IHS Case Study

Integrated Health Services
DR. ASIM MAHMOOD-THE PROFILE OF A PATHFINDER
“Dr. Asim is a very creative individual. He will never

follow the conventional path rather he will try the hardest
thing which comes his way and also he is very quality
conscious. He never projects his name rather he always talks
about Integrated Health Services. He loves to make systems
and whenever people ask him for using his systems he never
says “no”, he says come and learn. He is never ever a miser.
Asim believes in teams and it is the motivation of Asim which
is reflected everywhere. To work with Asim you should know
him”.
Dr. Ali Raza (Member
Top Team)
After proving his success in his native country, Dr. Asim Mahmood, an
entrepreneurial leader was thinking of expanding his business
overseas. He was particularly looking at United Arab Emirates and his
friends were ready to entertain him for the “Look-See” visit there. The
purpose of the trip would be looking for opportunities in the area of
providing school health services in UAE.
Integrated Health Services (IHS) - Pakistan was not established as a

commercial venture rather the intent was to provide quality health
services in the neglected areas. The business of Dr. Asim Mahmood
had considerably spread and the portfolio included seven different
units namely Health Consultancy and Infrastructure Development,
Occupational Health and Training, School Health, Home Medical Care,
Emergency and Rescue Services, Clinical Care, Lab and Vaccination
and Corporate Health.
Dr. Asim Mahmood- being the Executive Director of Integrated Health

Services was a pioneer in providing school health services in Pakistan.
He and his wife cum business partner Mrs. Asim are the owners of this
business and were now leading an increasingly viable service across
the different cities of the country especially in the Islamabad-
Rawalpindi region.
Refer to Exhibit 1 for complete business operations of Integrated
Health Services.
Assistant Professor Ch. Fazle Muqeem and Tehreem Waheed (MBA Final
Year Student) FAST Business School, Islamabad, Pakistan prepared the case
solely as the basis of class discussion. Cases are not to serve as
endorsements, sources of primary data or illustrations of effective or
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HISTORY
Dr. Asim Mahmood, an M.B.B.S, who graduated in 1992 from
Rawalpindi Medical College, Rawalpindi, had no issue in going abroad
for higher studies after graduation, but he decided not to go abroad
and serve in the area of primary health care. He thought of serving in
this area because he was of the view that primary health care is a
neglected area and needs to be attended to. Dr. Asim never looked at
a straight career for himself instead he was looking for innovation,
excitement and unique projects. He did his MCPS in Family Medicine
and MRSH from United Kingdom and MIOH from Finland.
ESTABLISHMENT OF AIRPORT MEDICAL CENTRE

After graduation, he did his MCPS in family medicine in year 1994 and
started off with a small clinic named Airport Medical Centre in
Rawalpindi. For establishing this small clinic he took a loan of PKR 10,
000 from his parents. Dr. Asim recalled that he earned PKR 80 on his
very first day and after two months he earned PKR 53,000 which was a
reasonably good amount at that time. People started trusting him and
his revenues increased. Concurrently he was also looking for
government jobs because there was family pressure to have a stable
stream of income alongside the business. This was obviously the family
point of view but Asim believed that normally there are two types of
working people, one who are employees and the other who are
employers and he definitely wanted to be the part of the later group.
ASSOCIATION WITH GOVERNMENT

In March 1996, he got three offers from the government and he joined
a government health institute in G-8 Sector, Islamabad. Also he used to
sit at his clinic in the evening from 5 p.m. through midnight. He was
never happy with his government assignment, because he was doing
Pathology which was not his specialty.
While there were never many adventures to seek with the morning job,
his evening clinic was really picking up and he had reached a threshold
of 150 patients a day. On the day he received 150 patients at his
evening clinic, he decided that he could not stretch himself more and
so in order to give more time to the clinic he resigned the government
job the next day. His decision and subsequent resignation made the
family a little unhappy.
THE PAKISTANI FAMILY MODEL-IN AID OF ASIM

While Asim was defining the new career path he had already married
and the first child was born. Mrs. Asim recalled that:-
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“This was a critical time when he left the job, but our
basic necessities were being fulfilled because we were
living with the parents of Dr. Asim”.
She (Mrs. Asim) further commented that both set of parents
understood the burning ambition of Dr. Asim to go it alone and were
supportive of his new career in the long run. With the family right
behind him Dr. Asim added a laboratory and a vaccination centre in his
clinic and hired another person for help. Whatever he earned he
invested back into his business. He was earning handsome revenues
from his clinic and the Airport Medical Centre was growing with Dr.
Asim being totally hands-off in terms of the management of the facility.
Being a restless soul he was now looking at the area of home medical
services as being the next area to target.
THE BIRTH OF IHS

In order to fulfill the purpose he established “IHS: Integrated Health
Services”. He named the company “Integrated Health Services”
because he practically integrated all the possible home patient care
issues under one canopy. Dr. Asim remarked:-
“My dream was never to buy flashy cars and property;

rather I wanted to do something for the society”.
Asim firmly believed that Pakistan and Pakistanis had to look beyond
the over arching hand of the government to achieve prosperity hence,
he felt assured that the response in this area would be overwhelming.
The idea also sat well with his notion of being self employed and his oft
quoted and repeated observation:-
“I would much rather be a cobbler and be self employed
rather than being a well paid employee”.
THE START-UP BACKGROUND-IHS

With his dreams on the platter in mid 1997, Dr. Asim Mahmood
successfully established IHS with a focus on, home medical services,
laboratory services (at the door step of clients) and school
health services. The first two were his own ideas, and the third was
presented by a mentor, who was a school health advisor at a
multilateral agency. This mentor upon leaving his job with the
multilateral agency, asked Dr. Asim to introduce the concept of school
health services in Pakistan because it was a neglected area.
To jump start home services, 1000 flyers were printed, and were
thrown in at random in the residential area of Sectors F-8 and F-7 of
the Capital City. A reflection of the flyer is appended at Exhibit-2 to
the case. Dr. Asim received the magic call (so to say) on the third day
after distribution of flyers. The caller requested vaccination of Hepatitis
B at a house located in Sector F-8 of Islamabad.
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Fortunately, there were two patients and both were prominent political
leaders of the country. Dr. Asim’s business broke even the very same
day and the cost of the flyers was recovered. With the passage of time
the revenues stream started building up and the word spread that
home care services are available at the door step. The intensity of calls
increased day by day. They were receiving calls for checking blood
pressure, blood sugar and vaccination etc. It was at this point that Dr.
Asim hired a paramedic Mr. Saeed Hashmi who was the first employee
of IHS and continues to serve to this day reflecting upon the kind of
commitment Dr. Asim evokes in his employees. Before joining IHS Mr.
Hashmi had served the Pakistan Air Force for 18 years in their nursing
department. Dr. Asim chose Mr. Saeed Hashmi as a final candidate for
his health centre from a long list of candidates.
Mr. Saeed recalled that:-
“Previously I was serving Pakistan Air force and working

there was a straight forward thing. When Dr. Asim told
me about his future aims I joined Integrated Health
Services considering this to be an exciting opportunity”.
Refer to Exhibit 3 for the video recorded interview of Mr. Saeed

Hashmi.
Alongside the effort to deepen the home care services Dr. Asim
starting touring different schools for introducing the idea of school
health services. As it was a new idea in Pakistan so it was a hard
challenge to persuade these institutions to join up. However, Dr. Asim
used his perseverance to the maximum.
Mrs. Asim elaborated that:-
“Dr. Asim is very optimistic by nature; he never creates

fuss or makes issue of any problem/hurdle which comes in
the way rather he thinks that every problem is God given
and He will provide the solution also”.
A PRODUCT OF FAITH & FAMILY SUPPORT

Dr. Asim had a strong faith in Almighty Allah, he observed:-
“Whatever happens, either good or bad, it happens due

to the will of God”.
Mrs. Asim- being the mother of two kids is also a doctor by profession
and she explained that being in the same profession was an added
advantage for both of them as they shared similar interests. After the
birth of the first child she took a break and later joined the husband’s
business. Mrs. Asim wanted to pursue surgery but later looking at the
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emerging family commitments she first went to Radiology and then to

Public Health. She was very happy now as the family had always been
her primary focus.
While commenting upon the critical times which she faced as being Dr.
Asim’s spouse, she explained that at the start Dr. Asim received three
job offers from the government but his heart was set on initiating his
own work hence he convinced the family to let him go his way. His wife
remembered that at that time (and even now) whenever he talks he is
very convincing and so he tends to have his way. She observed that
although there were many ups and downs, Asim’s confidence and grit
carries everyone through. She also remarked that:
“Asim is very good at hiding things”
And
“Asim doesn’t portray the problems as such rather

he always thinks of new things”.
Mrs. Asim stated that her Parents-in-law are very supportive and they
helped them in every way. Rather the father of Dr. Asim is always
there with good advice and the mother is always praying for Asim’s
success.
Mrs. Asim explained that:-
“I am very much privileged that we are living

together (i.e. with the parents of Dr. Asim)”.
Mr. Saeed Hashmi commented that:-
“Mr. Bashir – the father of Dr. Asim has a very

supporting role for the whole staff of IHS and he is a
very good person”.
BULDING IHS & THE UPHILL STRUGGLE

