Read the Conversation
EF: What have been the lessons learnt during 2020, a very atypical year?
PM: A key lesson learnt was to be nimble and have the ability to adjust in a changing environment and conditions. The Covid-19 pandemic meant we had to reset conditions for our employees to work from home, collaborate with our partners, logistics companies, and hospitals to be able to offer the same level of service pre-Covid and it was quite a challenge. We asked TNT, FedEx, and DHL for support with the logistics of moving our products around the country making sure they had the necessary permits to fully operate during lockdown from the government's department of trade and industry. We are very proud of ensuring the security of product supply and of managing to continue to operate mainly because our work involves life saving situations. Working ethically we have saved many lives with our work, we even chartered a plane to take a cardiologist from Capetown to Johannesburg to do the needed procedure and flew him back again. MEDTRONIC has worked in a ‘home office’ mode and with remote support and remote calibration of devices for patients fully functioning during the lockdown, accelerated due to Covid-19.
EF: Can you share your experience in remote leadership management?
PM: It was a testing experience, I knew I had to balance taking care of the organization in terms of people working without having human contact –everything being done electronically- which can be challenging as the contact one has in the office helps in the day to day work. What I did specifically with my leadership team was to contact them directly daily. With those employees who caught Covid, I was in contact with them to know how they were feeling. Connecting with our people, patients, and stakeholders was in my opinion the most important factor to ensure business continuity during these challenging times.
EF: What is MEDTRONIC’s footprint today in South Africa?
PM: Medtronic is present in South Africa and in other African countries as well: Namibia, Mozambique, Lesotho, Botswana, etc. In South Africa, we have offices in six main cities, Johannesburg, Durban, Port Elizabeth, Bloemfontein, and Nelspruit, this presence allows medical practices to have access to our wide portfolio all over the country.
EF: Has your portfolio performance shifted because of Covid, and how have you managed to keep the chronic disease portfolio performing in a communicable disease scenario?
PM: Medtronic has a very diverse portfolio with a wide variety of products and therapies, we are present in operating theatres, ICUs, and labs. Because of the diverse portfolio and applications, we have been impacted by Covid in some areas, while we have also gained a lot in other areas. Medtronic is one of the companies that contributed the PB 560 ventilator on an open source to the world to help mitigate Covid´s impact. Sharing the ‘recipe’ to assemble ventilators was our way to help the different countries. We have other types of ventilators and Covid related products like oxygen exhibitor, intubation tubes, cameras to facilitate the intubation of patients among others and we make sure to have them available because the global demand has been huge. In some places our capacity to manufacture ventilators was ramped up fivefold to keep up with the needed supply.
EF: Are we better prepared to deal with a second wave, has there been time to learn and act on the experience of the first wave?
PM: Yes, we have learnt from the first wave, yet the second wave numbers have definitely been much higher. The South African second wave strain was more infectious and needed a lot more hospitalization with a higher mortality rate, the difference has been quite a shock for us. The second wave hit us very hard and has been 2 or 3 times worse than the first wave.
EF: Healthcare and productivity have never been more important than now, so how can momentum be built on the importance of healthcare moving forward?
PM: We have to be very efficient in the way we allocate resources and fall back on technology to improve the way we do things. We are working on digitalization and the ability to see patients virtually which will make us work more efficiently and have better patient management control. A doctor can see his patient virtually and if an expert or specialist is needed he/she can join the virtual consult. The combination of virtual interaction and digitalization of healthcare I think will go a long way to reaching more patients as well as being efficient in the management of costs and make healthcare more accessible to many more people.
EF: What is your personal definition of access?
PM: Access is being able to get healthcare whenever you need it. At Medtronic, we are working on the concept of increasing access to devices and technology. Globally we don’t have enough healthcare workers, so we have to use the numbers we have optimally to reach as many patients as possible through technology.
EF: With Covid-19 there has been a shift to delivering healthcare to people’s homes as opposed to going to the hospitals, what is your perspective on the future of home care?
