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the 2009 wharton india economic forum
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titled india the road ahead took place
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in philadelphia and brought together
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CEOs of leading indian companies
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investors heads of nonprofit
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organizations sports celebrities and
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bollywood stars to discuss where india
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is headed in an age of economic
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uncertainty Indian knowledge at Wharton
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brings you one-on-one conversations with
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these leaders thanks very much for
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joining us today
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Apollo is Asia's largest healthcare
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provider can you give us a sense of its
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scope of operations whenever we big
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stock there's always something new but
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broadly we're in hospitals tertiary care
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owned and managed we have about 42 we
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have 8500 Plus beds 60,000 employees
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apart from hospitals we're in retail
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pharmacies we have 900 pharmacies today
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we should finish by by June we knew or
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well before June we'll have a thousand
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pharmacies we open one a day that's the
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kind of count we've been doing for the
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last for the last two years now and we
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have clinics we have a BPO an IT
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business processing I think the
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headquarters is actually quite close to
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Philadelphia and health insurance we
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have a new company it's about a year and
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a half old it's a joint venture with
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Muni Kree which is the world's largest
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reinsurance company and that's a new
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initiative of ours apart from that we
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have several other businesses with we're
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incubating the health highway we have a
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ambulance service we do a lot of
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insurance for for the underprivileged in
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rural areas where we manage the health
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insurance programs for them
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can you explain what the health highway
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is health I was a new project with IBM
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that you know as the technology provider
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we're we're creating a linkage between
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hospitals irrespective not just ours but
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hospitals across India and also doctors
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were patients records that would could
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rest on the highway and right from all
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aspects of information technology
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whether it's managing hospital managing
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the procurement or even finding
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resources in terms of Human Resources
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many many things and this is what it
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would provide scientific information
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tele radiology telemedicine everything
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would be part of the highway initiative
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and this would reach into rural areas
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definitely we're already quite robust
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that the network we have what would you
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say are the major problems with medical
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infrastructure in India today that have
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yet to be overcome the short answer is
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is that there's a huge supply shortage
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of quality beds you know it's a little
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skewed you would find beds and lots of
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competition in cities in urban areas and
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that's why Apollo's moving to talk to
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tier 2 cities where we're establishing
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again tertiary care hospitals we think
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that there's a lot of growth and the
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rural population can afford a good
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quality medicine and I think that supply
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so it's going to take a trillion dollars
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of public and private money over the
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next 10 years to even try and catch up
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to what the public actually needs and
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the other day I read a statistic see
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Indians are actually prone clinically
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proven that you know they're prone to
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heart disease and unfortunately you know
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we've been tagged as the diabetes
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capital of the world nearly 12% have
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been discussed are discovered diabetic
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and they're saying that the cost of
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preventive medicine by 2015 is going to
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be around fifty billion dollars
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I read that statistic we're seeing it
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happening it's quite frightening now
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with a lot of the technological advances
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both medical and informational that are
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happening as some of which you've cited
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what do you see taking shape or how do
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you see that the landscape transforming
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over the next few years in India
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listen visa vie some of those
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technologies I think that with you know
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I can talk for our hospitals that we've
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always been very technologically
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advanced in fact the CyberKnife dr.
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Adler who who discovered it
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I mean who actually who was the inventor
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he was in India last week and we bought
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the first cyber Knife in the region 360
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a slice CT and the CyberKnife is what
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the CyberKnife is what they use advanced
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radiology for for for cancer treatment
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the very few in the world and what it
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does is that it's it's so much more
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precise and the radiation used is is one
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tenth of what a normal machine uses so
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you know we have we have a PET CT in our
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hospitals so we've always believed in
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technology right from our first hospital
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when we opened in 1982 we had the first
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cat scan in in the country and we
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continue to do that because we think it
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plays an important role if you look at
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Indian medicine I think there were some
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doctors from the US that came to us and
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they were actually shocked that 95
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percent of our cases of our open heart
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surgery cases are done are done with the
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beating heart so you know that's
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cutting-edge technology in the u.s. they
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probably use their technology for maybe
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fifty to sixty percent and so I think
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that that India and by and large Indian
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doctors are well known we've had we've
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been fortunate to have
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a lot of them come back so one its
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technology and two it's the ability to
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harness the people with the talent who
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can do that
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and India is definitely proving itself
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as as a center for that excellence and
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so you're definitely seeing a higher
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number of doctors coming back after
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their medical training to India than
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before I would think so because every
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new hospital that we open we have quite
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a few applicants especially I mean not
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as many from the US but definitely from
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from England and other parts with and
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most of these are Indians but
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surprisingly you know we have one or two
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experts also working with us right now
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you mentioned your first hospital in
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1982 that was in Chennai correct and it
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was 150 bed hospital I believe and how
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what - what do you attribute Apollo's
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phenomenal growth over the years I mean
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that's it's not a very long period of
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time it's 1982 and and to go from 150
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beds to what you are today how what's
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helped to power to grow so quickly I
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think that this great growth has
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actually been over the last ten years we
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had the advantage of the previous 15
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years to prove test and and get the
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model right because at every time I
