Juan Carlos Ordóñez Zamudio - General Director, Salud Digna, Mexico

EF: What have been your priorities throughout the transition period of the pandemic and what adaptations have you made or are in the process of making to maintain the business and for creating new opportunities?

JCO: Our first and main priority has been and continues to be the safety of our employees, collaborators, and patients. When all this started, we thought being locked up for 40 days would be madness but nobody saw this coming, not the team, not our collaborators, not anybody. Back then our board got together and we decided on our priorities:

1.  Safety: we have been in contact with our different allies and the different organizations that help us with the measures needed to achieve a safe environment even beyond common sense.
2. Implementation: at first, there was a sharp decrease in the number of patients that came to our clinics but even at that point, we knew patient issues cannot wait too long to be resolved. We knew we had to develop fast and efficient protocols for a safe experience for our collaborators and our patients. For example, 510 employees, roughly about 8% of Salud Digna´s workforce, had to be sent home immediately due to their age, being pregnant or diabetic or because someone in their close family had cancer. For the first 4 or 5 weeks that was a big deal, we had to shorten our service hours, opening at 6 am but closing at 3 pm. As an essential activity, we never closed but we worked on safety and maintaining operations. 
3. Become the leading actor in performance of Covid-19 testing: We worked with allies and companies that had the right technology but at first, we were not successful because there are only very few companies that could come up with the test in the short term as very specific companies and organizations have the knowledge and equipment to go ahead in this area. Mr. Jesus Vizcarra, our founder, wouldn’t take no for an answer so we managed to find equipment used for research in some institutes that were not working at the moment due to present protocols. With the equipment from the ´Instituto de Investigación´ and the help of a former ambassador for Mexico in China, we procured what we needed. At first, it was a nightmare as nothing was available, not even hyssops, as well as having to deal with President Trump´s executive order where there were serious implications for companies in the United States manufacturing products connected to Covid-19 for selling outside their country. However, we have been successful in the short term doing the tests and manufacturing more than 7000 tests a day done in 49 different sites and with plans to open 29 new sites in the next 30 days. We now have the capacity, the technology, the people and the labs to manufacture about 20 thousand tests per day. We have two laboratories approved by INDRE, one in Culiacan and one in Tlalnepantla in Estado de Mexico, which are two of our national reference centres, and we are tired but delighted with what we have accomplished. We are the only laboratory in the country that is part of the external quality certification program from the CAP (College of American Pathologists) which is by far the most prestigious organization in the world offering laboratory certifications in quality. We have the technology, precision, and reliability in what we do and as a social organization, we deliver on social issues adding to what the public and private sectors are already doing. The price for a Salud Digna test was until very recently 1,300 pesos, which was the lowest price in the country by an average of 45%, and recently we lowered the price again to 950 pesos because we aim to make it available to the largest number of people. Our price could be reduced again because it is related to supply and because we now have more automated technology and supplies that are not as scarce. We are very proud and happy with our achievements and the accessible price. 

EF: How do you maintain the momentum of your financial strategy while balancing the interest of the patient? How do you maintain the balance between health and financial results when profit isn’t the priority?

JCO: Ours is a unique position as we are a nonprofit organization which is completely self-sustainable. We are not in any way subsidized. At the beginning of the pandemic, we implemented several adjustments and have gone on adapting to the ever-lengthening lockdown while fine-tuning decisions almost daily. But we decided very early on to base our decisions and actions on what is good for Mexico, both for society and our employees. Salud Digna´s employees have a sense of belonging and are proud to work in the organization and when all this is over, we need our employees to feel an even stronger bond and feel valued as human beings. So after a board decision, I communicated internally via video to our nearly 9000 employees informing them that it was our clear goal that not one of them would suffer a loss of their jobs or loss of income due to the pandemic. We did this because it was the right thing to do but also because we would be asking great sacrifices from them; we are in a very contagious pandemic and a lot will be required from them. It might have been healthier financially to fire 20% of our staff but we chose not to and instead took other financial measures of austerity. We have cancelled different activities planned for this year that implied expenses, which as things turned out, we would have ended up cancelling anyway. With no congresses, no travelling, certain areas of expense have been reduced. We are adjusting our numbers to be able to survive but we have been seeing a steady increase in the number of patients we serve in the last weeks. Just yesterday, for example, 53.508 people were served by Salud Digna, 7000+ of them for Covid-19 tests. People are still delaying coming in though and we are not at last year’s level and rightfully so. 

