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Our guest today is Dr. Shamshi Vil, founder and managing director of VPS Healthcare, a rapidly growing company in
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the UAE. Uh Dr. Shamir, thank you very much for joining us today on Knowledge at Wharton. Thank you, Mul. Thank you
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for having me here. Uh Mike, uh and my co-host today is Dr. Mike Yusim, uh director of the leadership center. Uh
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Mike, would you like to get started? I will jump in and Shamsir, welcome to the program here. Thank you, Mike. And a
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couple years back, you were a practicing radiologist. You practice medicine and now you deliver medicine and you deliver
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it to a lot of people. The last time I checked, some two million people patients a year come into one of your
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facilities. So, just thinking about the transition from a practicing a person who practice medicine to a person now
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who delivers medicine to a lot of others. What did it take to make that transition?
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uh I'm I'm trained as a radiologist. I spend almost uh 10 years of my life in
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medical training. then another two years for the the masters and then uh I realized that uh as a radiologist my
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life would be uh more or less contained in the basement of the buildings of hospitals because all the radiology
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departments are in the basement and you don't see the sunlight and I decided
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that my life uh should be used for the larger good of public and uh and being in a business family you know you always
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have that blood of uh doing something by yourself and uh I worked for an here in
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the government hospital uh in Abu Dhabi. Then I retire resigned from the job and
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didn't know what to do. So at that time didn't have any formal training uh in
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business. But uh I knew I had a a strong desire to do something to to build a healthcare uh system which could clearly
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bring out the change for for the patients. So with that dream I started and uh here I am with some good number
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of hospitals, good doctors, good team all around. So it's been a tremendous journey. You know, Shamshshire, I think
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many people have the dream of one day becoming an entrepreneur themselves. And from your experience, you you opened
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your first hospital, I think it was in ' 07. Um, what did it take to finally make
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that decision? And then once you made it, what are some of the steps you took to begin to learn all the business
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skills you have to have to run an enterprise like a hospital? Uh, it's always a learning u day. every day you
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learn something new and uh as somebody who didn't know how to run a business or
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had no previous experience of running hospitals. It was it was a completely new challenge and I was enjoying that uh
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journey to to be there every day uh talk to the mechanics, talk to the the contracting people, talk to them about
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construction, learn how the electro mechanics work inside an operating room uh how the uh the waste water should be
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ejected out of the hospitals. So everything was different. Everything was learning and I was very keen to learn.
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So I I would be there early in the morning spend 18 20 hours without any problems fully charged uh don't get
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sleep because of the excitement and which is still the case uh on on on sometimes when when you have some
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interesting projects. So uh ability to learn was something which helped me a lot. I was I was a good listener. I I
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would listen to people and I I would accept that I didn't have any experience. So I hired the best people
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on the job. Yeah. You know, it's a very interesting point and that is to become
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a leader of a hospital, your chief executive of the system which includes medical centers, pharmaceutical
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delivery. It's not just hospitals in three different continents. Um, you've
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had to become a general manager. You've had to do everything. You have to know
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everything. I say I'm the owner and the cleaner. You know, that's very my uh my
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main focus is uh I don't involve in operations. My important task every day is I have a team of 15 to 20 people who
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are all across uh in different areas that we operate who gives feedback after talking to the patients and I get all
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the uh most of them the the the the impulse from from the response from the patients. So I take it very seriously
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and then I work backwards to the systems. If it's more waiting time, I need to talk to the CEO to to see what
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can be done to reduce the times of waiting inside the emergency or in the pharmacy or if it is an out of stock
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pharmacy situation, what to do to tackle it. So, uh pretty interesting. So, you've built a very fast growing
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business. I believe you started in 2007 and you are now as I understand it close
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to a billion dollars worth of revenues. uh what was your strategy in building a business so rapidly uh in the UAE? Uh
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what were some of the steps you took? For me it was all about uh building the capacity you know uh I wanted to go
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where there were no facilities available. So for me I didn't want to build a hospital and expect everyone to
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come to this particular to this particular building. I would uh rather look at areas which were devoid of
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healthcare and go build capacity improve the the capacity efficiency comes then then gives you that uh ability to
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negotiate with your vendors it brings down your operating expenses you have uh service line optimizations where you
