In the era of startups, entrepreneurial decisions are the norm- not the exception. In 2020, the health-tech sector recorded 77 deals raising $455 million in funding when compared to $512 million funding in 62 deals in 2019. However, there are certain business areas where startups have not yet dared to go. One such area is ‘Radiology’. IndiaMed Today chronicles the journey of four such entrepreneurs who are blazing the trail in the field of radiology and share their unique experiences which have helped them as entrepreneurs.
Aran Diagnostic Imaging, Coimbatore
How did you first become interested in radiology?
It was fascinating to diagnose conditions and help the patient even before surgery and treatment. I am talking about the period -1990/91.
How and why did you move towards entrepreneurship?
There was a scan centre where I was working that was coming for sale; reluctantly took over hoping that I could
manage it well.
What were the challenges you faced when you started?
Old equipment, high CMC costs, replacement costs etc. were some of the challenges.
What are the core values that you have instituted in your organisation?
High-quality reporting, empathy to patients, back up each other to ensure errors are avoided.
How do you work with people who have a different perspective towards the work that you do?
Find the best quality in them and make them realise that will help them to move up in ladder; everyone has some.
Who are the people who have been your guiding light and strength throughout your entrepreneurial journey?
Family, friends, seniors, a few special employees, doctors and patients.
What advice would you give to the younger generation of radiologists who are looking to start their centre?
Knowledge, quality, good equipment
Since I was in my final year I was very much interested in imaging and its working physics. I understood that it was a challenging branch and yet very vast. Though we may not get recognised directly from patients our role was very much needed.
When I was pursuing my MD at KIMS Bengaluru a majority of the patients were from rural backgrounds. Seeing them travelling for investigations and timely treatment put me in deep thinking that something has to be done in this regard. Hence, I wanted to start a diagnostics centre at the periphery for an affordable price yet maintaining the quality.
When we started our first centre at Chikkaballapur in 2016, it was a new place, new people and we had a tough time for people to know us, accept us and trust us. We took utmost responsibility to open our centre at a well-known place which is near to the bus stand and public related offices. Though we faced this situation in the beginning later on we were very happy with the response we got.
Our main motto and thumb rule at our work is to have a healthy atmosphere amongst staff and respond to the patient or their side with utmost concern and respect. To guide them with proper information and deliver our services.
Yes, people had their views on us initially that going to rural areas after having a good job at city. A very few people had a feel of what we are doing is good and right for the public. The only way to answer them was by showing results and that dealt with the issues. It was my family who was with me through all times. My sons had to sacrifice a lot of time for me. My friends who trusted in my decision had always backed me whenever I had a doubt. Of course, my teachers and my senior doctors guided me with even minute things.
With my minimal knowledge and experience of this journey I would like to tell my younger radiologists to have
a healthy competition, never let down our fellow doctors, always have a good rapport and take anything sportively. The profession is as important as personal life so balance it.
The COVID-19 pandemic has brought the status of the public health infrastructure in the country into sharp focus. The overall government spending on health has increased in 2020-21 because of the pandemic. However, it remains to be seen if this increase is going to be sustainable. Healthcare, one of the fastest-growing sectors in the country, is poised to reach Rs 71.26 thousand crores by 2021, driven by increasing expenditures on health by both the private and public sectors. Rising income levels, increasing awareness on health and insurance penetration are seen as the key drivers of the Indian healthcare industry.
Entrepreneurship has always been an uphill task but never an impossible one if done with the right attitude and ethics. All the medical colleges teach the students the science of medicine but none of them shows to how to handle a business model of our own. The market can be categorised into four main segments as private hospitals, medical colleges, government hospitals and diagnostic centres.
Each of these entities owns its model of diagnostic setups. However, running the centres of their own has many challenges, such as investments, qualified technologists, radiologists and infrastructure. To fill these gaps I decided to enter the risky market and try my luck with an honest effort. I got into the field of radiology accidentally but later developed a keen interest and started learning in my college, where I came across two pioneers of radiology – Dr Ganesh K and Dr Prasad Hegde. Dr Ganesh taught me radiology and Dr Hegde enlightened me on the path of entrepreneurship in the radiology field.
I used to work for a corporate hospital in Bengaluru but somewhere my roots were calling me back and moved to my place, where the quality of machines, affordability and approachability of high-cost scans was a mirage.
This inspired me to start investing in small places where I can provide services at affordable costs. In the beginning, I started a small ultrasound scan centre.
Later, I came across Public-Private- Partnership (PPP) models, government tenders and started my centres both in the private and government sectors. My biggest fear at the beginning was, will my investment in high-end equipment pay me back better returns. Will installing 1.5 T MRI and 32 slice CT in small taluk and backward districts work out.
I started the PPP model in Gadag, where implementing the government projects at their campus was the biggest challenge. To realise it, I had to work with government officers at the state level.
The second challenge was getting a loan of more than Rs 5 to 6 crores, for which I worked with Canara bank and got a loan through ‘MSME’ thanks to the Government of India’s scheme. Later, the biggest jolt for my career was Quenching of MRI machines twice at government sites due to an accident that was not covered in the warranty.
