Featuring IWHTA president Mr. Naresh Jadeja's discussion with Dr. Devi Shetty, Chairman of Narayan Hrudalaya. He is also a member of Medical Council of India's Board of Governors. MCI oversees doctors registration and medical education in India. For the first time ever he talked about medical tourism and about skills and experience of Indian doctors, capacity of Indian hospitals, why health care cost at Narayana Hrudalaya is cheapest in the world and How government can boost Medical Tourism in India.

He is called the Henry Ford of Heart surgery. Dr. Devi Shetty is the chairman of Narayana Hrudalaya, the largest cardiac hospital for children in the world. Narayana Hrudayalaya group currently has 5000 beds in India and aims to have 30,000 beds in the next 5 years.

Narayana's 42 cardiac surgeons performed 3,174 cardiac bypass surgeries in 2008, more than double the 1,367 the cleveland clinic, a U.S. leader, did in the same year. His surgeons operated on 2,777 pediatric patients, more than double the 1,026 surgeries performed at Children's Hospital in Boston. Also he is planning a 2,000 bed general hospital in Cayman Island,an hour's plane ride from Miami to attract uninsured and under insured American patients.

Q: Why do you think India is going to be the top medical tourism destination?

A: The major factor is cost. It will be definitely lower in India compared to any other part of the world, even far cheaper than Africa. Today Medical Tourism is looked as an alternative, but it is a matter of time before people will run out of options. Health care Travel is for better outcomes and India can offer everything they need in terms of lower cost, best doctors and great infrastructure.

Q: If you have to compare infrastructure, equipments in Indian hospitals and those in USA and Europe then what is the situation of Indian hospital?

A: The outcome of the health care is the outcome of the interaction between man (Doctor) and the machine. You just need a Man, Machine and the roof. There is not a big technology in building a roof. So when let's talk about the Man or Women behind the machine. Our specialist is ten times more experienced than those medical specialists in USA and Europe. I will give you an example, In US when a heart surgeon retires after 30-35 years of active professional life he would have done around 2500-3000 heart surgeries in his whole life while we have surgeons who have done more than 3000 surgeries and they are still in their thirties. We have nurses who are 22-25 years old and have looked after more heart patients than the nurse who is about to retire in America. Now if you have ten times more experienced doctors and nurses than US and Europe and you have the same equipments that is being used in US then you can expect the health care outcomes. If you talk about the equipments, there are only 4 manufacturers in the world who manufacture top line of medical equipments; it is GE, Siemens, Phillips or occasionally other specialist manufacturer. These machines are not developed here nor they are available in some specific countries. Anyone with the money can buy it, infect we are the largest buyers of medical equipments in this part of the world. So if you have an expertise(Doctors and nurses) and if you have an infrastructure, then anyone can understand the outcomes. It is not a rocket science to understand that we can offer same or better services than US, not that we are gifted or anything, but it is just that we see more number of patients.


Q: How do you control cost of health care in your organization?

A: First thing is that you don't build 100-200 bed hospitals. You have to build the health city with 3000-5000 bed. You create a campus on 30 Acres of land. Build separate building for different specialties. You build 1000 bed hospital for heart, 1500 bed hospital for Cancer, 300 bed hospital for orthopedic, 300 bed hospital for eye and rest for other specialties and then you share your infrastructure cost that is CT, MRI, Laboratory, blood bank, infection control team, diabetic control team, management, finance services and software. If you share this among all hospitals then your cost go down significantly. Then of course we are doing the highest number of heart surgeries in the world. 12% of heart surgeries in India are done by us, so it gives you a huge paying capacity as well as huge buying capacity. Also we work 6 days a week unlike other western countries and our utilization of equipments are at least 12-14 hours a day. If you add all this factors then your cost will definitely go down.


Q: Do you think government support can help Indian Hospitals to better brand their image at international level? What changes you would like to see?

A: First of all we need smoother visa formalities. Patients coming from Bangladesh face many problems in terms of getting visa. Also we need more direct flights. If you have direct flights to Mumbai, Delhi and Chennai only, then other cities are not going to develop medical tourism. If patient coming from overseas has to change 2-3 flights then believe me he is not coming. Connectivity and road,airport infrastructure is improving very fast and we will see many changes very soon. But more than anything else we need government to Market India health care industry overseas. Today if you open big magazines like times in US, in the center of the magazine, Singapore government promotes their health care in 2-3 pages, now we as only one institution does more heart surgeries than all the hospitals in Singapore put together. So sheer size of the Indian hospital is phenomenal but so far no clear advertisement has ever appeared, advertising brand India as a destination for health care. And we as a individual hospital cannot do it, government has to take the responsibility to promote Indian health care and medical tourism in this country.


Q: Countries like Malaysia, inviting USA and UK educated and trained doctors to practice in their country with all the facilities however in India there are many restriction. Do you think it should change?

A: It has to change, we should be lot more open, we should not be parochial, we should not be scared of western doctors coming and flooding our market. In the medical science, doctors and skill is more important than machine, there are experts in other part of the world, if they have the freedom to come and demonstrate procedures or do it on a regular basis, our council should not stop them. I think people of the repute should be allowed to practice in India, today they are allowed for demonstration and they have limited registration, but it has to be lot more broaden, definitely.

Q: What would you like to tell to international patients looking for better health care options in Asian countries?

A: Most important thing in health care is the results or outcomes of the procedure. We have some of the best doctors in the world and we have the same infrastructure as they have in American or European hospitals. Actually I can confidently say that we have better infrastructure than most of the American hospitals. So if they want a better health care at the price that they can afford, this has to be an only alternative.