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want to retain the best talent you need to have certain volume so that comes with capacity so for me I was more on uh
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I was not focused on the revenues at all I knew if I focus on the quality and and
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get good doctors because that would bring me the revenue. So we went in for the accredititations. We we got the US
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accredititations to start with and that time it was not uh really required by uh
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any legal standards but we went and got all these things and it started teaching
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us how to do things in a more systematic way. Even though we have lot of anarchy
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which comes with the growth that we have but we have teams who are only focused on certain activities and they're not
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concerned about what's going around the group. So we have some people who are on
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the ground uh firefighting things every day but some people who are on the top who goes around building new centers
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like me I'm I'm more into uh building capacity I'm more into projects you
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would see me at any point of time in one of those projects the sleeves rolled up
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I still love to do it and I think speed is of essence we take decisions very fast you know we appreciate your courage
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in getting everything going back in ' 07 and we also appreciate your courage in
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moving out of Abu Dhabi you're still there of course But in addition, you have operations now in Oman, not too far
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away. London, that's pretty far away. India, culturally, quite a gap there. And you're here now in the US to think
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about partnering with a couple of US hospitals as well. Looking back on on your movement out of your home
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territory, what of what's one of the more difficult cultural chasms you had to cross to make things work?
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See, it's always uh the comfort zone that you leave when you go into a a new
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territory or a new market, but you adapt very fast. You know the local cultural sensitivities. You know uh what ticks
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you need to know the the the the you know the demand of the people and I think if you can be Omani when you reach
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Oman or or being in London, you have to behave the way that what they want to see and what they want to hear from you.
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So once we can adapt to the local requirements of the market regardless of the market and keeping the patient uh
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need in the center it it works and and it's so good to uh uh of a time to exploit and and and to grow fast because
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technology has grown. You could reach uh any part of the world. Tomorrow morning
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I'm having some meetings in London. I fly back to Abu Dhabi the same night. The next day I have something else. So
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you can't be in a better position than uh what you can dream about. So just use
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the time and take decisions. So if you were to look back on your journey uh and I assume that in the past seven or eight
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years it's just barely begun. What have been some of the most testing challenges
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that you have faced? How did you overcome those challenges and what did you learn from them? We started at a
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time when uh the insurance law was introduced in 2007 in UAE. At the same time there was uh the financial world
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crisis which was going on. So there was kind of a lot of mixed responses to our beginning of the hospital during that
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time. But I was very confident that uh whatever the crisis is going around healthcare is going to be the last one
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which is going to be affected. In fact, we saw increase in the number of patients visiting the hospitals during
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those periods because you know they that leads to headaches that leads to you know psychiatric consultations. Uh you
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know jokes apart it's again uh the the testing times which gives us that opportunity to uh be what the market
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needs but you need to be realistic. You need to set uh the goals which are achievable and then uh go all out. You
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know, going back a little bit in our conversation here, one of the great aggravations that many patients complain
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about is weight time. And you referenced waiting time and trying to get that down. In your own experience, what are a
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couple of the tactics, the management tactics to cut weight time? And just to go back to another phrase, make the
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hospital that much more patient centered. I think the the concept was to uh to make a network of clinics all
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across going to the communities because we don't want patients to come inside
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the hospitals when they really don't have to come in because it's unnecessary
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cost. It's a lot of headache when people should not be in the hospitals coming
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inside is again something that we don't want to have in our group. So we have
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started up opening clinics all across the communities where we educate the patients that if it's something that
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they need on an urgent basis that's the place to be but if they are terribly
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sick then then come to the hospital. So there's a there's a difficult situation
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where you educate the the public and everyone wants to see the doctor when they when they are sick and they want to
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be the first to see the doctor. So again it's improving the accessibility point
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of view. You know, it's really interesting because uh hospitals are there to bring patients in and render
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services, but from what you've said, one of your tactics here, one of your strategies really is to keep patients
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out of the hospital, clinics, wellness programs, better diet, exercise, and all the above. And I think in that sense,
