Sophie Kobouloff-Dacre-mont brings a unique combination of entrepreneurial prowess, education and family background to Russia's private health care system.

Over the past nine years, she has worked at the European Medical Center (EMC) in various capacities, running the marketing department and sometimes acting as the clinic's general director.

But in order to fully explore the uniqueness of managing modern health care delivery, and for the benefit of her patients, Kobouloff-Dacremont – who already had a business degree from the famous French EDHEC Business School and MBA degree from the United States – decided to go back to school, receiving a doctorate in health administration from the Medical University of South Carolina in 1998.

Kobouloff-Dacremont told The Russia Journal that her education, as well being raised in a medical family, has helped her resolve the classic conflict within the health care industry – cutting costs vs. improving the quality of health care – in patients' favor.

The Russia Journal: How would you characterize the private Russian health care sector today?

Sophie Kobouloff-Dacremont: Russia's private medical sector is developing tremendously, especially in the dental segment where new clinics are opening up all the time.

But the pace of foreign health care development has slowed down, as there are very few players on the scene, and the prospects for new ones entering the market are even slimmer.

This is because setting up a health care business, usually seen as a special domain, is even more difficult than in other sectors with its stringent licensing, medical diplomas and myriad of other requirements. Correctly comprehending the situation and setting up a health care facility requires a lot more than just time and money.

RJ: When was the EMC founded?

SKD: We are the oldest on the market. Europe Assistance founded the EMC in 1989. The current team of investors and managers took over in 1994 and turned it into a medical and dental clinic with several facilities in Moscow, Yerevan and Prague.

RJ: Now that you have been working in this market for about nine years, how would you describe the status of the EMC today?

SKD: Without any fear of being accused of immodesty, I can say the EMC is No. 1 in the private health care sector. Regarding dental care, our specialists, notably in the domain of dental implants, are among the best in the world.

An example will help to make this point clearer. Traditionally, any treatment involving implants and ceramic bridges – a costly and lengthy procedure – usually takes about two years to complete, but the duration has been reduced to a little more than a week at the EMC's dental clinic thanks to its specific technique. Interestingly, there are only 10 surgeons who have mastered this technique in the world, and one of them is at the EMC. Finally, the EMC's in-house dental laboratory custom-makes the ceramic work in direct cooperation with the dentists.

On the medical side, the EMC is the only foreign private clinic in Moscow with its own in-house surgical and in-patient departments. These include surgical theaters and an intensive care unit staffed with foreign-trained medical personnel.

They are supported by our in-house diagnostic center, something exceptional in Moscow as most other centers send their lab exams out and direct their patients to outside facilities for X-ray and endoscopic examination.

RJ: Who are your typical clients, and how affordable are your services?

SKD: About 95 percent of our patients in the dental clinic are Russian, which is understandable considering the high incidence of dental diseases in Russia. In the medical clinic, the clientele is split 50-50.

Our prices are reasonable. They are higher than in some European countries, but lower than those offered in the United States. But one has to remember that life in Moscow – in terms of rent, food, restaurants – is even more expensive than abroad.

Secondly, facilities and equipment are also more expensive here, just as it's more expensive to attract foreign medical practitioners with a good reputation, as they need to be offered better conditions than they have in their home countries.

All these cost-influencing factors are reflected in our prices, and I think the same applies to other businesses in Moscow.

RJ: What is the ratio of Russians to expats on the EMC staff?

SKD: This is a question that needs to be approached with care. For instance, how can one describe an ethnic Russian who has been trained in the West as a physician with many years of work experience abroad?

Most of our Russian doctors – about 95 percent, including 20 full-time expatriate practitioners – are foreign-trained professionals. The few Russian-educated doctors have been carefully selected.

They still have to receive additional in-house training and work under the supervision of a foreign-trained professional.

RJ: What are your major advantages over competitors in the sector?

SKD: Without any doubt, our doctors. They are not only very good professionals, but are also usually some of the best in their fields of specialization. Such fields include orthopaedic surgery, obstetrics and gynaecology, including fertility problems. Our practitioners systematically study abroad at least once a year to constantly stay abreast of the latest techniques in their fields.

Secondly, as I already said, we are the only one offering comprehensive services in one location.

Finally, being very patient-oriented, our staff speaks 15 major languages to ease patients' interactions at the EMC.

This helps to avoid worsening their health conditions already under heavy stress due to illnesses by adding effects of language and other cultural barriers.

RJ: How much has been invested in the EMC, and how profitable has it been over the years?

SKD: We are a private company that has systematically reinvested its profits over the years.

It was only recently that we took out a bank loan to set up a full-range clinic, which is normal when you build a complex facility in the health care sector, which is very capital-intensive.

On the profitability issue, I would say nobody remains in a business unless he or she is making profits.

Today, we use our profits to reimburse the loans, so the final profit margin is quite slim. This is understandable, bearing in mind the huge capital outlay in investment. However, I can't give you any exact figures on these issues.