PM: We stay very close to the doctors and the Covid-19 protocols, during the first wave a doctor mentioned patients were refusing to come to the hospitals, and to counter that a hospital group created virtual health solutions, selling vouchers to patients so they could start connecting remotely to doctors. Of course, this sort of action was done in all areas of life with people all trying to do things remotely. I do agree that there is a shift towards people adopting digitalization in healthcare and Covid has helped to accelerate that shift. Medtronic has always driven technology and with all the devices it has implanted in patients, it can never be too fast for us. We put the “med in the tech industry”, we probably calibrate between 95 to 99% of our devices remotely and invest time and money on educating and allaying doctor´s fears showing we really can do this remotely and getting them to accept this. The uptake has been faster than we expected and Covid has helped the acceleration.
EF: Worldwide the business model has shifted to delivering health as a service rather than the sale of a product- how has this trend translated into South Africa?
PM: We have already seen pockets of early adopters driving this trend and now we can identify over ten remote and digital health companies working on their launchings as opposed to a few early adopters before. Now it’s already the future and nobody needs to be convinced of the benefits of health services. Today the challenge lies on working how to do it. In our case, the general acceptance to ‘calibrating devices remotely’ was slow at first and we had to offer virtual support rooms to help, advise and assist doctors. Pre-Covid there wasn’t so much pressure to move in that direction.
EF: What is the balance of your business between the private and public sectors?
PM: Today it would be 30% public and 70% private mainly because the private sector is quicker to adopt new ideas and the public sector sticks to what has worked for them in the past. We are in the business of saving lives and we are working on adding to that 30% through technology, collaborating with teaching hospitals and universities to fast track tech, we are investing in education and in super specialized doctors in neurology, cardiology etc. We do fellowship sponsorship in South Africa and we are sponsoring two doctors in Canada in cardiology who will be back in two years to work with us to help increase access to care. We need doctors to understand and use the latest technology. As far as the public sector business is concerned we are aiming at getting 50%, this means we are aiming to increase access to a lot more people. There are a lot of patients in the public sector that would benefit from our technology in cardio for example. If we can get the whole health ecosystem to work with it (emergency services, stroke centers), not only on the symptoms but in educating on the symptoms so patients would know to arrive at the hospital before they have the stroke -we would make a big difference to the numbers.
EF: As South Africa’s number one Med-Tech company you have an important role as an example to others. What will be MEDTRONIC´s role over the next years and what would you like 2021 to be remembered for?
PM: 2021 will be remembered for the collaboration between the sectors, for increased access to healthcare for big or small hospitals, big or small cardiology practices or for teaching hospitals -I think we all want to be remembered for increasing access to care. Some people still pay a lot of ‘out of pocket’ to have access to healthcare and to increase access in a cost-effective way there must be continued investment in education and change to build up capacity. We have explored new operating models looking for ways of increasing access. Sometimes we partner with a specialty hospital –a urology hospital in Pretoria for example- to look into urological ailments, interventions, or medical care. Or we partner with cardiology and heart hospitals or with orthopedic, cranial, or brain specialized hospitals. We try and increase access through collaborations to influence and shape the market and push for more collaboration. With the technology and the products we have, we can really change people’s lives, we can unblock problems in the blood flow in the heart mechanically in one go -as opposed to taking drugs forever- and our way the patient is back on his feet almost immediately. The next generation’s treatment of high blood pressure will be a quick procedure and it is over and done with, it is the perfect solution for the patient. We must start educating doctors and healthcare workers so that they understand the big scope of solutions we have for the patients.
EF: You have a very long career in Med-Tech, what keeps you motivated?
PM: The ability to make a difference I think is the strongest and most constant motive; it helps me to wake up every day and come back for more. Being in the business of saving lives is very motivating. We have a purpose and cause an impact! For example, a case of a young boy with a muscular movement disease called dystonia kept him moving constantly, so he couldn’t rest day or night. A neurologist who was about to retire, decided first to help this boy, money was found for the boy to have an operation in Cape Town’s Red Cross hospital, a 16 hour drive was necessary, he had the operation and our technology called deep brainstorm relation was customized for him and implanted. I consider it a great success and a very emotional story especially if you see him now.
Every two months or so I run a two hour breakfast and invite a special guest not from the healthcare sector to hear new different stories of how people work and do things, it also showcases what we do as we are in the business of saving lives. This is eye opening for our own employees for them to understand the importance of our business – the motivation is huge and the feedback we get is priceless. Access and collaboration are very powerful motivators for us, for example, giving our ventilator recipe to the world was amazing and unique.