International hospital expansions: A health or profit imperative?

The Mayo Clinic recently announced that they will be opening a new multispecialty hospital in Abu Dhabi, the wealthy capital of the United Arab Emirates. Sheikh Shakhbout Medical City, the 741-bed hospital offering critical, outpatient, and surgical care, is scheduled to open next year. 

Mayo Clinic officials have framed this expansion as a part of their “humanitarian mission,” saying that this hospital will provide “hope and healing for those who need it most.” However, health policy experts suspect that the new hospital serves more of a financial purpose than a altruistic one.  

“A hospital in Abu Dhabi does not exactly speak to the Mayo Clinic’s commitment to humanitarian values,” said Shannon Brownlee, Senior Vice President of the Lown Institute, in the Duluth News Tribune. “This is really about capitalizing on Mayo’s excellent, and well-deserved reputation in order to expand its business opportunities.”

By expanding to one of the wealthiest cities in the world, the Mayo Clinic is centering its international strategy around where the money is, not where the most pressing health needs exist. “If the Mayo Clinic really wanted to help humanity, it would build primary care clinics in rural Appalachia, sub-Saharan Africa, or any number of places in the world where people are in real need of medical services, and can’t get them because they are too poor,” said Brownlee. 

The Mayo Clinic’s partnership with the UAE also potentially endorses a government that international experts call a “police state.” The UAE does not have a free press, punishes anti-government dissent, places women under a separate (more restrictive) legal status, and has banned transgender and homosexual activity. The health effects of inequality and violence caused by these policies should not be understated.

Additionally, the repressive political system in the UAE will likely make it difficult for the new hospital to provide high-quality health care to all the patients who need them. For example, the UAE government has stated its intention of investigating and potentially punishing those who air complaints online of side effects and treatment-related harms.

However, the Mayo Clinic is not the first hospital to open a hospital overseas to expand their brand. The Cleveland Clinic opened a multispecialty hospital in Abu Dhabi in 2015 as well. According to Michael Page, deputy director for the Middle East and North Africa division at Human Rights Watch, “The Gulf states have a tremendous amount of wealth and financial power that is quite attractive for large institutions. It’s not just the Mayo Clinic. There are academic institutions like New York University over there, and they likely have quite generous agreements with the government.” 

As large hospital systems continue to seek revenue, we can expect to see more expansion into wealthy areas around the world. This is a prime example of what Dr. Victor Montori calls “looking for mission where the money is.”