1. Meeting of the International Society of Orthopedic Centers (ISOC) April 29 – May 01, 2010 (Bologna) ISOC Meeting April 29 – May 01, 2010 (Bologna) Presenting the Schulthess Clinic Zurich

2. Background of Matthias Spielmann Position Overview 2003 – datoCEO Schulthess Clinic, Zurich (CH) Educational background 1976 – 1982Grammar School in Economics; Zug (CH) 1983 – 1987Hotel Management School; Lausanne (CH) 1992 – 1994Bachelor of Business Administration (BBA); Zurich (CH) 2002 – 2004Master of Health Administration (MHA); University of Bern (CH) Further Education 2009European Health Leadership Programme, INSEAD; Fontainebleau (F) Overview of career 1988 – 1996Manager/Vice Director/COO in Catering-, Hospital- and Hotel- Industry 1996 – 1997COO Ami Clinic; Cham (CH) 1998 – 2003CEO Public Hospital; Riehen (CH)

3. Key figures of Switzerland Foundation1291 Square41‘285 km 2 (divided in 26 cantons) Population7‘782‘900 LanguagesGerman (63,7%) French (20,4%) Italian (6,5%) Romanic (0,5%) CapitalBern Economic CapitalsZurich and Geneva Main IndustryBanking & Insurance Tourism Pharma Watches ProductionJohnson & Johnson Med. Tech.Zimmer GmbH CompaniesStryker AG Medtronic AG etc.

4. Brief overview of the healthcare structure and system in Switzerland Financial statistic ●Health providing in Switzerland 2007: US$ 52 Mia ●Health costs 2007 = 10,8% GDP (USA 15,3%/F 11,0%) Social insurance in Switzerland ●The federal statute of the new health insurance system was introduced 1996 and revised in the meantime three times already. ●Each person in Switzerland is insured obligatory (premium per head) and has therefore the right to get all medical services without paying additional fees. ●Auxiliaryinsured patients are free in the choice of the doctor as well as the hospital.

5. Schulthess Clinic Corporate Film Please dive in now for some minutes in the world of Schulthess Clinic in Zurich!

6. The clinic at a glance Focus Orthopedic surgery Founded1883 Owned bynon-profit foundation Turnover 2009US$ 139 million Status University clinic grade “A” (Swiss Olympic Medical Center; FIFA Medical Center) Employees/totally 800 of it are Physician35 Orthopedic Surgeons 45 Assistants 27 physician (resident system = all employed) Beds160 Operating Rooms9

7. Facts and Figures 2009 Number of cases total8‘000 Divided after departments Upper Extremities1‘550 Lower Extremities2‘700 Hand Surgery 850 Foot and Ankle Surgery1‘400 Spine Surgery (incl. Neurosurgery)1‘300 Pediatric Orthopedics 200

8. Development Patients/Personnel/Turnover Patients, station- arily, leaving Status Staff (Fulltime) Turnover in Mio. US$ %- Quota Personnel- costs (incl. Social payments & Extras) No. of Care days %-Quota of the Auxiliaryinsured Average duration of stays (in days) 1997 4‚48940073.92546.3251'34954.3811.40 2000 5'32641281.22547.3550'06953.619.40 2003 5'65345689.83053.3845'82954.218.11 2006 6‘235510117.04749.1050‘12252.388.00 2009 7‘251586146.35246.0849‘28455.106.80 1997 - 2003+ 25.9%+ 14.0%+ 21.5% 2003 - 2009+ 28.3%+ 28.5%+ 62.9%

9. Overview of teaching & research efforts Research –Scope: Outcome research, prognostic studies neuromuscular adaptation, osteoporosis, prosthesis development and clinical testing, injuries in football (F-MARC), pathophysiology of rheumatoid arthritis, … –Number of scientists:14 –Annual grant funding: $1 Million USD –No. of peer-reviewed articles: 101 in 2009 Teaching –University affiliation currently not available –Cooperation with ETH and University Zurich & Lausanne

10. Strategic Plan/Direction/Major Initiatives underway and Future Challenges Economic Success Rise in Labor Costs and Medical Devices – Worsening Tariff System Extension Qualified Staff in Europe

11. …a low cost medicine! The dream of…

12. Thank you for your attention!