Expanding Cedars-Sinai’s Global Care Model with Heitham Hassoun, MD

Summary

---

Podcast Summary: Expanding Cedars-Sinai’s Global Care Model with Heitham Hassoun, MD

Podcast: Becker’s Healthcare Podcast
Host: Scott Becker
Guest: Dr. Heitham Hassoun, Chief Executive, Cedars-Sinai International
Date: February 23, 2026

---

Overview

This episode features a compelling conversation with Dr. Heitham Hassoun, Chief Executive of Cedars-Sinai International. The discussion centers on the expansion of Cedars-Sinai’s global care model, the opening of new international clinics, strategic priorities, the practical challenges of cross-border healthcare, and insights into medical education and global workforce trends. Dr. Hassoun shares his career trajectory from surgeon to global executive and reflects on what differentiates Cedars-Sinai’s international approach.

---

Key Discussion Points & Insights

1. Dr. Hassoun’s Background & Cedars-Sinai’s Unique Approach

• Background:

  • Over 20 years in academic medicine (formerly at Johns Hopkins).
  • Transition from practicing vascular surgeon to global healthcare executive.
  • Seven years at Cedars-Sinai, leading international strategy and operations.
  • “I've been at Cedars Sinai for just over seven years now. I came from Johns Hopkins… I got involved and became quite passionate about our formal global sort of program at Hopkins… My career morphed into more of a hospital administrator and an executive and sort of leading our strategy and business and operations around international and everything we do that's in the global context.” (01:11)

• Cedars-Sinai’s DNA:

  • Retains a unique identity as both a top academic medical center and a community hospital.
  • Does not offer degrees, but has a university structure supporting research and training.
  • Emphasis on patient-centric care: “[Cedars-Sinai] truly is about patient care and how do we connect with patients and then as an extension to our communities.” (03:15)

2. Evolution of Cedars-Sinai’s International Strategy

• Initial Focus: Primarily on facilitating medical travel for patients to Los Angeles for care.
• Current Scope (Reflecting shift in global healthcare delivery):
  • Expansion into direct care locations around the globe.
  • Emphasis on bringing care closer to patients’ home countries and improving local care capacity.
  • “You need to bring not only direct care closer to patients where they are, but also improve the continuity of care and the care delivery in those communities…” (03:15)
  • Cedars-Sinai now looking worldwide for strategic opportunities, with a dynamic, focused approach.

3. 2026 Priorities and Exciting Developments

• New International Footprint:

  • Opening a wholly owned flagship clinic in London (Harley Medical area).
  • Existing smaller clinic in partnership with Guy’s and St. Thomas’, London.
  • Plans for similar concierge clinics in Singapore, Dubai, and Mexico City.
  • “We're opening our clinic in London, our first wholly owned asset overseas…our flagship will be opening later in the springtime.” (07:04)
  • Focus on primary care clinics acting as nodes for high-touch access and referrals into the broader Cedars-Sinai network.

• Strategic Partnerships and Expansion:

  • Partnerships with local hospitals like View Hospital in Qatar.
  • Vetting partners carefully—“not a revenue game,” but about the right fit for mission and quality.
  • Looking at opportunities in Western Europe, specifically mentioning Spain and Germany, as regions of growing interest for private care.
  • “Now is a good time to invest in. And then when we invest, we don't go alone, we go in partnership.” (10:24)

4. Challenges of Global Expansion

• Quality and Cultural Context:

  • Vital to deeply understand local markets beyond regulations: “Because culture, as we always talk, right, eats strategy for lunch every day of the week.” (12:19)
  • Quality cannot simply be exported; models must be adapted to local realities.

• Talent Recruitment and Workforce:

  • Building a global administrative team—grew from 11 to 65, with 35–40% based overseas.
  • Reference to Pittsburgh’s UPMC for its unique model of direct ownership and operation globally.

• Investment and Risk:

  • Starting global operations with clinics (~$10–20 million) rather than full hospitals (~$200 million) to foster relationships and understand the ground realities.

