Thinking bigger and learning from others’ experiences

Sciana Fellow Oliver Reich reflects on his Sciana experience, economics in healthcare, and mental health

Oliver Reich is the director of santé24, the telemedicine provider of the SWICA Health Organisation, one of the largest health insurance companies in Switzerland. He is a former board member of the Swiss Forum for Integrated Care (fmc) and member of the board of directors at Spitex Zürich Limmat AG. Furthermore, he acts as a lecturer at the Faculty of Medicine at the University of Zurich.

Before joining santé24, he worked in multiple capacities for the Helsana Group as the head of health sciences, a health economist, and in managed care. Since 2000, he took on a consultancy role at Andersen Consulting (now Accenture). He is a member of Sciana's fifth cohort.

This interview has been edited for brevity and clarity.

Sciana Network: What comes to mind when you think about your experience in the Sciana Network?

Oliver Reich: [What] comes to mind is the many inspiring and talented people from the three different countries. I think that is probably the most beneficial for the whole experience. Being able to do discussions, to learn from their experiences, and vice versa, in different settings, is really cool. 

I think you don't have that many situations, or workshops, or conferences [that are] unique and intimate - [being in a] situation away from home, more or less not distracted by daily work, and being able to take the time to talk with each other.

SN: Part of the Network's mission is to equip the leaders who are in healthcare to tackle future challenges. Could you provide examples of what you've learned about leadership while participating in this programme?

OR: To be honest, looking at the programme, we didn't have that much of a focus on leadership, and that's because, I think, the starting point for each of us is probably different. I'm more experienced in terms of age, and already [there is] a self-awareness aspect in the way I lead after many years [...] But what's always interesting is get[ting] the various and different perspectives on how [other members of the Cohort] lead in their experience in different policy settings. 

I'm very curious, and I want to learn from others. It's always a give and take, so if I give, then I also get. I try to grow on the insights that I get, the knowledge from others, and the experiences that they've had because no situation is the same. [In] one situation, I react like this, and the others, in another situation, have to react differently. You can do that when you are open enough to learn from others and listen to others, and maybe in a future situation, you'll be able to react accordingly.

SN: Your cohort Sciana Challenge this year is building a connected and sustainable health ecosystem. What does this challenge mean to you, and could you share more details about what your working group has been investigating?

OR: I think, at the end of the day, [it's about being] efficient and [using] a bit more system-orientated thinking. We're all in our daily jobs, and we are quite often in a hamster wheel, solving problems, be it subjects or personnel, financial resources, and stuff like that. 

What's really cool is, especially with the combination of One Health, is that we get a more strategic level [and a] system level that forces us to take this distanced view of our situations: personal situations, company [and] team situations, country situations or [the] world's situation. That has really helped, I think, the approach that we had. [It] is something I will take home with me. 

Being able to drill down and consciously go up again to another level, [to] think not just strategically for the company but really system-wise, [and to] take that as a co-responsibility for us, to not just think about our own country, or system, or company, but also from a wider perspective.

SN: How important is economics in organising healthcare systems? How do you align private economic incentives with public healthcare initiatives?

OR: I know that one does that, but I don't think you can really separate private and public because, actually, they go hand in hand. Even if you are a private company, you are still doing services for the public. So, you'll always have a combination of both, and to be sustainable, I think you have to have both perspectives. You have to have a purpose. 

Of course, being a health provider, you are naturally doing something with the public. It's not maximising profits; that is not the goal. We want to make the best medicine, or the optimal medicine, for our population. I think that's where economics comes in. 

What I try and bring in is more [of] the Pareto principle. You can't do everything perfectly. [My] fundamental view is that [if] we always try and do everything very, very perfectly, then we don't get anywhere. That's another point on leadership; we have to try things out. We have to adapt when things are not going well or [when] the world has changed. 

[This] is an ability that healthcare is not good at. We like to plan. We like to implement. Like building a hospital, it takes 15 years. By the time the hospital is built, it's out of date. It's not what the patients will be using, and it's not what the clinicians will be needing. 

One last thing on economics: we are talking about resources, and financial resources are, of course, one of the main drivers. How can we maximise the output of the effort or the financial resources? How can we get the best value out of it?

SN: Looking forward, what is a challenge in your field that you're looking to explore further or understand how to respond to?

OR:  [The utilisation and adaptability of resources] is already a challenge. Talking about personnel, for example, we still [have a] very physician-orientated healthcare provision. And I think we have to think about other ways of performing and providing care. Maybe delegating typical physician tasks to nurses or to other specialised personnel. In Switzerland, we are far away from these sorts of things. But we are slowly getting there because we have been running into problems. 

We won't be able to provide enough care. The supply of healthcare professionals is deteriorating, and on the other side, the number of patients is increasing. So, we will have a gap at the end of the day. Either you change the settings and change the way healthcare is provided, in terms of the possible resources in the system. 

How can we use them optimally? That's the link to healthcare [and] to our group. [It is] using technology in order to make it more effective and efficient. [It is] not replacing professionals, but aiding them, supporting them to make better decisions and to help the processes committed.

SN: Your final residential meeting coincided with European Mental Health Week. What's one thing you do to protect and support your mental health?

OR: My family. I love to spend time with my family and friends, to discuss and spend time with them, even though sometimes it's not so easy. I am also highly engaged, in my free time, in hockey, where I can engage with young people. Since I played myself for quite some time, I give something back to the community, more or less, and that helps certainly a lot. 

It's boring, I know, but [when I] have time, I try to do sports. I'm most creative when I go jogging. So, if I have to do a presentation or a workshop, I always go jogging. It's like part of working. But then when I come home, I have to write everything down, and I'll have the outline of a presentation. 

Oh, and one last thing: I regularly ask myself, am I happy with my life? I think that is something I force myself to do: [be] happy with my life, in terms of work; [be] happy with my life, in terms of family and friends. If I'm not, then I'm forced to change something. 

In my experience, if I look at my friends and colleagues, just as an example, people are doing the same job for years and years. I'm not criticising that. But usually, you don't do that because you say to yourself, "Okay, this is what I want to do." It's probably more comfortable to just stay because you know how [things] go and you earn enough. As a worker, you're in the flow, and you do that for ages and ages. 

I think from time to time, we need challenges. You have to jump into the cold water and learn something new again. That keeps you mentally healthy.