As I drove away from the SZTNAOI 2023 (South Zone and Silver Jubilee Conference of Tamil Nadu AOI), the road seemed to gently guide me towards a cherished destination: Manipal. I was en route to visit my son, who is shaping his future in architecture at this prestigious institution. The picturesque drive, framed by the majestic Western Ghats, felt symbolic of Manipal’s own evolution—from a modest hillock to a beacon of healthcare and education. The credit for this transformation largely goes to the visionary TMA Pai, a fact that never ceases to amaze me. Dotting my journey, almost every Kilometer from my hometown of Chitradurga to Manipal, were billboards promoting the Manipal Arogya Card—a homegrown insurance scheme—prompting me to reflect on the brand strength of Manipal. Additionally, Manipal Hospitals is making headlines following its acquisition of AMRI Hospitals in Kolkata.
I’ve had the privilege of experiencing Manipal both as a student at the esteemed Kasturba Medical College and later, as a faculty, imparting knowledge to the next generation. As I reminisced, the healthcare chessboard of India unfolded before me, and Manipal’s strategic moves on this board were hard to ignore, especially given its recent alignment with Temasek.
The evolution of Manipal in the healthcare sector, transitioning from a simple hillock to a distinguished medical powerhouse in India, can be attributed to four foundational pillars or 4Ps – Priorities, People, Policies and Processes. Firstly, their priorities set them apart; while many entities focus mainly on profits, Manipal has always been steadfast in its mission to provide quality healthcare that’s affordable to everyone, underscoring its dedication to genuine patient welfare across all socio-economic backgrounds. Secondly, its policy framework, shaped by visionary leadership, is rooted in upholding the highest medical standards and an emphasis on continuous research. This strategic approach has enabled Manipal to navigate myriad challenges, constantly emerging stronger. Thirdly, the institution’s vibrancy is derived from its people — a community of dedicated professionals ranging from visionary leaders, devoted medical staff, to ground-breaking researchers. The talent nurtured and cultivated within Manipal’s walls forms the backbone of its sustained excellence. Lastly, when it comes to processes, Manipal stands out for its emphasis on efficiency and consistency in healthcare delivery. Merging cutting-edge technology with traditional care models, the institution has refined its processes, always keeping patient-centricity at the forefront. These processes, ever-evolving, draw insights from feedback and align with global best practices.
Manipal’s growth is deeply anchored in innovation, prompting the question: Why haven’t other players managed to emulate this success? Reflecting on this, my mind drifts to a compelling read, “THE INVERSION FACTOR – How to Thrive in the IoT Economy” by Linda Bernardi, Sanjay Sarma, and Kenneth Traub. This book delves into the complexities of innovation, outlining pitfalls that companies often stumble upon. One of the most common deterrents is the fear of cannibalization. Organizations, apprehensive about their new offerings cannibalizing existing sales, sometimes overlook the broader risk: if they don’t innovate, competitors will, causing an even more substantial dent in their market share. Another hesitancy arises from a reluctance to adopt technologies or ideas linked to competitors. However, in our dynamic business environment, tapping into all available resources, even if competitor-sourced, might prove advantageous. Moreover, the efficacy of an idea lies not just in its conception but in its execution. A perceived skill gap might deter some from pursuing innovation, but the real solution lies in skill acquisition or strategic partnerships. Furthermore, companies must guard against the “Not Invented Here” syndrome. A blinkered approach, favoring only in-house innovations, can blind organizations to groundbreaking external solutions, potentially curbing their growth trajectories.
Recently, following a staggering $2B investment from Temasek, Manipal Hospitals has poised to take ambitious steps. Its acquisition of AMRI Hospitals underscores this aggressive strategy. However, the play isn’t solely about expanding bed counts. Apollo Hospitals, holding a significant presence in Kolkata, heavily influences the medical tourism scene, notably the flow between West Bengal and southern hubs like Bengaluru and Chennai. With the AMRI acquisition, Manipal aims to contest Apollo’s dominance in the region.
Yet, hurdles remain. While Manipal is steadily bridging the bed-count disparity with Apollo, their revenue figures tell a different tale. Manipal’s earnings stand at Rs. 0.58Cr per bed annually, trailing behind Apollo’s Rs. 0.86Cr/bed. This delineates two primary challenges for Manipal: amplifying its brand’s footprint to rival Apollo’s esteemed legacy and enhancing operational efficiency. It’s vital, however, to remember Manipal’s roots as an educational hospital and its unwavering commitment to offering affordable care to the marginalized.
A question often arises: Why is Temasek, a foreign entity, channelling such extensive funds into India’s healthcare? The rationale is clear-cut. Temasek perceives a niche in the Indian healthcare matrix, one that several domestic players seem to have bypassed – the burgeoning private medical colleges.
During my Strategic Management course for senior managers at IIM Lucknow, I explored the opportunities and challenges of the Indian healthcare landscape as part of my capstone project. I encouraged my peers to center our study on Apollo Hospitals Enterprises. Collectively, we observed that the Indian economy is continually rising. With each passing day, a significant portion of the population experiences an elevation in social status. Concurrently, the number of chronic health cases is surging. The growth is further fueled by the expanding realm of healthcare education, the proliferation of insurance companies, and the increasing acceptance of health insurance.
Although various governments have come and gone since India’s independence, healthcare policies have largely remained static. Furthermore, the Indian government’s allocation to healthcare barely touches 1%. As a result, a significant number of patients bear their medical expenses out-of-pocket. This landscape offers a vast, untapped market, a “blue ocean,” for international entities like Temasek.
However, Foreign Direct Investment (FDI) in healthcare is a double-edged sword. While it has certainly elevated the country’s healthcare quality, it has also granted foreign companies easy access to India’s healthcare data. In today’s era, data is paramount. Such data can be harnessed to craft innovative treatment methods or, if misused, could skew the healthcare landscape of the nation and its populace. Thus, there’s an urgent need to implement rigorous checks and balances.
My brief visit to Coimbatore for SZTNAOI 2023 was a remarkable opportunity. For the first time, I was invited to a Tamil Nadu state conference as a faculty member. It allowed me to rekindle old associations and forge new friendships. Apart from delivering an innovative talk on enhancing the performance of cochlear implants using artificial intelligence and machine learning, I also participated as a panellist in a discussion on the challenging scenarios in cochlear implantation. Along with other panellists, being recognized by the legendary Padmashri Prof. Dr. Mohan Kameshwaran as one of the “top surgeons of the country and cream of the nation” is an honour I will forever hold dear.
As my journey drew to a close, Manipal, with its verdant vistas and towering academic edifices, emerged as a symbol of foresight and ambition. The future of India’s healthcare industry, reminiscent of my drive through the Western Ghats, is bound to be filled with twists, turns, challenges, and moments of unparalleled splendour. As always, I look forward to observing, absorbing, and evolving with the times.
Prof. Dr. Prahlada N.B
08 October 2023.