Paul Hokfelt brings a unique set of management skills to Clinique La Colline
Paul Hokfelt cannot keep a secret. He doesn’t want to. “What I’ve always made as a principle is: be very transparent. Take away everything that can create a suspicion by being overly transparent,” he says.
Hokfelt is chief executive of Clinique La Colline, the 110 year-old Geneva medical clinic he and his partners purchased in 2011. It is the most recent venture in a career that has taught him several principles for managing in cooperation with physicians. Honesty and transparency are key in that relationship because it is natural for doctors to feel suspicious of managers in a business partnership.
“Some people think I’m abrupt. Some people think I’m too much straight to the point. But, in all truthfulness, it is because I am trying to be honest with myself, but also with others,” he says.
His office is similarly no nonsense. All glass and unadorned white walls, black leather and chrome, the space is a reflection of the man, smart but not posh, focused and functional. Hokfelt is in a pressed white shirt. His silvery hair is kept short and streamlined, adding to the impact created by the dark frames and right angles of his glasses.
After finishing a hushed conversation with one of his leading physicians, Hokfelt seats himself at the conference table to describe for Swiss Style how he came to be at the head of a small private clinic literally in the shadow of its biggest competitor, the cantonal hospital.
Hokfelt spends most of his time these days in this office or somewhere in the clinic managing its greatest asset – its relationship with the doctors. That’s a change from previous endeavours where he spent much of his time on the road formulating and closing deals.
Hokfelt discovered early in his career that he likes to do deals. He enjoys the act of creation – bringing elements together to create something of greater value – and the intellectual rigour. Later on he discovered he could do it in the field of health care, too.
“In the late eighties I met some people who changed my life,” he says. He refers to the entrepreneurs who had bought three Swiss diagnostic labs to form Unilabs. They were not prepared to run the business themselves and asked Hokfelt to step in. He directed Unilabs for 12 years, during which time it grew through acquisitions, expanded outside Switzerland, and was listed on the Swiss stock exchange. He says that opportunity gave him experience with various aspects of managing a company as well as experience in the medical field.
About that time the hospital management company Capio was expanding into France. They tapped Hokfelt to run that group because, he says with a laugh, he knew how to work with doctors and because, frankly, the Swedish firm was finding French culture challenging.
Already a skilled deal-maker, Hokfelt proffered two conditions. First, he did not want to uproot his family to move from Geneva to Paris. And, second, he wanted to pick his own team. Capio agreed to relocate the French group office to Lyon and, because most of the former team elected to stay in Paris, Hokfelt had the rare opportunity to build his team.
They grew Capio’s French operations from 16 to 23 clinics and, when the company was sold in 2006, Hokfelt was named CEO.
The company Hokfelt inherited had upwards of 60,000 employees and operations in Spain, France and Germany. But something bothered him. It was the combination of businesses – hospital and diagnostic – under the Capio umbrella. “There’s a big difference,” he says. “In one you deal with a tube of blood. In the other you deal with a patient.”
While some might see that detail as insignificant – a widget is a widget, after all – Hokfelt recognized the fundamental difference in how the businesses are managed.
“With a specimen, you get as many together as you can in one place and your production will be the cheapest,” he explains. “The patient is a patient, and you cannot decentralize the management of a patient. So, fundamentally, you have extreme centralization on the one hand and decentralization in your organization.”
Capio agreed to split off labs from the hospital business and Hokfelt found himself in the middle of his next deal. With a freestanding diagnostic lab business now in the stable, he was able to gain Capio shareholder backing to acquire Unilabs. Within a year they had integrated the two, doubling the size of Unilabs, and Hokfelt became executive chairman at the end of 2007.
Hokfelt intended to stay at Unilabs only until new management was put in place, and when he heard that the Trinitarian Order of Avignon, who ran Clinique La Colline, wanted to part from the business, he decided to investigate.
He called on two people who became his partners in the deal: Geneva banker René Piccioto, whom he had met when Capio bought Piccioto’s French clinics, and Giorgio Gherardi who helped found Unilabs in 1987. They closed the deal in February 2011.
Hokfelt says the religious order had achieved its particular goals with the clinic, but did not run it like a business. He wanted to change that. As managing partner he determined that the way to profitability was through building a reputation for good medicine, and sought to change minds or personnel in pursuit of quality.
“You cannot create a good and profitable medical business on a spread sheet,” he says. “You need to create it by good medicine and good quality. It’s always first. The rest comes afterwards.”
His strategy to reach the level of quality he desires has been simple: work with the best doctors – La Colline has concentrated on recruiting – and give them the best instrument to work with – that meant investing millions in buildings, equipment and training.
These were valuable lessons he’d learned from his days at Unilabs. Managing together with doctors, he says, is a very specific field requiring specific skills because of the passion they have for their work. To be successful, according to Hokfelt, you have to be as passionate as they are.
“[The doctor] is very seldom somebody who relates to business and managerial issues. He is a surgeon. He has spent a long period of his life getting good at being a surgeon. At the same time, we do have things that we need to manage together,” he says, adding, “There are numerous areas where we have very close contact and this needs to work.”
Traditionally, Swiss physicians have been independent. La Colline, and others like it, are modelled on the belief that, by linking doctors and clinic, both will be stronger. Hokfelt’s role is to bring those elements together to create the best deal for both. In that sense, maybe it’s not so different from equipment finance after all.
Article by Peter Carson