English Text of Dr. Monika Lehnhardt's Presentation: Knowledge goes Public, held in St. Petersburg in May 2009 at the First Monsana Conference.

1. Knowledge goes public
Let me now come to the topic I announced before: Knowledge goes public.
We experience fundamental changes in the Health Care Systems all over the world. One of the key
factors is a very different relationship between doctors / medical specialists and the patients.
Exploiting all possibilities to open access information, reading neutral and objective articles, enjoying
open exchange of experience with congenial people, the patient of the 21st century has become
enlightened and self-confident, an equally entitled discussion partner of the medical professionals.
Internet is obviously the medium where open access to information, exchanging experience and
networking is happening. Thousands of patients’ communities share their knowledge, their
experience and their concerns. Patients have become experts in technology and methods of
treatment available for their health problem.
Patients have become very mobile and they are willing to travel far when they expect a more
advanced medical approach, a more experienced medical professional and a more humanitarian
behaviour of care-givers.
The motivation to seek medical treatment abroad may be twofold. One reason could be to save
costs. The value of what journalists like to call “Health Tourism” has increased by 250% or 30% every
year since 2004. It is very popular for US citizens to travel to countries like Panama, Brasilia and Costa
Rica. The main treatments are plastic surgery and dental treatment. But also South Africa, Thailand
and Hungary are attractive for many patients. In Asia the leading country in Health Tourism is no
doubt India, where the cost for a cardiac intervention would cost US$ 4.000 as compared to US$
30.000 in the United States.
The other reason to motivate a patient to seek medical treatment abroad is quality. This means the
level of skills and experience of the medical expert, availability of latest technology equipment but
also a humanitarian approach of care-givers to the patient.
Needless to say, patients would preferably see a combination of the two motivation factors: save
costs and get higher quality. Definitely they expect to get “value for money”.
They will search for hospitals with an accreditation or so-called “centres of excellence”.
We – with an experience of 30 years in the medical field – can effectively support the patient to find
the solution that is tailor-made for him and her.
Not only patients changed over the last decade, but also the behaviour of medical experts.
The increasing role of Internet the sheer number of Weblogs (estimated 60 Million) creates pressure
on the medial professionals to share their knowledge and their experience. Personal publishing is
the result, publications are made accessible in a very fast way, they are free of charge and they invite
comments from readers. “Knowledge means power” a slogan frequently used in previous times is
only applicable when knowledge is kept for one’s self and not shared with others. What we see now
are mutual empowerment processes leading to more transparency and this means a significant
behavioural shift.
Doctors who refer their patient to another clinic – especially abroad – want to be sure that their
patient gets the best possible treatment and is referred back for post-operative / post-intervention
care. Again, we with our decades of experience in the medical field (especially in ENT, ophthalmology
and from personal experience also in oncology) can support you to identify your referral partner.
By using the impressive possibilities of exchanging information via Internet you will soon feel like an
affiliate of the clinics and the experts you are referring your patients to.
Patients – as we said before – become experts and they develop a clear idea about their chances and
options for medical treatment and they will be able to discuss these questions with the professionals
on a high level. They will not only read objective and neutral articles in the Internet, they will use it as
a platform for communication with other patients suffering from the same disease or parents with
children who have the same problems. They may use chat-rooms, join communities and contribute

2. to weblogs. Personal experience from others will help to make a decision where to have the
treatment.
When we take Cochlear Implant as an example there are a few decisions to be made:
-Where to go for diagnosis – where to go for surgery – where to go for fitting and where to go for
rehabilitation.
As we know after 20 years providing Cochlear Implants to children THE most important factor in
improving the chances for full inclusion in mainstream kindergarten and schools is rehabilitation.
And here again, Internet is offering a new dimension in Live Online Rehabilitation and Parents
Coaching”. This is the most modern approach and we will demonstrate how it works. Parents will
quickly understand the huge impact and see how easily this can be realized. We with our experience
in working with children with CI and their parents will help to get this project started. And this will
happen tomorrow. Initially the partners will be the Rehabilitation Centre in Friedberg Germany and a
parents’ community in St. Petersburg. But I am convinced this concept will spread into many other
cities and countries in the very near future.