Aster Healthcare provides healthcare across all economic segments. While Medcare focuses on premium healthcare, Aster focuses on providing quality healthcare across the Middle East and India. What services do you provide to low-income populations in the UAE? What is your vision for Access?
We have the huge advantage of having three verticals. Many of the healthcare players don’t have hospitals, clinics and pharmacies. We have all three. So that’s one. We also have three economic segments like you’ve said. So, what’s the difference between Medcare, Aster and Access? We say that it’s like going on a flight from Dubai to Delhi. Your beginning point and destination are the same. You come with an illness and you have to get it cured.
But the way in which you get the service – like first class, business class and economy – that’s the way we look at these verticals. So, there will be a difference in the service being provided, ambience, service levels and settings. But ultimately, the treatment has to be the same. Sixty per cent of our total business comes from Dubai. So, we thought that this is the best place for us to experiment. If you look at overall business, Indian business is 13 per cent; GCC is 87 per cent. In that 87 per cent, I think 80 per cent will be Dubai.
We thought there is a requirement for us to segregate healthcare services because the cost structures are different when you go to different levels. For example, in a company with 1,000 people, there will be about 50 people who are top executives; 250 people who are middle level executives; and the remaining 70 per cent are lower end blue collar workers and support staff. That is the population demographic in the UAE too. Moreover, Dubai is completely covered by insurance, like Abu Dhabi.
A senior executive in a company would require Medcare-like care. That is what their company also wants. They can’t provide it for everybody. Then the middle segment will require normal healthcare services. And the Access vertical’s services are a little more stretched. You will have to come, wait. It won’t be as posh. This is also what the insurance companies, and the company want. On the basis of that, we created this economic segmentation of our services.
How can the Access category of services be provided in India, where there is a high demand for affordable healthcare at the base of the pyramid?
We think that there is a significant opportunity at the bottom of the pyramid in countries like India and in other GCC countries. The Aster brand in India is for the middle-income population. Below that, there is a huge segment which is the people who are now going into the Ayushman Bharat programme. We would like to look at that because that’s going to be a significant opportunity. We have not started clinics in India because there is no coverage for outpatients through the insurance system. Only the inpatient is covered. Once the outpatient gets covered, then the situation will change. We can have clinics like we have in UAE, and also hospitals.
We have this in mind and are looking at a way in which we can be providers for the Ayushman Bharat by having a presence in the tier II and III cities as well as in the metros and tier I cities. We are strategising how we can go there and cater to the nearly 50 per cent of the population covered by the Ayushman Bharat.
What could be your strategy for servicing the Ayushman Bharat scheme?
There are two ways: one, we can have blocks which can serve patients under the Ayushman Bharat along with our existing hospitals, so that we can share resources. But that will be only the large cities because we are mostly in the cities. The other is to go to tier II-III cities and have smaller facilities with maybe general wards, and the cost of everything, including nursing care, will come down.
So, you can have a lower cost base and you can serve people within that price bracket because presently the issue is the price point in Ayushman Bharat, which is lower than what we could bear, due to all our costs and investments. So, we are not able to serve that segment even though we want to. Our WIMS Medical College Hospital in Wayanad, Kerala does that. It serves patients covered by Ayushman Bharat.
We could start in Kolhapur, a tier II city, where we already have an establishment – Aster Aadhaar. But if you look at even the metros and tier I cities, there is large population in the Ayushman Bharat crowd. Everybody who is in a metro is not a high-income or a middle-income person.
You often mention about profit being a by-product and patient-centricity being the core at Aster. How do you as a leader pass this on to the doctors who join you?
That’s very important. Ultimately it all boils down to the culture of the organisation and its values. The philosophy of profit has to be a by-product in healthcare rather than the aim. We have got a lot of profit, but the aim is always to care for and cure the patient. We have a very clear annual operating plan, which is a KPI for all the people in the company. This has growth or financial as one component. But the other five components are not related to finance. This includes clinical excellence where you must be the top; and service excellence. And how to take care of our own people; and the community connect or the brand equity.
We achieve community connect through Aster Volunteers and giving back to society. And then, of course, innovation and digital which is very important. We drive these priorities into the minds of people starting from the induction programme. People come from different organisations. So, the induction programme is compulsory for employees, where they get a flavour of what Aster actually is – its philosophy and values. They constantly hear this from the leadership team too.
One thing we are now planning is giving our employees from across eight countries an opportunity to send questions, or ask them in the virtual town hall, and we will be replying to them. This means anybody in the organisation can have that opportunity. Hear them out and then clear their doubts.
How have you developed the senior leadership team?
The leadership team which is working around me comprises about 10 people; and beyond that there are 40-50 people. That’s a total of 60-70 people which is the top leadership team. We meet quite frequently. This message of top organisational priorities is shared with them, and they have to percolate this down to the people in the system.
Our brand promise is ‘We will treat you well’. So, when we say we will treat you well, the treat doesn’t mean that it is treatment. It is the way in which you treat people. And when we say treat, it is not just the patient. It is everybody – all the people in the organisation, our vendors and all other stakeholders. Overall, we have been able to convey the philosophy as well as the culture to a large extent.
How do you see the role of healthcare companies in CSR?
We are really fortunate to be in a profession where we have the benefit of always touching the lives of people. In any other profession, they can only touch it indirectly and sometimes not at all. In our case, we see about 50,000 patients a day across the world. So, this is an opportunity to provide something. Even a smile, a pat on the back of a person, could be taken as part of CSR.
In healthcare CSR can be organised in such a way that the healthcare professionals can do something for the benefit of the people by donating their time, if not money, for such activities. We have asked our doctors to do a certain number of surgeries or procedures free of cost. Then, the organisation need not bear the cost completely. This is contributed partly by the people who provide the service. And there are a lot of people who are ready to serve.
At Aster, what do you do differently in terms of social responsibility?
There is a humongous requirement for money and we feel very sad when we find we have an opportunity to provide treatment, but the patient is not able to receive it because of lack of funding. So apart from routine CSR, we try to address such situations through various ways. For example, there is a limit to funding so we try to connect such patients with people who could help them.
One of the ways is through crowd funding which is quite effective especially in cases where there are significant amounts of money involved. CSR is something which all healthcare organisations should participate in. For us, it has become a movement now, with 18,000 Aster Volunteers and more people joining. People have that passion to do things.
We also have given employment to 108 people with special needs in the organisation. They have mingled within the organisation. Except for people who are on wheelchairs, you won’t even know they have some special need because they are a part of the organisation. That again is part of our CSR programme. What we want to do is to provide training for such people in our hospitals; they then get a certificate which allows them to take up jobs elsewhere, as there is a limit to how many we can take. That’s another way in which healthcare organisations can discharge their responsibility. For example, in our Kochi Hospital, we have a blind band.
A band of musicians who play in the morning for three hours and in the evening for three hours – six days a week. They are all blind, but they entertain patients coming into the OPD. This helps them earn a living. At the same time, the people who go there realise that people with challenges have their own unique capabilities that must be encouraged.
(By 2019, Aster Volunteers Global Programme, run by the Aster DM Foundation, had impacted nearly 12,50,000 people across eight countries through a variety of services including free surgeries and investigations, child health and wellness, mobile medical and wellness camps, disaster relief and aid.)