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think we believed in the fact that that
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the quality and the patient service
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outcomes outcomes are just critical in
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Apollo if you see that you match us
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anywhere whether it's an open heart or
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or or even a liver transplant we have
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world-class outcomes in all our
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hospitals I think the focus on that has
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helped us grow and and for people to
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have the confidence in us the phenomenal
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growth over the last 10 years in many of
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these sectors I think has been the
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ability to access capital much easier
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and the fact that you know we have we
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have two or three levels of management
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who had grown with us and who were able
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to
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take over the mantle to move into new
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projects and just move it right from
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doctors to to nurses to management you
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know P personnel all fields that they
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were able to care to take that through
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and I think that's a great combination
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hmm well with our world-class facilities
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and the level the success of outcomes
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that you've cited imagine the one thing
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that might hamper Apollo would be
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perhaps the actual infrastructure in the
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country and globally you compete with
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hospitals from Thailand for instance
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where infrastructure isn't so much of an
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issue people can sort of fly and very
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easily get to where they need to go
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how does Apollo compete in that
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particular scenario you know 15 percent
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of all our major hospitals have
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international patients with us the
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patient's a lot of them what Thailand
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doesn't see are for higher end
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treatments and I think they come because
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of the quality of the outcomes we do you
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know our doctors in Chennai for instance
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have done the largest number of cement
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less hip replacements in the world so
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people will come from the US and Canada
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for them Thailand is for the regular
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type of where there's a cost arbitrage
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but they come to India for open heart
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and for the more difficult surgeries and
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when it comes to infrastructure your
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answer to that there's very little I can
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say in in India's defense except the
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fact that I think we've been able to
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overcome that within our little island
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of a hospital but we can't take it
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outside but but the government has now
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understood they've gone to Thailand
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everybody studied Thailand as a model in
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the whole region Singapore has Malaysia
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everybody is trying to replicate that
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model effectively and I think that the
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numbers are telling in the region but
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it's not just Thailand that dominates
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but the other hospitals in the whole
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region are benefiting from opening this
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sector up and do you see improvements in
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infrastructure that are either happening
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now or that are planned that you think
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will sort of help to improve the
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situation connectivity yes you know they
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privatized airports in in India we have
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three of our major airports are private
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for and I think that there's been a sea
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change in in the number of flights that
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come in the connectivity in terms of
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roads India has embarked not maybe the
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scale of China but what the US did in
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the 50s and 60s during the Great
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Depression I think that we have that
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we've been we're investing in a larger
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network of roads than that so it's I
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think that all these will tell we still
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have issues in terms of electricity but
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I think it doesn't really affect the
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hospital as much as it does you know a
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state problem and do you think that
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despite these difficulties that perhaps
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there's been a benefit to innovation in
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medicine in India in other words because
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there are infrastructure issues to
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overcome you have you know a rapid
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adoption of of teller Diagnostics or
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teleradiology which I think you
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mentioned earlier I think that that's a
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really good observation that possibly
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this advancement that we had in you know
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in telemedicine is probably is it is is
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in response to a need so we actually
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have diagnostic bands which have
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satellite connectivity with with the
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east row that's the Indian Space
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Research so they've given us the the
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ability with their with a satellite and
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we go into the rural areas remote areas
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where we were able to do you don't
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diagnose people with heart or ailments
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do the ultrasounds and the x-rays and it
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gets beamed into our main hospitals so
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and this is on
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moving vans so I think that yeah the
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innovation has been there in response to
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a need we use telemedicine extensively
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after the tsunami we had we had an
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outpost in Andamans
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that's the island that got hit it was
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completely submerged the first thing
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that that the government put up got
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linked up again was our telemedicine
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Network station and so we were doing
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Conn consults across the ocean into this
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area and I think that was it it was a
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huge need that was served that's
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remarkable well you're now you've been
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branching into retail pharmaceuticals
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and into health insurance as well where
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do you see Apollo
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five years down the road or maybe even
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ten years in terms of its strategy and
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how its developing I think it was
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probably you know India's such a nascent
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country in terms of health care that we
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start with that at the beginning we
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provided every need it's like the Wild
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West you set up you put your stakes in
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every part of health care but I think
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that there are enough players coming in
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and competition coming in that we have
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to choose which are the areas that we
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will continue to dominate and be really
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good at and some of these have been and
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and some of this is definitely health
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insurance
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where we feel that it's that access for
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people is going to come from from there
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there's only they need in India is
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probably the size of the US population
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the 300 million people who can afford
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health insurance so we just need to be
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able to make them aware and say that big
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one for us hospitals will always remain
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the core of our business diagnostic
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centers I think the pharmacies are a
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means to an end
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we got into the retail space we're quite
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good at it we have a thousand and and
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the very fact
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next year they'll you know that project
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will break even and start doing well so
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there's definitely strength in that and
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we'll continue to find we might expand
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across our own Geographic border into
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other markets