Beyond the family support Dr. Asim continued to build IHS and never
felt disappointed. Dr. Shahid, an early joiner like Saeed Hashmi and a
member of the core team recalled about Dr. Asim:-
“He (Dr. Asim) is very consistent in nature and he

never let go of hope even though there was little
success in the start”
In this back drop Dr. Asim continued visiting schools and presented his
idea during the year 1997 but unfortunately he didn’t get any client.
However, as a typical pathfinder his struggle went on and thus
observed Dr. Shahid:-
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“Dr. Asim used to work continuously for even 18-20

hours for establishing IHS and for making the
systems work”.
The idea of school health services finally got Asim into business and
one private school agreed to open an IHS clinic on its premises. IHS
was paid annual charges of PKR 250,000 which were provided in
advance by the school. A similar agreement was also signed between
IHS and another school in Rawalpindi at the same time. Refer to
Exhibits 4(a) through (c) for evidence in this regard.
ASIM AND THE WORK-FAMILY BALANCE

Mrs. Asim- as a mother of two kids remarked that “we miss out on
Socialization, I go on my own, unlike other couples” and further
elaborated that:-
“Everybody has to do some sort of adjustments in his/her

married life”.
But, she had no regrets and commented that “Asim never made a
wrong a decision”.
She remarked that:-
“My career is a compromised one and I have no regrets

and I don’t want to put my kids at stake”. She further
elaborated that” one has to set his/her role and priorities
and then work accordingly”.
Dr. Asim has a unique sense of keeping the work-family life balance
and despite his busy schedules he is the storyteller who puts his young
kids to sleep at night.
Although her wife described that:-
“At times he doesn’t even remember the academic

classes of the kids…but believes that his daughters will
run the Business when they grow up”. Please see Mrs.
Asim’s video interview appended as Exhibit 5 to the case.
DR. ASIM-THE ORGANIZATION BUILDER

Mrs. Asim commented that “Dr. Asim has been a source of
inspiration for his friends” and also his way of thinking is
“conviction and hard work is required for whatever you are
doing”.
She recalled that:-
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“Partnerships never suited us, we were always

deceived”.
The Work Environment at IHS

The Director Projects remarked:-
“It is the team work and family friendly environment

within Integrated Health Services which is a reason
behind its success”.
The Manager Home Medical Care mentioned that:-
“It’s a family friendly environment here at Integrated

Health Services”.
There is no issue of timings as long as you complete your work and

satisfy the clients. Also Dr. Asim is great believer in trust. This is one
reason why people do not leave his set up.
Human Capital Begets Financial Capital

As Doctor Asim worked on both the Home Care and School Health
portfolios the work force grew to eight employees. Mr. Saeed recalled
that:-
“Dr. Asim gave me free hand and encouraged me to hire

individually other male and female nurses. He trusted me to
that extent that he made me accountant also. Now, I am
working as Manager Home Nursing Care”.
The Director Projects believed that:-
“The IHS staff gives outputs because they are

emotionally involved in their work”
The Manager home medical care being a very senior employee at
Integrated health Services remarked that:-
“He gives us (the IHS staff) handsome salaries plus a

yearly increment. Also if anybody among the staff needs
immediate financial help he provides us that, without any
delay”.
Dr. Asim was now at a stage where he wanted to take his organization
into newer segments and hence the penetration into the Home Nursing
Care Services.
START OF HOME NURSING SERVICES
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As the first penetration into this service area, Dr. Asim and his team
were able to successfully provide ICU- services for thirteen days, at
home in a room for a female patient residing in Islamabad, who was
suffering from Hepatitis-C. The lady suffering from the disease was the
wife of a building contractor in Islamabad. The person took his wife to
London for medical help and she remained there for sometime but
didn’t get well. So the husband brought her back, as it was the desire
of the couple. It was in this context that Dr. Asim was requested to set
up the ICU. Dr. Shahid recalled that:-
“When we provided ICU services at the door step of a
patient we provided medical instruments from
thermometer to ECG machine on our own”.
Dr. Asim hired doctors and trained ICU nurses. At that time school
health and home care businesses were going pretty well, and so Dr.
Asim took IHS into the corporate sector.
ENTERING CORPORATE SECTOR: 1998-1999

By the end of year 1998 and start of 1999, Dr. Asim made proposals for
different organizations like leading multinationals in oil industry and
tobacco industry for providing vaccination services.
HEALTH SERVICES TO THE LARGEST PRIVATE SCHOOL

NATIONWIDE
In year 1999, Dr. Asim got a chance of making remarkable penetration
in the area of school health services. One day he got a call from the
head of the largest private schools system of the country. He was
asked to come to Lahore and present his ideas on school health to the
Executive Board of the school. Dr. Asim went to Lahore made a
persuasive appeal and got the contract to provide vaccination services
to all students in all branches of this school. The target was achieved
and 52,000 students were provided with vaccination services. Refer to
Exhibit-6 for the service contract and to Exhibit-7 for Dr. Asim’s
views on this contract and many of his other targets that he has been
able to deliver on. By now IHS was firmly established in home health
care, vaccination services and corporate health..
END YEAR 1999 & START 2000-MAKING HEADWAY INTO

CORPORATE PAKISTAN
At the end of 1999, Dr. Asim and his team made contact with the
Islamabad Traffic Police for vaccination of Hepatitis-B. For that purpose
Dr. Asim had a meeting with the Superintendant Islamabad Police and
successfully sold him the idea. This opportunity created worth and
credibility for Dr. Asim and his company. Allied to this opportunity was
the inauguration of Rescue 15 in Islamabad. As the name suggests
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they offer relief and help in emergency, accidents, thefts and other
disasters. Dr. Asim was hindered to operate because he did not have
ambulances so he convinced The Red Crescent Society to volunteer
two ambulances to Rescue 15 where IHS team was providing free of
cost services. Refer to Exhibit-8 for the service agreement. The flood
gates now opened IHS was able to provide emergency medical
coverage to the development arm of a Multilateral Agency.
A multinational petroleum company requested Dr. Asim and his
team to provide a field hospital in Sind and Dr. Asim Obliged. In 2002,
due to time constraints, Dr. Asim sold the Airport Medical Center. Also
in May 2002, IHS managed a big break of penning down a company
health care agreement with one of the largest conglomerates of
Pakistan.
JOINED DISTANT LEARNING PROGRAM

One of the outstanding accomplishments of Dr. Asim has been that
along with his company he has also developed himself. He has never
lost an opportunity to upgrade his skill set. He therefore applied for a
distant learning program in occupational health and got membership
from the Finnish Institute of Occupational Health, Finland. Dr. Asim has
the distinct honor of being the third Pakistani to have been awarded
this certification. With this new degree in his hands he further
expanded his business and started Research and Health consultancies,
which has become one of the highest revenue earning areas. During
this time Dr. Asim also consulted to provide National Guidelines for the
Prime Minister’s nationwide Health initiative.
IN SERVICE OF THE NATION- BALAKOT & SAVE THE CHILDREN

Dr. Asim and IHS have always conducted business through morality
and nation building has been one of the major themes of his work,
hence the involvement with the earthquake stricken areas and the
work with NGO SAVE THE CHILDREN. For the city of Balakot the UAE
Red Crescent Clinic was established in the year 2006. The staff of this
clinic comprises 17 employees including two lady doctors, two male
doctors, security guards, dispensers, computer operator and sanitary
workers. Dr. Asim from IHS Islamabad is administering this clinic and
monthly record is sent to IHS, Islamabad. The doctors here are in touch
with Dr. Asim and whenever they need any help and guidance, Dr.
Asim is there to provide it. Mainly the patients who come here for
treatment are suffering from skin diseases and seasonal problems. The
patients from Kaghan, Naran, Mansehra and Ghari Habibullah also
come here for the treatment. IHS-Red Crescent Clinic Balakot has had
the honor of serving 1,40,000 patients, free of charge to date. The
health ministry of United Arab Emirates is providing funding for this
clinic on a six monthly basis. Refer to Exhibit 9 (a & b) reflect upon the
agreements done with UAE Red Crescent and SAVE THE CHILDREN.
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IHS- THE COMPANY OF ETHICAL PRACTICES

The company seems to have separated from the owner/creator and
has developed an identity of its own, Dr. Shahid Nadeem had an
interesting remark to offer in this context:-
“No other organization is working like Integrated Health

Services with ethical practices and standard operating
procedures. Currently, I am working as Director Projects.
When IHS was established, there was no competition at
all. Unique services at the door step of clients were being
provided at that time from the platform of IHS. We use to
take very low profits for superb services which we
provided, because at IHS we can’t compromise on
quality”.
Dr. Shahid added:-
“Our motto is client satisfaction first no matter if while

doing so substantial revenues have to be sacrificed.”
Dr. Ali Raza acknowledged that:-
“IHS believes in making systems and efforts should be

done to meet standards”.
DECEMBER 2002: DR. ASIM & CORPORATE TRAININGS:
In December 2002, the business volume of IHS was getting low, so in