Teamwork, discipline, quality of the reports and keeping low cost at private centres and following government rules according to an agreement. Recruiting radiologists at small places and paying them a fair amount of share and regularly discussing the problems faced by my colleagues and coworkers and partners.
My staff is my pillar and my partners are my strength, without whom I wouldn’t have been where I am today.
Initially, it was my teacher Dr Hegde who inspired me to start this “Doctor Entrepreneurship”. But my entire family, wife, parents and brothers all stood by me in tough times. It’s their constant support, belief and blessings that encouraged me to walk through this rough voyage.
The younger doctor generation should take up the challenges and make a difference. The government and banks are coming up with different investment plans along with start-up investment firms, which are looking for ideas. We can make wonders if we take the initial tough road and sail through the hurdles. Believe me, we are capable of doing wonders if we believe in ourselves. Nothing is impossible, no need to worry we are doctors, we have professional security and knowledge. With this strength, we can take the risk.
How did you first become interested in radiology?
I was always fascinated by technology and right through my undergraduate course I slowly began to realise how certain cutting edge technology can radically transform healthcare, including making a diagnosis and then treatment of patients. When I finished MBBS way back in 1993, healthcare technology was booming. Ultrasound, CT scan & MRI scan were beginning to change the way clinicians looked at patients from an entirely different
perspective, impacting how an accurate diagnosis could be made with absolute confidence. A short posting in Radiology during my internship made me resolve that radiology was my true calling.
How and why did you move towards entrepreneurship?
The entrepreneurship journey has been very memorable so far. I happened to meet the right people at the right times who had faith in my abilities and supported my setting up and running a diagnostic centre. The idea was to be at the forefront of technology and deliver the best for our patients in terms of quality healthcare at a very affordable cost. A straightforward way to address this incongruity about quality and affordability was to do “volumes”. Newer machines meant high capital expenditure and we had to recover this without resorting to market gimmicks. Now we have grown by leaps and bounds with all the cutting edge imaging technology under one roof including but not limited to MRI, CT, 4D ultrasound, Digital Mammography, Digital Radiography, PACS etc.
What are the core values that you have instituted in your organisation?
Quality always comes first. One of the first important decisions we took was to tread the quality path. We are probably the only diagnostic centre anywhere to boast of being triple-accredited by NABH for Medical Imaging Services, NABL for our Laboratory Services and ISO 9001 for quality management services. A good orientation towards these quality programmes meant that the core functioning of the centre was well taken care of by the various process leaders with a strong sense of ownership. We also believed that our customers come first and the working of the centre is designed to be highly customer-centric placing a very high value on their time spent at our centre. My team also believes in strong ethical practice, which builds the trust of our customers.
What were the challenges you faced when you started?
Challenges always bring out the best in me. Getting regulatory approvals was the first challenge I had to face. It was eased by help through good friends and well-wishers. Handling unscrupulous local competitors are always a work in progress. Strong faith in the quality and effective communication with patients and referral doctors pays a
rich dividend. Unruly local elements are another nuisance we face. We have to devise effective methods to handle these situations by out of the box thinking.
How do you work with people who have a different perspective towards the work that you do?
The most important role of a radiology administrator is to make people with diverse backgrounds work together in harmony. An effective and relevant training programme brings all the stakeholders to learn from each other, which builds a strong team. Trust and mutual respect should form the core values of a team and a leader should foster these qualities amongst the team members. As much as we focus on our strengths, we must also address our weaknesses to make ourselves stronger. A strong foundation based on quality, ethics and trust builds a reliable team, which stands you in good stead.
Who are the people who have been your guiding light and strength throughout your entrepreneurial journey?
My family including my parents, wife and children strongly believed in my dreams and gave me unstinted support. Dr Ashwath Narayan, a close friend and now a minister in the Government of Karnataka very graciously let me learn from my mistakes and lovingly guided me when I strayed. My foundation as an able radiology administrator is to a large extent due to his benevolence. Dr Gururaja Rao, my present CEO believed in my abilities and helped set up the present diagnostic centre in Yelahanka. Many other friends and well-wishers have provided timely help and support in the effective running of the centre. \
What advice would you give to the younger generation of radiologists who are looking to start their centre?
I would like to strongly recommend radiology as a career to anybody who would care to listen to me. I would be
delighted to have somebody come by and experience in real-time how much satisfaction there is in being a radiologist. They will be able to experience first-hand, how over the last 20 years, how the “art of diagnosis”
in healthcare has shifted from history and physical exam to imaging, and that imaging is now becoming the
new physical examination. I know for sure we radiologists make a significant difference for our clinical colleagues
who are trying to help their patients.
Even when things are hard, you feel good about what you’re doing, because it is worthwhile caring for the sick and needy. A successful radiology department requires a functional and effective leader who is fluid and flexible in their approach. An effective leader is necessary to consistently move your team in the right direction. An effective leader understands the power of, and the necessity for, contextual leadership.
Only those leaders who can quickly recognise and adapt their methods to the situation at hand will be successful
over the long haul. Remember that the most important leadership skill you can ever learn is how to lead yourself.