• Blending Care Models:

  • The future is a mix of medical travel and regionalized centers of excellence: “The survivors will be the ones that are able to blend the two models. And that's what we're trying to do.” (15:58)

5. Surgeons, Workforce Shortages, and Medical Education

• Shortages Worldwide:

  • U.S. specialty shortages echoed or exceeded internationally; high volumes in some global centers build specialized expertise (e.g., aortic dissection in China, coronary procedures in India).
  • “Some of the things, for example, within my field in China, an aortic dissection is so common, they get such high volume…from a technical perspective, they're incredible.” (23:16)

• Medical Education Lessons:

  • U.S. system produces mature, broadly educated doctors, but could benefit from more modular, stackable post-MD training pathways.
  • “I do think we need to do a better job of making your journey, once you have your MD, a bit more modular and tailored to what you want to learn and stackable, as opposed to being so…big commitments…” (21:17)
  • The challenges and merits of each model discussed; quality and experience remain crucial.

• Globalization of Science & Workforce:

  • Increasing integration of research, technology, and standards internationally.
  • “There is an internationalization or globalization of science and investment and it's very interesting. It's harder and harder to draw clear lines…” (25:15)
  • Expresses belief in maintaining high standards for entry into the physician profession.

---

Notable Quotes & Memorable Moments

“We're building the modern railroad for healthcare… what excites me is… opening our clinic in London, our first wholly owned asset overseas.”
— Dr. Hassoun (07:04)

“Culture eats strategy for lunch every day of the week… you just have to take the time and really understand what's happening, the dynamics, the physician practices.”
— Dr. Hassoun (12:19)

“The survivors will be the ones that are able to blend the two models [medical travel and regionalized centers]. And that's what we're trying to do.”
— Dr. Hassoun (15:58)

“I think it should be hard to become a doctor and to become a surgeon and I think we should carry that sort of profession, feel that a higher standard than just simply knowing certain things and having certain knowledge. The experience matters.”
— Dr. Hassoun (24:04)

“Now is a good time to invest in [Europe]. And then when we invest, we don't go alone, we go in partnership. So you got to build the right partner and be able to provide for those developing markets. Really that high touch, high quality care offering.”
— Dr. Hassoun (10:24)

“Some of the things…in China, an aortic dissection is so common, they get such high volume…from a technical perspective, they're incredible. But then…most of the technology and the research…are coming more from American and US minds and money.”
— Dr. Hassoun (23:16)

“The reality is on the ground that I see is…it's kind of hard to pull that back. And we are living in a world that truly is more integrated than not.”
— Dr. Hassoun (25:15)

---

Additional Segments & Time Stamps

• Dr. Hassoun’s Hopkins Soccer Reference & Fun Rapid Fire Q&A (Johns Hopkins, soccer vs lacrosse):

  • “…Johns Hopkins soccer is the team to support.” (18:59)

• International Surgeon Experience & Medical Training Discussion:

  • “I wouldn't say I'm concerned, but I wonder how it'll evolve in the future. I think it should be hard to become a doctor and to become a surgeon…” (24:04)

• Cultural Integration & Personal Background:

  • Having lived in Saudi Arabia, Texas, and Baltimore, Hassoun reflects on his multicultural perspective and career path. (20:54 – 22:45)

---

Conclusion

Dr. Heitham Hassoun articulates a vision for Cedars-Sinai’s international expansion grounded in cultural adaptation, high-touch local care, meaningful partnerships, and a pragmatic blending of medical travel and in-region excellence. The conversation offers nuanced perspectives on the global talent pipeline, evolving care models, and the essential importance of maintaining rigorous standards in healthcare delivery across borders.

---

Listen to This Episode If You:

• Want insight into how top U.S. hospitals are expanding globally.
• Are interested in the practicalities of launching international healthcare ventures.
• Seek perspectives on global physician training, workforce challenges, and care quality.
• Enjoy thought-provoking commentary on healthcare globalization.

---

Transcript

[A]

Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Beckershospitalview.com and click on the Events tab in the upper right.

[B]

This is Scott Becker with the Becker's Healthcare Podcast. We're thrilled today to be joined by a brilliant physician leader. We're joined today by Dr. Haitham Hesson, and Dr. Hesson is the president of the Cedars Sinai International effort. He'll explain to us in more detail what exactly that is. But a brilliant career as a surgeon, professional, and as a leader doctor soon. Can you take a moment to introduce yourself and tell us about Cedars Sinai and Cedars Sinai International?