May 2002 Dr. Asim took a strategic decision to join regular
employment once again in a leading company in the oil sector. Also he
thought to start providing trainings of first aid at corporate and school
level and consulted Pakistan Red Crescent Society for that matter. Dr.
Asim and his dedicated team launched a program known as “FATS”
abbreviated for First Aid Training for Schools. The duration of the
training was six hours. Dr. Asim, himself was the master trainer and he
trained his staff, so that they will be able to provide trainings at
different schools. And so Dr. Asim tried to dilute the cyclical effect of
the business. A contract was duly signed between IHS and Pakistan
Red Crescent Society, who were the sponsoring agency. Refer to
Exhibit 10 (a & b) to reflect upon the market niche that Dr. Asim made
in this area.
In the original contract it was decided that Rs. 2000 per training will be
given to Pakistan Red Crescent Society. But, after two to three months
the head of Pakistan Red Crescent Society ended the contract. Later
on, the first aid trainings were provided solely by IHS. As the profit
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margins were low in schools and colleges, so Dr. Asim turned to the
corporate sector where he already had a presence.
The first break on this leveraged path came from a multilateral agency
and IHS charged Rs. 25,000 for the event.
The next break came in the tobacco sector with a leading
multinational. The first aid trainings for this tobacco company were
provided at its different factories in different cities. This was a major hit
for IHS and the top management at this leading tobacco company was
very much impressed with the work of Dr. Asim and his team. On a
query by the top management of the company Dr. Asim decided to go
into trainings in occupational health, general health and ergonomics.
The contract that Dr. Asim won was worth a couple of million rupees
and it was decided that trainings in general occupational health (for
factories workers and office staff), ergonomics trainings (for office staff
only) and first aid trainings for both will be provided in one year. Dr.
Asim and his team not only provided the trainings but won the
confidence of the company and to date the organization is a client of
IHS. In terms of capacity building of the organization Dr. Asim has
converted IHS into a total solution provider for the healthcare needs of
his corporate clients. The services include:
 Managed health care ( IHS was pioneer in introducing this
concept)
 Training services
 Creating health awareness
 Arrangement of hospitals on panel for employees
 Claims verification of medical bills
 Rescue and emergency care for employees based in Rawalpindi
and Islamabad
 Providing health policies
 Acting as health contractors ( IHS was pioneer in this field, and
was providing health contracting services to oil companies)
While acting as health contractors, IHS has also had opportunity to
send doctors to the oil fields in Oman also.
Institutionalizing Training Capabilities

Many other companies also contacted IHS for trainings in stress
management and other topical areas and Dr. Asim obliged this time by
bringing in trainers and paying them a share of the profits. According
to Dr. Asim, running an organization is not a “one man job”. He
believed that good, loyal, honest and sincere people are required for
doing a good job. Therefore the complete devolution of authority to Dr.
Ali Raza and Dr. Shahid Nadeem for running the children hospital and
the Medical Center in Sector I-8. He is now operating at the strategic
level. Dr. Asim’s Mantra is:
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“I might lose money but I would not lose systems”.
DEVELOPING EMPLOYEES- EXAMPLE DR.ALI RAZA

Dr. Asim newest venture is the Children Hospital in the, F-10 Sector of
Islamabad. The hospital broke even after three months. Dr. Ali Raza
being the Director of Integrated Health Services Children hospital F-10
Islamabad observed that the idea of this unit stemmed from a real
need. Catering for the health needs of children government hospitals
are there but there are a limited number of beds for them and quality
health services are also not provided to them. In this context the F-10
facility was established. The facility is now a year old. The environment
of the hospital has been created keeping in view the comfort needs of
the children. Refer to Exhibit 11 for the video interview of Dr. Ali Raza.
Free of cost health services are provided to the poor and the needy
children at this hospital and a charity profile is kept for this category of
patients.
A feedback system is maintained in the hospital and according to this
feedback system the satisfaction level of the clients is near 100%.
Parents are very much satisfied with the services which are provided
here. Also the response time is very quick here. Doctors and other
medical staff give patients enough time and enough care so when the
parents leave the hospital they are satisfied. Follow-up calls are made;
a day after the child is discharged from the hospital just to inquire
about his/her health. Because of these practices patient referral has
become an important source of bringing in more business.
CLIENTELE IMPACT
The Director Projects at IHS remarked that:-
“Dr. Asim doesn’t have a bossy attitude at all, rather his

emphasis is on services provided to the clients”.
The mother of Ms. Salma Khan is a client of Integrated Health Services

for the last ten years. Ms. Salma commented that:-
“My mother is old and ill as she can’t walk and
communicate so I am availing the home care services
from IHS since the earliest times and I am a very satisfied
client. They provide twenty four hours medical services
and when you call them its like a hospital coming into
your home. They know me and my mother very well and I
know them very well. I have confidence in them as I have
crossed many bridges with IHS because of my mother’s
illness”.
The lady was so much impressed and satisfied from their home care
services that she is writing a book named as “Hands on the
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shoulder” on her experiences with her ill mother and the services
which should be provided to such a category of patients.
Dr. Tariq is working as a health advisor for a large multinational

company in Islamabad. As a health advisor they are availing the
services of Integrated Health Services for their company. Dr. Tariq is
responsible for the clinical and personal health of all employees at this
company. He observed that there were a number of reasons for which
they chose IHS. Some of the more important reasons were:
 IHS has better infrastructure

 Requisite experience of working with other
multinationals
 Worked in the area of school health care
 Worked voluntarily during earth quake
 IHS – are pioneers in their work
 Are trust worthy and have a very good team
Another reason cited by Dr. Tariq was that they continue to build
special expertise in certain areas like:-
“Very few people are there, who have worked in the area
of ergonomics and Integrated Health Services is among
one of them”.
RELATIONSHIP OF THE CLOCK AND THE CLOCKMAKER

Then the critical area now is to see as to where Dr. Asim stands in
terms of his impact on IHS. Dr. Tariq (the health advisor of the large
multinational being a client of IHS) had the view that:-
“I know Dr. Asim for a long time, he is a very good

physician, and I found him committed to whatever
he is doing. He has a vision and he is working rightly
for the achievement of that vision. Also he tries to
create a better environment for the people of his
company. Asim is a kind of person who works very
hard and in his case I must say “Persistence always
pays” ”.
A very satisfied client observed:-
“I respect his diagnostic and clinical ability. As a

doctor he is brilliant. There are a lot of good people
working in this country who are working for the
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betterment of the society. I think it’s a wasted life if

you don’t help others in the hour of need”.
Director Projects stated that:-
“Dr. Asim has stuck to the same business from day

one with the same zeal and motivation. He never left
IHS, although he got many offers to go abroad”.
Director IHS Children Hospital believed that:-
“Asim had a novel way of doing things. He brings

into reality his imagination”.
Manager Balakot Medical Facility observed:
“Dr. Asim is a very good and benevolent

administrator”
While the training business seems to have taken a hit the school health
business is doing very well. Currently IHS is working as the market
leader in school health area.
“Now after almost 10 years in school health, IHS is a

market leader in provision of various types of health
services to the educational institutions in Pakistan. Due
to the commitment and non-commercial approach IHS is
the largest operator of school health in the country with
over 0.8 million students enrolled so far“.
In a way the life time contribution of Dr. Asim to the health sector is his
own words is that, “there is a consumer everywhere” all you need,
is to harness the energy of your organization in the right direction and
with a sense of purpose.
WHERE TO GO?
From the continued life and work of successful leaders like Dr. Asim
there are many lessons to be learnt and the key is to remain persistent
and to fear nothing.
It may also be useful to remember that in Pakistan, Dr. Asim has been
a pioneer in providing health services but he is now going to try his
luck in United Arab Emirates. It is a different market, The critical
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factors which should be kept in mind before going there could be that,
Are there people present in UAE who are already providing this kind of
service? Will they welcome the school health services provided by Dr.
Asim and his team? Will his leadership and management philosophy
developed for Pakistan work in a different environment? Is he not
becoming too commercial and overambitious?
BUSINESS OPERATIONS
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Figure 1: Showing business operations at Integrated Health Services
Source: Company Documents
TEHREEM’S VERSION
INTEGRATED HEALTH SERVICES
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“Dr. Asim is a very creative individual. He will never

follow the conventional path rather he will try the hardest
thing which comes in his way and also he is very quality
conscious. He never projects his name rather he always talks
about Integrated Health Services. He loves to make systems
and whenever people ask him for using his systems he never
says “no”, he says come and learn. He is never ever a miser.
Asim believes in teams and it is the motivation of Asim which
is reflected everywhere. To work with Asim you should know
him”.
Commented by
Dr. Ali Raza
After proving his success in his native country, Dr. Asim Mahmood, an
entrepreneurial leader was thinking to expand the horizons of his
business. For that purpose he contacted his friends in United Arab
Emirates who will take the charge of his accommodation during his one
week stay in United Arab Emirates. The purpose of the trip was to
make a ground for providing school health services in UAE.
Integrated Health Services- Pakistan was not made as a commercial

organization rather the purpose was to provide quality health services
in the neglected areas. The business of Dr. Asim Mahmood was spread
into seven different units namely Health Consultancy and
Infrastructure Development, Occupational Health and Training, School
Health, Home Medical Care, Emergency and Rescue Services, Clinical
Care, Lab and Vaccination and Corporate Health.
Dr. Asim Mahmood- being the Executive Director of Integrated Health

