Thursday, February 17, 2005

Global docs

Global docs
The Hindu Business Line

When Mr and Ms Schmidt (name changed) landed in Bangalore from Germany, an airport pick-up, a helpful escort and a linguist were waiting for them. Their destination seemed designed for cheer, with a landscaped park, fountains and personalised warmth from across the swank, sweetly scented lobby. It was a hip, Web-enabled eighth-storey room that they checked into and they had one of the best views of the airport, the golf course and the city's green top.

Before they left Germany, they had chosen this one (built for foreigners) from the city's many packages ranging from Rs 2,700 to ultra-special spaces tagged at Rs 8,000 a day. Here, they could later change money at the currency desk, check out the bookstore-cum-florist's or order something familiar to eat. Or, tell the travel desk where the lady could sightsee while the German gent kept his appointment. At the end of a five-day sojourn, someone had taken care of their return, just so that the Schmidts could fly back home hale and happy.

SURPRISE! That was not a plug from a five-star hospitality player, but a glimpse of the new and evolving face of today's Indian healthcare providers. Corporate hospitals, as they reach out across the borders, have thinned the line between what once seemed to be two different worlds. They are borrowing ambience ideas, service concepts, promotion strategies and even talent from the hospitality sector. They are also allying, when they are not in competition, with the other to make equally impressive service deliveries. Foreign airlines are their promotional vehicles.

The makeover does not come without investments of crores of rupees. Healthcare managers admit to the pulls of a multibillion-dollar market segment. Schmidt is just one of the annually 1.8 lakh - and growing - tribe of foreign nationals who are choosing an Indian hospital over the ones back home for complicated treatment.

The globalisation of Indian healthcare - medical tourism if you like - has been happening in all big cities and it could be the next big thing to happen after IT, say industry insiders. Bangalore, that microcosm of all trends, must have caught the crest of that wave. Out there, high-end, multispeciality hospitals are going the extra mile to get visible at home and abroad. Bye-bye phenyl and mop, enter flowers and personalised service amidst fancy décor. At just a click of the mouse, people in far-off countries can check out what each of the dozen-odd top-draw hospitals offer - coronary bypass, kidney transplant, dental, cosmetic, orthopaedic or neuro surgeries. Most of them offer what they call transparent and fixed cost `packages' or competitively priced medical treatments. In fact, therein lies the attraction.

Upmarket hospitals such as Manipal, Wockhardt and Sagar Apollo are samples of those polishing up their act and re-inventing services and human resources at crores of rupees' investment. Their Web sites are telling and the way they speak has changed, if you notice how `comfortable' and `hassle-free' are increasingly their watchwords. As they look for 10-20 per cent foreign clientele, there is subtle emphasis on soft skills as much as on the A toZ of their medical talent. Healthcare delivery has come a long way in the past decade, especially in technology-backed, tertiary medicare, says Vishal Bali, easily one of the most heard voices in his industry. According to the Bangalore-based Vice-President (Operations) for the Wockhardt Hospitals Ltd, "Indian clinicians were always recognised as superior to many, but there was a big technology gap. Ten years on, this gap has gone and clinicians are now riding the technology wave."

Something interesting is brewing amidst all their medical feats. The first stirrings of the new direction of India's top-end healthcare came in August 2003. Early player, the Apollo group, which has treated over one lakh international and NRI patients, joined hands with an unlikely partner, the global travel major Kuoni Group, to float Sitacare. The first exclusive outfit to channelise medical travellers to India is also headed by qualified medical man Sanjay Sharma.

In Bangalore, the grey building of the Ramdas Pai group-owned Manipal Hospital, located on 11 acres on Airport Road, is undergoing a Rs 2.5-crore chemical facelift. It recently launched on its eighth storey an entire Executive Floor with 25 Web-enabled luxury rooms for the international patient. The International Patient Centre, replete with travel planners, foreign language assistants and escorts, has created a separate kitchen headed by an F&B manager to please foreign palates. A helipad and a tie-up with Air Deccan make Manipal the only civil hospital with an air ambulance service.

In South Bangalore, the 250-bed Sagar Apollo Hospital is barely three but knew where it wanted to be right from Day 1. Some 15 patients from Europe, Japan, the US or the Gulf stream in every month. Sagar's arrangement with Sri Lankan Airlines allows those flying into or through Bangalore to have complimentary medical checks at the hospital. The patients get to stay at Hotel Atria. Wockhardt has forged an affiliation with Harvard Medical Institute and plans to add a 250-bed super speciality hospital with seamless services in South Bangalore by 2006.

