Dr. Prathap C. Reddy December 23, 2017
It was the early 1980s, long before the era of consumerism set in. Quality healthcare in India was the privilege of a few. If you couldn't afford to travel abroad for treatment, you would probably die. The death of a 38-year old patient of mine, only because he could not afford $5000 to go overseas for a coronary bypass surgery, galvanised me into action. I thought to myself, "How many more will lose their dear ones for monetary reasons, and why should they?" Only the powerful and rich had access to good healthcare.
I told myself that I would build the best hospital in the country, which would have the most advanced treatment options, so that no Indian would have to travel abroad for treatment. I wanted to prove to the world that Indians are global citizens, second to none, and that we had the potential to deliver the best clinical services possible.
It was an audacious dream, given the stark reality of the regulations in India at the time, the difficulty of raising capital, and the talent vacuum. Sure enough, very few people believed in my vision. I was even called crazy when I said we could bring world class healthcare to India.
There were reasons for the pessimism - regulatory and policy barriers against the notion of private, professionally managed corporate hospitals were strong. It took me almost three years and over 50 trips to Delhi to get the required permits, but ultimately in 1983, the then President of India, Giani Zail Singh, inaugurated our first hospital in Chennai.
Once our hospital was operational, I had only one driving intention: To live up to the wishes of my patients. My approach to management has always been intuitive. I preface every decision with the question "What does my patient deserve?" And the answer directs my decision-making.
To begin with, the Indian patient deserved the very best of clinical outcomes. For this, I needed to ensure that our hospitals were well-equipped with the best of equipment and state-of-the-art technology. I had to attract the best of clinical talent; convince talented doctors to serve in India. And I needed to train our support staff - nurses and paramedics - to ably support our doctors on every case.
All this I accomplished, not without struggle, but with relative speed and ease. Apollo Hospitals gained the trust of patients, and we brought the best of treatment to India. Thenceforth, no one needed to go abroad to receive cutting-edge care. Our clinical outcomes improved by leaps and bounds.
I wished to replicate and scale this success, but this brought its own set of challenges. Indeed, I had written a letter to our dynamic late Prime Minister, Rajiv Gandhi, saying "I wish I had set up a beedi factory or a beer factory instead of a healthcare facility." His understanding of the issues, and subsequent approval of our outreach, transformed the healthcare system in the country. Today, we have over 5,000 hospitals in India doing excellent tertiary care work. Apollo Hospitals has grown, expanding the network and reaching more patients and providing real health and happiness. But for me, that was not enough. Our experience with patients had proven that beyond Clinical outcomes, they were looking for two other Cs as well - Care and Compassion. These quintessentially Indian attributes would make the difference between the cold walls of a hospital and the warm fuzziness of a place of healing and recovery.
And so, we began the next phase in Apollo's journey - the institutionalisation of tender loving care. This was a challenge too, not because of lack of intent, but because of the complexity of the task. For a truly great patient experience, several departments needed to work seamlessly in an unbroken flow - from something as simple as administering medication, to ensuring the appropriate diet, to serving the meals warm, to keeping the room clean, to attending to the patient's family and joining in their prayers - several processes needed to function like clockwork. We had to be present in the patients' vicinity, but never intrude on their privacy. We had to check on them regularly, but never too much.
We have spent much of our energy for the last several years trying to perfect this process. We have learned valuable lessons, rigorously trained and re-trained thousands of our staff, and developed several processes which converge to deliver on patient experience. Our service protocols are next to none, and put us at the top of the world. We can say with satisfaction that Apollo Hospitals has been successful in delivering the three Cs of patient expectation - Clinical Outcomes, Care and Compassion. Needless to say, we are not perfect - we are still learning, and striving to continuously improve.
And that has been my most valuable management lesson - always strive to live up to the wishes of your consumer. In today's management parlance: be customer-centric. Every decision and investment must be dictated by the wishes of the consumer, and how our actions will deliver on his/her expectations.
With this credo, the impossible has been achieved. The critics have been silenced, the sceptics convinced. Apollo Hospitals has accomplished formidable things - we run the largest solid organ transplant programme in the world; we have performed over 1,70,000 coronary bypass surgeries, at a success rate comparable to the very best in the world. And in emulating our model, the Indian private healthcare sector has been born. The healthcare sector has emerged as one of the largest employers in the country, especially of skilled labour, and has proven to be an engine of economic growth - which our government should be proud of.
There is even greater potential for improvement. Despite all this progress, we still have an acute shortage of hospital beds in our country. To adequately serve the healthcare demand, we need double the number of doctors, treble the number of nurses, and quadruple the number of paramedics. With job creation being at the top of our economic agenda now, healthcare as a sector has a lot to offer our country, which is expected to be home to nearly one-third of the world's workforce by 2028.
In healthcare, we are constantly pushing the boundaries - by sharing and collaborating to improve patient experience, transforming care delivery through telemedicine and optimised protocols, digitalising and democratising health through mobile solutions and telemedicine, and working with Artificial Intelligence and Big Data to develop India-specific patterns for disease detection and cure.
But against all this, there is severe cause for concern too. While we can take great pride in the fact that no Indian needs to travel abroad for treatment, and conversely, patients from over 120 countries visit India for medical treatment, there is an urgent need to pay close attention to the tsunami that is soon going to engulf us - the burden of non-communicable diseases (NCDs).
NCDs are responsible for two-thirds of total morbidity and about 53 per cent of total deaths in India. According to the World Economic Forum, by 2030, over 36 million deaths will be caused by NCDs alone, and the economic cost of this will be $5 trillion for India alone - over 50 per cent of India's GDP. Most worryingly, NCDs affect the most productive age group. We need to pull ourselves up and come together with a sense of urgency and purpose. Apollo Hospitals has already embarked on this journey - for example, by providing extensive awareness of the importance of early screening and detection through our Healthy Heart programme, as well as providing guidance on prevention and reversal of disease. I sincerely believe that this is a time for all stakeholders to act with greater immediacy and trust. It is a time for the 4 Ps - Public-Private-People Participation - to come into play at the earliest.
I have made this my mission. True to my credo, I am still working on living up to providing what the citizens of India deserve - long, healthy, productive lives, free of disease. I urge you all to join this mission against NCDs, a mission to promote happiness and well-being.