Services was a pioneer in providing school health services in Pakistan.
He and his wife cum business partner Mrs. Asim are the owners of this
health business and were earning handsome amount of revenues from
their business.
Refer to Exhibit 1 for complete business operations of Integrated
Health Services.
This case was written by Tehreem Waheed as her final year

project under the supervision of Sir Fazl-e-Muqeem, as the basis
for class discussion rather than to illustrate either effective or in
effective handling of an administrative situation.
17
HISTORY
Dr. Asim Mahmood, an M.B.B.S, who graduated in 1992 from
Rawalpindi Medical College, Rawalpindi, has no issue in going abroad
for higher studies after graduation, but he decided not to go abroad
and serve in the area of primary health care. He thought of serving in
this area because he thought that this is the most neglected area and
took a firm decision to do something on his own in this field. Dr. Asim is
not like an ordinary doctor; his career is full of innovative and unique
projects in which he had remarkable success.
He did his MCPS in Family Medicine and MRSH from United Kingdom
and MIOH from Finland.
ESTABLISHMENT OF AIRPORT MEDICAL CENTRE

After graduation, he did his MCPS in family medicine in year 1994 and
started off with a small clinic named as Airport Medical Centre in
Rawalpindi. For establishing this small clinic he took a loan of Rs.10,
000 from his parents. Dr. Asim recalled that he earned Rs.80 on his
very first day at his new clinic and after two months he earned Rs.
53,000 which was a reasonably good amount at that time. People use
to trust this doctor and his revenues began to increase day by day.
Side by side he used to apply for government jobs also when his family
pressurized him because they were of the point of view that
government jobs are more secure and had much more added
advantage over private jobs. This was what the family thinks, Dr. Asim
had an alternate point of view and he never liked serving for
government or any body else. He had an entrepreneurial instinct and
wanted to rule people rather than people ruling him.
START OF GOVERNMENT JOB

In March 1996, he got three government jobs and he joined a
government health institute in G-8 sector, Islamabad. Also he used to
sit at his clinic in the evening from 5 p.m-10/12 p.m. He was never
happy working there, because he was posted in Pathology department
in a health organization, which was not his specialty.
Dr. Asim was never happy and satisfied working there because he
thought that your hands are bound when you are working for some one
else. On the other hand, his evening clinic was going very well and he
checked even 150 patients a day. On the day he received 150 patients
at his evening clinic, he thought that he don’t have the stamina to
check this huge number of patients in evening only. On the very same
day he took a decision that if he resigned from his morning
government job and utilized that time also in his clinic then he can visit
more patients at his clinic. He took a firm decision and he resigned and
18
after resignation he informed his family who were a bit unhappy with
his decision.
THE PAKISTANI FAMILY MODEL

That was the time when the couple was blessed with a baby girl. Mrs.
Asim recalled that:-
“That was a critical time when he left the job, but our
basic necessities were being fulfilled because we were
living with the parents of Dr. Asim”.
She further commented that parents of both Dr. Asim and Mrs. Asim
were very supportive.
Now Dr. Asim can fully devote his mind and energies to his clinic. So he
added a laboratory and a vaccination centre in his clinic and hired
another person for his help. Whatever he earned he invested back into
his business. He was earning handsome revenues from his clinic but his
desire to work in the area of home medical services was not being
fulfilled at his clinic.
THE IDEA BEHIND IHS

In order to fulfill that purpose he established “IHS: Integrated
Health Services”. He named the company “Integrated Health
Services” because he practically integrated all the services in this
organization. Dr. Asim remarked that:-
“My dream was never to buy flashy cars and

property; rather I wanted to do something for the
society”.
For doing so, he created health systems in the private sector because
he thought that you can’t rely on government to do all the things. In
fact government can’t do all things and people in the private sector
have to do good things. He further explained that:-
“I wanted to become an employer rather to be

employed”.
He convinced his family by saying that “cobbler is self employer

and is responsible for his own work”.
BACK GROUND: IHS

In mid 1997, this entrepreneurial leader Dr. Asim Mahmood was
successful in establishing IHS with major emphasis in providing
19
services in three things namely, home medical services, laboratory

services ( at the door step of clients) and school health
services. The first two were his own ideas, and the third was
presented by Dr. Zahid, who was school health advisor at a multilateral
agency. When Dr. Zahid left his job from this multilateral agency, he
suggested Dr. Asim to introduce the concept of school health services
in Pakistan because it was a neglected area till then.
To start with providing home services, 1000 flyers were printed, and
were thrown in the houses of Sector F-8 and F-7 of Islamabad. The flyer
said that if you need any kind of health services at your door step call
at our help line. For details of flyer see Exhibit-2 .Dr. Asim received a
phone call on the third day after distribution of flyers. The call was
regarding the vaccination of Hepatitis B at a house located in sector F-
8/3 of Islamabad.
Fortunately, the patient was a prominent political leader and the other
patient was Member of National Assembly, of Pakistan. Dr. Asim’s
business broke even at the same day which fulfilled the cost of printing
flyers. See Exhibit-3 for the initial receipts. With the passage of time it
began to spread with the word of mouth and the business of providing
home services at the patients door step started flourishing. The
intensity of calls increased day by day. They were receiving calls for
checking blood pressure, blood sugar and blood vaccination. At that
time Dr. Asim hired a paramedic Mr. Saeed Hashmi who was the first
employee at IHS. Mr. Saeed joined Integrated Health Services in the
year 1997. Before joining IHS he spent 18 years in Pakistan Air Force in
the nursing department. Dr. Asim chose Mr. Saeed Hashmi as a final
candidate for his health centre from a long list of candidates.
Mr. Saeed recalled that:-
“Previously I was serving Pakistan Air force and

working there was a straight forward thing. When Dr.
Asim told me about his future aims I joined Integrated
Health Services”.
Refer to Exhibit 4a for the verbatim and refer to Exhibit 4b for the
video recorded interview of Mr. Saeed Hashmi.
Side by side Dr. Asim went to different schools for introducing this idea
of school health services. As it was a new idea in Pakistan so it was a
hard challenge to persuade the heads of schools. Dr. Asim was an
optimistic person so he never loose hope.
Mrs. Asim elaborated that:-
20
“Dr. Asim is very optimistic in nature; he never

creates fuss or makes issue of any problem/hurdle which
comes in the way rather he thinks that every problem is
God given and He will provide the solution also”.
STRONG FAITH AND THE ULTIMATE BELIEF IN GOD

Dr. Asim had strong faith on Almighty Allah, he believed that:-
“Whatever happens, either good or bad, it happens due to

the will of God”.
ROLE OF PARENTS AND WIFE IN MAKING DR. ASIM SUCCESSFUL

Mrs. Asim- being the mother of two kids is also a doctor by profession
and she explained that being in the same profession was an added
advantage for us because we realized the problems of each other.
After the birth of baby girl she took a one year gap and then she went
to school health area. Mrs. Asim wanted to pursue in surgery but as Dr.
Asim was also very busy so her wife sacrificed for the sake of kids and
family and pursued in Radiology. But later she left radiology and joined
the business of her husband. She is very happy and satisfied with
whatever she dropped out because of her children and family and had
no regrets at all. As a doctor she wanted to help the society and she is
contributing his share for doing so. Currently, she is doing Masters in
Public Health from a private institute.
While commenting about the critical times which she faced in the
career of Dr. Asim, she explained that at first when he initially started
his career he got three jobs in a line. But he was never willing to do
government job rather he wanted to be an entrepreneur but the family
wasn’t expecting the fact. But Dr. Asim persuaded his family on this
government job issue. His wife remembered that at that time (and
even now) whenever he talks he is very convincing so he convinced
the whole family. So, after a year of government job he left that job.
Although, ups and downs were there but the wife was confident
enough that her husband will do something to bring the situation at a
level which will be acceptable to both the families. Also, she remarked
that “Asim is very good at hiding things” and
“Asim doesn’t portray the problems as problems

rather he always thinks of new things”.
Mrs. Asim stated that her parents in law are very supportive and they
helped them in every problem and never let them alone. Rather the
father of Dr. Asim provided with good advice at every step at his career
and the mother is always praying for his son’s success.
Mrs. Asim explained that:-
21
“I am very much privileged that we are living

together (i.e. with the parents of Dr. Asim)”.
Mr. Saeed Hashmi commented that:-
“Mr. Bashir – the father of Dr. Asim has a very

supporting role for the whole staff of IHS and he
is a very good person”.
CONTINUOUS STRUGGLE
He struggled and worked very hard alone but continued the journey
and never felt disappointed. Dr. Shahid recalled about this
entrepreneurial leader and his close friend Dr. Asim that:-
“He is very consistent in nature and he never left

hope although there was no success and no
revenues at that time”.
He continued visiting schools and presented his idea during the year
1997 but unfortunately he didn’t get any client. He didn’t lose hope
and continued his visits and got his first client in the area of school
health services in 1998. Dr. Shahid recalled that in the beginning:-
“Dr. Asim used to work continuously for even 18-20

hours for establishing IHS and for making
systems”.
The idea of school health services attracted the head of a private

school in Islamabad. So, the first clinic at school was made whose
annual charges were Rs. 250, 000 which were provided in advance by
the head of the school. Another private school in Rawalpindi also took
services in school health care from them.
FAMILY LIFE
Mrs. Asim- as a mother of two kids remarked that “we miss out in
Socialization, I go on my own, unlike other couples” and further
elaborated that:-
“Everybody has to do some sort of adjustment in his/her

married life”.
22
But, she had no regrets and commented that “Asim never made a
wrong a decision”.
She remarked that:-
“My career is compromised career and I have no regrets

and I don’t want to put my kids at stake”. She further elaborated
that” one has to set his/her role and priorities and then work
accordingly on that”.
Dr. Asim is very busy individual but he never missed out the story
telling part for his children at 9pm every night.
Although her wife described that:-
“At times he doesn’t even remember that in which class

the kids are studying in” and “Dr. Asim promotes that her
daughters will run over the business in the future when the
parents will get old”.
DR. ASIM AS A SOURCE OF MOTIVATION FOR STAFF AT IHS