[C]

Absolutely. Thank you, Scott, and it's a pleasure to be with you. And I enjoy your podcast, I enjoy your meetings, and I enjoy all the provoking thought pieces that you put out and looking forward to your upcoming book in the summer. I, yeah, I've been at Cedars Sinai for just over seven years now. I came from Johns Hopkins, where I spent better part of my career as a surgeon, academic surgeon and scientist. But along that journey, and it's been almost 20 years now, honestly, I got involved and became quite passionate about our formal global sort of program at Hopkins, which was, you know, at the time and still is a leading one. And, you know, I was, as a faculty member was very organic, starting with going overseas and doing cases at some of our partnerships and hospitals. But that morphed. My career morphed into more of a hospital administrator and an executive and sort of leading our strategy and business and operations around international and everything we do that's in the global context. And so, yeah, I've been doing that at Cedar Sinai, like I said, for the past seven years. And we've grown a lot. It's really exciting. I continue to be bullish and quite ambitious despite any of the turbulence and headwinds we are facing. And so, yeah, happy to dive into any details around that.

[B]

And so Cedar Sinai, one of the great institutions in the world, I think, ranked the last few years in the top five, I think one year, maybe top one or two in U.S. news and world Report. Fantastic institution, the international. Tell us about the focus of their international effort. Tell us your Exact titles. Our audience gets that right, Dr. Hesson, and then talk to us about the international effort and the core priorities there.

[C]

Yes. So my, my exact title is Chief Executive, Cedars Sinai International. And that is a senior vice president level position in the health system, if you will. It has morphed. When I arrived here was, you know, I was recruited as a vice president and medical director. And the titling is purposeful in this change in the context that, you know, I have responsibilities over. You know, really, if you think of all of our Ms. Vision values as a complex academic medical center today, Cedars Sinai, looking at all the things we do in a global context, patient care, of course, we have a brilliant culture of a very highly patient centric approach. And I think that remains central to our ethos and our operations is everything we do truly is about patient care and how do we connect with patients and then as an extension to our communities. Now, Cedars Sinai has been, it's very different than a Johns Hopkins and I could speak to that freely because I spent so much of my career there. But I'm very familiar with some of the other top academic medical centers. Of course, I think historically a differentiator for us is we truly are a community hospital here in West Los Angeles. It was born that way and even today still has much of that carved into our infrastructure and into our DNA as a community hospital. But obviously we are a top 10 funded hospital when it comes to research. We have incredibly talented trainees, residents and fellows, PhD scientists and students and doing masters really are complex. We actually now have the Cedars Sinai University, though we don't have schools, we don't give out degrees for medicine or nursing or pharmacy or any of that type of thing. So it's a bit unique. I think Cedars Sinai has developed its own path as an academic medical center. And you know, my, my job has, you know, when I arrived we were doing an excellent job at taking care of patients that would come to us and try to kind of grow the brand and awareness, but only really focused on the medical travel enterprise and patients to come to Los Angeles and get care. The reality is to, you know, in my view, to be a top program today, you need to be do far more than that and you need to be bring not only direct care closer to patients where they are, but also improve the continuity of care and the care delivery in those communities, whether it's our neighboring countries. You know, like most of us in the US we're dealing with a good bunch of people coming from Mexico or Canada. Of course, decades we've been sort of the trusted place for the Gulf countries to the government sponsored patients to treat travel and get care. Very complex care here. Certainly, you know, 10 years ago was heavy on, on China as, as sort of the, the East Asia kind of because of the population, et cetera, and India and South Asia. But I think a lot of that is dynamic today and looking, I mean we're, we're almost all over the world in terms of strategically finding where opportunities are and building communities. But you know, we still stay focused and strategic in our approach.

[B]

Fantastic. And talk about as you head into this year and we're already in 2026, what are you most focused on and excited about? And doctor, soon do you end up doing a lot of travel with the CEO job of international, you know, going to the Gulf countries a lot and talk to us a little bit about that. Is that fascinating?

[C]