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you're delivering health services fully. It's not just what happens when somebody
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comes in and needs an X-ray. The best thing is they don't come in for an X-ray
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at all. That's right. And uh what we have done is we wanted the hospital to do cardiac surgeries, neurosurgery, knee
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replacements and uh let the patients who needs uh the wellness programs to go inside the malls uh do their shopping,
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get into these clinics, get themselves checked on a continuous basis because we have launched programs for the disease
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management of people suffering with diabetes so that they don't uh miss their medicines that leads into
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complications and end up spending a lot of money and time on recovering. So these kind of in you know in initiatives
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have been liked by people initially they are kind of hesitant to go to outreach programs but once they find value that
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is when we can see there's a successful program launched. So what are some of
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the most surprising innovative things that you have tried out? I heard something about a dental clinic that was
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done quite uh innovatively. Can you tell us that story? So there was a zoo on the
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uh the outskirts of Abu Dhabi where a lot of childrens used to go and I took my uh children as well and uh I had my
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one of my clinic managers who was just passing by and we had a a good discussion and he came up to with a with
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an interesting idea of uh you know why don't we start a a dental clinic inside
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the inside the zoo for the children who comes in so that they walk in they get a
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a routine checkup done we identify the carries and you know let them know that there's a carry happening.
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And now at that time I thought it's it's a crazy idea and I I I had to give him
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his you know uh due credit that I finally yielded into his compulsion of opening up the clinic and now we got
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requests from parents to have some facilities even for the parents to be in the inside the clinic when they when
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they come with the children. So I think this innovative ideas of reaching out to
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the masses especially inside the malls inside the hypermarkets that you see here as well uh healthcare is going to
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take a lot of change in the years to come. You know if you think about the years to come digital delivery of uh
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appraisals of diagnostics I I think it's out there still slow to develop but if
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we were to sit down in five years my guess is digital medicine is going to be a big piece of what you're doing.
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Digital is already there. we have uh diagnostic imaging which is connected right across the group and can be
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reported from any any facility or even from home. So that again uh reduces the need for a lot of radiologists on on the
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on the ground and that has really helped in faster decision-m process. So it's
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all about taking the right decision at the right time using the right technology and that saves life. You have
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something called as the golden hour where you need to be connected. You can't expect when that golden hour is
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going to happen. It could be on a Sunday, it could be on a holiday and you don't have people on the facility and
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then if you have a digital platform where people can log in, see the films, report the uh the clinical needs that
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could save lot of hassle for the patients. So uh just last week uh India's prime minister Narendra Modi was
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in the US and he was in Silicon Valley talking to a lot of uh uh CEOs there about something called digital India. M
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uh and I think as as far as I understand it, the plan is to connect more than 600,000 Indian villages through a fiber
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uh network. Uh what kind of opportunities would this provide do you think for health care uh providers
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especially to people at the bottom of the pyramid who traditionally don't have
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access to healthcare? I think this could lead to a lot of two-way communications
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when it comes to healthcare delivery and uh to reach out to these areas are very
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difficult. You know they have their own logistic problems to reach out to to take the best of doctors to those rural
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areas. It's it's like next to impossible. So if you have the connectivity then you have things like
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teley medicine which could be used uh we could have lot of information uh passed
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out to these public in their own languages. So I think you could have lot of two-way communications. You don't
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have to wait essentially for a complication to happen before uh they could talk to help. They could talk to
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somebody who can give them the help to to overcome the situation. Uh for a person like yourself going back
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to let's say 06 and 07 you were a professional radiologist but inside you there was the entrepreneur and and and
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the business person. And for our listeners and our readers who got that entrepreneurial bug somewhere that one
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day may be more out and more recognized, what what advice would you have from your own experience on that kind of a
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transition? Yeah, I think it's all about that uh the the listening to your heart,
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your your your gut feeling and what you like to do. And I think that's what's
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very important. And I remember when I was doing my training, I always used to think of a day when you know I could
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have a hospital treat lot of people that was always inside the heart and and there was a time when it came and I have