Interestingly, these and a dozen other medical and wellness centres form the tourism promotion plank of the Karnataka Government in its `Garden of Life' promo at international healthcare expos. Manipal Hospital CEO R. Basil says the 650-bed hospital is investing over Rs 30 crore, mainly to add another luxury, international space with 23 rooms-with-best-view on the 11th floor; this will be in the charge of a floor manager. Its tie-up with Tanzania's Health Ministry brings 30-50 patients from that country every month. Over 1,000 patients from the Arab world, Sri Lanka, Canada, Malaysia, New Zealand, Pakistan, Bangladesh and Nepal have been there, but that's obviously not enough. It arranges hotel stay at a discount at The Leela opposite, the Balji group's Royal Orchid and has 14 serviced apartments at its disposal, besides travel for patients' kin. For good measure, it has tied up with Sitacare. "We want to make it the most friendly hospital in the world. A lot of people are being trained for a change of mindset and to be interactive," says Basil, a former medical electronics industry professional. "We have to be different. Like hotels you should have a cheerful ambience and good personalised services. It helps when you handle depressed and suffering people. Eventually, we want practices that would put Manipal Hospital in the league of Raffles, Mayo, Johns Hopkins or (Bangkok's trend-setting) Bumrungrad."

At Sagar, a big draw is the presidential suite, in reality a large furnished private two-bedroom, kitchen-living room apartment within the hospital, at Rs 8,000 a day; and a similar birthing suite tagged at nearly Rs 30,000 for three days. Sagar plans to have another multi-crore 250-bed hospital and top it all by signing up with Sitacare.

If Sagar's Executive Director Dr P. R. Krishnaswamy calls non-resident doctors the health ambassadors of India, at Manipal, Senior Manager Rajesh Pandey's days are full of interaction with eight overseas liaison agents and creating CDs and brochures, some in Arabic. In all this is the unmistakable peg that Indian doctors are much more skillful than most; and that the cost of a dental, cosmetic or a cardiac process in Indian cities can come at one-eighth to one-fourth of the costs in the US or the UK. Bangalore's coronary bypasses at around Rs 1 lakh have made it an attractive heartcare destination.

Talking of the UK, its National Health Service system is unwittingly aiding Indian hospitals. It started with Gregory Bates, 53-year-old European power lifting record-holder from Sussex, who was put on several months' hold for a coronary bypass surgery in the UK or Europe. Like him, Leeds businessman Ian Brown, 56, was wait-listed for an angioplasty. They separately decided to give up the advantage of £3,000-4,000 each and instead have their treatments in India at their expense. Bates came to Wockhardt in August 2004, Brown followed in October.

Brown also sounded out compatriot, retired policeman and violin repairer George Marshall who at 73 was worried about the 8-month NHS queue. Coronary bypass over on January 20, a relieved Marshall would be back in the UK on February 9. He chose Bangalore over Germany, which would have been considerably more than the £5,000 he spent here for the treatment. "The procedure was faultless and the stay was absolutely first class," he said of his very first medical visit to India. They are the new brigade of 1.8 lakh travellers to India during 2004, says Sanjay Sharma. Growing at 20-30 per cent, up to 2.15 lakh medical tourists may be heading for Indian centres during the 2005-06. Sitacare has created three health, wellness and beauty options for these travellers and would be adding Asian Heart Institute, and L. H. Hiranandani Hospital, Mumbai, to its list.

Bali, who heads the CII Healthcare Panel, is convinced that if infotech created Brand India and made it a key service provider to the world, the same is happening in healthcare. "People seek and accept us not just because of the cost advantage but because we offer the same quality of services that are accepted in the developed world."

Krishnaswamy says that because modern medicine is impersonal and intimidating, the smart looks and services of hospitals like Sagar Apollo make it that much more caring. After all, half the healing comes with comfort and security that you are being cared for according to the traditional Indian tenets of hospitality. His word of caution is that while wooing foreigners, healthcare deliverers should not get lost in the frothy trappings of the travel or hotel industry, but stay by their core noble values of nursing, care and empathy. Nor lose sight of the legal and insurance risks.

If professionally managed hospitals with their clinical talent are seeking their place in the world, Wockhardt's Bali says it should be no surprise: "Can any sector today afford not to be on a global scale, not have global standards and connectivity? We should not miss this bus." The spin-off is that Indian patients are getting upgraded standards at lower costs.

Is it healthy for the medicare sector to hitch itself to the tourism-hospitality wagon? Apollo's Dr Sharma's view is that there are dozens of Schmidts and Marshalls searching for a perfect medical deal and there are also Greece, South Africa, Jordan, Malaysia, the Philippines and Singapore out to catch their eye. The travel-tourism vehicle would be the best means to bring them in.


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