insurance

Date Started: September 2018

Founders: Walid and Karim Dib

Based: Abu Dhabi

Employees: Nine

Amount raised: $1.2 million

Funders: Oman Technology Fund, AB Accelerator, 500 Startups, private backers

 

How to get exposure to gold

Although you can buy gold easily on the Dubai markets, the problem with buying physical bars, coins or jewellery is that you then have storage, security and insurance issues.

A far easier option is to invest in a low-cost exchange traded fund (ETF) that invests in the precious metal instead, for example, ETFS Physical Gold (PHAU) and iShares Physical Gold (SGLN) both track physical gold. The VanEck Vectors Gold Miners ETF invests directly in mining companies.

Alternatively, BlackRock Gold & General seeks to achieve long-term capital growth primarily through an actively managed portfolio of gold mining, commodity and precious-metal related shares. Its largest portfolio holdings include gold miners Newcrest Mining, Barrick Gold Corp, Agnico Eagle Mines and the NewMont Goldcorp.

Brave investors could take on the added risk of buying individual gold mining stocks, many of which have performed wonderfully well lately.

London-listed Centamin is up more than 70 per cent in just three months, although in a sign of its volatility, it is down 5 per cent on two years ago. Trans-Siberian Gold, listed on London's alternative investment market (AIM) for small stocks, has seen its share price almost quadruple from 34p to 124p over the same period, but do not assume this kind of runaway growth can continue for long

However, buying individual equities like these is highly risky, as their share prices can crash just as quickly, which isn't what what you want from a supposedly safe haven.

UPI facts

More than 2.2 million Indian tourists arrived in UAE in 2023
More than 3.5 million Indians reside in UAE
Indian tourists can make purchases in UAE using rupee accounts in India through QR-code-based UPI real-time payment systems
Indian residents in UAE can use their non-resident NRO and NRE accounts held in Indian banks linked to a UAE mobile number for UPI transactions

Lexus LX700h specs

Engine: 3.4-litre twin-turbo V6 plus supplementary electric motor

Power: 464hp at 5,200rpm

Torque: 790Nm from 2,000-3,600rpm

Transmission: 10-speed auto

Fuel consumption: 11.7L/100km

On sale: Now

Price: From Dh590,000

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

Messi at the Copa America

2007 – lost 3-0 to Brazil in the final

2011 – lost to Uruguay on penalties in the quarter-finals

2015 – lost to Chile on penalties in the final

2016 – lost to Chile on penalties in the final

Specs

Engine: Duel electric motors
Power: 659hp
Torque: 1075Nm
On sale: Available for pre-order now
Price: On request

Credit Score explained

What is a credit score?

In the UAE your credit score is a number generated by the Al Etihad Credit Bureau (AECB), which represents your credit worthiness – in other words, your risk of defaulting on any debt repayments. In this country, the number is between 300 and 900. A low score indicates a higher risk of default, while a high score indicates you are a lower risk.

Why is it important?

Financial institutions will use it to decide whether or not you are a credit risk. Those with better scores may also receive preferential interest rates or terms on products such as loans, credit cards and mortgages.

How is it calculated?

The AECB collects information on your payment behaviour from banks as well as utilitiy and telecoms providers.

How can I improve my score?

By paying your bills on time and not missing any repayments, particularly your loan, credit card and mortgage payments. It is also wise to limit the number of credit card and loan applications you make and to reduce your outstanding balances.

How do I know if my score is low or high?

By checking it. Visit one of AECB’s Customer Happiness Centres with an original and valid Emirates ID, passport copy and valid email address. Liv. customers can also access the score directly from the banking app.

How much does it cost?

A credit report costs Dh100 while a report with the score included costs Dh150. Those only wanting the credit score pay Dh60. VAT is payable on top.

The specs

Engine: 4.0-litre V8

Power: 503hp at 6,000rpm

Torque: 685Nm at 2,000rpm

Transmission: 8-speed auto

Price: from Dh850,000

On sale: now

The Settlers

Director: Louis Theroux

Starring: Daniella Weiss, Ari Abramowitz

Rating: 5/5

UAE squad

Humaira Tasneem (c), Chamani Senevirathne (vc), Subha Srinivasan, NIsha Ali, Udeni Kuruppuarachchi, Chaya Mughal, Roopa Nagraj, Esha Oza, Ishani Senevirathne, Heena Hotchandani, Keveesha Kumari, Judith Cleetus, Chavi Bhatt, Namita D’Souza.

Representing%20UAE%20overseas
%3Cp%3E%0DIf%20Catherine%20Richards%20debuts%20for%20Wales%20in%20the%20Six%20Nations%2C%20she%20will%20be%20the%20latest%20to%20have%20made%20it%20from%20the%20UAE%20to%20the%20top%20tier%20of%20the%20international%20game%20in%20the%20oval%20ball%20codes.%0D%3Cbr%3E%20%0D%3Cbr%3E%3Cstrong%3ESeren%20Gough-Walters%20(Wales%20rugby%20league)%3C%2Fstrong%3E%0D%3Cbr%3EBorn%20in%20Dubai%2C%20raised%20in%20Sharjah%2C%20and%20once%20an%20immigration%20officer%20at%20the%20British%20Embassy%20in%20Abu%20Dhabi%2C%20she%20debuted%20for%20Wales%20in%20rugby%20league%20in%202021.%0D%3Cbr%3E%20%0D%3Cbr%3E%3Cstrong%3ESophie%20Shams%20(England%20sevens)%3C%2Fstrong%3E%0D%3Cbr%3EWith%20an%20Emirati%20father%20and%20English%20mother%2C%20Shams%20excelled%20at%20rugby%20at%20school%20in%20Dubai%2C%20and%20went%20on%20to%20represent%20England%20on%20the%20sevens%20circuit.%20%0D%3Cbr%3E%20%0D%3Cbr%3E%3Cstrong%3EFiona%20Reidy%20(Ireland)%3C%2Fstrong%3E%0D%3Cbr%3EMade%20her%20Test%20rugby%20bow%20for%20Ireland%20against%20England%20in%202015%2C%20having%20played%20for%20four%20years%20in%20the%20capital%20with%20Abu%20Dhabi%20Harlequins%20previously.%0D%3C%2Fp%3E%0A
Countries offering golden visas

UK
Innovator Founder Visa is aimed at those who can demonstrate relevant experience in business and sufficient investment funds to set up and scale up a new business in the UK. It offers permanent residence after three years.

Germany
Investing or establishing a business in Germany offers you a residence permit, which eventually leads to citizenship. The investment must meet an economic need and you have to have lived in Germany for five years to become a citizen.

Italy
The scheme is designed for foreign investors committed to making a significant contribution to the economy. Requires a minimum investment of €250,000 which can rise to €2 million.

Switzerland
Residence Programme offers residence to applicants and their families through economic contributions. The applicant must agree to pay an annual lump sum in tax.

Canada
Start-Up Visa Programme allows foreign entrepreneurs the opportunity to create a business in Canada and apply for permanent residence. 

Skewed figures

In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.