How did you first get started in the medical assistance industry, and how did you come to be in your current role?
After more than 15 years at sea as a senior doctor for Princess Cruises, moving into the medical assistance field offered me a great opportunity to utilise both my clinical and geographical knowledge. I started as an office doctor with CEGA in 2015 and became Chief Medical Officer in 2017.
How big a benefit have your previous postings been in your current role?
My postings as a senior ship’s doctor with executive committee responsibilities on board, life as a trauma doctor and time spent running my own GP and travel medicine practice have all laid invaluable groundwork. I believe, however, that it is one’s own life experiences that make a manager and a leader. My travel experience and immersion into different cultures and countries have given me a broader global view and understanding of the requirements of people and a glimpse into what makes us human.
Can you talk us through a typical day in your job?
There is no typical day and no two days even begin to resemble each other. This suits my personality, which thrives on challenges. Most days will include a review of the morning handover of cases from the night team, followed by a quick huddle with the medical team to discuss any potential issues for the day. The rest of the day could be spent in client meetings, reviewing complex cases, approving and authorising air ambulances, having discussions with medical staff in overseas facilities and more – the list goes on and there is never a dull moment or indeed a spare moment.
I am fortunate to be part of a strong and passionate team of doctors, nurses and paramedics who all have the same goal of putting the patient first. Together, we provide medical assistance and repatriation services to thousands of individuals every year (many in remote and offshore destinations) on behalf of travel and international health insurers, or for the energy sector, NGOs and more. We also work closely with our in-house cost containment and claims teams to validate medical bills from overseas hospitals.
Often in the medical assistance world, we take it for granted that insurers have the same in-depth knowledge of the world of aviation medicine that we do
What, in your opinion, are the main hurdles that an assistance company faces when organising a repatriation, and what are the best methods for overcoming these hurdles?
Medical repatriation is complex and has to be managed with expert precision. It can involve several modes of transport: for example, road transfers by ambulance, commercial flights with stretchers, seats or full intensive care support and, of course, air ambulances. Inevitably, hurdles can crop up.
Most hurdles can be overcome by constant communication with all the parties concerned and by giving everyone adequate information and reasonable expectations of the repatriation process. If an individual is expecting an air ambulance, there needs to be an understanding that this will not happen in the next hour and that a medically escorted repatriation can take days to set up in some instances.
The main challenges are visas and entrance requirements for certain countries, flight availability (whether that be commercial or bespoke air ambulance), weather conditions and obtaining adequate information from the treating facilities to allow an informed decision regarding fitness for transfer. Sometimes, a treating doctor overseas may not fully understand the effects of altitude and may consider someone fit to fly when they’re not. In cases like these, it’s normally up to the assistance provider to explain the risks. On the other hand, a doctor may declare a patient unfit to fly because he or she may not be familiar with the facilities and care available in the air, such as intensive care medical escorts, sea-level pressure cabins, and appropriate medical equipment.
Meanwhile, repatriation from a hostile area will often necessitate security support. For example, a road ambulance may need security protection and intelligence for the journey to an airport – and this will need to be organised before a repatriation starts. Being able to draw on a global network of medical, security and transport partners is essential to all of this.
How can travel medical assistance companies ensure a more efficient and frictionless working relationship with insurers?
Again, communication is key. Often in the medical assistance world, we take it for granted that insurers have the same in-depth knowledge of the world of aviation medicine that we do. Discussion and explanations of cases is essential for them to understand the logic and guidelines behind our decisions.
On the medical side of assistance, what technological advancements would you say have had the most revolutionary impact on your business in the last decade?
Technological advancements have increased customer choice and improved the medical assistance journey; from the explosion of social media, which enables us to communicate with clients in remote areas, to sophisticated IT systems that give us a 360-degree view of our assistance customers’ needs.
Our own technological advancements include a range of mobile assistance tools; not least our Intrinsic Assistance app, which we developed with our security partners Solace Global. It enables ill or injured travellers to raise an alert and request integrated medical and security assistance at the swipe of a screen, wherever they are in the world. Crucially, it also enables them to receive alerts about real-time risks in their area, so they can change their travel plans and reduce the severity of, or even avoid, an emergency situation. Our global network of overseas partners and agents are always available ‘on the ground’ to support them.
Advances in technology will always need to be supported by highly-skilled staff, who put the customer at the heart of everything they do
We’ve also launched an agile medical screening product, Antidote, that automates pre-travel medical screening. It gives customers the chance to self-declare pre-existing medical conditions to their travel insurers quickly and easily and to find out how their conditions might impact on their travel insurance cover.
In addition, customers abroad who call our global assistance helpline with minor medical problems can now get transferred immediately to a UK doctor by phone, with our new 24/7 ‘Speak to a Doctor’ service. This helps to reassure worried travellers, reduces the number of visits to overseas medical centres and contains the costs of insurers’ medical bills.
And what new or forthcoming advancements do you think will prove game-changing over the next few years?
Technology is advancing all the time and we’re always keen to look at new solutions that improve the assistance experience. We’re currently running trials of Digital Doctor, which integrates video doctor and advanced diagnostic services into the medical assistance process. This is likely to have a major impact on travellers’ wellbeing, especially when they are in remote or hostile locations.
We’re also looking at different ways of making it easy for customers abroad to reach out for help; not least via wearables. And we’re exploring ways in which AI can help us further improve the information and support we provide to our assistance customers.
Customers today expect their assistance providers to have the technological systems in place to provide the best service. But it’s important to remember that advances in technology will always need to be supported by highly-skilled staff, who put the customer at the heart of everything they do. The reassuring, expert voice at the end of the phone in an emergency abroad will always be valued.
What impact – if any – do you think that Brexit may have on your business?
That’s the burning question of the moment, isn’t it? I think a crystal ball is the only accurate way of assessing post-Brexit changes. By the time this article goes to print, the country may well be closer to a clear Brexit outcome, but as a company, we have worked hard over the last three years to prepare for every eventuality. This has meant collaborating with global clients and partners to ensure that our service delivery is as seamless as possible in a post-Brexit world.
The provision of medical assistance is always complex, of course, but are there any countries in the world that pose a particular headache at the moment?
Unfortunately, no country can be regarded as safe in the current political climate and sadly we see this reflected in our medical cases. Few people choose a travel destination based on the medical care available in that country, but travel insurance can offer them a safety net, should they have a medical emergency abroad – and we work hard to reinforce that message.
What would you say are your proudest achievements, both personally and professionally?
There are many. Every patient or their family member who I have had a positive impact on, in even the smallest way, reminds me why I chose this career many years ago (don’t ask how many!). I would not have changed any of my professional life choices. Being Chief Medical Officer of CEGA has afforded me the opportunity of working with a superb medical and operations team and of still being able to make a difference to people’s lives.