“If I Really Want to Help People, I Have to Invest More”Interview with the General Director of a Group of Russian Private Clinics

Healthcare Financing Russia

December 16, 2013 | The general director of the Tonus group of private clinics, Olga Mikhalyova, MD, has clear objectives in setting new standards in the Russian Healthcare business. Medical Solutions asked her to explain more.


Text: Diana Laarz
Photos: Fabian Weiß  


Olga Mikhalyova, MD, was born in 1972 in the Nizhny Novgorod region of Russia. She studied medicine at Nizhny Novgorod State Medical Academy, where she began to specialize in dermatology. After completing her degree in 1996, Mikhalyova worked as a dermatologist at a beauty salon. In 1999, she opened her own dermatology practice, but soon teamed up with neighboring doctors working in other fields. Since 2007, their practices have been working together, including administratively, under the umbrella of the Tonus Group. Today, the group has 15 facilities in Nizhny Novgorod and the surrounding area, at which about 200 doctors are working. Mikhalyova no longer practices medicine herself; instead she handles the strategic development of the clinics as the group’s general director.

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Tonus Group is the only option in Nizhny Novgorod for a digital mammography.


Medical Solutions: Dr. Mikhalyova, when you opened your own small dermatology practice in Nizhny Novgorod 14 years ago, would you have believed you would ever be in charge of a group of clinics with about 200 doctors?

Dr. Mikhalyova: No, it was completely inconceivable. All I wanted was my own little practice. But a gynecologist and a psychotherapist were also working right near me. At some point, we got together and thought: We need to offer our patients other diagnostic and treatment options, as well. The Tonus Group has been growing ever since.

How big is it today?

Right now, we have ten facilities in the city and five in the Nizhny Novgorod region, including two pediatric clinics. Our strategy is that whenever there is enough demand, we open a new branch location. We don’t want long waits at our facilities. We try to get as close as possible to where potential patients live. Today, we cover a large sector of healthcare, from lab tests to mammography and dentistry to minimally invasive surgical interventions.

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The Russian government guarantees citizens free medical care. So why is a private clinic like Tonus, where patients pay out of pocket for their treatment, needed in the first place?

Good healthcare requires heavy investment. The government does not provide enough funds to make this investment. To this day, for example, the city’s government-operated polyclinics do not have an MRI [magnetic resonance imaging] unit to offer solid diagnostic services. Basically, patients have two options: Either they don’t get the scan at all, or they get it at a private facility, where they have to pay for it.

Are affluent residents of Nizhny Novgorod the only ones who can afford that kind of scan?

I don’t want to give the impression that we are a charitable organization. The equipment we buy is expensive, so naturally, we have to make sure our investments pay off. But the average bill at our facilities comes to 1,500 rubles, or 35 euros. If there is a true medical need, anyone can afford that. For example, we often welcome retirees to our clinics. Yes, of course, going to a private clinic costs money. But on the other hand, we are the ones who are giving people the ability to receive high-quality healthcare in the first place.

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The private clinic took advantage of Siemens’ financing solutions.

How has Nizhny Novgorod changed as a result of your work?

I do see what we offer as a gift to the city - definitely. We invest in medical technology at the highest level and make it available to the people here. That opens up a lot of options for them. One of the first things we offered was laser eye surgery. I had the surgery myself, so I know what it means to someone to suddenly be able to see well again. I want to share that joy with others. Today, our clinic is home to the first, and so far only, digital mammography system in the city. During the first year of operation, we scanned 2,500 women, diagnosing 62 cases of breast cancer. This is real help that we provide. 

That means people also accept this help?

We will continue to advertise and work to get them to do so. The Russian healthcare system does not have a good reputation. Many Russians themselves have a low opinion of the medical options available. Those who can afford it go abroad for treatment. But I think we, specifically, as the market leader in private medicine in Nizhny Novgorod, have managed to start turning things around in recent years. People see that there are good options available here, with equipment from globally recognized providers.


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Investments in high-end technology give healthcare providers a competitive advantage.

Why do you keep stressing the quality of your medical equipment?

We are, of course, running a business. But medicine is a field that involves more than just commercial considerations. Our main objective is to give people more opportunities to secure good treatment. If I were only looking at profit, I would certainly be able to find medical technology providers that are cheaper than Siemens, especially in the East – in China or Korea. But, I repeat, if I really want to help people, I have to invest more: In world-class technology, in excellent service, in a wealth of experience. There is no other MRI unit as advanced as ours in all of Nizhny Novgorod. Some medical facilities buy old, used equipment from abroad. But when they reach their limits in terms of diagnostics, they send their patients to us. And those are our competitors! If I’m really focused on people and their health, I have to do more. And then I can also afford more.

About a year ago, you invested about two million euros in new medical technology from Siemens. To do so, you signed up for the leasing program offered by Siemens Finance. Is this a common financing model for you?

No, this was our first time. But we were very interested in the offer right away, so we immediately drew up a business plan. Once we had that, it was clear that we could do it. The leasing program is a one-of-a-kind opportunity for us. We would never have been able to make an investment this big on our own. But now the units have been successfully in operation for several months, and they are in high demand. We are now repaying the trust that Siemens placed in us.

Was trust a major factor in your decision to make this investment?

Trust on both sides is hugely important. We have been working with Siemens since 2007, and we have come to know them as a partner that supports their customers. Without mutual trust, this transaction would never have come about. And we are already in talks about new projects.