LUNCH WITH BS: Devi Shetty
Dr Wal-Mart
| Dr Devi Shetty "" heart surgeon, hospital builder and do-gooder "" abounds in contradictions. He is a pro-poor doctor who believes in the market laws of supply and demand. He has the business of healthcare on his fingertips the way any corporate healthcare bigwig would, but clearly his passion is not in maximising corporate profits. He has no quarrel with intellectual property rights but is clear that those who have given mankind path-breaking medical discoveries have been driven not by the desire to make "mega bucks" but "to take away the pain". He has trained in the UK and holds all kinds of firsts in heart surgeries in India but is not an FRCS, holding an MS from Mangalore's Kasturba Medical College, writes Business Standard. |
| Lunch with Shetty has perforce to be in his office in Narayana Hrudayalaya, 25 km out of Bangalore (the three hours it takes to go to and return from a city restaurant is better spent in performing one more "procedure"). You take off your shoes and put on soft-foot covers, the way you would before entering an operation theatre. The food, once you have talked and seen video clips at length, is incidental, mine a standard lunch thali of Karnataka vegetarian food from the hospital canteen and his out of a food carrier, Mangalore vegetarian. |
| Generally, he is "very conscious" of what he eats. It is cornflakes with curd for breakfast, lunch at one ("it is my heavy meal"), a cup of tea at around four, and dinner at 9 pm (two chapatis, some vegetables, a piece of fish or chicken). "Human beings are designed to be vegetarian" and although most of his meals are vegetarian, he is not a strict vegetarian. "On certain Mondays and Saturdays I don't eat any non-veg food." He exercises seven days a week, on a treadmill or a walk in the morning. "I recommend the treadmill for half an hour in the morning for business people, primarily because you can spend this time with yourself in introspection. I see people chatting with friends when they go for a walk. You rarely get time to spend with yourself." |
| After returning home from the UK, Shetty and his team have built four of the largest heart hospitals in India "" BM Birla Heart Research Centre in Kolkata in 1989, Manipal Heart Foundation in Bangalore in 1997, then the Rabindranath Tagore Institute of Cardiac Sciences in Kolkata, and finally the Bangalore showpiece Narayana Hrudayalaya. These account for well over a 1,000 beds and should make any man satisfied with what he has done with his life. But no, he has a mega plan to build three hospital complexes with altogether 15,000 beds "" in Bangalore, Kolkata and, maybe, Gujarat or Delhi. |
| Why? "Now 9 per cent of heart surgeries done in the country are by just these two hospitals (Narayana Hrudayalaya and at Kolkata). Around 8-9 per cent of heart surgery products sold in the country are bought by us, accounting for 40 per cent of our revenue. If we can raise the 8-9 per cent to 25-30 we can negotiate directly with the OEMs and get the material at half the price. I call it the Wal-Martisation of healthcare. This country requires 2.5 million heart operations in a year, now we are doing only 70,000." |
| What's preventing the crash in prices? The government for one. "Twenty-two to twenty-five per cent of the money spent by a person in pain goes to the government. They get a percentage on everything you put on the human body. The customs duties and tax policies are made as if only the rich get sick. Every policy of the government is made looking at corporate hospitals in Delhi and Madras. Today, rheumatic heart disease has been eradicated in the West, but its prevalence is very high in India." |
| He attributes a lot of the current problems of Indian healthcare to shortages. He is not so worried about the appalling conditions of public hospitals as "eighty per cent cent of healthcare is offered by the private sector. Today, some of the private sector hospitals like ours charge less than government hospitals. The root cause of high private healthcare costs is opportunistic pricing." |
| The solution? Give land for hospitals at a discount, facilitate clearances, keep taxes low, encourage as many people to become doctors as possible, don't create a shortage of medical college seats, encourage as many to become nurses and technicians, and encourage as many industrialists to set up hospitals. "Once you remove these artificial barriers, prices will crash." |
| A role model for India? "Cuba has a wonderful healthcare model that we can adopt." Its attributes are "not depending on MBBS doctors alone, but a huge number of semi-qualified people offering primary healthcare," and ignoring IPR, as "they can copy any medicine." |
| To those who work with Shetty, he is god. Hospital administrators at places from where Shetty has walked away think he is not. Some cardiac surgeons don't feel he is an exceptionally great surgeon. He is not a "dare devil, avoids complicated cases." An associate of 15 years in Kolkata feels he wins with his smile and basic courtesies. His PR is super but it is not something put on. He is very obviously attractive and his persona is utterly and genuinely charming. He is elegant in his shirt sleeves and suspenders but his spoken English remains very Indian. |
| He knows the knitty-gritty of administration, understands politics (how to work with politicians and bureaucrats) and, above all, knows how to cut costs (shades of Wal-Mart). Says the associate, "I think he is exceptional. Proof of the pudding is in the eating. Who among us has successfully built and run four hospitals?" |
| Age 50 is the great divide for Shetty. Before that age you seldom have the ability to influence policy. After that age, when you have made your own bed, you tend to sit back, blame things on the government, "knowing well they have neither the wisdom nor the ability." He is also clear that "there is a wrong notion about wealth. For whatever reason I have control over a part of it. But what do I do to the poor with the power that I have? If I am not rich nobody will hear my voice. So along with wealth comes a lot of responsibilities." At 52, Shetty is still running and counting the new hospital beds he will create. |