Global Perspectives: The Unique Role of Visiting Physicians

Dr. Heitham Hassoun is vice president and medical director for Cedars-Sinai International and Professor of Surgery. He previously served as global medical director for Johns Hopkins Medicine and was an associate professor in the Department of Surgery at Johns Hopkins University School of Medicine.

If you have worked in any facet of global healthcare, you know it’s a complex field. Fortunately, there is a simple principle behind the projects and partnerships that succeed: The patient comes first. Because patients are best served when they have access to optimal expertise in a local setting, visiting physician programs are a core component of global healthcare.

With that in mind, I’ll share a few thoughts on the role visiting physicians can play in achieving the best outcomes for those in our care. Full disclosure: I have a special affinity for this topic because it was my introduction to international work. Not so long ago (so it seems), when I was a vascular surgeon at Johns Hopkins and endovascular therapies were still a nascent field around the globe, I was afforded the privilege of performing or proctoring the first endovascular aorta repair procedures in several countries in the Middle East and Asia.

"Visiting physicians serve their patients best when they are mindful that they’re in a culture and environment that are likely to differ from their own in significant ways."

It’s hard to say which number is higher: the miles I’ve traversed or the lessons I’ve learned. 

Repeatedly, my travels teach me to be humble. My expectations about other cultures are invariably upended. And always, I am reminded that when we work together with mutual respect, our patients win. 

In that context, what goes into achieving optimal clinical outcomes when a visiting physician joins the care team? The short answer: a lot. Building multifaceted, intricate clinical relationships requires time, patience and, above all, goodwill. 

Here’s what doesn’t work: Flush with confidence, the visiting physician swoops in to perform the procedure and departs triumphantly. That can be entertaining in movies and TV shows, but it doesn’t work in actual hospitals. 

In the real world, visiting physicians add value when they become effective members of the care team. They must obtain the proper credentials from the appropriate governing body. They must have the right skills for the procedure and solid lines of communication with the team leaders. Crucially, they are humble and, like all good guests, respectful of their hosts. 

Visiting physicians serve their patients best when they are mindful that they’re in a culture and environment that are likely to differ from their own in significant ways. They adjust their thinking about people, processes and protocols. They strive always to be culturally aware. 

For its part, the host hospital must deploy the appropriate team in a setting that prioritizes clinical excellence. For surgeries, it must be ready to provide the patient with appropriate perioperative care and manage any complications that may arise. Those prerequisites are absolutely essential, which is why Cedars-Sinai International only partners with organizations that meet rigorous standards of quality, patient safety and reporting and are unequivocally transparent and collaborative. 

A productive relationship between the visiting physician and host hospital has other requirements, including well-formulated legal, logistical and financial arrangements. In the end, however, collaboration depends on mutual trust. 

Patients are not the only beneficiaries when healthcare professionals trust each other. New hospitals strengthen their brand. Established hospitals fortify the loyalty of the populations they serve. Visiting doctors enhance their reputations and expand their referral networks. 

Everyone wins.

When we reach across cultural boundaries, success comes from remembering why we are collaborating. I have a favorite formula for productive collaboration between visiting physicians and their host hospitals; it happens to be the same formula we apply to all our endeavors at Cedars-Sinai International: Better together.