‘The health problem is not economic’: Víctor Raúl Castillo

Newsweek magazine included Colombian doctor Víctor Raúl Castillo Mantilla, president and CEO of the International Hospital of Colombia – FCV, on his list of the best hospital CEOs in the world. This recognition highlights its influence in the field of global health, demonstrating that, despite the difficulties faced by health systems in Latin America, it is possible to achieve global standards of excellence.

The list is made up of 24 CEOS from around the planet and there are only three Latin Americans on it. The manager spoke with Portafolio.

(Read more: ‘The biggest challenge we have in health is uncertainty’: pharmaceutical company Lilly)

How did you receive the news?

A huge and pleasant surprise. Being among the best hospital CEOs in the world, along with leaders of institutions such as the Mayo Clinic and Cleveland Clinic, is a recognition of the work of each of the five thousand employees who make this institution something extraordinary.

Where did the idea of ​​creating a hospital come from?
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It starts in Pinchote, Santander, near San Gil, in a health post in 1981, I saw medicine from the 18th century, a table, three chairs; antiparasitics, little antibiotics and the basics. This unfortunately happens today in many places.

So I decided to change that reality. Transform medicine in my region.

In 1986 we created the Cardiovascular Foundation, then in 1990 I began this journey.

It’s wonderful, in our history we have never had a large donor, everything is with our effort. We have more than three decades of experience and contributed to the transformation of Bucaramanga into one of the healthiest cities in Latin America.

He has already reached the goal…
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No, sir, we must continue.

Today we have 800 beds and we are going for 1,300 beds in two years.

This is construction, resources, and construction with technology and talent in health. And now we have to move to a great hospital, where people aspire to be treated here. Where people are fans and expect to be served here.

As a Foundation we help the less fortunate, and they represent a large percentage of our patients. They are people with limited resources who require not only health care, but also all the support in medications, transfers, accommodation and maintenance for their companions.

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(See: Health reform: this was the debate this Wednesday in the Chamber)

How to achieve new goals without philanthropists?
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That has been an advantage. In this region, donors are few.

Then we knew it would all depend on us. We had to produce our own future, make money work for us – what it must work for – to be who we are. All with own resources.

If you had an offer of support today, with resources, what would you do?
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We have many things to work on. We have a teaching project; We want to have 36 specialties, with family medicine, to train more doctors.

When you are already doing this and the results are noticeable, you look with interest at how to prolong your existence with more doctors.

To whom do they owe this success?
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My God is the great patron of this hospital. This is a bet of 5,000 employees and everyone who has passed in history. All our workers have contributed to being what we are and represent.

And the money is enough for them, because the State cannot do it…
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The money is enough, we have done this with 250,000 square meters, all with our own resources and with excellence for the patient.

If one compares with what is official, the Government builds them, equips them, maintains them, and the employees are outsourced and yet they go bankrupt.

The health problem is administrative management. We are proof that things can be done well. All our doctors are employees, they all earn well.

The minimum salary for a specialist is $20 million. And we are competitive.

Recently, I was invited to the House of Representatives to speak about the reform. And the problem is in public hospitals, doctors are hired by cooperatives and unions, that is the most aberrant thing there is.

When one looks at the distribution of resources to the private sector, they are paid up to 30% less than what they give to the public and, yet, they do not achieve it.

I think that the conversation must be taken care of and managed well.

(Read more: Health reform: scientific unions assure that it does not solve job insecurity)

To do?
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Health cannot be run like a business. Today in the country there is an average of US$450 per capita to provide health to all Colombians.

If it were business it is not enough. As a foundation it is enough.

How do you see the reform?
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Three things must be said: The first is that the country needs reform.

Law 100 is very battered, it was well designed but poorly implemented.
It has been mired in major crises in each Government.

The EPS system was broken and there is no chance of recovering it. But despite this, we cannot burst the hospitals; We also cannot let the doctors leave and we need the system to care for the people.

Today the best solution is to remove the reform from the political discussion.

I think that the actors must reach an agreement and I am referring to the Government, Congress, doctors and the system in general. The fundamental thing is to move the reform forward, it has already been modified, discuss it, surely what comes out is better than what we have today.

Are health institutions measuring themselves well today?

Supersalud ranks the EPS and IPS by profitability, and not by the number of lives saved, infections and contagious diseases that are generated, but are controlled.

These entities must also be measured by quality, innovation, research, and health outcomes, not financial ones.

But it seems that the entities like that measurement…
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Well, all the forums held today about health are wallets and cash, when they should be about health and prevention. I think that with the introduction of Artificial Intelligence this will help us a lot in concentrating on what corresponds to us.

I assure you one thing, health is not a problem of economics, it is a problem of doing things well.

(Read more: Health reform: most relevant points of the project being discussed in Congress)

CESAR GIRALDO
Portfolio