EF: Your strong points have always been diabetes and eye-tests, both non-communicable diseases, and yet here you are 5 months later providing services for communicable diseases. How fast were you able to adapt your portfolio and how did you manage to have this incredibly fast reaction and capacity to adapt and adjust? 

JCO: We like to think we are both flexible and fast learners. Our team is very open-minded, hardworking, and creative. From a logistics and an expansion point of view, flexibility and open-mindedness are essential because this is a situation we weren’t prepared for; not us, not the private sector, not the government or any government for that matter, so we needed to react quickly and positively. We have a team, a mindset, and an organization that can deal with whatever comes and I think our people has shown these past months that they are the very backbone of our organization and that they also can rise up to a challenge of this magnitude. I look forward to the moment where we can meet and look at each other in the eye and exchange stories about all the difficulties we had to deal with. Just a “mission accomplished” kind of meeting. 

EF: What would be your advice to build momentum in planning next year’s budget allocation of resources?

JCO: We analyze each of our big projects that involve investment. In 3 cases, we decided to wait it out as we cannot make decisions in the middle of the existing whirlwind reality. We had planned big changes to optimize efficiencies in the organization but we have decided to put that on hold as it involves a big allocation of resources. We have a meeting every 15 days to review the situation, the pandemic, doctor’s opinions, vaccine situation, and how we are handling the new normal. Mammographies, pap’s, and our eye tests are not at the level they were this time last year, but laboratory, tomography, and X-ray have tripled. We are offering tomography tests 24 hours a day at some clinics as that is something that generally cannot wait. But this is unchartered territory so I strongly advise caution to not assume anything, not to take decisions to cancel investments, but to analyze what’s coming and wait it out always and be aware that these moments are also moments of opportunity for those who have capital.

 EF: What would you like 2020 to be remembered for as far as your organization is concerned? What could SALUD DIGNA epitomize this year and what would you like to stand out for considering there are 4 months of the year left?  

JCO: What automatically comes to mind is that we need to be a leading participant - no easy task as there will be a lot of effort involved from all of us to get out of this situation with the least amount of pain possible. I have tried to get the message through to my team so that they are aware of the commitment needed and of the sense of urgency. Since we began performing Covid-19 tests and testing 7000+ thousand patients per day, we are very close to reaching a total of 500,000 Covid tests. That is a lot of people who have found an answer in a time of need at Salud Digna and not only in testing but, in all the other areas where we offer quality services to our patients at the lowest price in the market. We are delighted with what has been achieved and I would like Salud Digna to be remembered as part of the solution and as a social sector organization that made a great effort and delivered for the nation. Apart from the public sector, we are the largest provider of Covid-19 tests in the country with the largest capacity. It has been the hardest thing I have ever done by far in the nine years of being a part of the Salud Digna team. It has been a very challenging but incredibly satisfying journey. 

Post-interview

EF: How long are the videos for your team and what will the next one communicate? 

JCO: My next video will be a week from now, so I only have an outline. People are tired of being careful, so we have to motivate and strengthen the idea of continued carefulness; it is not time to get careless yet. We talk of internal things, to keep the inner fire burning and to keep us motivated and alert. Salud Digna´s anniversary is coming, so the message from Mr. Jesús Vizcarra is going to be the centre of the video as it is always very meaningful for all of us to listen to his messages and his vision for the times we are living and the role that we should be playing, especially in helping others live better lives. 

Have you ever considered exporting the Salud Digna´s model to other countries? 

JCO: We have actually been working in Nicaragua with a clinic that has been very well received! We are currently looking at El Salvador and Guatemala with a team in each country to see what would be our next step, but with the pandemic, we had to bring our teams back but so far we have had a great experience.