Partnership
Benefits of Partnerships
Shared Resources: Partners can pool their financial resources, equipment, and facilities, allowing for greater capital and operational capacity.
Complementary Skills: Partners often bring different expertise and skills, creating a more well-rounded business operation.
Shared Workload: The division of responsibilities can lead to more efficient operations and better work-life balance for the partners.
Expanded Network: Each partner brings their own professional and personal networks, potentially leading to more business opportunities.
Increased Creativity: Multiple perspectives can foster innovation and creative problem-solving.
Tax Advantages: In some jurisdictions, partnerships may have certain tax benefits compared to corporations.
Easier Financing: Banks and investors might be more willing to lend to or invest in a partnership due to shared responsibility and resources.
Challenges of Partnerships:
Decision-Making Conflicts: Partners may disagree on important business decisions, leading to potential deadlocks.
Unequal Commitment: Partners might not contribute equally in terms of time, effort, or resources, causing resentment.
Liability Issues: In general partnerships, each partner is personally liable for the business's debts and legal issues.
Profit Sharing: Determining a fair way to split profits can be challenging, especially if contributions are uneven.
Communication Problems: Poor communication between partners can lead to misunderstandings and conflicts.
Different Working Styles: Partners may have conflicting work ethics or management styles.
Exit Strategies: It can be complex to dissolve a partnership or buy out a partner who wants to leave.
Trust and Reliability: The actions of one partner can affect the entire business, so trust is crucial.
Long-term Vision Misalignment: Partners may have different goals for the business's future, leading to strategic conflicts.
Personal Relationship Strain: If partners are friends or family, business conflicts can affect personal relationships.
Access to neurosurgical care is limited in low-income country and middle-income country (LMICs) and marginalized communities in high-income countries (HICs). International partnership represents one possible means of addressing this issue. Insights from surgeons in HICs have been explored, but data from LMICs' counterparts are scarce. Marchesini et al. aimed to study the perspectives of neurosurgeons and trainees from LMICs regarding global neurosurgery (GN) collaborations and interests, motivators, and challenges in participating.
An online survey was conducted targeting neurosurgeons and trainees from LMICs. The survey explored demographics, previous experiences, ongoing activities, interests, and barriers related to GN activities. Data were collected between July 2022 and December 2022 and analyzed.
Responses involved 436 individuals. The most represented region (25%) was Sub-Saharan Africa, and most respondents were male (87.8%) aged 35-49 years. Interest in GN was high, with 91% after its development. Most respondents (96.1%) expressed interest in training, professional, or research experience in HICs, but only 18.1% could cover the expenses. A majority (73.2%) strongly agreed to return to their home country for work after HIC training. Ongoing HIC-LMIC partnerships were reported by 27.8% of respondents. Clinical exposure emerged as the most relevant motivating factor (87%), while financial concerns, lack of opportunities, and lack of program support were identified as important barriers. Funding and dedicated time were highlighted as the most crucial facilitators.
Understanding the perspectives of neurosurgeons and trainees from LMICs is essential to expanding HICs-LMICs collaborations and improving access to neurosurgical care worldwide. Financial support and targeted interventions are needed to address barriers and promote equitable partnerships in GN 1).
Global neurosurgery seeks to provide quality neurosurgical health care worldwide and faces challenges because of historical, socioeconomic, and political factors. To address the shortfall of essential neurosurgical procedures worldwide, dyads between established neurosurgical and developing centers have been established. Concerns have been raised about their effectiveness and ability to sustain capacity development. Successful partnerships involve multiple stakeholders, extended timelines, and twinning programs.
Lippa et al. outlines initiatives and challenges within the neurosurgical community. The narrative review aims to provide a practical tool for colleagues embarking on clinical partnerships, the Engagements and assets, Capacity, Operative autonomy, Sustainability, and scalability (ECOSystem) of care. To create the ECOSystem of care in global neurosurgery, the authors had multiple online discussions regarding important points in the practical tool. All developed tiers were expanded based on logistics, clinical, and educational aspects. An online search was performed from August to November 2023 to highlight global neurosurgery partnerships and link them to tiers of the ECOSystem. The ECOSystem of care involves 5 tiers: Tiers 0 (foundation), 1 (essential), 2 (complexity), 3 (autonomy), and 4 (final). A nonexhaustive list of 16 neurosurgical partnerships was created and serves as a reference for using the ECOSystem. Personal experiences from the authors through their partnerships were also captured. They propose a tiered approach for capacity building that provides structured guidance for establishing neurosurgical partnerships with the ECOSystem of care. Clinical partnerships in global neurosurgery aim to build autonomy, enabling independent provision of quality healthcare services 2)
Long-term partnerships between academic departments in low- and middle-income countries (LMICs) and high-income countries (HICs) focused on education and training are playing an increasingly important role in scaling up global surgical capacity. Haji et al. believed that there multi-faceted approach consisting of in-country targeted hands-on training, out-of-country fellowship training at the mentor institution, and ongoing mentorship using telecollaboration and Internet-based tools is a viable and generalizable model for enhancing surgical capacity globally 3).