Caspian Energy Journal Caspian European Club
Monday, 30 October 2017 16:15

Every initiative is successful if undertaken by a specialist who loves his job, - Imran Agayev Featured

The operations performed in Azerbaijan are so complicated as to be unique in their class globally


Caspian Energy (CE): Mr. Agayev, what do you think about the state of medicine in Azerbaijan from the point of view of a practicing physician and head of the large private hospital?


Imran Agayev, Chief Physician, PhD, at Medistyle Hospital: The state of medicine can be assessed by several criteria, and education is the main one. Our advantage is that we have passed more than one school of medicine. I graduated from the Azerbaijan Medical Institute, and I am very proud of this. I went through the Russian school of medicine, which we have always respected as a source of qualified knowledge in this field. Then, after 1998, we took advantage of the possibility of using the achievements of the Turkish school of medicine. In addition, internship of our physicians and students in Germany and the USA has been practiced since the end of the 1990s. Again, all possibilities have been created in our country for a person who is interested in medicine and has a serious intention to deal with medicine. Everything depends on a specialist. A person can go to the United States, study there for 12 years, but learn nothing during this time.


Thus, the state of medicine today is, first and foremost, professionals that we have, the desire to devote lives to this noble profession, providing comprehensive support to the development of medicine by the state, which is also present today.




CE: Our medicine is often criticized. For example, the equipment is available, but not every physician and in not every clinic can interpret images...


Imran Agayev: If it were so, these physicians would not work here. Our patients have the definite opinion, which can hardly be changed, that medicine, physicians and services are low-competent in Azerbaijan. Patients think it would be better to go to neighboring Turkey, to Iran, to receive treatment there than to get treatment here, in Azerbaijan. Most often a person, without having any experience of communication with local medicine, with local physicians, immediately subconsciously decides to go somewhere abroad to receive treatment outside Azerbaijan. Namely these people create the distorted reputation for our physicians. For example, if only 2 operations from 20-30 surgeries were unsuccessful, we hear only about the unsuccessful ones. And we do not hear about positive results, we are not interested in them. This is a patient's problem. A patient wants to prove once again that he was not mistaken, that he was right that physicians are not good in Azerbaijan. The more complicated a surgery is, the more complicated an organ with which you work is, the chance of a fatal case is higher.


 We have very good specialists. The operations performed in Azerbaijan are so complicated as to be unique in their class globally. For example, in our clinic we have the physician who performs operations in the field of gynecology. In total only 7 operations of this class were performed globally, and one of them was performed in Azerbaijan. This is also the case for diagnostics, surgery, organ transplants, and cardiosurgery.




CE: Do you think that the statistics of fatal cases after operations in Azerbaijan is not worse than, for example, in Turkey or Iran?


Imran Agayev:Honestly, I do not have statistical data, I did not compare it. But again, judging by the complexity of operations that are being performed in Azerbaijan, everyone talks about those operations that could not be performed in Azerbaijan, but were performed in Iran or Turkey. But no one talks about the operations that could not be done in Iran and Turkey, but were performed in Azerbaijan.




CE: For example, which cases do you mean?

Imran Agayev: I do not consider it necessary to give specific examples. Another problem we have in the field of healthcare, namely in private clinics, is the legal insecurity of a clinic. Nowhere in the world, be it Turkey, United States or Europe, a patient can groundlessly accuse a clinic of something. If this happens, a clinic in its turn may submit a claim against a patient. In our country it is the case every day. A patient can groundlessly blame a clinic, but a clinic cannot do anything in response. A patient submits a claim to the prosecutor's office, to the higher instances, complains about a clinic in order to return the money.


CE: Without any reason?

Imran Agayev: It happens, just like that. Very often clinics face such cases in their practice, people are satisfied with medical services, but for mercantile reasons they appeal to the courts.


CE: That is, private clinics are powerless before the law?

