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‘Primary healthcare needs more attention from policymakers’

Dr Santanu Chattopadhyay, Founder & Managing Director of NationWide Primary Healthcare Services, discusses several critical issues which are affecting the Indian healthcare industry and his own experience in entrepreneurship in an exclusive interview with Faiz Askari, Editor – North, SupportBiz.com.

Incorporated in April 2010 with a pilot clinic in the Whitefield area of Bangalore, NationWide now has more than 500 customers subscribing to its health plan. NationWide has raised USD1.2 million through two rounds of fundraising. 

What are the key issues faced by the Indian healthcare industry?

The healthcare industry in India, which accounts for about 4.2 percent of the country’s GDP, is one of the highly regarded and fastest growing industries across the globe.

The lack of focus on primary healthcare services has resulted in issues such as affordability, accessibility and lack of continuing care. Due to the highly skewed hospital based delivery model, healthcare services in India are patchy which further translates into non-comprehensive coverage in terms of geographical reach and social strata. Therefore, only a small section of our society in India can afford good quality healthcare services.

So, if we have to improve the overall healthcare infrastructure in India, it is important to concentrate more on primary healthcare facilities and preventive health strategies which have a direct impact on overall socio-economic development of a country.

In urban parts of India, the healthcare scenario is rapidly changing. How do you look at this scenario? What does it actually mean in terms of delivery and outreach of the healthcare services?

As previously stated, the present hospital based model has restricted healthcare services to certain areas thereby resulting in fragmented care and a patchy coverage.

With the exception of the government and some NGOs, there is no organization in India that focuses on primary healthcare as an important lever to improve the overall health status. Many large entities have shied away from entering this service sector.

Health in India is primarily viewed as a patient's concern. Any healthcare intervention in the prevalent primary care set-up is limited to providing prescriptions and lifestyle advice to out-patients and lacks “continuity of care”.

As a result, genuine and tangible improvement in the health parameters are not seen in the Indian context compared to developed countries in the West.

The primary objective for NationWide is to improve the overall health outcomes for our customers and bring down their healthcare costs through a long-term relationship model between the patients and their GPs.

Technology is a great enabler in this field. What role does IT is providing in your set up?

Yes, you are right that technology has a lot of potential to improve our healthcare system. However, traditionally, healthcare as an industry has been a laggard in embracing technology.

For example, most of the healthcare organizations heavily rely on hand-written notes for medical records. This makes these records difficult to retrieve and analyze. Ideally everyone should have their medical records consolidated in one place which can be retrieved at the time of need.

In India, people go to various healthcare providers at different times and every time a new medical record is created leading to inefficiency and unsafe medical practice.

To address this, at NationWide, even before we started our service we developed a very good Electronic Medical Record (EMR) system to capture patient’s medical summary. The medical summary can be downloaded or printed from anywhere and could be a life saver in medical emergency.

We are developing a technology tool which can track health outcome parameters for all our patients.

What are the key challenges you are facing in your business?

Rampant commercialization of healthcare industry has affected service standards offered to the common man; creating a sense of mistrust towards the medical fraternity. Thus winning back the common man’s trust in general practitioners is undoubtedly one of the major challenges faced by organizations like ours.

Another major challenge was to create a well chalked out career path for family physicians, as aspiring doctors do not find practicing as a GP motivating and appealing enough anymore. This has resulted in more and more medical graduates opting for a specialist career thus creating a manpower crisis in primary healthcare segments.

This situation is an offshoot of the prevailing myth that a GP is under qualified and any MBBS pass out can operate as a family physician. However the fact remains that general practice requires very specialized skill sets on part of the doctors for a holistic management of their patients.

Therefore, every MBBS doctor ideally has to go through three years of rigorous training before being able to practice as a qualified family physician.

A hospital or a healthcare institution is also an SME. But do you consider that it has several unique issues considering the criticality of this business? And what are these unique issues?

Healthcare has a long business cycle which implies that one cannot expect return on investment very soon. This makes the segment unattractive for traditional investors who expect return within a time period as short as four to five years.

As stated earlier, NationWide is an exclusive primary care service provider catering to a B2C segment. Hence, one of the major issues involved is high initial set up cost compared to the initial revenue.

The healthcare industry currently accounts for 4.2 percent of India’s GDP and is reckoned to be the engine of Indian economy in the years to come. As this industry holds great potential, mere privatization of the segment will not help.

Though privatization will help provide world class services and place us on a global platform, the issue of extending services to all sections of the society along with enhanced geographical reach will not be addressed effectively. Thus the government’s participation in the process is a necessity. In order to excel, every industry needs to have a regulator to catalyze the development process. In this case who could be better than the government itself.

Where would you like to see your business in next two years? What targets have you kept for yourself?

Our growth strategy is to consolidate our position in Bangalore, by opening up to 20 clinics in strategic locations across the city in next 18 months and then move on to other Tier-1 metros. Till date we have opened three full service clinics (Whitefield, Indiranagar and Koramangala) and four satellite clinics in Bangalore.

Over the next five years, we plan to open around 250 clinics across India. At a later period, we will also be looking to percolate the same services to the rural sector via public-private-partnership (PPP) initiatives. We feel that we will be one of the qualified players to do so due to our proven experience in the family doctor model.

As we have a well chalked out expansion strategy, we shall be going in for our next round of VC funding by end of this calendar year.

While we are very aggressive in our plans, at the same time we realize that it is important to gain the confidence and trust of our subscribers as well as other walk-in customers. Hence, customer or patient satisfaction will always remain our prime focus.