Mrs. Asim commented that “Dr. Asim has been a source of
inspiration for his friends” and also his way of thinking is
“conviction and hard work is required for whatever you are
doing”.
She recalled that:-
“Partnerships never suited us, we were always

deceived”.
But she said that good and bad people are in every society and she
gave the credit to the society by making a final comment that:-
“Whatever we are, we are because of this

society”.
FAMILY FRIENDLY ENVIRONMENT

The Director projects remarked that:-
“It is the team work and family friendly environment

within Integrated Health Services which is a reason behind its
success”.
The Manager home medical care mentioned that:-
“It’s a family friendly environment here at Integrated

Health Services”.
23
There is no issue of timings as far as you complete your work and

satisfy the clients. Also there is an issue of trust, Dr. Asim trust us a lot.
These are the reasons which don’t let us leave IHS.
GROWTH OF HUMAN CAPITAL

At that time the human resource grew to a team of 8 members in
home care and a team of 8-10 persons in hospital. Mr. Saeed recalled
that:-
“Dr. Asim gave me free hand and encouraged me to hire

individually other male and female nurses. He trusted me to
that extent that he made me accountant also. Now, I am
working as Manager Home nursing care”.
The Director Projects believed that:-
“The IHS staff was working from the heart at that

time”.
Dr. Asim thought to further expand his business and after entering into
school health, the next target was to start home nursing care services.
START OF HOME NURSING SERVICES

When Dr. Asim started providing home nursing services, the demand of
home nursing services began to grow in the twin cities of Rawalpindi
and Islamabad.
Another remarkable achievement of Dr. Asim and his team was that,
they successfully provided ICU- services for thirteen days, at home in a
room for a female patient residing in Islamabad, who was suffering
from Hepatitis-C. The lady suffering from the disease was the wife of a
building contractor in Islamabad. The person took his wife to London
for medical services and she remained there for sometime but didn’t
get well. So the man thought to bring his wife to their home back in
Pakistan, as was the desire of the couple. As the lady was a very
serious patient and needed ICU- services so they contacted Dr. Asim.
Dr. Asim and his team successfully provided the services at home. Dr.
Shahid recalled that:-
“When we provided ICU service at the door step of a
patient we provided medical instruments from thermometer to
ECG machine on our own”.
Refer to Exhibit 5a for a detailed verbatim of Dr. Shahid Nadeem

working currently as Director Projects. Refer to Exhibit 5b for video
recorded interview of Dr. Shahid Nadeem.
24
Dr. Asim hired doctors and trained ICU nurses. At that time school
health and home care businesses were going pretty well, and the next
target was to provide services at corporate level.
ENTERING CORPORATE SECTOR: 1998-1999

By the end of year 1998 and start of 1999, Dr. Asim made proposals for
different organizations like leading multinationals in oil industry and
tobacco industry for providing vaccination services.
HEALTH SERVICES FOR BEACONHOUSE SCHOOL SYSTEM

In year 1999, Dr. Asim got a chance for making remarkable
achievement in the area of school health services. One day he got a
call from the head of Beacon House school system, Lahore to come and
present about the idea. Dr. Asim went to Lahore on the call of the head
of the school. He presented his idea and got the contract. The target
was to provide vaccination services to all students in all branches of
Beacon house school system throughout Pakistan in three months and
Dr. Asim along with his dedicated and hard working team did that
successfully in the provided time frame. The number of students in all
branches of Beacon house school system throughout Pakistan were 52,
000, who were provided with vaccination services. Refer to Exhibit-6
for the service contract details. Dr. Asim earned Rs. 25 per child for
vaccination. After that, Dr. Asim got another opportunity in the area of
school health services that was to establish health system at another
private school.
At that time, the business was spread to providing home health care,
corporate health and vaccination services.
END YEAR 1999 & START 2000

In the year end 1999, Dr. Asim and his team thought to provide
vaccination of Hepatitis-B to Islamabad Traffic Police. For that purpose
Dr. Asim had a dialogue with ISP Mr. Nasir Durrani, who was influenced
by the idea and vaccination services were provided to the whole staff
of Islamabad Traffic Police. This opportunity created worth and
credibility for Integrated Health Services.
Also this opportunity created another opportunity. The opening
ceremony of Rescue 15 was to be inaugurated on 1st January, 2000
and the IHS team provided free of cost emergency services round the
clock till year 2004. Rescue 15 is a public sector organization for relief
and help in the emergency, accidents, thefts and other disasters. At
that time Dr. Asim didn’t had enough revenues to buy ambulances so
The Red Crescent Society volunteered two ambulances to Rescue 15
where IHS team was providing free of cost services.
After that another milestone of IHS was to provide emergency medical

coverage to the Development Arm of a Multilateral Agency. IHS had the
25
honor, being the first to provide expatriate health services to an

Embassy.
A multinational petroleum company requested Dr. Asim and his

team to provide field hospital in Sindh. Later on, the IHS team also
provided field clinics in the provinces of Sindh and Baluchistan.
In 2002, due to time constraints, Dr. Asim sold his first Rawalpindi
Hospital as a running business.
Also in May 2002, IHS joined the Hashwani group and Dr. Asim
provided Medical coverage to Marriott hotel, being an OPI. In May
2003, Dr. Asim resigned from Marriott Hotel. Dr. Asim is clinically a
good physician and served as Chief Medical Officer for Hashu group
and is providing medical services in all branches of Marriott hotel.
Refer to Exhibit-8 for details of the service contract.
JOINED DISTANT LEARNING PROGRAM

Then Dr. Asim applied for a distant learning program in occupational
health and got membership in Finnish Institute of Occupational Health,
Finland. Dr. Asim had the honor of being the third Pakistani who got
this training in occupational health. Refer to Exhibit-9 for degree of
Finnish Institute of Occupational Health In year 2005, Dr. Asim further
expanded his business and started Research and Health consultancies,
which is currently the highest revenue earning area.
Dr. Asim provided National Guideline for Prime Minister Health
program.
UAE RED CRESCENT CLINIC- BALALOT

IHS had the honor of providing free health services in Balakot for the
earth quake hitted patients. UAE Red Crescent Clinic was established in
the year 2006 in the Balakot area of North West Frontier Province of
Pakistan. The staff of this clinic comprises of 17 employees including
two lady doctors, two male doctors, security guards, dispensers,
computer operator and sanitary workers. Dr. Asim from IHS Islamabad
is administrating this clinical unit and monthly record is sent to IHS,
Islamabad. The doctors here are in touch with the Dr. Asim and
whenever they need any help and guidance, Dr. Asim is there to
provide it. Mainly the patients who come here for treatment are
suffering from skin diseases and seasonal problems. The patients from
Kaghan, Naran, Mansehra and Ghari Habibullah also come here for the
treatment. IHS, Red Crescent Clinic Balakot has the honor of serving 1,
40,000 patients, free of charge till now. The health ministry of United
Arab Emirates is providing funding for this clinic and funding for six
months is provided from UAE embassy to IHS Islamabad and from
Islamabad the funding is provided to this clinic. This clinic is an OPD
unit and severe referral cases are transferred to Ayub Medical
Complex, Abbottabad. Health advisors from IHS Islamabad come here
26
for creating health awareness for the masses and seminars are
arranged for that purpose. Mostly seminars related to personal hygiene
are arranged for the masses. Refer to Exhibit-10 for video recorded
interview of Dr.Jhangir.
MANAGEMENT HIERARCHY AT IHS

IHS has 126 regular employees and the number of temporary
employees varies from time to time. For the deployment chart of
employees refer to Exhibit-11.
MASS VACCINATION CAMPAIGNS

In the year 1997, Dr. Asim thought to create awareness of hepatitis C
in the masses, but it didn’t prove to be successful. At that time nobody
else was providing these vaccination services. IHS provided vaccination
services at different camps made at different places because people
can’t afford to come at their centre in which vaccination service was
provided. Dr. Asim made Mr. Saeed the in charge of home medical
care and made a team of 4-5 people, who use to go for providing
vaccination services at the doorstep of clients.
Then they thought to introduce this program in different schools and
colleges of Islamabad which fortunately proved very successful.
Dr. Asim mentioned that:-
“I earned revenues up to 88 thousand a day during
vaccination in Islamabad College for Girls F-6/2,
Islamabad”.
That was the maximum revenue which he earned in this program. In

other schools and colleges he earned revenue from 50-60 thousand per
day at that time.
With this success, he thought to move towards corporate vaccinations

for Hepatitis B, Dr. Shahid remarked that:-
“Vaccination of Hepatitis B and C and provision of health

services at the doorstep of clients are the two major
contributions of Integrated Health Services”.
At that time, he started the trend for vaccination registration. Uptil