Imran Agayev: I think that you also often heard that a patient submitted a claim to some instances and a physician was brought to justice. But I do not think you've heard cases when it was the other way around and when a clinic sued a patient for libel or for the spoiled reputation of a clinic. Very often untrue information appears in all kinds of media, social networks only in order to discredit a clinic. For example, when a patient appeals to the prosecutor's office for one reason, the prosecutor's office starts dealing with a clinic closely, and raises other issues. A patient is displeased with a physician, but he complains to the appropriate instances, which affects all the personnel of a clinic, including management, he complains to the Ministry of Labor and Social Security, to the labor inspectorate. And further, these instances begin proceedings that affect the staff of a clinic not even involved in this particular case.

Verification of documents begins to check how peoperly a contract of employment was drawn up. They apply to forensic medical examination and other cases begin to be investigated. A patient, not thinking about the consequences for a clinic, purely for the sake of his financial gain and personal interests can do harm to a clinic.

I think the reason for that is the legal insecurity of clinics. We often do not use the services of lawyers to deal with legal affairs of a clinic.


CE: So, it turns out that there is no mutual trust, who is at fault? ...

Imran Agayev: Many are guilty. It can also be media sources that do not check the information. People sometimes learn information about deaths in clinics, but nobody finds out a true reason, true circumstances. Everyone thinks that if a physician took a patient for surgery, finally he is guilty. If a physician is guilty, then a clinic is guilty as well. But in fact, a patient's death can occur for many reasons. Before each operation, patient's relatives are obligatorily warned about risks in percentage. If a risk is above 50%, then a surgery can always end in a fatal outcome. When relatives agree and the worst happens, they invariably apply to instances to complain about a clinic.


CE: How do you see cooperation with world clinics, world producers? Is it possible to bring the best technologies, the best medicine to Azerbaijan without hindrance?

Imran Agayev: Of course, it is not possible to install this equipment in all hospitals, but most of them have the brand-new equipment and use all modern technologies, and they are serviced by specialists who know how to use them. Equipment can be brought and installed, but the main thing is to be able to use it. There are specialists for whom the opportunity was created to pass trainings on the use of equipment in the country of an equipment supplier. In the future specialists come to us, for these physicians, and conduct courses, etc.


CE: Let's talk a little about your clinic. How many departments do you have, what is the specialization of the hospital?

Imran Agayev: The clinic offers all polyclinic services, all methods of check-ups, including clinical check-ups, digital check-ups, radiological check-ups, visual check-ups and laboratory check-ups. We have the staff of the widest degree of specialization. As a rule, clinics receive a certificate, and all those specialities that are stipulated in the license are available in our clinic at the high level. Very good physicians from all over Azerbaijan work for us, and among them are the physicians who received education in Turkey, USA, and Europe. Almost all kinds of treatment, check-ups, manipulations and surgeries are performed out at our clinic.


CE: Are there any subdivisions among them?

Imran Agayev: There are large clinics with the full range of services, including cardiology, neurosurgery, gynecology, etc. We have, for example, cardiology, but it is subdivided into invasive cardiology and cardiosurgery. We also have the Department Gynecology of, not Department of Obstetrics and Gynecology but Polyclinic and Operational Gynecology. Moreover, we have Traumatology, Pediatrics, Urology, Andriatrics, Neurology.


CE: What makes you feel pride most of all in your clinic?

Imran Agayev: We try to bring all the specialties to the highest level. We are very proud of our Department of Gynecology, Department of Pediatrics. Our specialists working in this field are very famous in Azerbaijan, for example, Vugar Bayramov and Sadagat Bayramova. They are both very experienced specialists as the leading physicians, therapists, operating physicians. We have the very good Department of Pediatrics. Many pediatric surgeons perform operations namely at our clinic because we perform high-quality monitoring of small patients in the in-patient department in good conditions with good physicians.

