Diagnosing the Entrepreneur Behind Dr. Devi Shetty In healthcare, you should love people. You should be very comfortable in dealing with people!

A saint to perhaps many, Padma Bhushan and Padma Shri, Dr Devi Shetty had attended to St Mother Teresa late
in her life, which inspired him to make health care services affordable for the poor and the middle class. Pioneer of
inexpensive cardiac surgeries and treatment, Dr. Shetty later went on to build affordable health care services chain,Narayana Health, which now operates 32 hospitals across India. Entrepreneur was at Narayana last month, to examine both, the entrepreneur and the doctor in Dr. Shetty.

From the first facility established in Bengaluru, in 2000, with approximately 225 operational beds, the company has grown to a network of 23 hospitals and seven heart centres across India and single hospital overseas at Cayman Islands with over 5,600 operational beds across all its centres and potential to reach a capacity of over 6,700 beds.

Devi Shetty is a cardiac surgeon with 33 years of experience. After completing his MBBS at the University of Mysore in 1978, he had registered with the Karnataka Medical Council in 1979. Post that he had received a master's degree in surgery from the University of Mysore in 1982. He founded Narayana in the year 2000 and initiated the concept of "micro health insurance scheme' in Karnataka, India. This led to the Karnataka government implementing the Yeshasvini scheme, a micro health insurance scheme for rural farmers.

How did you combine being a doctor with entrepreneurship?
I never had the desire to build a hospital in the beginning. I always wanted to work for big hospitals and reach out to as many people as possible. I left England in 1989, started my career here in Kolkata and Bangalore and my initiative was always to make heart surgery affordable. But I wasn't reaching where I wanted to and tried various combinations but nothing worked. I always wanted to have the freedom to tell people that you don't
have to pay much for the surgery if you don't have the money. That's the only thing that made me build this organization. And today, the greatest joy of whatever I created is that I am in that position to do this.

Is affordability in healthcare an issue?
The greatest roadblock to affordable healthcare is medical education. We simply do not produce enoughdoctors and specialists to replace the ones we have, forget about adding surpluspower. Hence unless the medical education gets liberated from the capitation fee and the shortage, this country will not see affordable healthcare.
Even if one finds a doctor, he would be in much demand as he would be the only one with the necessary qualifications. Nobody can reform delivering healthcare in India because of the shortage of doctors and specialists. Once they are in abundance, there will be thousands of hospitals that will come up and thecompetition will force the costs to come down.

But there are so many medical colleges today, why are we scrambling to get the doctors?

We have over 2 lakh doctors who are just MBBS holders; we produce them in abundance but are we producing enough number of specialists? No! If you create adequate number of PG seats to meet the country's demand, who will pay Rs 2 crore for the seat? The structure of medical education will collapse.

How have you managed to bring down the cost of healthcare?
We can become the first country in the world to dissociate healthcare from affluence. Within seven-10 years, India can prove that the wealth of the nation has nothing to do with the quality of healthcare its citizens can enjoy. We can do it because we have that many young people who aspire to become doctors and specialists, but we aren't
giving them an opportunity. So, essentially we have to realize that the delivery of healthcare is not related to
anything finite. Healthcare is given by skilled people like us. When I die, someone else will be taking my position
because human resource is replenishable.

People need to be aided with technology, which again is expensive?
These technologies are software-based. They can be scaled up without any effort, there's hardly any cost. The
most expensive software is the first one; second one is just the price of the CD. So essentially, healthcare is limited by human skills.

People need to be aided with technology, which again is expensive?
These technologies are software-based. They can be scaled up without any effort, there's hardly any cost. The
most expensive software is the first one; second one is just the price of the CD. So essentially, healthcare is limited by human skills.

What's your perspective on the healthcare start-ups that are there in India?
All of them are doing a great job but then my concern with the start-ups is their expectations of what they get
at the end of three-five years. That is unrealistic! In terms of valuations, they expect hundreds of billions of dollars in valuations. Ultimately, the value should be generated. There is simply isn't that kind of money in healthcare. These start-ups are doing a fantastic job. But expecting a huge return in valuations, which is driving them and the private equity people to invest that remains my concern.

What is your advice to healthcare start-ups and entrepreneurs of today?
They are all behaving like a bull in a China shop. You have to just identify one human need and address that very
well; dazzle the patients and the doctors and then move to the next one. Today, they come with a boutique of services and all of them are suboptimal and doctors are most difficult people to convince because most of them aren't tech savvy. If a doctor doesn't like your software, then you have no market. So they aren't spending enough money to dazzle the doctors. Most of the products are not up to the mark.

What are your learnings from the journey so far?
In healthcare, you should love people. You should be very comfortable in dealing with people. You should have
that kind of empathy and sense of belonging to people, who are totally strangers and make them feel comfortable. Essentially that's what is important and this is what I've learnt and I want the younger doctors of today to follow.

(The article was first published in the January 2017 issue of Entrepreneur Magazine)