By Dr. Hernando Delizo, Ms. Aysa Redondo, Dr. Judith Paayas, Dr. Roberto Tan DMD, and Dr. Kelly Salvador
On December 10, 1994, Clinica Manila, a revolutionist in delivering healthcare to the Filipino, was blessed over by His Eminence, Jaime Cardinal Sin, an icon of the EDSA 1986 Peoples’ Revolution. As parks and gardens shrunk, giving way to economic progress, the Philippine malls become the community place for Filipinos where they are able to engage in varied lifestyle activities in one convenient location. Clinica Manila became the game-changer providing accessible healthcare in the malls. Clinica Manila, with over two million patient served in 25 years, became an archetype for many other clinics as mall based clinics sprouted after. Hospitals and even Health Maintenance Organization (HMOs) established their own chain of clinics in malls, truly changing the Filipino’s behavior in accessing healthcare. But why shouldn’t they? An estimated over P50 Billion annual spend is credited to ambulatory (out-patient) services as per the National Statistics Office, 2018 National Health Account.
Clinica Manila’s many firsts
Established in 1994, Clinica Manila holds the distinction of the Philippines’ first, biggest and most comprehensive multispecialty, high-technology clinic in the mall wherein close to hundred (100) medical, dental and surgical specialists hold clinical practice in about 1,000 sq. meter of premium space at the second floor of Building A in SM Megamall.
Clinica Manila was the first DOH and Philhealth accredited free-standing ambulatory surgery center in the Philippines with its 3 operating suites. Small to medium day-surgeries in different specialties were performed led by General Surgery, Cosmetic & Reconstructive, Ophthalmology, OBGynecology, Head & Neck and Orthopedics.
Out–patient plastic and reconstructive surgery in a mall happened first in Clinica Manila with its Board Certified specialists way ahead of the current frenzy and commercialism of cosmetic surgery. History was again made with cataract surgeries done in the confines of Clinica Manila, way before eye surgery centers became a common thing in the malls. Starting their practice in Clinica Manila Drs. Achelle Ronquillo, Glenn Milan and Manolito Reyes stayed on to build a robust practice till the present time.
Raising several eyebrows on the diagnostic side, Clinica Manila had the first mall based CT Scan services, which saw ambulances from Metro Manila and nearby provincial hospitals without the equipment bring in-patients for a more affordable imaging tests. Another pioneering service, is Clinica Manila’s ambulatory mammography diagnostic test, typically done in the hospital during those time.
It was not uncommon for mothers to have blood extraction at Clinica Manila, get their grocery list done, come back to pick up their test results, then see their doctors in the same day. Expectant mothers and children running around in the clinic have become common place with a play area within the facility. Typical children clinics in those days were cramped and drab, oftentimes a challenge for mothers to get their children visit the pediatrician. Until Clinica Manila, bringing children to consult with a pediatrician has never been made easy with mothers cajoling their children of going to the mall.
Mall based chain of dental clinics started also with Clinica Manila, which was initiated by investor-partner, Dentista, Inc. The group’s original members were Dr. Roberto Tan, Dr. Ronald Yniguez, Dr. Ernesto De Leon, Rodrigo Ronquillo. Soon after its opening in SM Megamall, Dentista, Inc. opened in other SM and Ayala Malls. The group’s organization was inspired by Dr. Juan Quejada, recipient of 1994 Most Outstanding Professional in Dentistry by Philppine Regulation Commission. On the other hand, Clinica Manila’s Rehabilitation Medicine was led by former Health Secretary Dr. Antonio Periquet.
The list of innovations introduced by Clinica Manila could go on and on, but indeed it has proven time and again its penchant for revolutionary thinking.
A journey back in time
As the saying goes, every legend lies an impossible dream. Continuing its innovative visions Clinica Manila, operated by Ambulatory Healthcare Institute, Inc. created two divisions from its inception, the ambulatory clinic, Clinica Manila and it Health Maintenance Organization, HealthCheck.