Also it stands to mention that we have the experienced traumatologist who performs all kinds of operations to replace joints, correct other anomalies, etc.


CE: So, you have both the outpatient and inpatient departments, don’t you?

Imran Agayev: Yes, we also have the surgery block and the ambulance. We cooperate with many insurance companies, which set strict requirements. This says a lot, since insurance companies very carefully choose clinics.


CE: Do you feel the government support?

Imran Agayev: Yes, of course. All conditions are always created in the field of medicine on the part of the state. As a result many private clinics are being established. And this is a big responsibility. If I open a clinic, the state supports me in all respects, provided that I myself properly treat my job and properly do my job.

In accordance with the Decree of Mr. President, over the past two years the private sector has received a relief from inspections of the regulatory bodies. The attitude of the tax inspection to businessmen, to private entrepreneurs has become more loyal, given the change in the country's course toward the development of the non-oil sector. Opportunities were created for the development of clinics. And if a clinic is really good and is able to work, then it is given such an opportunity.


CE: You have withstood the crisis and are now expanding, are not you?

Imran Agayev: Yes, we have withstood and are expanding. The point is that the clinic should constantly modernize, grow, and bring new technologies, new equipment. This ultimately affects the quality of service delivery to patients. Nowadays we can bring equipment thanks to the existing customs regime, which fosters the import of modern technologies into the country. We have all necessary pharmaceuticals, and can also buy them abroad.


CE: The state program encouraging teachers, who want to work in the regions, is currently in place in Azerbaijan in accordance with the President's decree. Is there a similar program for physicians?

Imran Agayev: Yes, certainly. Since I continue to work simultaneously at the medical university, I see graduates, at least of my speciality - dentists. Earlier when we graduated from universities, we tried, if possible, to avoid receiving appointment in the regions. Today the situation is different. A physician, who goes to the regions, has more opportunities to gain experience, the full kaleidoscope of variety of cases. There are no problems with salary, working conditions. Many of my graduates now work in Ganja and are very pleased with their job. There are those who work in Yevlakh, in Mingachevir, and these are very good specialists. A specialist himself, having learned everything and acquainted with the conditions, chooses the region.


CE: And if, for example, Azerbaijan has the extensive mountainous area, high-mountainous villages, does your clinic have the opportunity to provide medical services to such patients?

Imran Agayev: Since we have the ambulance, we have the opportunity to go to the regions, to any place where the car gets to. If there is a possibility to render service on the spot, we do it because our cars have all necessary equipment. If not, the same ambulance car delivers a patient to the regional center or to Baku.


CE: Do you plan to open representative offices in the regions?

Imran Agayev: Our clinic is relatively young. We have been operating since 2011. As soon as it becomes possible and it turns out that there is a need to open branches in other regions, and we can meet this need, then, of course, we will expand. Now we make permanent visits to the regions with our physicians. All clinics in Azerbaijan communicate with each other thanks to the established Private Hospitals Association. We receive an offer from a certain clinic that it needs a certain specialist and we are asked if we can provide such a specialist for 2-3 days. Then we conducts talks, a physician arrives and performs his job. Regularly the physicians of our clinic travel throughout the territory of Azerbaijan. Very often we organize charity events, perform free check-ups, operations, both in our clinic and by our physicians in other clinics. We perfectly understand the situation of people, especially those who live far from the centre.


CE: Does a private hospital as a business in itself stimulate an investor who has decided to risk?

Imran Agayev: In the field of medicine, just like the way it is in any other field, a man should love the work he does. If he loves and does his job professionally, of course he will make good money. The problem appears very often when people choose an occupation having no notion about it. They do it having no clues about a specialty, being not a professional, and moreover, without applying for a help to specialists. Every business, every job is successful if a professional, who knows and loves his work, stands behind it. That is to say, it is wrong to pursue the earnings first while opening a clinic. It is a noble affair as you deliver care to a patient. If a patient is satisfied with you, if you provide good, quality-based services, of course you will earn on it.