Yes, I think I definitely have a fascinating job. It involves, you know, I don't think you could do this job without traveling and being sort of heavy traveling because you're really building relationships and you need to really understand, you know, what's happening in the communities that we serve that we partner with. I think, you know, for us today, I'll tell you what I'm most excited about. And we've been on a journey of I feel like we're building the modern railroad for healthcare. And you know, I think that requires, you know, I think the big Achilles heel and in my view has been this continuity of care, like truly creating and on the one hand, if you're a technical thinker and it and all this, it is true that, you know, if we had all hospitals and everyone on one system, on epic, for example, like what we use and we can have access to information and imaging and follow up and continuity of care, it's very helpful, but that's not realistic in the world we live in, both from and from a commercial aspect, but also from a regulatory aspect. And so, you know, you can do affiliations and one of the great things at Hopkins and what I learned to do because I was the global medical director, which was we had about a dozen plus affiliations that had the brand that came with sort of requirements to place medical directors and then have quality sort of infrastructure and share KPIs and that starts to allow you to create sort of a structured approach to, you know, having an equal playing field for the hospital. But it doesn't necessarily address that continuity of care direct to the consumer, direct to the patient. And so I think today we're very, I mean what excites me is, you know, we're opening our clinic in London, our first wholly owned asset overseas. This will be in the Harley Medical area. We have two clinics actually a smaller one in partnership with the guys in St. Thomas is already open but our flagship will be opening later in the springtime. But that's just the beginning. You know, we are working on a partnership in Singapore where we have an office, but we want to extend that into an actual again a clinic. I call these concierge clinics. You know, the semantics can be highly variable. What it really is, is primary care for the community that we serve and strategically for us that's we have to be in London, we have to be in Singapore, we need to be in Dubai and we need to be in Mexico City. We have a long history of patients and activities there. But I also think those are international cities with crossroads, modern crossroads of the globally traveling patient and consumer that would want to access Cedars Sinai and who know Cedars Sinai. And also we'll have our doctors, physicians there who are very good at 247 high touch care and make sure that these patients and these customers always have access to at a primary level that can immediately connect into our space specialty care model. So this is why I think it is kind of this railway we're building the tracks. Of course there's a lot of gaps between those cities but through organically partnerships like we have at the View Hospital in Qatar now, beautiful hospital and it's really coming into its own, kind of growing into its shoes from a workforce and capability perspective. I think that clearly the Gulf, we want to have more presence in Saudi and uae. We're picky, picky, not in a bad way, but in a good way. We're not looking just to jump into partnerships for the sake of that. It's not a revenue game, it's a, it's really, you know, having the right minded partners and trying to be able to connect the dots and deliver top care. I'm really also, and I'll stop here because I know I don't want to keep sort of belaboring some of the same issues, but I am also very bullish on the private sector development in other areas such as even Western Europe. Very, very, and I'm really excited about that. We're putting a lot of effort. I do think that there will be a Cedars Sinai hospital. You know, we have been talking with, you know, great potential partners in Spain and Germany, very traditional areas that our, our partners don't Necessarily. I mean our suing our colleagues at, you know, wherever, Hopkins, Mayo, Cleveland don't traditionally go because of the obvious dynamic of the government based systems and then the, the private sector challenges. But that's all changing. Now is a good time to invest in. And then when we invest, we don't go alone, we go in partnership. So you got to build the right partner and be able to provide for those developing markets. Really that high touch, high quality care offering.

[B]

And how do you assure the quality, the reimbursement, the recruitment? I should have a different way. What are the most interesting challenges as you go into another country to provide care and to develop clinics and develop hospitals? Is it the recruiting talent? Is it reimbursement? Is it maintaining the cedar sign? Equality in another place? What are the big issues you think about?

[C]

Yeah, great question and very insightful one. You know, I think the reality is it's all of those things. And I think the main thing to know and understand is number one, you really take your time to understand the market, not just from a business or regulatory on paper, but to know the people and to see how. Because culture, as we always talk, right, each strategy for lunch every day of the week. And I think that's a critical piece to it and you just have to take the time and really understand what's happening, the dynamics, the physician practices. I think revenue is a challenge because there aren't many places that have revenue streams like we have at Cedar Sinai in la. So it's impossible to transplant our system. It'll immediately be rejected. If nothing else, there's not enough oxygen or supply chain of what the fuel needed to do the work. So you have to build a global workforce. I'm not talking about the clinical operations, just the administration of my team. When I arrived, we were 11 people. Now we're 65. But of those, almost a little less than half, probably about 35 to 40% are deployed somewhere globally, either employed by us or working in a consultant role. I think you need to have the. And we obviously need to continue to grow. But you know, I think one of the things that US hospitals that are active international have been leery to do, which is to get comfortable, you know, outside of your local market. Certainly some have. You know, I've always been intrigued and impressed by Pittsburgh and my colleague who runs international now, Joel Nelson, you know, I've gotten to know him a bit and understand how they think and do things. I mean they, they have over 3,000 employees. Everything they do overseas is, is, you know, really they own and operate any. Anything they don't get into consulting or advisory. And it's almost opposite to what all of us, we all tap, tap, put our foot in the water, so to speak, and by consulting and advisory and education things before we tackle management and ownership. But I think there's something to be said about that because that is obviously maybe the easiest way to control the operations and the quality. But it's also very difficult to stand up the workforce. And it's so no wonder they operate mostly in Europe, where you might be a lot more alike than if we were operating in Southeast Asia or deep in South America or what have you. But I think, of course, I think for us, I think the main thing is you need to be very strategic. You need to build the relationships, and you need to be realistic about what you can and cannot do. And I think we're steadily moving, and that's why for us, doing these primary clinic nodes, where you might be looking at a $10 million investment, initial or $20 million, as opposed to a $200 million hospital or something, is easier. And that's how you start to build the relationships and understand, you know, through your doctors on the ground, the specialty market, and what we can actually do and can't do. And how much of that, how much does the future involve this medical travel or traveling to the US for spine surgery and for transplants and for cancer care, or how much of that is actually going to be localized? I mean, clearly private healthcare is being regionalized with centers of excellence in different parts of the world. I don't think, though, that patients are going to stop traveling to other countries or even the US it's going to be a mixture. And I think the survivors will be the ones that are able to blend the two models. And that's what we're trying to do