The original incorporators met for the first time on April1, 1994 at Kulyawan Center in #9 Alfonso XIII St., San Juan City. The seven incorporators were Dr. Hernando Delizo, Dr. Kelly Salvador, Dr. Jose Antonio Abaya, Dr. Juanito Evangelista, Dr. Enrico Tanco, Dr. Rolando Bautista and Mr. Ramon C. Cuervo III, the only non-healthcare professional in the group. The recognized leader Dr. Hernando B. Delizo had 4 years earlier started a single entrepreneurship, St. Lawrence Clinic in 1990 located in Sampaloc, Manila. Armed with the knowledge and experience gained, Dr. Delizo, pursued to build the core service component of a large out-patient multi-specialty facility with a pioneering free standing (out-patient) dialysis services and eye center, Mediserv Center for Ambulatory Care (Mediserv Inc.) in 1991 along A.H. Lacson (Gov. Forbes), Sampaloc, Manila and ARDI, Inc. in 1992 which operated Alfonso Memorial Clinic in Pasig City.
Construction immediately started in June 1994 upon the approval of the space of the newly finished SM Megamall, the biggest in the Philippines in terms of leasable space. The clinic development raised eyebrows in terms of its size and bold positioning that caught the attention of a business writer, as “overly ambitious” and “misplaced”. How did it come to be located in SM Megamall is cited in a related story.
In late 1997, a hostile take-over/intra-corporate legal battle happened. The founding chair, Dr. Delizo, was ousted and removed from his office. A year after the take-over Health Check, Clinica Manila’s HMO, collapsed and folded. A protracted legal battle for AHCII/Clinica Manila’s rightful ownership and control was set in motion.
The Clinica Manila’s ambulatory healthcare DNA footprint didn’t stop with the take-over as concept evolution of ambulatory care services continued on. What would have been the branches of Clinica Manila with the aborted Chase Manhattan investment to AHCII, gave way to a new chain of mall based ambulatory clinics. Vista Health established in late 1997 Healthway, with the former Vice president of AHCII (Clinica Manila), Dr. Juanito Evangelista named as its first President.
While the legal battle was ongoing, Dr Delizo went on as business development consultants for various healthcare projects, notable of which included the development of MD Eastwood, the first ambulatory clinic in Eastwood City led by Dr. Jim Sanchez and Sta Lucia Healthcare in Sta. Lucia mall in Cainta, Rizal. In 2000 Dr. Delizo joined Dr. Allan Hernandez of Wellcare Clinics and Laboratory in Dasmarinas, Cavite, in reinforcing the first mall based ambulatory clinic in the province of Cavite. Dr. Delizo and Dr. Hernandez together with their business partner, Ms. Aysa Redondo, took business development leadership in the Calabrazon foray. From a one small roadside clinic operation it grew and continue to grow into a multi-location facility in Cavite and Laguna.
It was also at this time, that Dr. Delizo tested and developed new service concepts that integrate different components of services, all outside the hospital. Pre-paid out-patient healthcard was developed initially named MediSave was later marketed as OneHealthCard ®. In 1999, Dr Delizo decided to go back to school after about a decade of intuitive entrepreneurship, enrolled in Master of Business Administration, Regis Program at the Ateneo Graduate School of Business in Rockwell campus. After his graduation in 2001, Dr. Delizo embarked to start the first investor-owned Long term-Subacute care, Wellness Place, the Professional Care Homes in a gated community, Philam Homes Subdivision in Quezon City. The new out-of hospital, community based service facility for older persons was the paper submitted by Dr. Delizo in his Ateneo-MBA Entrepreneurship class. The plan is to seamlessly connect the home based-ambulatory care services.
Retaking and rebuilding of Clinica Manila
After 8 years of hiatus in the management of Clinica Manila, a writ of execution from the Court of Appeals was effected in February 6, 2006. The decision executed in January 23, 2003 rendered null and void ab initio the take-over of AHCII/Clinica Manila in 1997. The ruling was sustained by the Supreme court on June 16, 2004 and final rendering of justice was served by Regional Trial Court Branch 211 of Mandaluyong City restoring management to Dr. Delizo and his group being the rightful owner of AHCII/Clinica Manila in SM Megamall.
The re-taken Clinica Manila operations resumed in March 15, 2006 with only a handful of MDs left, many were unsure whether the Delizo group will be able to pull through the difficult task of rebuilding Clinica Manila. The “void” left behind by the MDs was rapidly filled up by new clinicians, who by that time, already appreciated the value of having a clinic located in a busy mall. Clinica Manila’s ambulatory care DNA proved resilient as those who left became the initial doctors of yet another ambulatory clinic in SM Megamall.
Clinica Manila’s appreciation of the dynamism of market and its demand made it easier for the decisions to chose one option over another as regards new technology or process. Clinica Manila addressed the issue of unmet need or demand, thus whole body bone densitometry (DXA) device was acquired to have medical grade test for bone mineral density and body composition. Clinica Manila has the only whole DXA device in a mall, again another first.