CE: Is the diversification applicable to the Azerbaijani medicine of today as there are lots of all possible specialties, including the ancient and the most effective ones which go back to the 6th century B.C., in the time of Budha and Confucius? 

Imran Agayev: You know, if there is a demand for such services, then there certainly should be a supply as well. We have physicians who gained education in India, China and Japan. But the methods which are popular in Asia may not be popular and in demand here. For instance, an acupuncture. Before  getting an education in a certain area, a physician should think how broad will he/she be able to apply in future. If a physician decides to study for becoming a Philippine healer, then it is obvious that this specialty will not be in demand in Azerbaijan.  In principle, a good financial base and specialists are needed in order to launch something new in Azerbaijan. And once again, there should be a guarantee that this specialty will prove its value and the clinic will face no losses.  Of course, as specialists, we all want to provide the best and the most contemporary conditions to our patients, apply the state-of-the-art technologies and the last word in science. But after all, it is all about the funding.


CE: Is there a possibility that it is new specialties which will help to increase the population’s trust in the Azerbaijani medicine?

Imran Agayev: We have to consider the legality of healing methods. For instance, let’s take the healers. They will never manage to get a license for treatment in Azerbaijan. We have a list of approved specialties and methods for which licenses are provided. In general, Azerbaijan has specialists practically in all areas. But the amount of specialists is determined by the demand. We have very many neuropathologists because the problem of the nervous system is widely spread. We have a lot of gastroenterologists because we are people who like eating much and greasy food. There is always a demand for physicians of this specialty. Dentists also may a lot of work as almost all have teeth problems. But there are specialists who don’t have much work as people do not face this problem so often.


CE: How do you assess the impact of the ecological factor on your work? 

Imran Agayev: Ecological factor certainly does exist in our life. Especially, in comparison with the decades and centuries left in the past, the living conditions of people are changing, including the consumed water and food. A person living in the village has an opportunity to eat natural products, drink pure water, maintain right mobile living, which means that his organism will be healthier. But everything changes as the years go by. For instance, children used to be told before that they should not chew a gum while now it turns out that it makes them no harm but use. That is to say that the dento-facial chewing part of the child’s body does not get a required load, which means that we can substitute it with something and that would be a gum.


CE: Do you think Azerbaijan should broadly promote the environmentally clean and natural feeding?

Imran Agayev: This issue is always propagated. We have an agriculture developing well. There is always an access to good vegetables, fruits, beef and dairy products, so we don’t have any problems with it. But why doesn’t a kid get natural products? People have another pace of living today, which is more active than before. We have many working women for whom it is hard to find free time, spare time for a child and feed him naturally. Children used to get a natural feeding before, including mother’s milk for 2-3 years after a birth. Now, mothers feeding their child for a year are a hero.


CE: Does the water and air pollution, caused by the petrochemical products, increase the amount of your work?

Imran Agayev: Of course, the more is the number of operating industrial enterprises the higher is the environmental pollution. No matter how well the cleanup methods are applied, there are enterprises which operate improperly and do not use these cleaning methods as they are expensive. It happens in the whole world, not only here. The state has certainly set an utmost control over it. It is fixing emissions, limiting the import of old vehicles into the country and controlling the quality.

But there are enterprises which evade from their commitments. They do not observe the terms of eliminating the consequences of their production, which accordingly causes an environmental pollution. But I think that further production growth will also develop the cleaning methods.

You see, if a chief of an enterprise is a conscientious man, he does his job conscientiously. While producing something, he thinks of the consequences and the way it will impact on the environment. If he is an unconscientious man, he will neglect it. This can happen both in Azerbaijan, Russia, Europe and America.

The health of the nation is certainly important for all of us. It has been often said that the more is the number of patients the better is for clinics. But we think not only of our pocket but also the health of the nation.



Thank you for the interview






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