Secret Diary Of An Entrepreneur

"One Needs To Be Curious To Grow"

Secret Diary of Devi Prasad Shetty Part - 2

Soumik Kar

I always wanted to come back to India. Shakuntala and I were already talking about it. When Birlas offered me the job to set up their super-specialty hospital dedicated to cardiac surgery, I was ready. I came back in 1989. Heathrow to Howrah was such a change, both in terms of protocol and aftercare. The first two months only went in training the nurses and the doctors. One of the doctors surprised me by saying he didn’t know babies could be affected by heart diseases! 

I always wanted to specialise in paediatric surgery but many colleagues tried to dissuade me, saying the outcomes aren’t good or that I would never make money… The idea was never to make money but to save lives. Outcomes? The world’s safest surgeon is the one who doesn’t operate. I wasn’t going to let a 1% failure rate prevent me from operating because 99 out of 100 times we were saving lives. No other job can offer that satisfaction. 

HowrahI still remember the first time I performed open heart surgery on a nine-day-old baby. It was, 1992. We had rewritten medical history, marking the beginning of paediatric cardiovascular surgery in the country. I was so happy and proud to hold that baby…Amma told me she had rushed to see me on television with the infant’s family. That day she couldn’t stop smiling…I had ticked off a life goal…

She was one of the reasons I became a doctor. It was a Saturday afternoon. I was trying to build a car with match sticks when my aunt from Bombay came to visit us. She was telling Amma about this wonderful doctor, who had saved her kid’s life by performing a couple of surgeries, without taking any money. “The world is a better place because of people like that doctor,” Amma said. Those words lingered…I wanted to be like that doctor…to make the world a better place and become somebody that Amma admires.

Chidhood photo of Devi Prasad Shetty Making the decision to become a doctor was easy, but going by my academic record, it was pretty ambitious. I was an average student, who pulled out the books just before the exams. I could spend hours drawing and painting but Maths was a recurring nightmare. It was just so daunting…I don’t know what I would have done if it wasn’t for Achutha Acharya. I was good at drawing, I was his favourite student. So, he started teaching me Maths too. “There is nothing in the world that you can’t do if you put your mind to it. There is a district level exam and I want you to take it,” he said. I didn’t want to disappoint him, so I took the exam and I did extremely well. Sometimes, you need small successes for that confidence boost. For me, it was passing that district level examination. I was relieved to give up Maths though three years later, in 10th standard…physics, chemistry and biology were more my kind of subjects. 

Dad? Dad was always away on business. He ran hotels in Bombay so he was always shuttling back and forth. Apart from his simplistic view towards life, he didn’t have that much impact on me. Amma was a more a defining influence. I can still hear her saying “Pechu, share your sweets with your friends before you eat!” I guess my sense of empathy comes from her…

surgery is easier than fixing phonesOne needs to be curious to grow. When things don’t work, you have to improvise. When I was in London, Shakuntala would go back to India for long stints. Those days, international call rates were exorbitant. I wasn’t making too much money. Whenever I would call home, the eye would always be on the seconds trickling by. I thought I will perform a surgery; see if there was a way to extend my time at the phone booth. First, I tried my luck at the coin booth. I took a coin, tied a stitch with a 6.0 prolene suture, tried to insert it in and take it out immediately just as the call was connecting. But the second I would drop the coin in, the machine would swallow it. Then I moved to the calling card. I tried the same thing, but it didn’t work. So, I studied the card under the microscope to see if there was a line where the card was crushed. I put cello tape on top of it, so it wouldn’t, but it got stuck and I couldn’t use the card again…

Narayana HrudayalayaThinking different didn’t work at the phone booth but it worked in the hospital set up. By making our own disposable gowns and drapes, we were able to reduce costs on sterilising and maintaining linen by more than half. We moved to digital x-rays to save on the cost of film, bargained our way to buy only reagents instead of blood testing machines and used technology to remotely monitor patients in the ICU. As Mother would say it wasn’t about doing one great thing but a lot of little ones. 

