A surgeon at heart

Written by Sudhir Chowdhary | Updated: Jul 31 2010, 04:17am hrs
Naresh Trehan is a man on a mission when it comes to Medanta, an Rs 1,200-crore integrated healthcare facility. With 50,000 heart surgeries to his credit, Trehans skills as a medical practitioner are well known. Its his entrepreneurial skills that are coming to the fore as he tells Sudhir Chowdhary about Medanta, his past battles at Escorts and why his new project will create a buzz in the Indian healthcare market

After 50,000 cardiac surgeries, there are few who doubt Naresh Trehans expertise and accomplishments in the field. What has amazed people is his rapid transformation into a successful entrepreneur. As the founder of the Rs 1,200-crore Gurgaon-based integrated healthcare facility Medanta, the heart surgeon is working tirelessly to establish a unique healthcare institute, on the lines of Mayo, Cleveland, Harvard and John Hopkins. His rationale is simple: From Germany to Japan, there is not a single institute on the lines of a Harvard or John Hopkins. So why not build such a institute for 1.6 billion-odd people in the sub-continent, he reasons.

The cardiac surgeon-turned-entrepreneur should be a happy man. Medanta is running to full capacity, especially the cardiac care wing, since it began operations early this year. Normally, hospitals achieve 100% occupancy levels in two to three years time. Around 300 doctors and 1,100 paramedics have joined the integrated healthcare facility, comprising a hospital, a research centre and a medical and nursing school.

For his dream project, Trehan has laid emphasis on two things. Adoption of the latest technology for diagnosis and treatment and selection of right medical practitioners. These are people who are not only the worlds best doctors, but have reached a stage where they are looking beyond themselves and are keen to teach and do research. Technology acquisition of about Rs 300 crore has already been implemented, including necessary equipment for robotic surgery and other healthcare equipment like SOMATOM Definition Flash CT scanner, Artis Zeego cathlab, ACUSON SC2000 ultrasound system and Biograph mCT, a PET.CT scanner.

Spread over 43 acres, Medanta is a conglomeration of multi-superspecialty institutes that are led by renowned medical practitioners in their respective fields. It has over 1,250 beds, of which 600 are already operational. There are 45 operation theatres catering to over 20 specialties. In a nutshell, we have built an institution that matches the highest standards of healthcare delivery across the world. It will offer not only the best technical facilities, but also clinical research, education and training, he says.

Unfazed by the early success, Trehan sounds philosophical as he says, I personally believe that good medicine makes good business and thats the only way forward. Its a sacrosanct business and should not be treated with the same yardstick like an airline or hotel business. As I say it, healthcare is business with a soul. And I always say this to my colleagues: If you dont love people, do not become a doctor.

Without any doubt, Trehans love for people owes its genesis to his childhood. Trehans parents were well-known doctors in Pakistan, but the Partition made them refugees in New Delhi. I have vivid memories of shifting to a three-room apartment opposite Plaza Cinema in Connaught Place and having to share one room with my parents and sister because two of the rooms were used by my parents as their clinics. I was around six then and used to see patients coming to my house, he reminisces, adding, the medical profession is all about real-life drama and its people-connected.

Since childhood, Trehan was keen on learning new things. Like any child, he had a new ambition everyday. I wanted to become a pilot as I was the president of the aero-modelling club of Modern School. But when it came to appearing for the NDA exam, my parents had second thoughts. Subsequently, Trehan did his MBBS from KG Medical College, Lucknow, in 1968 and thereafter proceeded to the United States. He started practicing heart surgery under the guidance of Frank Spencer at New York University. Spencer was one of the finest teachers of heart surgery in the world and a pioneer, because he was one of the three people who started coronary bypass surgery, says Trehan.

I went to the US with the belief that whatever the new frontiers of medicine are, I want to learn them and come back to India. Once I arrived there, it was clear that cardiac surgery and neuro surgery were emerging fields and coronary artery bypass was just being invented at that time. Fortunately, after I finished my training, Spencer asked me to stay on as a professor of teaching, research and practice. A lot of people from India started coming over to me in New York for their bypass surgery as it was not being done in India. Everybody said the same thingwhy here, why not in India he recalls.

Trehan came back to India in 1988 and set up Escorts Heart Institute and Research Centre, where he had a 20-year stint as its executive director. A realisation came to me in 2003-2004 that the heart institute we had built 15 years back, we are still following it and others are trying to copy it. On the other hand, India has moved ahead and is almost on the verge of being a developed country. If you have 1.2 billion people, you need to develop your own methodologies, instead of merely copying standards from the West. I felt that it was time to build a world-class medical institute, which leads with new technology, methodology and research.

But the journey from Escorts to Medanta was, indeed, a roller-coaster ride for Trehan. Following days of a bitter battle with the new owners of Escorts, Fortis Healthcare, Trehan sold his 10% stake in Escorts Heart Institute for Rs 70 crore and exited in 2007. At some point, when Rajan Nanda got into trouble, he sold Escorts Heart Institute overnight, which was not right in the sense. And the new owners could not quite comprehend the scheme of things. They felt there was a conflict of interest between Escorts and Medanta. There was disagreement and hence the parting of ways, he recalls.

Today, Medanta has generated enough excitement in the Rs 1,50,000-crore Indian healthcare market. Our healthcare costs are already 15-20% lower than the current market rate, Trehan says, adding, Medanta is making high-end healthcare affordable to the masses, including the economically weaker sections. Already, the hospital offers 5% free and another 20% as subsidised treatments.

Trehans business logic is simple. While he has invested significantly in technology acquisition, he is seeking to divide the cost over a large patient base so that Medanta is able to offer its services at a more affordable rate to the public.

I always emphasise that Medanta is made by doctors and run by doctors. A doctors relationship is with his patient. Hence, you are devoid of looking at the topline or bottomline. On the other hand, a businessman has no feelings. They look at cold-blooded numbers. I always tell my doctors, there is no such thing as the patient is wrong or demanding. On the contrary, he is the victim, he says.

As Spencer used to say, if you cant stand the heat, dont go into the kitchen. Likewise, doctors are always on the edge of the knife. A patients life and death is 24x7 with us. Its a different existence, but a very fulfilling one. Somebody asked me what would I like to be in my next life My response was quick, a heart surgeon, Trehan concludes.