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How Entrepreneurship Can Unlock Hidden Potential in Indian Healthcare Sector Business models, especially in healthcare, relying solely on maximizing returns are not sustainable

By Dr BS Ajaikumar

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A recent study published in medical journal The Lancet lists India among the biggest underachievers in healthcare access in Asia. According to Global Burden of Disease Study India is at a dismal 154th position among 195 countries on the healthcare index. As an oncologist, I find it worrisome that the country has the third highest number of cancer cases among women in the world. Another cause of concern is the rapid rise in cancer cases in the country. According to data by National Cancer Registry Programme, India is estimated to have 1.73 million new cancer cases by 2020.

Need For Robust Healthcare

Besides being disturbing, these statistics also highlight the dire need for a robust healthcare infrastructure, the apparent lack of which is distressing. The doctor-patient ratio in India is 1: 1,674. This means that only one doctor is available per 1,674 people in India against the World Health Organization's norm of one doctor per thousand.

While many would find these facts alarming, an entrepreneur would approach this gap between healthcare infrastructure and requirement as an opportunity to make impact, both social and economic. I would like to quote Warren Buffet here, who famously said, "Predicting rains doesn't count. Building arks does."

Contribution of Private Sector

While the Indian government continues to invest in healthcare, this battle cannot be won without support from the private sector. It is an imperative to bridge the widening gap between the needs of the patients and the offerings of traditional models of healthcare services in the country. This lacuna also presents itself as an opportunity to promote the health start-up culture in the country. If promoted well, entrepreneurial zeal can bring the latest technologies, which have changed the face of healthcare in developed nations, to the hinterlands of India.

Not only this, the rising burden of diseases demands commensurate investment. It is estimated that India needs about 600,000-700,000 additional beds over the next five to six years - indicative of an investment opportunity of $25-30 billion. The upsurge in the entrepreneurial zeal of the country, as evident from the statistics, could act as the potential driver of a robust healthcare infrastructure. Data shows that healthcare start-ups are fast gaining traction in India. In 2015, around 300 healthcare start-ups emerged in the country. The total healthcare industry size is expected to touch $280 billion by 2020.

According to a recent report published by India Brand Equity Foundation, the healthcare sector in India is one of the fastest growing industries, and expected to advance at a compounded annual growth rate of 22.87% to reach $280 billion by 2020. The report further says there is an immense scope for enhancing healthcare services penetration in India, presenting ample opportunity for development of the healthcare industry.

Entrepreneurship is the Key

I believe entrepreneurship is the key to unlock the potential in Indian healthcare sector while ensuring that its social benefit reaches far and wide. A health entrepreneur not only brings a focused approach to his work but also applies his domain expertise which differentiates the business from a system-driven model. Usually, an entrepreneur, particularly in healthcare, approaches the sector as a need-based market. For instance, as an oncologist when I compare the latest technologies available abroad with the ground reality in India, I see an immense need for investment on bringing those latest developments here.

Health entrepreneurs having expertise in their respective domain might not be well-equipped with financial know-how. For instance, when I started this journey, I did not possess any financial knowledge. My only wealth was my domain knowledge and a passion to make a difference in my homeland. Nevertheless, I acquired the requisite knowledge on business finance while being on the job. Comparatively, the driving force in a system-driven model is not always passion and domain knowledge. Take for instance, a private equity fund that starts a hospital in India, might be well-equipped with the knowledge of finances but will lack the zeal to make a difference. Their focus is more likely to be on maximising return on investment and minimising operating costs.

Need for Sustainable Healthcare Models

Hence, I believe that business models, especially in healthcare, relying solely on maximizing returns are not sustainable. Whereas an entrepreneurship which is built from scratch by a healthcare expert is growth-oriented because of his/her vision. One becomes a doctor out of an inherent will to help others. Otherwise, considering the high scholarly level, we could have easily opted for any other educational qualification leading to a high-paying profession. The resolve to alleviate the sufferings of society brought us to the medical field.

I look at India as an enormous country where cancer is being poorly served and treated in a rudimentary manner. There is an absolute dearth of research and latest technologies. I look at this as an opportunity to make a difference through my entrepreneurial venture.

The million-dollar question, however, before me is whether it would be easy to bring about a change, especially in a nation as vast and diverse as ours. Through my venture, we have already brought the latest technology and healthcare to Bengaluru but that model needs to be scaled to a national level. This presents an opportunity to collaborate with private equity funds. This will ensure better returns for them and help me achieve my vision of creating a national infrastructure serving cancer patients while having a social impact. After all, the ultimate goal of a social entrepreneur is making an impact at the grass root level. Creation of wealth is incidental.

Dr BS Ajaikumar

Chairman &CEO, HealthCare Global Enterprises

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