After moving back to India, I was shuttling between Calcutta and Bangalore…my family was there. When Dr. Ramdas Pai approached me and gave me the complete freedom to set up the Manipal Heart Foundation, I moved to Bangalore. Though we were doing some brilliant work, I wanted to create something larger. I realised there weren’t enough rich people who could subsidise the poor…that model just wasn’t going to work. 

I have much to thank my brother-in law. He convinced my father-in-law, Charmakki Narayana Shetty, to give me capital to start a hospital, to leave a legacy behind. The 225-bed hospital in Bangalore in 2000 was named after him. The hospital was always part of the larger plan, other things weren’t…

Devi Prasad ShettyIf being an entrepreneur has taught me one thing, it is “never say never”. I never wanted to build a company. I wanted to build a charitable trust, but I soon realised only a limited amount of money could be raised through a trust. That amount was nowhere close to what we needed, so we transitioned from a charitable trust to a for-profit organisation. 

I never wanted to raise money from private equity, I didn’t want to compromise on providing affordable healthcare just to generate a return. I didn’t want to tell a story that wasn’t part of our dream. So, I told them our real story…I told them providing affordable healthcare was possible adhering to sound business principles. In 2008, JP Morgan and PineBridge Investments pumped in Rs.400 crore for a 25% stake in the group. In early 2015, CDC invested Rs.300 crore.  But I was apprehensive; I had heard that private equity investors came with unrealistic expectations. But our investors never interfered; they compounded our belief and taught us to think big. The only thing they were rigid about was that all accounts had to be sorted within the quarter. They brought in a financial discipline, which wasn’t there before. 

I had said we would never go public, but seven years after our first private equity investment, we filed our IPO to give an exit to investors. The trick is to be transparent in your dealings and ensure the business grows. You do that and you will automatically have a happy set of investors. Of course, when you deal with human life on a daily basis, everything else seems trivial. I believe things are never as good or bad as they seem, it’s always somewhere in between. 

I still see around 100 patients a day and perform one or two surgeries a day. That’s what I really want to do, everything else is thrust on me. But if I don’t do those things, I can’t do what I really enjoy. I do them because of this great desire to change the world.

Amid all this, I always wished I had spent more time with my family. Shakuntala brought up the kids almost like a single parent. All credit goes to her…the kids never held my absence, against me. 

Sketch of detectiveShakuntala says I never act my age. I don’t act like a father or grandfather. I am more of a friend, my sons are my sounding board. Shakuntala is my biggest critic, she keeps me grounded at all times. It’s funny, I am a hero to so many mothers – they hand me over their most prized possession. Yet, she compares me to Forrest Gump or Inspector Clouseau in Pink Panther! These guys do random things but emerge as heroes in the end. She says there is no method in my madness. There can’t be…Not when you are trying to be five years ahead of competition. Not when you are working on pushing the cost of surgery constantly lower. In London, I became an excellent surgeon, but I didn’t have to meet the families of patients. In India, I would meet the families both before and after surgery. It didn’t take long to figure out that healthcare was out of bounds for majority of the people. Most people didn’t come back to the hospital after finding the cost. They wouldn’t even bother asking for a discount…I would let patients who could pay subsidise the ones who couldn’t. But they didn’t come back…I knew I had to do more…

That’s been the driving factor. Its taken 26 years, but the cost of surgery is down to half – of course, with the help of government schemes. No other service has seen that kind of reduction in price. We believed in it, so we made it happen. We set audacious goals – 35 heart surgeries a day! They laughed at us when we conceived the Rs.5 per month insurance plan but over 100,000 farmers gained and underwent heart surgery. The industry norm for a super-specialty hospital was $30-40 million. Our plan: Build a 200-300 bed super-specialty hospital at an investment of $4-6 million in six months. People thought I was crazy...but we managed to put up our Mysore hospital at just $7 million! It took nine months instead of six but it worked out in the end… 

You will never have all the answers but we have only one life to live, we should touch as many lives as possible.

This is the second of a two-part series. You can read the first part here.


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