The business of healthcare: Interview with founder of Ethiopia’s Pioneer Diagnostics Center
We speak to Brook Fekadu, founder and CEO of Pioneer Diagnostics Center (PDC), a medical diagnostic imaging service provider in Ethiopia. The company, established in 2006, provides MRI, CT scan, X-ray and ultrasound services. In May 2020, private equity firm Zoscales Partners acquired a stake in PDC.
– Telehealth to expand the accessibility of quality healthcare in Africa
1. Tell us about one of the toughest situations you’ve found yourself in as a business owner.
Some MRI scans require a substance, called contrast media, which is used to enhance the contrast of structures within the body. Contrast media is given to the patient during the scan. When we imported the MRI machine for Pioneer Diagnostic Center, we had imported enough of this substance to last us a year and assumed we could import more when we ran out. Since contrast media is a pharmaceutical product, we later found out that it had to be registered by the Ethiopian regulatory authority before it can be imported.
The initial shipment passed scrutiny because it was imported together with the MRI machine. We came to find out there is a national list of drugs imported into Ethiopia and contrast media was not on the list. This meant that we had to find a supplier willing to register their product in Ethiopia; get the product added on the national drug list; and then apply for registration. Since Ethiopia had only two MRI machines at the time, and the volume of contrast media expected to be consumed was not high, none of the existing pharma importers were interested.
We had to come up with a short term and long term solution. In the short term, we received a one-time import permit from the regulatory authority so we could fulfil our immediate needs. To solve our problem long term, we set up a separate medical supplies import company, got contrast media added to the national drug list, completed the registration process and starting importing contrast media. This company we set up as a solution to our problem grew into a business in its own right and became an ISO 9001 certified medical equipment and supplies distributor with over 140 employees.
2. What business achievement are you most proud of?
I am very proud of the countless lives that have been positively impacted by the imaging services we provide at Pioneer Diagnostic Center. I remember an elderly man that walked into our centre and said he had fallen while hanging a picture a couple of days back and now had a constant headache. An MRI scan showed he had blood inside his skull. The fact that we were able to image his brain and possibly save his life was a proud moment. Many children, mothers, fathers, sisters, brothers, have come to get scanned and we have diagnosed them and saved their lives.
I am also proud that the existence of our diagnostic centre has played a significant role in the development of neurology and radiology practice in Ethiopia. Prior to the availability of MRI, neurologists in Ethiopia were using an invasive procedure called myelography in order to image a patient’s spine. This procedure was very painful to the patients and did not provide good images. Instead of undergoing this painful procedure, our MRI machine enabled patients to lie down and get a scan for a few minutes while listening to music resulting in much clearer images that the neurologists can use treat the spine.
Now, many more MRI machines exist in Ethiopia. By being pioneers of MRI imaging in Ethiopia, we had our own version the 4-minute mile. We showed that such a sophisticated piece of equipment can be operated in a sustainable manner in Ethiopia.
3. Describe your greatest weakness as an entrepreneur.
I believe in rewarding excellence. While this is a good thing, it should be balanced with discouraging mediocrity. I tend to avoid confrontation and later realised that I was not as honest and critical as I should be, especially with the senior members of my team. Even though I did not enjoy doing it, I realised the importance of being honest with senior team members. I made sure criticisms and constructive disagreements were not personalised and focused on seeking what is good for the company. Dialogue and constructive criticism is now part and parcel of our organisational culture and it has played a significant role in solving issues and achieving goals.
4. What conventional business wisdom do you disagree with?
Company before employees. I believe happy employees who believe in what the company is trying to achieve will make a company successful. There is nothing like having a dedicated, motivated group of employees working together for a goal. With such a team anything can be achieved.
5. Is there anything you wish you knew about entrepreneurship before you started?
Delegate! When we were doing our first MRI project, I was directly involved in every aspect of the execution. I was involved in small details like picking up the installation team from the airport, arranging where they stayed, clearing the machine from the port, renting a crane for unloading, etc. Soon I realised, I was getting stretched and needed to rely on a team. If I focused on managing the project and got execution help from the get-go, it would have been less stressful. As an entrepreneur, the sooner you learn to delegate and rely on others, the better.
6. Identify an untapped business opportunity in Africa.
Due to a shortage of clinicians in Africa and the emphasis on social distancing, I believe telehealth is a good business idea. Experienced primary care physicians and specialists are in short supply in Africa. Patients have to travel long distances to get quality care. Connecting remotely located clinics to a central telehealth facility with experienced and specialised physicians will significantly improve the accessibility of quality healthcare to most Africans. In addition to collaborating with remotely located health facilities, telehealth can allow individual doctors and nurses to start a home care practice by leveraging the telemedicine infrastructure and centrally located experienced clinicians.