December, 1998 1.2 Million vaccinations were been registered, but the
profit margin was very low in vaccinations. The return per vaccination
was not more than Rs. 30, so he thought to quit from this business
area.
QUALITY CONSCIOUS
Another reason was that many other people have entered into this
business, which was using low quality vaccines imported from China.
27
The group of people who were selling these low quality vaccines also
contacted Dr. Asim and offered him to use the same vaccines which
also had a good profit margin than the original ones. Dr. Asim bluntly
rejected the offer because he believed that:-
“In medicine we never compromised on quality”.
IHS- PRACTICING ETHICAL PRACTICES

Dr. Shahid Nadeem mentioned that:-
“No other organization is working like Integrated Health

services with ethical practices and standard operating
procedures”.
Currently, I am working as Director Projects. When IHS was established,

there was no competition at all. Unique services at the door step of
clients were being provided at that time from the platform of IHS. We
use to take very low profits for superb services which we provided,
because at IHS we can’t compromise at quality. Our motto was:-
“Client satisfaction no matter if we were getting low

revenues. The purpose behind the establishment of IHS
was not to make money but to provide quality service”.
Dr. Ali Raza acknowledged that:-
“IHS believes in making systems and efforts should be

done to meet standards”.
DECEMBER 2002: INITIATED TRAININGS

In December 2002, the business volume of IHS was getting low, so in
May 2002 Dr. Asim took a decision to join a leading company in the oil
sector. Also he thought to start providing trainings of first aid in
corporate and school level and consulted Pakistan Red Crescent
Society for that matter. Dr. Asim and his dedicated team launched a
program known as “FATS” abbreviated as First Aid Training for
Schools. The duration of the training was six hours. Dr. Asim, himself
was the master trainer and he trained his staff, so that they will be able
to provide trainings at different schools. A contract was made and duly
signed by IHS and Pakistan Red Crescent Society that they will provide
combined trainings in all schools of Pakistan. They were charging Rs.
250 per student in some schools while in some others the charges
were Rs. 300 and Rs. 400.
28
It was decided in the contract that Rs. 2000 per training will be given to
Pakistan Red Crescent Society. But, after two, three months the head
of Pakistan Red Crescent Society ended the contract. Later on, the first
aid trainings were provided solely by IHS. As the profit margins were
low in schools and colleges so Dr. Asim thought to shift to corporate
sector for the same trainings.
CORPORATE SECTOR: FIRST AID TRAININGS

Entering the corporate sector with this thought proved very successful.
The first call came from the Development Arm of a multilateral Agency.
IHS charged Rs. 25,000 for providing first aid training to the staff of this
agency.
After successfully delivering the trainings at this agency, the next
client was a leading multinational in the tobacco sector. The first aid
trainings for this tobacco company were provided at its different
factories in different cities. This was a major hit for IHS and the top
management at this leading tobacco company was very much
impressed from Dr. Asim and his team. The top management asked Dr.
Asim that what other service they can provide to them. Dr. Asim said
that IHS can provide you trainings in occupational health, general
health and ergonomics. Also the top management requested Dr. Asim
to assess their tobacco factories and report to them what were the
deficiencies and loop holes. Dr. Asim did the same and reported to top
management. Dr. Asim gave a proposal of worth 1.8 Million and it was
decided that trainings in general occupational health (for factories
workers and office staff), ergonomics trainings (for office staff only)
and first aid trainings for both will be provided in one year. Dr. Asim
and his team not only provided the trainings but also gave
recommendations to this tobacco company. This tobacco Company
remained a client of IHS from year 2003 till now.
Also side by side Dr. Asim was providing trainings in occupational
health in different oil companies.
Another client for trainings in the corporate sector was a multilateral
agency working for labor relations. A doctor from this agency
contacted Dr. Asim and requested to provide trainings in stress
management. This was a 4-5 day training session which was provided
in a Continental Hotel, Bhurban. Dr. Asim earned Rs. 75,000 per day
from this training. The top management of this agency was also
present in the training session and they felt very happy and satisfied
from the training.
COMPENSATION
The Manager home medical care being the very senior employee at
integrated health Services remarked that:-
29
“He gives us (the IHS staff) handsome salary plus a

yearly increment in pay. Also if any body among the staff
needed any sort of financial help he provided us that,
even up to hundred thousands in the hour of need”.
RESEARCH AND CONSULTANCIES

Another vital area in the operations of IHS was research and
consultancies. Dr. Asim had the honor of providing National Health
Guidelines for the Prime Minister program for viral hepatitis case
management. It took two years for the whole activity because the
gastronologists all over Pakistan were called and after discussions and
workshops consensus was made and then the guidelines were
produced.
COMPLETE HEALTH CARE FOR CORPORATE SECTOR

After that, another milestone of IHS under the supervision of Dr. Asim
was that they thought to provide complete health care requirements to
different companies.
Dr. Asim made a complete list of areas in which they can provide
health care services in the corporate sector. The list includes the
following areas:-
 Managed health care ( IHS was pioneer in introducing this
concept)
 Training services
 Creating health awareness
 Arrangement of hospitals on panel for employees
 Claims verification of medical bills
 Rescue and emergency care for employees based in Rawalpindi
and Islamabad
 Providing health policies
 Acting as health contractors ( IHS was pioneer in this field, and
was providing health contracting services in oil field in oil
companies)
While acting as health contractors, IHS sent his doctors to the oil fields
in Oman also.
DELEGATION OF RESPONSIBILITY
Many other companies also contacted IHS for trainings in stress
management and Dr. Asim and his dedicated team provided those
trainings. In all these trainings Dr. Asim himself was the master trainer,
as the load of trainings were increasing day by day and Dr. Asim felt
that he cant provide all the trainings himself, because he also had
other tasks to do .
30
So he hired another doctor, Dr. Alamgir who took charge of providing

first aid trainings from year 2005-2008. But, Dr. Asim still needed other
trainers so he started building teams of trainers. He believed that :-
“The company had the base and the trainer had the skills
which makes training successful”.
Whenever Dr. Asim hired a trainer for providing trainings in a particular
area, he decided to pay them one third of the revenue which IHS will
earn.
According to Dr. Asim, running an organization is not a “one man
job”. He had this concern that what will happen if one day he will
become ill, then who will run after the whole business. He believed that
good, loyal, honest and sincere people are required for doing this
business. He remarked that I have handed over the charge to other
loyal doctors for the F-10 children hospital and things are going well
this way. He gave the credit to Dr. Ali Raza and Dr. Shahid Nadeem for
running successfully the children hospital. He delegated responsibility
to other individuals who are loyal and honest. While delegating
responsibility Dr. Asim came out of the day to day operations and he is
at the strategic and planning level now.
LOOSING MONEY BUT NOT SYSTEMS

Dr. Asim made directors for running the various segments of the
business. He commented that:-
“I would loose money but would not loose
systems”.
For him, systems which he made matter a lot rather than money.
I-8 INTEGRATED HEALTH SERVICES HOSPITAL

I-8 Integrated Health Service centre is basically a satellite facility and
the OPD sector which runs from 9am to 9pm. Dr. Ali Raza being the
Director Charge and Services is responsible for the operations of I-8
IHS centre, F-10 Children Hospital and school health.
DR.ALI RAZA -DIRECTOR IHS CHILDREN HOSPITAL

Dr. Asim had a children hospital in the posh area, F-10 of Islamabad.
The hospital broke even after three months. Dr. Ali Raza being the
Director of Integrated Health Services Children hospital F-10 Islamabad
commented that the idea of this unit stemmed from the need. Roughly
out of every hundred (100) people 45-50% comprised of children who
are less than 15 years of age. For catering the health needs of children
government hospitals are there but there are a limited number of beds
for children and quality health services are also not provided to them.
So, as the aim of Integrated Health Services is to help the society and
create health awareness in the masses. They thought to establish a
31
sub branch of IHS and name it is IHS- Children Hospital and this unit is
located in the posh area of Islamabad. IHS Children Hospital is a year
plus now. The environment of the hospital is made keeping in view the
psychology of the children. Refer to Exhibit 12 for the video recorded
interview of Dr. Ali Raza for details of thematic rooms.
Time Duration 1st quarter 2nd quarter 3rd quarter Currently

No. of Patients 400 600 1000 > than 3500
HELPING THE POOR AND NEEDY CHILDREN

Free of cost health services are provided to the poor and the needy
children at this service unit. A charity profile is made for such type of
needy children. The health of a child is not compromised in any way no
matter whether the needy child’s parents had paid for the service
taken or not.
FEED BACK SYSTEM
A feed back system is maintained in this children hospital and
according to this feedback system the satisfaction level of the clients is
100%. Parents are very much satisfied from the services which are
provided here. Also the response time is very quick here. Doctors and
other medical staff gave the patients enough time and enough care so
when the parents leave the hospital they are very much satisfied for
two reasons. First reason is that their ailing child is cured now and
secondly the doctors and staff treated them very well. Also follow up
calls are made, a day after the child is discharged from the hospital
just to inquire about his/her health. All the parents which come here for
the treatment of their child are referred either by their friends or
relatives. So, the promotion of this health centre is mostly done by
word of mouth.
ROUND THE CLOCK HEALTH SERVICES
The very unique thing about this centre is that it provides 24-hours
health services to the patients. There are two shifts of doctors whose
contributions are the reason behind the success of this hospital. One is
the IHS staff and the other is the visiting staff present at this centre.
The IHS staff is the permanent staff which serves here round the clock
in shifts of eight hours. Among the visiting staff two doctors are always
present at the centre for serving the society. Two files are maintained
for the record keeping of every child. One file is maintained in the
hospital record and the other file with complete information is handed
over to the parents of the child. So, the health services provided at this
hospital are very much personalized services.
CLIENTELE IMPACT
32
The Director Projects at IHS remarked that:-

