Entrepreneurs breathe life into dying breed of general physicians

Written by Soma Das | New Delhi | Updated: May 15 2012, 09:24am hrs
Niti Pall is neither an environmentalist nor a curator. Yet, this doctor-entrepreneur from the UK, a cancer survivor herself, is zealously trying to revive an endangered species the general physician and restore their natural habitat, the neighbourhood clinic.

In June 2011, Pall raised over $1.5 million from friends and family to float her venture Pathfinders Health India. The venture set up its first clinic in October 2011, followed by three more.

A month earlier in Mumbai, Wellspring Healthcare founders Gautam Sen himself a doctor and son Kaushik Sen set up their first primary healthcare centre, their dream of the previous six years. In six months, they have hired 19 full-time doctors and now have a network of four clinics in Mumbai.

Pall, who runs similar clinics in the UK, gets her doctors selected in India take an exam at Londons Royal College of Practitioners before they can practice. At a macro-level, she follows a matrix model, with a hub and spoke strategy.

Her clinic ecosystem operates in two layers. A family medical health centre (hub) with around four doctors and two nurses can handle 70 patients a day and serve a population of 10,000-20,000 each. These would be designed to support around 5-10 smaller clinics which she calls DIBs (doctors in boxes), located about 20 minutes away from the hub. These DIBs cater to 35 patients a day. A rule book and standard operating procedures, with a complete formulary of drugs with first-line and second-line therapies have been put in place online for doctors, a percentage of whose income is linked to the health outcomes of the patients they see.

Per-visit charges are R200-400 in Delhi depending on how posh the locality is, with a promise of a few free follow-ups. Also on offer will be a pharmacy store adjacent to the clinic to sell branded generics on heavy discounts of up to 40% for which Pall is in the process of tying up companies like Ranbaxy, Cipla and Dr Reddys.

In the process of reinventing the concept of GP, I want to also create a career growth path for these doctors and demonstrate that use of technology along with familiarity with personal case histories of the patients can greatly enhance health outcomes, Niti said.

The Sen duo are clear that just transplanting the US or UK model here may backfire; so they customised it for the Indian context. The Sens found financial backing from Narayan Murthys Catamaran Ventures, Reliance Venture Asset Management, Bluecross Blueshield Venture Partners LP and Sandbox Industries.

A 1,500-sq m establishment with three doctor consultants, a pathlab, a routine radiology lab, a pharmacy and a dedicated space for minor procedures such as suturing and plastering completes a Healthspring clinic, the brand of Wellspring venture.

Unlike Pathfinders, Wellspring chose to standardise prices within a city but charge differentially across cities. For now, patients pay R350-300 per consultation and avail of free follow-ups the week after. However, just like Pall, the Sens are also betting big on the house visit model of doctors.

Both players are working out and offering various family and periodical (monthly, annual) membership packages.

Hyderabad's Viva Sehat, (backed by Singapore's Viva Healthcare) and Bangalore's NationWide Primary Healthcare Services are also making similar endeavours. The rise of such models is imminent and important as 80% of healthcare services can actually be taken care of by primary healthcare centres. This will reduce a disproportionate emphasis on the tertiary care in the $60 billion healthcare sector, said Arvind Singhal, chairman, Technopak Advisors.