A new model of expansion was developed with opening of Clinica Manila Pasig, the first franchised model in 2011 in Tiendesitas, Pasig City with about 500 sq. meter of space. It was a full service ambulatory clinic just like the Megamall facility complete with DOH-Philhealth accredited day surgery also.
The next wave: taking leadership, again
Hash tags #ClinicaManilaRefresh #ClinicaManilaGame-Changer@25 #ClinicaManilaEmbracing4.0 embodies the future of Clinica Manila. A defining principle of what it would be its deep understanding and expected mastery of its targeted population. Personalized healthcare and industryspecific intervention in a preventive mode are evident in the processes that are deployed or being deployed. Patient engagement is not confined to the physical clinic interaction alone but wherever factors or situations exist that influence their health outcome. Understanding the social determinants expressed in accessing medical services are evident in their lifestyle in a given environment as compiled in decades of data stored. Collaboration, cooperation and convergence are key traits in Clinica Manila employing to ascertain its growth potentials in consonance to its mission-vision.
The renovated design, relocation and zoning of services were planned to deliver the renewed covenant to the clientele and the public. Following Steve Jobs’ dictum, “Design is not just what it looks like and feels like. Design is how it works.” The renovated Clinica Manila’s functional façade and lobby makes the strongest statement that invites mindful visual interaction. The new pharmacy has been transformed into interactiveintegrative pharmacy, an irreversible trend and appreciation of patients/clients wanting to know more about what they take including functional food, fitness-sports support items that empowered clientele look for.
The other component of the functional lobby is a separate entrance to indicate a new set of services that encapsulates the essence of game-changing services, the Center for Preventive Healthcare and Integrative Medicine.
Integrative Medicine is an operative practice principle in Lifestyle MediZone (LMZ) Department of Clinica Manila, where exercise and healthy food are core practice interventions. The new Clinica Manila characterizes to be a facility open for complementary diagnostic tests and intervention that are supported by evidence based studies and culled from long and experience-based real world practice. Intravenous therapy, hormone balancing, oral administration of vitamins and minerals are anchored on clinically sound decisions and laboratory tests.
“Food is medicine” concept as a core component of integrative medicine is embodied in our service brand, RxFood (prescribed by doctors). This unit is headed Ms. Mabelle Aban, a certified sports nutritionist and Exercise is Medicine ® fitness professional.
Acupuncture is a standard offering for pain management and other medical conditions with our 2 Beijing-trained acupuncturists, Dr. Michael Hahn, a Korean national holding a retiree visa and Dr. Judith Paayas, a graduate of the Ateneo School of Medicine and Public Health. Dr. Hahn other than having his over 40 years of clinical experience applied to Clinica Manila patients, he is committed to teach Filipino healthcare professionals in skills in the practice of Traditional Chinese Medicine. Dr. Paayas took her special studies in China Academy of Chinese Medical Institute of Acupuncture and Moxibustion andin China Beijing International Acupuncture Training Center.
The new Clinica Manila boast of Ortho-Sports, Fitness and Rehabilitation put together in one integrated and contiguous setting. The mini-gym in the new facility dubbed as, MOVE by Clinica Manila is the company’s definitive response to encourage clients to engage in regular physical activities that brings about the realization that indeed exercise is medicine. Clinica Manila has established collaboration with proponents of Exercise is Medicine ® (American College of Sports Medicine), a program of Philippine Association for the Study of Overweight and Obesity, represented by Prof. Hercules Callanta, Exercise is Medicine ® Chair and a faculty member of the College of Human Kinetics, University of the Philippines-Diliman. The MOVE by Clinica Manila is in synch with the multi-sectoral plan to bring down incidence of Non-Communicable Diseases (NCDs).
The new Clinica Manila is breaking more new grounds with the acquisition of relevant state of the art machines that helps us expand services which include Optical Coherence Tomography (OCT), the first of its kind to be made available in a mall clinic setting. Having indirect calorimetry and Cardio-pulmonary Exercise tests refine the appropriate exercise and vital capacities of athletes, those wanting to be fit and into fat/weight loss management program. Intended to provide truly relevant and meaningful content for corporate executive check-up packages and wellness programs all the above mentioned services/processes can positively impact client medical/health outcomes.