“Dr. Asim doesn’t have a bossy attitude at all rather his
emphasis is on services provided to the clients”.
Our ultimate aim is that:-
“Task should be fulfilled and client should be satisfied,

the environment is not tensed here like other organizations. I
own everything here at IHS and I work independently and no
matter how big offer I get from outside world I will reject that
for the sake of IHS”.
The mother of Ms. Salma Khan is a client of Integrated Health Services

from the last ten years. Ms. Salma commented that:-
“My mother is old and ill as she can’t walk and
communicate so I am availing the home care services from HIS
since their beginning and I am a very satisfied client. They
provide twenty four hours medical services and when you call
them its like a hospital coming into your home. They know me
and my mother very well and I know them very well. I have
confidence in them as I have crossed many bridges with IHS
because of my mother’s illness”.
The lady was so much impressed and satisfied from their home care
services that she is writing a book named as “Hand on a shoulder”
on her experiences with her ill mother and the services which should
be provided to such kind of patients. The book is based on her personal
experience and once it is completed it will be distributed free of cost.
Refer to Exhibit 13a for the video recorded interview of Ms. Salma
Khan.
Dr. Tariq is working as a health advisor for a large multinational

company in Islamabad. As a health advisor they are availing the
services of Integrated Health Services for their multinational. Dr. Tariq
is responsible for the clinical and personal health of all employees at
his company. He remarked that the number of reasons for which we
chose IHS were:-
 IHS has better infrastructure

 Requisite experience of working with other
multinationals
 Worked in the area of school health care
 Worked voluntarily during earth quake
 IHS – being the pioneer in their work
 Are trust worthy and have a very good team
33
IHS provided first aid trainings to our employees and also is looking
after the vaccination services of our employees. Also they gave
trainings to the staff of this multinational company to make better use
of office equipment. Dr. Tariq another satisfied client commented that:-
“Very few people are there, who have worked in the area of
ergonomics and Integrated Health Services is among one of
them”.
Refer to Exhibit 13b for the video recorded interview of Dr. Tariq.
GLOBAL FUND FOR AIDS, TUBERCLOSIS AND MALARIA

Another remarkable success of this entrepreneurial leader was working
in a health project which was funded by a multinational working under
health sector. Third world countries are funded by this multinational
.So, in round six for Tuberculosis Dr. Asim applied for the fund for
creating awareness in school children. The program under this
multinational was to make school children as ambassadors in their
communities. The function of these ambassadors will be to create
awareness in their communities regarding tuberculosis. Dr. Asim
remarked that:-
“There are eight things which are of vital importance which
should be known to people in rural areas”.
The purpose of establishing school tuberculosis club was to promote
volunteerism in students. School tuberculosis club is a five year nation
wide program and is first of its kind in Pakistan. Currently this program
is working in ten districts of Pakistan but it can be spread across all
over Pakistan, because it is scalable and extendable program.
HEALTH RADIO
This idea focused and innovative entrepreneur leader had another
milestone coming in his way which is the concept of Health Radio. Dr.
Asim made a concept paper for this project. This project basically talks
about a twenty four hour live radio transmission for providing medical
health advice to the masses. This Health Radio will basically provide
two major functions:-
 Health talks by specialist doctors
 To provide emergency health services
Currently, work is being done on this project with the financial
assistance of a developing agency working under a multilateral
organization. This project was made to serve the whole country but
currently a pilot program is being aired on local radio station FM 88 in
district Chakwal only. It will be a half hour Radio program which will be
aired thrice a week. Three people will be involved in this radio program
namely an anchor, a gynecologist and another medical specialist.
These radio programs are meant to serve the purpose of creating
34
awareness and providing medical advice to women in their child

bearing age. Also for providing emergency services the mapping of
Chakwal city is being done by this developing agency. The budget
required for this activity id $ 8.2 Million. In the year 2009 twenty
percent financing will be provided by Dr. Asim and the rest eighty
percent will be provided by this developing agency.
The pilot program will be run in Chakwal city only, and time buying is
made from FM 88 but a proper radio station is required in order to
serve twenty four hours of medical health and advice. For that purpose
Ministry of Health, IHS and this developing agency have joined hands
together and made a consortium and have applied for a radio channel
license from the license issuing authority, PEMRA.
ROLE OF DR.ASIM IN MAKING IHS SUCCESSFUL

Dr. Tariq (the health advisor of a large multinational being the client of
IHS) had the view that:-
“I know Dr. Asim for a long age, he is a very good

physician, and I found him committed for whatever
he is doing. He has a vision and he is working rightly
for the achievement of that vision. Also he tries to
work in a better environment for the betterment of
the people of his company and he is going to
achieve that one day .Asim is a kind of person who
works very hard and in his case I must say
“Persistence always pays” ”.
Commented
by Dr. Tariq
A very satisfied client who is availing health services for her mother
from the past ten years said that:-
“I respect his diagnostic and clinical ability. As a

doctor he is brilliant. There are a lot of good people
working in this country who are working for the
betterment of the society. I think it’s a wasted life if
you don’t help others in the hour of need”.
Commented by Ms. Salma Khan
Director Projects stated that:-
“Dr. Asim is stick to the same business from day one

with the same zeal and motivation. He never left
IHS, although he got many offer from abroad also”.
35
Commente
d by Dr. Shahid Nadeem
Director IHS children hospital believed that:-
“Asim had a novel way of doing things. He brings

into reality his imagination”.
Commented
by Dr. Ali Raza
Manager Medical care and being the most senior employee of IHS
stated that
“Dr. Asim don’t have any bossy attitude. We have

no fear of him, he is like my brother. He says me,
“you are my elder brother”.
Commented by Mr. Saeed
Hashmi
“Dr. Asim is a very good administrator”
Commented by
Dr. Jhangir
TRAINING BUISNESS
Training business is going down due to the economic conditions in the

country. The organizations which require first aid, fire fighting and
disaster management trainings now negotiate at the cost at which the
training is provided.
SCHOOL HEALTH
On the other hand, business in the school health sector was going very
well. Currently IHS is working as the market leader in school health
area.
“Now after almost 10 years in school health IHS is a

market leader in provision of various types of health services
to the educational institutions in Pakistan. Due to our
commitment and non-commercial and professional approach
36
IHS is the largest operator of school health in the country with

over 0.8 million students enrolled so far and 223,180 current
registrations (till June 2007) “.
Mrs. Asim, being the life cum business partner is running the school
health area of the business.
EMPLOYEES FEEL A SENSE OF OWNERSHIP
Dr. Shahid Nadeem believed that “-
“Everybody feels a sense of ownership and this

particular feeling does not let us leave Integrated Health
Services, although we have options but we don’t want to
avail them”.
The Integrated Health Services staff worked with Dr. Asim, free of cost
even at the time of need. An era came, when Dr. Asim called a meeting
and commented:-
“If you are willing to leave IHS you can go, but nobody
left Dr. Asim at that critical time rather the staff
worked free of cost with him”.
LIFE TIME CONTRIBUTIONS FOR IHS

Dr. Asim gave the credit to his parents and wife for their endless
support which they provided to him are still providing. He mentioned
that:-
“I worked for even 18-20 hours continuously but

they never complained”.
The struggling life of Dr. Asim talks about a Pakistani model of working
in which the support of parents and wife matters a lot.
He thinks that the following successful events are a milestone in his
career:-
• Dr. Asim considered the setting up of ICU service as being a
milestone in his career path. That successful setting of ICU
service enabled the newly established business to enter into
home care with full power.
• Another successful event which he will never forget is entering

into school health business.
37
NEED FOR PROMOTING HEALTH SERVICES

Whatever work has been done in the last 13 years since the
establishment of IHS till now, 75-80% things have worked only 20%
things failed. Dr. Asim is so much optimistic in nature that he is even
happy and satisfied on the failed things because he said that at least I
have worked and tried no matter I failed. He thought that there is a
strong need for promoting health services in the country. The life of Dr.
Asim is an emblem for the masses, depicting that there are individual
who are brave enough and have the power to work for the betterment
of their country no matter how many hurdles come in their way and
how worsen the situations may be.
Dr. Asim had this view that “there is a consumer every where” and
the economic conditions of the country does not matters a lot. He gave
the example that people are making a handsome amount of money
even in Afghanistan. Dr. Asim believed that a lot more has to be done
in health sector of Pakistan. A good amount of aid is also coming to our
country but unfortunately, that aid is being misused. He remarked
that:-
“I wish that the aid is used properly at the right

place”.
The Director Projects had this vision that in the future they will spread
this home care service to other cities like Karachi and Lahore.
FUTURE OF IHS
The key to success is to remain consistent and moving forward,
without regretting at the losses. He had this view that if you have the
will to do something for the society and for the sake of your country
then you can easily accomplish your tasks, no matter how worsen is
the condition of the country. He said that it also depends in the
industry in which you are working. People can’t compromise on their
health no matter how bad the economic conditions are in the country.
Every body is concerned about his health and wanted a better
treatment. Over the last one year, things have changed a lot. In
Pakistan businesses are going down and large lay offs have been
made. But, Dr. Asim believed that:-
“Health is a sector which will never go down, because