[B]

100%. And the shortages that we have in the US are much larger in some specialties overseas, which at least if we're able to keep on producing great specialists here, there will be some continued travel here for care. I'm going to ask you two or three questions, and one I'll ask you. I had a chance to visit our podcast with Dr. Mehmet Goal Dr. Faith Memic. Go. Is he with you in Cedars Sinai, Qatar?

[C]

Yeah. So Dr. Gould is a very experienced and seasoned hospital executive in the region. There's. And he's hired by our partners as a CEO of the hospital. So he's an employee of Technically now they call it Apex Health, which is owned, it's under A sort of the holding company's Power International, but it's a leading development company in Qatar, and he works for the Healthcare group. And I think now he actually recently had an expanded sort of responsibility beyond the Vue Hospital, which is the Cedars Sinai affiliate and their sort of flagship, but also all the operations in Qatar, because they're. They're going fast. They move pretty fast. Those guys try to keep the tiger by the tail, as I always joke, but we love them, and I think the partnership's been amazing.

[B]

No, he's a ridiculously gifted person and leader. And it's so interesting to be able. For me to be able to connect dots, because I had a chance to speak to him on his podcast not long ago and get to know him some and have visited with him over the years, but what a fascinating, brilliant person.

[C]

Yeah.

[B]

Another question is this. And. And if this is too complicated a question, Dr. Hassoon, don't answer. Okay, so here is the question. Johns Hopkins, better today or back in the day? Better in soccer or lacrosse? Which one has a stronger program at Johns Hopkins? I know it's a tough question. Give us your thoughts.

[C]

Oh, you got me there. I thought I was bracing myself for where are you going to put me? Talk about Hopkins International or medicine or something on the spot. That's an easy one. I mean, I played Hopkins soccer and I still follow Nate. So if you. If we look at it in this context, which I'll choose to do, is Johns Hopkins soccer, since the time I played there between 1989 and 1993 to today, has grown and developed tremendously compared to lacrosse team, which may have gone mostly the opposite direction. I will say that Johns Hopkins soccer is the team to support.

[B]

That is a fair statement, and I love the analysis and thank you. And I did see that you played soccer at Hopkins. I have one more question for you. When you work with surgeons internationally and obviously in our country, we are the huge beneficiary of surgeons that come from other countries to hear and thank God for it, because our healthcare surgery is so much worse and the surgeons that we work with are so well trained from other countries. I literally have two questions here, so bear with me. What are the shortage shortages look like in some of the other markets that you're in of surgeons, proceduralists, specialists? What are the shortages look like compared to here? That's one question. And I guess the second question is some countries are doing a tremendous job of producing doctors that are out truly practicing after college med school residency at 27, 28, and we somehow have made it to. People are not out really practicing until 30, 31, 32, and more and more of them practicing part time. Is there something we could learn from medical education in other countries? I mean, we produce great doctors, but not quickly and not efficiently. Is there something we could learn from other countries on that? And what does the. I assume the doctors that you work with in other countries are great. Are there bigger shortages in other countries in here, or what does that look like? Sure.