Beauty and Aesthetics remains a regular offering for a mall based clinic, with updated packages for face and body treatments with the acquisition of new machines. However, the new Clinica Manila has more up its sleeve offering more state of the art and contemporary services in its menu – Cellular therapy such as Platelet Rich Plasma administration (PRP), minimally invasive procedures such as hernia surgery under local anesthesia and hysteroscopy.
The dental group remains to be a leader in the industry with its current 5 branches, continuously acquiring new technologies, the most recent one was a dental CT Scan, Cone Beam Computed Tomography (CBCT), is a special X-Ray providing 3D Images of the dental examination object.
Collaboration with local government units and agencies
Clinica Manila signed an agreement with FNRI-DOST for accelerating appreciation and use of its online Healthy Eating Lifestyle Program (HELP) platform by having its first mall based outlet in SM Megamall. Clinica Manila support SME products deemed of high quality having passed the rigorous process that have been approved by FDA, under Clinica Manila’s program, “Food is Medicine”. Likewise, Clinica Manila is collaborating with Mandaluyong City Health Office to dvelop urgent center to help declog the Mandaluyong City Medical Center of ER cases.
The healthcare sector is expected to reap the early benefits arising from the rapid development of what is dubbed as Industrial Revolution 4.0. Keen in maximizing the IR4.0 for its clientele, Clinica Manila early on has been an early adaptor. Revitalized Corporate services Department deploys mobile health capabilities with features of predictive analytics and artificial Intelligence with refined market focus and directed intervention based in data analytics.
From the unpublished data of Clinica Manila, Diabetes mellitus is a major condition among clients seen with about 7.13% of blood sugar test results of the clinical laboratory are in the range of diagnostic criteria for diabetes Diabetes Mellitus while about 16.45% are considered pre-diabetic with ages 20-40 years old accounting for about 22.68%. These glaring data compel Clinica Manila to take a more proactive stance in managing metabolic diseases exemplified by Diabetes Mellitus by using the principles of IR4.0
In association with The HBD Partners group, Clinica Manila is deploying AimHealth System (AimHealthph.com). A platform to identify risk for and help in the management of obesity, hypertension, heart disease and diabetes mellitus (see related story). Multi-cardiogram, as screening tool for coronary artery risk scoring that support doctors and clients and may serve as guide minimizing unnecessary coronary arteriogram. This service is made possible in participation with Premier Heart Japan, Inc. Collaborating in a pilot A-Eye Project of Quantum Insights and Analytics, Inc., Clinica Manila is an early adaptor for artificial intelligence platform that allows medical practitioners to instantly screen for diabetic retinopathy and other health conditions beyond visual impairment, through a noninvasive eye scans with simple use of a medical-grade device.
Taking advantage of the growing technological advances TeleMedicine dedicated unit connects with allied clinics and serve enrolled personal and corporate accounts for continuing care even outside a testimony of Clinica Manila’s positioning as a first mover on preventive healthcare employing appropriate technology, AI and predictive analytics.
Research as integral component of service development
Research collaboration with academic institutions as well as bilateral interactions and exchanges among centers of excellence in the Philippines and abroad is part of game-changing approaches of Clinica Manila. These are all necessary ingredients in order to craft a better outcome for its clientele and the targeted population by enhancing knowledge base in real world clinical practice and acquire best business practices.
An example of this is a study, in collaboration with renowned researchers such as Dr. Leilani Mercado Asis, a member of the Uinversity of Santo Tomas Faculty of Medicine and Surgery, on the the effect on the bone health of night shift workforce among young adults which is not well characterized as yet unlike those who are 50s and over. Clinica Manila’s primary target the confines of Clinica Manila. All these are for deeper understanding are the workforce in the the Business Process Outsourcing (BPO) industry. Shift work has been linked to osteopenia/osteoporosis due to several mechanisms, which include change in clock gene expression, hormonal disruption via melatonin suppression, sleep disturbances and vitamin D deficiency. Other health risks associated to shift work include work-related stress and unhealthy lifestyle.
Ultimately, it is not about Clinica Manila the physical facility in Megamall or anywhere that is considered its legacy but the firm belief and visible passion to accomplish change in providing better and holistic healthcare for the Filipino. After all, if health is wealth, and we measure our wealth in our currency, PESOS, we therefore should aim to spend/stock up with Happy P.E.S.O.S. This means we all go for Physical, Emotional, Social, Occupational, Spiritual Happiness.
In Clinica Manila, we say, “pag Healthy Ka, Happy Ka!”