Tatiana Romanyuk, the founder of the EMS clinic network, graduated from the Executive MBA program of the Graduate School of Management of St. Petersburg University (GSOM SPbU) in 2011. During this time, the business has grown from a relatively small medical center to two large high-tech multidisciplinary institutions: the grand opening of the second clinic took place relatively recently, in October 2021. There are 15 medical departments for adults and children and 54 medical specializations in the EMS network. In an interview, Tatiana talked about studying at GSOM SPbU, the thorny path in business, and the secrets of success.
25 years ago, you created the EMS company. Did you imagine then that in 2021 you would have two multifunctional family clinics with comprehensive outpatient care for adults and children?
Did I think I would have two clinics? I thought I'd have twenty of them, but I only have two! (Joke!) 25 years ago, I did not dream of clinics, I wanted to create a company to settle insurance events (international assistance) with my ambulance service. We did it: teams of our doctors flew all over the world, they helped with the repatriation of sick patients from one country to another. But it turned out that St. Petersburg is not the city where you can create a large international assistance company — Moscow is more suitable for this.
Then I decided to open clinics. The assistance direction has been transformed into a call center that deals with the settlement of insurance cases on the territory of St. Petersburg under voluntary health insurance programs. Why didn't we create a large network of clinics? Firstly, we were not interested in the project of a network of small medical centers without a full-fledged diagnostic base.
To create clinics of the format we need, with a license for radiation diagnostics, non-residential premises of 1200-1500 sq.m. are required, it is difficult in a city with such real estate. But there were attempts to find it, we even made design planning solutions at three sites, but in all cases, something did not coalesce: either there was not enough electrical power, or something else was wrong. Secondly, a large network requires a lot of staff, and highly qualified doctors are a huge shortage in the labor market. We did not agree to a reduction in quality.
As a result, we now provide comprehensive and high-quality polyclinic care. We understand that there is not a single clinic that could independently solve absolutely any human health problems. You need to be aware of your boundaries and, if necessary, redirect patients to colleagues; it is impossible to be super successful in everything. That is why we are now so inspired by the direction of preventive medicine when we can help a healthy person not to wait until the disease begins to appear but to take his health under control.
Why then, 25 years ago, did you choose medicine?
In 1996, it was about survival, making money in a way that would bring satisfaction, and you would feel like a decent person. For me, it was helping people. I'm not a doctor, but I was able to act as an organizer.
How did the transformation of the ambulance into a multifunctional clinic take place?
When we opened an ambulance, we were very different in quality and service from the city service, and even with only four cars, we could compete with the city service in speed in terms of arrival to the patient. Then the city service was in a difficult situation, but gradually its equipment with machines, facilities, doctors were improved, and I understood that our demand would fall, and competition would grow.
Due to the assistance direction, we created a good customer base, and we understood what quality and what areas of polyclinic care are in demand. In 2002, the first family clinic appeared — only seven offices, but it is quite a lot. We divided the children's and adult streams and efficiently used the room.
In 2009, I went to study at GSOM SPbU. During the same period, the building owner we occupied had a raider seizure of the business. I was studying, and I was kicked out of the building. Both owners — the former and the new — demanded rent, one of them raised the cost twice, we had to persuade him to put up with us a little more. I didn't want to move anywhere, it was important for me to create a higher-level medical institution.
Finally, in 2011, just in time for graduation from GSOM SPbU, we won a tender for the right to rent the place and made a good clinic for 29 rooms with endoscopy and an X-ray department. However, for this purpose, a global reconstruction had to be carried out in a place built into a residential building, which could only be legalized in court. But this is another story.
Why did you go to study, being already a successful manager?
It is classic. I am an entrepreneur, and I need to ensure a stable business in the long term. We need to see what will happen next, including thinking about retirement. At a certain point, the number of people and tasks that I had to manage became too large, and I turned from a spider with eight legs into a spider with 27 legs. There were so many directions and managers in direct subordination, whose work I coordinated. I felt that I wouldn't last that long on a physical level. There would be problems not only in business but also in the family. What's the way out? The only adequate way is to study, build a company with professional management, find answers to questions and study best practices.
Why did you choose GSOM SPbU?
When I came to GSOM SPbU for an interview, I was fascinated by the place and the people. Our Business School is special, intelligent. You immediately see the difference when you get to some other educational institution after SPbU. This energy of GSOM SPbU is consonant with me as a resident of St. Petersburg.
Many graduates note that thanks to their studies at GSOM SPbU, they entered the professional community, which will help a lot in the future. What do you think about it?
Sure. For this, among other things, we go. You're the first one inside the company. You have no equal there, no matter what anyone says. Everyone else is in a different position — they are inside the system, and you should also be outside it. You have to communicate, be inspired, draw energy from people with the same level of problems and requests and with those who are above you — from teachers with entrepreneurial experience, experts. We are still friends. Our group has a personal chat, we communicate periodically. I am very friendly with Andrey Kolesnikov, who is currently lecturing at GSOM SPbU on the EMBA program.
Tell us about the concept of the second clinic since it's not just a family medical center?