[C]

And I think all the questions you pose are all sort of interrelated. I'll start maybe on the back end a little bit in the sense that. Absolutely. I've long. We can learn and we should learn and adapt, you know, and the hardest part is to. Is change is very difficult and it requires sort of leadership and sometimes, you know, requires breakthroughs. I mean, I think, you know, when I was coming up, I just. I knew I wanted to be a vascular surgeon before I went to med school. And I was, you know, Michael DeBakey. I'm a Lebanese American. And in our community, there was no bigger icon and American than Michael DeBakey, especially since I grew up and I'm from Houston, Texas. And so, I mean, I knew I wanted to be a vascular surgeon. And so I think, you know, but you had to. Literally at that time, there was no way you can take a modular approach. At least today there's some improvement. You can go directly from med school into vascular and do your surgery, surgical training in five years, as opposed to back then when we had to do general surgery for five and then two of vascular. But the reality is, I think if you just think about, you know, I'm a bit on the fence about the undergraduate education. So, you know, the four years of college and the four years in medical school, I think it produces for us more mature people more broadly kind of versed and maybe more prepared to take on a very noble and challenging occupation of being a physician, responsible for people's lives and life, in some ways, livelihoods. So I kind of like the system we have about becoming a doctor, having to go through that process and not. Not squishing it together and even having to go to college first, then med school, because it forces you to grow up a little bit before you make these important choices. Having said that, though, I do think we need to do a better job of making your journey, once you have your MD a bit more modular and tailored to what you want to learn and stackable, as opposed to being so, you know, big commitments and then having to make Big decisions when you're still trying to figure out exactly what you want to do in your career as a physician. I mean, for me, I would never have thought I would be where I am today. And it's so much, it all makes sense to me now having grown up as an American expat. You know, I moved to Saudi Aramco and Saudi Arabia from Texas when I was young and then I went to boarding school, you know, on the east coast and I went to Hopkins. And then like my whole life was this mixture of cultures and communities. And then it was easy for me to go into a developing field that was especially driven by Gulf countries and the money there and the resources to build the healthcare. But you know, you can't sometimes plan that. I was just a nerdy scientist and clinician. So, you know, getting back to the physicians, how they look worldwide. Look, I think clearly the world is much smaller now with information sharing and there's no doubt with, you know, AI and tools that are going to be in the future that there is going to be a, you know, you know, I think the knowledge gaps are going to close in different communities and they're going to get pretty tight to where most, most of the knowledge we have will be available to everyone. The reality is though, is that we don't have enough knowledge about truths and, and the biological sciences. And I, and I think it's, it's different than physical SC and other disciplines. And I think that's where experience matters. Real world, tangible experience. And I think where culture matters. And I still stand heavily behind the United States people, especially from the European side. But others will like to kind of poke holes of our expensive system. We do leave patients and people behind. Those are not things that we like or proud of. But the reality is the depth of our regulatory system, our peer to peer review system and our social structure allows us to, and I believe when you get out and start practicing healthcare, you're practicing at the highest level you can. And we don't have a tiered system within the physician. So all these things lead to a very high level of professional level of care delivery. I wouldn't say I'm concerned, but I wonder how it'll evolve in the future. I think it should be hard to become a doctor and to become a surgeon and I think we should carry that sort of profession, feel that a higher standard than just simply knowing certain things and having certain knowledge. The experience matters. And so, you know, it'll be interesting to see how this all evolves over time. The last Thing I'll say is, you know, between. I mean, I think there are differences in physicians skills in different parts world based on what they see. I mean, some of the things, for example, within my field in China, an aortic dissection is so common, they get such high volume. Or if you're in India and you're a cardiologist and the amount of coronary artery disease and the amount of stancing cats, I mean from a technical perspective, they're incredible. But then you need to have most of the technology and the research and all that goes into the clinical trials are coming more from American and US minds and money. So I think today we're in a different world than when I was growing up in the field. There is an internationalization or globalization of science and investment and it's very interesting. It's harder and harder to draw clear lines. Despite what when you live and see in the media and our leaders today and sort of the movements that are happening kind of retracting to within boundaries and borders, the reality is on the ground that I see is it's from an economic perspective and maybe even a social one, it's kind of hard to pull that back. And we are living in a world that truly is more integrated than not 100% doctor suddenly.

[B]

Thank you so much for joining us. I love the reference to Dr. DeBakey. You went to Baylor College of Medicine or did your residency. They're a magnificent program. Fantastic. My daughter spent last summer in Beirut, so I got a chance to learn more about Lebanon than I thought I ever would in my life. Thank you so much for joining us today on the Becker's Health Care podcast. What a pleasure.

[C]

Amazing. Thank you. And I can't wait to see you in Chicago next time at the meeting.