everybody is concerned about his health and can’t compromise
on it”.
38
In Pakistan, Dr. Asim was a pioneer in providing health services but he

is now going to try his luck in United Arab Emirates. The critical factors
which should be kept in mind before going there could be that, Are
there people present in UAE who are already providing this kind of
services at schools? Will they welcome the school health services
provided by Dr. Asim and his team? How will he convince the head of
schools there? Do they really need these services?
Exhibit -1
BUISNESS OPERATIONS
39
Figure 1: Showing business operations at Integrated Health Services
EXHIBIT- 2
DETAILS OF FLYERS
40
EXHIBIT- 3
INITIAL RECEIPTS
EXHIBIT- 4a
VERBATIM OF MR. SAEED HASHMI
Mr. Saeed Hashmi – being the very old employee of IHS is working
currently as Manager Medical care. In the beginning, I joined as a
screening and vaccination officer. Also, Mr. Saeed recalled that there
were some old and needy patients who required our home care
services for checking blood pressure and temperature. Integrated
Health Services was pioneer in providing such unique services at
homes of clients. A file is maintained for such older patients and as IHS
was providing 24- hour’s service so some old patients avail their
services during night time and some patients used to avail health
services during day time.
HELPING THE POOR AND NEEDY
Dr. Asim is a generous, humble and down to earth individual. He
helped the poor and needy patients from his own money. There are 8-
10 patients who are provided with five thousand per week for the sake
of their treatment. He is always in search of good, honest and loyal
people who can contribute in the society by becoming a part of
Integrated Health services. Dr. Asim had a very good team which is
also a reason behind his success.
EXHIBIT- 4b
VIDEO RECORDED INTERVIEW OF MR. SAEED
HASHMI
EXHIBIT- 5a
VERBATIM OF DR. SHAHID NADEEM
Dr. Shahid Nadeem- a friend and class fellow of Dr. Asim Mahmood did
his M.B.B.S from Rawalpindi Medical College, Rawalpindi in 1992. Then
he did his house job and ended that in 1994. Dr. Shahid did his MCPS in
family medicine and established a clinic in Faizabad. As both Dr. Asim
and Dr. Shahid were class fellows and friends so they were in touch
with each other. Dr. Shahid was getting fewer patients at his private
clinic so he was a bit worried. Dr. Asim asked Dr. Shahid to join IHS in
the evening time while continuing his private practice in the morning at
his Faizabad clinic.
Dr. Shahid was persuaded by this unique idea of Dr. Asim of

establishing a health centre named as Integrated Health Services, so
he joined him. As the idea was very novel also there were no
competitors at that time. Dr. Shahid left IHS in 1999 for doing MCPS
41
and winded up the set up of Faizabad clinic. He again joined Integrated

Health Services after his specialization. At that time, both the friends
established the home care services.
Dr. Shahid left IHS and joined Shifa International Hospital, Islamabad
with a good salary package. Due to some family constraints Dr. Shahid
resigned from the Shifa International Hospital and again joined
Integrated Health services. Dr. Shahid got an offer from Saudia Arabia
and went abroad. After 2.5 years, he again resigned from the job and
came back to Pakistan due to family problems. Dr. Asim again offered
his friend Dr. Shahid to join Integrated Health Services. It’s been three
years now, I am working for IHS after returning from Saudi Arabia. Dr.
Shahid stated that “I am Director Projects now; previously I
worked as Director Home care”.
He commented upon the need and scope of Public health Dr. Shahid
stated that “Public health and family medicine has scope and I
privately did Masters in Public Health”.
I see myself growing in Integrated Health Services 8-10 years down the
road. Our health business will remain the same; we have no threats in
this area.
EXHIBIT- 5b
VIDEO RECORDED INTERVIEW OF DR. SHAHID NADEEM
EXHIBIT- 6
SERVICE CONTRACT WITH THE SCHOOL
Exhibit-7
SERVICE CONTRACT WITH MARRIOT HOTEL
Exhibit-8
DEGREE OF FINNISH INSTITUTE OF HEALTH
Exhibit-9
VIDEO RECORDED INTERVIEW OF DR. JHANGIR
Exhibit-10
MANAGEMENT HIERARCHY AT IHS
Exhibit-11
THEMATIC ROOMS
The environment of the hospital is very soothing and relaxing. The

children are not frightened from the hospital because their favorite
42
stuff toys are placed every where in the hospital. The rooms in which
the children are admitted are known as “thematic rooms” rather
named as “room #1, room #2” and so on. There are basically three
thematic rooms named as the “blue”, “yellow” and “purple”
thematic rooms. The yellow thematic room has yellow bed cover,
yellow wall paper and yellow stuff toys which are made just to ease out
the child and the child feels at home in this scenario. The children who
come for regular check ups are provided with gifts by the doctors.
These presents are bought by the doctors themselves from the market
and the busy doctors have to take out time for this activity from their
busy schedule. These gifts include story books and stationery items
like pencils, colored markers, coloring pencils, sharpeners and erasers
etc.
BIRTHDAY REMINDERS
Apart from this, a profile is maintained for every child and birthday
reminders are sent to the children. The children whose vaccinations
are due are given reminders a day or two days before from the hospital
staff.
Exhibit-12a
VIDEO RECORDED INTERVIEW OF MS.SALMA KHAN
Exhibit-12b
VIDEO RECORDED INTERVIEW OF DR.TARIQ
Exhibit-13
MISSION STATEMENT
Provide quality healthcare through integrating professional services,
focusing on immediate attention, prevention, detection, and early
correction, in a manner affordable for every one
Help in developing a society that is health conscious and prepared to
face threat of any disease that it may face now or in future through
health education, research and trainings
Reduce the sufferings and costs associated with morbidity and
mortality by better and immediate health care, for individuals, groups,
and society
Initiate and implement strategies in the health sector that are
innovative, quality oriented, focusing on the needs that cover all
spectrums of the corporate sector & the society in general
Source: Company documents
43

IHS Case Study

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Integrated Health Services

DR. ASIM MAHMOOD-THE PROFILE OF A PATHFINDER

“Dr. Asim is a very creative individual. He will never

Integrated Health Services (IHS) - Pakistan was not established as a

Dr. Asim Mahmood- being the Executive Director of Integrated Health

ESTABLISHMENT OF AIRPORT MEDICAL CENTRE

ASSOCIATION WITH GOVERNMENT

THE PAKISTANI FAMILY MODEL-IN AID OF ASIM

THE BIRTH OF IHS

“My dream was never to buy flashy cars and property;

THE START-UP BACKGROUND-IHS

Mr. Saeed recalled that:-

“Previously I was serving Pakistan Air force and working

Refer to Exhibit 3 for the video recorded interview of Mr. Saeed

“Dr. Asim is very optimistic by nature; he never creates

A PRODUCT OF FAITH & FAMILY SUPPORT

“Whatever happens, either good or bad, it happens due

emerging family commitments she first went to Radiology and then to

“Asim doesn’t portray the problems as such rather

“I am very much privileged that we are living

Mr. Saeed Hashmi commented that:-

“Mr. Bashir – the father of Dr. Asim has a very

BULDING IHS & THE UPHILL STRUGGLE

“He (Dr. Asim) is very consistent in nature and he

“Dr. Asim used to work continuously for even 18-20

ASIM AND THE WORK-FAMILY BALANCE

“Everybody has to do some sort of adjustments in his/her

“My career is a compromised one and I have no regrets

“At times he doesn’t even remember the academic

DR. ASIM-THE ORGANIZATION BUILDER

“Partnerships never suited us, we were always

The Work Environment at IHS

“It is the team work and family friendly environment

The Manager Home Medical Care mentioned that:-

“It’s a family friendly environment here at Integrated

There is no issue of timings as long as you complete your work and

Human Capital Begets Financial Capital

“Dr. Asim gave me free hand and encouraged me to hire

The Director Projects believed that:-

“The IHS staff gives outputs because they are

“He gives us (the IHS staff) handsome salaries plus a

START OF HOME NURSING SERVICES

ENTERING CORPORATE SECTOR: 1998-1999

HEALTH SERVICES TO THE LARGEST PRIVATE SCHOOL

END YEAR 1999 & START 2000-MAKING HEADWAY INTO

JOINED DISTANT LEARNING PROGRAM

IN SERVICE OF THE NATION- BALAKOT & SAVE THE CHILDREN

IHS- THE COMPANY OF ETHICAL PRACTICES

“No other organization is working like Integrated Health

Dr. Shahid added:-

“Our motto is client satisfaction first no matter if while

Dr. Ali Raza acknowledged that:-

“IHS believes in making systems and efforts should be

DECEMBER 2002: DR. ASIM & CORPORATE TRAININGS:

In December 2002, the business volume of IHS was getting low, so in

Institutionalizing Training Capabilities

“I might lose money but I would not lose systems”.

DEVELOPING EMPLOYEES- EXAMPLE DR.ALI RAZA

“Dr. Asim doesn’t have a bossy attitude at all, rather his

The mother of Ms. Salma Khan is a client of Integrated Health Services

Dr. Tariq is working as a health advisor for a large multinational

 IHS has better infrastructure

RELATIONSHIP OF THE CLOCK AND THE CLOCKMAKER