This is a multifunctional outpatient clinic with a priority on prevention, including physical rehabilitation, physical practices, physical testing and development of a personal physical activity, assessment of metabolic metabolism — we call this area medical fitness. I told myself: if the idea of preventive medicine and longevity technologies does not work, then at least we will make an excellent club-type clinic.
Anti-age is a fashionable theme. Everyone wants to know more about it and is waiting for the development of longevity technologies. Five years ago, we thought this direction was promising and interesting. Still, there were problems with doctors who understood this topic — they simply did not exist, only isolated specialists, and even then, they were mostly abroad. We are raising our specialists and waiting for those trained in international two- and three-year programs. But our gynecologists, phlebologists, dermatologists, therapists, nutritionists have already passed numerous programs on anti-age, nutraceuticals, and much more. We are talking about an integrated approach. Doctors should learn how to work with healthy people while curing diseases. There are two problems: the first is the culture of consumption. Unfortunately, we turn to doctors only when severe breakdowns and the manifestation of the disease already appear; the second is the standards of medical care: they exist only if there is a diagnosis, respectively, doctors know what to do if there is a diagnosis, there is no diagnosis — there is no medical standard. There are no standards for prevention, and the traditional clinician does not always understand what to do. Although, perhaps, the imbalance already exists and is even noticeable to the doctor, but there is no disease according to the established criteria yet. Doctors are not taught what to do in such cases. Here is just the perfect field for our participation.
How was the clinic opening in the pandemic conditions, what other difficulties had to be overcome?
The opening and establishment of the clinic was a wonderful period, except that I didn't sleep much. But there were also difficulties. I have four key employees who jumped out of the project: HR director, marketing director, and two medicine heads. Just while hiring and adapting staff, at a time when you need to promote the clinic. And all of them left St. Petersburg for various serious objective reasons. Some of them will return to us at the end of the year. Plus, of course, the staff was sick. There are a lot of difficulties with hiring. There are problems with line staff: people come, study for clinic administrators, can't cope with the amount of information, say it's difficult, and leave. The feeling that the covid period has changed people a lot. They got used to the home regime, cognitive abilities decreased, people have become lazier and less stress-resistant.
The main difficulties arose with people? Or not only?
We have prepared very well technically, from the point of view of creating a property complex, we are super well done. But there was a problem with promotion: the game rules in the digital marketing market have changed a lot, plus because of the pandemic, we could not hold any offline marketing events. The grand opening took place only on October 26.
Two clinics, 15 departments, and 54 medical specializations — the personnel issue is probably the most difficult. Tell us more about working with the team.
We have a strategy for retaining and attracting staff. It is not easy to get more than 200 people interested in the work — you need tools and shared goals. In addition, personal contact with everyone is important. After the initial adaptation, when we understand that the doctor is professional and in demand, he goes through an eight-hour training, in which I also personally participate. We analyze our values, principles and the process of communication between a doctor and a patient, teach them how to build a proper dialogue, give them tools on how to prevent burnout, and maintain awareness.
There is a lot of training for doctors now, but when we started, there was none. I invited a specialist from Belgium to St. Petersburg, then 15 of our employees were trained. Based on the training of a Belgian doctor, we created our own, creatively reworking it and adapting it to the specifics of our mentality and the Russian language specificities. It's not easy for me - I'm not a doctor, but I'm an expert, I look through the eyes of a patient, and I've been in the healthcare system for 25 years.
We also have a very open dialogue in the team. We do not humiliate anyone and recognize the right to make a mistake. We try to praise more if there is something for it. Everything is honest and open in our team. All complaints and thanks of patients are public with us — if someone turns out to be not up to par, then these are, as a rule, communication mistakes, in such situations we simply recommend re-take the training.
What else is needed to create a united team?
We initially thought about the strategy of retaining doctors and not only doctors, and one of the tools has become a tradition — to sum up the results twice a year and award the best employees according to objective indicators (KPIs) with tea service elements. Company service and tea service are very close concepts. Here is a beautiful service: cups, a teapot. If any element breaks — the spout flies away from the kettle, then the price of the entire service falls. Everyone should feel like an element of service in the company. We present the best doctors of each medical department and other departments with very beautiful branded cups produced by the Imperial Porcelain Factory. And anyone who wants to get an "imperial" teapot must first collect all the other elements of the service. And there is a real case when a very talented doctor who planned to emigrate to America, including for the sake of sporting interest to collect the whole set, postponed her move and then completely changed her mind. And she's still with us.
The company and you are the winner of many awards and included in various profile ratings. What do you consider the major victory for 25 years?
It's hard to answer. Perhaps this is what I decided after 50 years to study at the International School of Design. And I became a designer myself and the designer of the second clinic. I picked up the materials, carried out the author's supervision, and spent four months on the construction site. And my team solved all other issues independently, allowing me to devote myself to creativity and the new clinic project fully. GSOM SPbU forms the skill of continuous learning and personal development. That's why I'm still planning to study singing.
What advice would you give to those who are now looking for their way and choosing an educational institution?
There are no options here: all managers need a basic MBA education in any case. If you are an entrepreneur, you should build regular management in your company. You should be aware of your strengths and weaknesses and consider them while assembling a team. I do not know what is cooler in St. Petersburg than GSOM SPbU, but you need to choose the coolest.