Collaboration over competition to improve global health care

Collaboration over competition to improve global health care
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At a recent seminar by a Danish neonatologist and nurse on neonatal intensive care units in their country, one of the most striking differences I learned between the U.S. and Denmark is that at least one parent is at the infant’s bedside in the neonatal intensive care unit around-the-clock throughout their baby’s stay. 

The expectation isn’t that a parent visits every day, but that a parent is there 24/7 throughout their baby’s stay. 

Many challenges stand in the way of implementing this in the United States, including the lack of federal policies for paid maternity leave. Without maternity leave, mothers often return to work while their baby is still in the neonatal intensive care unit in the hospital.


As an economist, I see from a global perspective that health care can shift so that organizations across borders collaborate to help solve health-care problems. Organizations can better solve problems related to access to care, research, training and development if they work together.

International medical travel (or medical tourism) is one means to address inequities in access to medical care across the world — due to differences in quality, price or availability. 

Thousands of patients travel to the U.S. every day, many for diagnoses and treatments that are not available closer to their homes. 

Recently, a British infant with an extremely rare heart condition traveled with his parents and grandparents to Boston Children’s Hospital for treatment. The doctors treating the child are world-renowned experts who not only performed the complex surgery, but also had published research on the outcomes of children who had received treatment for this rare condition. 

Across a large number of surgeries and treatments, there is a strong association between the number of procedures performed at a hospital and patient outcomes. For uncommon treatments, medical travel can provide access to care not available locally, but also further reinforces the “practice makes perfect” phenomenon.

To be sure, Americans travel outside of the country for medical care due to cost. The United States has the highest health-care spending of any health-care system in the world. 

A friend recently shared that he traveled to Costa Rica for a dental procedure that would have cost $27,000 in the United States, but he paid only a fraction of that amount. He would have preferred to get care near his home, but the out-of-pocket cost made the treatment unaffordable.

The effects of cross-border sharing of new research is possible, as research on rare diseases requires not only multi-hospital collaboration, but global collaboration to collect information on a large enough number of patients. 

research study on genetic Parkinson’s disease spans 43 countries and 103 sites to garner a sufficient number of patients within specific subgroups. This kind of research would not otherwise be possible or would take substantially longer to complete without collaboration among researchers from across the world. 

Researchers and clinicians in academic medical centers invest their own human capital to find breakthrough discoveries that will improve health, prevent disease and treat serious illness. The goal of this research is to improve the health of society — not only in local communities, but to share discoveries across the world, so that these innovations can improve health and save lives.


American health-care providers and providers across the world, disseminate these discoveries and knowledge in a multitude of ways. Hosting clinicians and other leaders from countries across the world in clinical observer programs, enables them to learn about cutting edge diagnostic approaches, treatments and therapies that can be brought back to their home organizations. 

For instance, among many U.S. programs, Cincinnati Children’s Hospital & Medical Center has programs for both international clinical observers and researchers and Memorial Sloan Kettering Cancer Center offers one-month observerships for clinicians and scientists as well as short workshops for international health-care professionals and a three-month fellowship for physicians from across the world to learn about cancer care.

Cleveland Clinic offers a clinical preceptor program for physicians to have one-on-one observations and learn best practices and an international nurse scholar program for nurses in leadership and clinical areas. 

Clinicians and administrators from hospitals across the U.S. and abroad provide consultation and management services to governments and health-care providers, advising on a broad portfolio of areas ranging from service line to health-care organization and provider network development. 

As one example, UMPC International in Ireland provides consultation and management services to providers across the world, including San Pietro Fatebenefratelli Hospital in Italy, KingMed Diagnostics in China and Hamad Medical Corporation in Qatar. These services help to strengthen the health-care services and infrastructures in local communities abroad, so that cutting edge, complex medical care can be provided close to home.

With breakthrough discoveries nearly every day, health-care organizations, providers, researchers, administrators and leaders need to proactively think about how to continuously learn from each other to strengthen health care delivery across the world by collaborating, not competing.

Tricia Johnson, Ph.D., is an economist in the Rush University Department of Health Systems Management and a Public Voices Fellow through The OpEd Project.