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to break the the the the mold and come out of it and and follow my heart and and there's no regret because for me at
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that point of time the decision was there was no point of return and I I can't go back and do practice. So uh you
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know I think I I I would advise a lot of youngsters to come forward uh to be in healthcare especially because the world
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needs a lot more healthcare than what it is right now and and there are a lot of
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good things that you can that you can do to to make money to to do good for the people. There's lot of corporate social
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responsibilities that you can do and and the world needs a lot of people uh from
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here. Give it a try. Yes, why not? Okay. So, one one of the key attributes of any
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good entrepreneur and I think you referred to it somewhat in your previous answer uh is the ability to pick the
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right team. Uh and and uh I was listening to Mark Zuckerberg from Facebook talking about how he selects
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people uh who are his direct reports and he said what I look for is if I am willing to work for that person then I
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hire that person to work for me. What do you look for in your team? Uh you know for me uh it's about uh people with the
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right attitude. The people uh who don't feel that they have done it all. They have seen it all who would
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still have uh the fire in their belly something to prove and uh you know uh treat people with a lot of respect and
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and for us we always had an issue with job descriptions when when I remember the first CEOs that I hired and they
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asked me for a job description and I said that you tell me what you can do for us. So that was an approach that
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I've taken and I still follow that and uh I used to call a lot of the the top
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directors when they join I used to call them personally on a disguise name so that I get a good firsthand experience
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of how they are with people at a lower level. So uh kind of freestyling when when it comes to recruiting senior
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people uh they need to uh be people oriented people driven yet taking decisions and not afraid of the
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eventualities. And looking back over the eight years since you uh founded the hospital
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itself, could you pick out an incident or a decision or a time that seemed exceptionally
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challenging and just walk us through what happened and what decision you reached? because we keep taking these
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tough decisions on a on on a daily basis. But some of the decisions were we have to build a a tertiary care hospital
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and we were given a real estate uh building uh and the and and we were only given 10 15 days to decide whether we
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need the building or not and it was a commercial building at that time. So we we uh you know brought some consultants
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from us they came and said it's not going to be possible and uh that was a very difficult moment and then uh I
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remember one of the local architects on the site he gave me a solution for cutting across the vertical
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transportation and that was a challenge and I have to completely trust Honum to take that building which was something
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like a 200 million project and uh looking back uh uh that's something of a feather in our in our cap and and it has
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done extremely as well the the hospital which looked like a hotel feel like a different environment altogether. We
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have gourmet kitchens inside. We have uh the music playing all the time. People come in to have a cup of coffee. So
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that's the building. You know just a quick observation of what you've said
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with a question to it. A lot of learning what you do now you've learned by doing
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it. You've got out you went out you made a decision. Should we open up a clinic
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at a zoo? I don't know but let's try it and see what happens. You call it paid
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experience you know some of it works some of it works some some failed we had closures but we learn from every mistake
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we try hard not to repeat the mistakes but eventually you know keep doing the same mistakes but again it's the 8020
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rule you know the 20% of those things which clicks very well compensates everything. Yeah. We have uh I think
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about a minute or so left and for the uh I wonder if I can ask you to do a little
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bit of crystal ball gazing. Where do you see you and the enterprise going versus
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the next seven or eight years? You've already come a long way during the past
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seven or eight years. What's next? We want to go global. We want to uh be in
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lot of more markets than what we are right now. We want to provide a lot more advanced care for the less privileged
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across the world. Uh we have manufacturing activities. We uh we u are getting very strong into the
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manufacturing activities as well. So what we feel is that we have to build a a healthcare ecosystem where uh we have
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an integrated uh healthcare delivery approach where we control the various aspects of healthcare delivery right
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from patient care, the logistics, supply chain, the the pharmaceuticals, the back
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end, the IT, the home care. So we we feel that that's where we need to go. It's a long journey. Right. Well, uh
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Shashir, thank you so much for joining us today. Mike, yeah, thank you. We appreciate you're coming from Abu
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Dhabi for joining us. A great experience. Thank you so much. Thank you so much for being on the knowledge at
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Wharton show. Thank you. Thank you. [Music]