I am astounded that my blog, “Surviving Strategies for Indian Small Hospitals Using the McKinsey 7S Model amidst increasing corporatisation” has generated much interest, and more than 2000 readers have read it. Some friends have even asked me to elaborate on the McKinsey concept to sustain their hospitals. I am motivated by these requests, and I need to expand the McKinsey concept with examples of best practices across the country and my own experience. As a result, I will be exploring each “S” in the McKinsey concept in my future blogs with valuable tips on how small hospitals can develop a clear, long-term strategy to survive and thrive in an increasingly corporatised healthcare environment.  

The healthcare scenario in India is rapidly evolving, with even many international companies pouring investment into this sector. A growing economy, a rising number of chronic diseases and increased health awareness among the population are fuelling such faster growth. As the corporate hospital chains grow like mushrooms, they will inevitably look for new markets in lower-tier towns. The ever-changing healthcare landscape will force small hospitals to face an uphill task for survival as they compete with corporate hospital chains. The larger entities, backed by substantial financial resources and advanced and sprawling infrastructure, have an insurmountable advantage. However, the very qualities that make small hospitals vulnerable—such as their size and limited resources—can also be leveraged to create a unique competitive edge. Small hospitals can carve out a sustainable niche and build a loyal patient base by focusing on innovation and differentiation.  

The Power of Specialisation

One of the most effective ways small hospitals can differentiate themselves is by specialising in specific areas of healthcare. Unlike corporate hospitals that often try to cover a broad spectrum of services, small hospitals have the opportunity to focus on niche areas where they can develop deep expertise. This specialisation can take many forms:

• Specialised Surgeries:  When working in Kerala two decades back, I knew a famous hospital in Thalacheri, Kerala state, a centre for excellence in treating haemorrhoids. Taking a cue from them, our hospital focused on surgery for congenital ear problems during our early days. And despite being in a remote region, we successfully attracted patients from India and abroad. Similarly, small hospitals can become centres of excellence for particular treatments or surgeries in their specialities. By investing in specialised training for their doctors and acquiring state-of-the-art equipment, these hospitals can build a reputation for excellence in their chosen fields. Patients seeking high-quality care for specific conditions will prefer a hospital known for its expertise, even if it is smaller in size.   

• Chronic Disease Management: Small hospitals can also excel in managing chronic diseases such as diabetes, hypertension, and asthma. Our hospital is a centre of excellence for thyroid and parathyroid problems. More than 6000 patients with hypothyroidism follow up with us regularly for their testing and dosage adjustments. And that is a considerable number. Similarly, small hospitals can position themselves as leaders in chronic disease management by offering comprehensive care programs that include regular monitoring, patient education, and personalised treatment plans. This focus improves patient outcomes and creates long-term relationships with patients who require ongoing care, demonstrating small hospitals’ empathetic and caring nature.

• Community-Based Health Programs: Small hospitals are often deeply embedded in their communities, giving them a unique understanding of local health needs. By developing community-based health programs, such as maternal and child health services, preventive care initiatives, or mental health support, small hospitals can address specific health challenges faced by their communities. This differentiates them from larger hospitals and strengthens their role as vital community resources, making them an integral part of the local healthcare ecosystem. As a service to the community, we regularly conduct free newborn hearing screening programs and free ear surgery camps. These camps have helped us develop goodwill and draw patients from the entire Southern India. 

Personalised Care: The Heart of Differentiation

Recently, healthcare has become increasingly impersonal and mechanical, and small hospitals have the opportunity to stand out by offering personalised care. Unlike corporate hospitals, where patients can sometimes feel like just another token number, small hospitals can provide a more intimate and compassionate healthcare experience. This approach not only offers medical treatment; it also helps build relationships and trust with patients.

• Patient-Centric Approach: Small hospitals can implement a patient-centric approach where patients’ needs and preferences are at the centre of all decisions. This approach can involve spending more time with patients during consultations, involving them in treatment decisions, and ensuring they feel heard and valued. When patients think their care providers genuinely care about their well-being, they are more likely to return and refer others to the hospital.

• Continuity of Care: Small hospitals can differentiate themselves by ensuring continuity of care, where patients see the same healthcare providers throughout their treatment journey. This continuity fosters strong patient-provider relationships, improving health outcomes and higher patient satisfaction. Additionally, by maintaining detailed patient records and following up regularly, small hospitals can offer personalised attention that is often lacking in larger institutions.

• Family-Oriented Care: The family doctor concept is ancient in India, and many small hospitals operate in close-knit communities with strong family ties. Small hospitals can create a welcoming environment that resonates with their patient base by offering family-oriented care, such as involving family members in care decisions, providing support groups, or offering family-friendly facilities. This approach enhances patient satisfaction and reinforces the hospital’s role as a trusted community partner.

Collaboration for Greater Impact

Another critical strategy for small hospitals is collaborating with local governments, non-governmental organisations (NGOs), and other community stakeholders. Small hospitals can extend their reach, access additional resources, and offer subsidised services that align with public health goals by forming partnerships. These collaborations can take several forms:

• Government Partnerships: Small hospitals can partner with local governments to provide essential healthcare services, such as immunisation drives, maternal and child health programs, or emergency care during public health crises. These partnerships can help small hospitals secure government funding, access public health resources, and gain recognition as crucial healthcare providers in their regions. Arogya Bagya, PM Healthcare Scheme, and several other programmes are good starting points, though they involve a lot of bureaucracy and paperwork. 

• NGO Collaborations: Working with NGOs can enable small hospitals to offer specialised programs, such as free or low-cost surgeries, health camps, or disease prevention initiatives. NGOs often have the expertise, resources, and networks needed to address specific health issues, and by collaborating with them, small hospitals can enhance their service offerings and reach underserved populations.

• Public Health Alignment: Small hospitals can align their services with broader public health goals, such as reducing maternal and infant mortality, combating infectious diseases, or promoting healthy lifestyles. By doing so, they can attract patients looking for healthcare providers committed to improving community health and tap into public funding or grants aimed at achieving these goals.

End-note: Innovating for the Future

Innovation is not just about adopting the latest technologies; it’s about rethinking how healthcare is delivered to better meet patients’ needs. Small hospitals, with their agility and closer connection to patients, are well-positioned to experiment with new models of care.

Prof. Dr. Prahlada N. B
18 August 2024
B.C Joshi Guest House, Lucknow

Leave a reply