In recent years healthcare has become an integral part of the business ecosystem in India. While healthcare itself is a noble profession and majorly contributes to humanity, the successful healthcare entrepreneurs are making a valuable contribution to the national economies around the world, their stories as influential role models on a groundbreaking journey are inspiring many young aspirants.

Leadership in the health care sector is spread across management and clinical workforces, creating peculiar challenges. Therefore Strong and competent management and leadership workforces are thus required to navigate the sector.

Dr. Vivek Desai is the founder of HOSMAC India Pvt. Ltd. He Has been a Hospital Planning & Management Consultant for the past 20 years and formed Hosmac India Pvt Ltd in 1996. The firm now has 4 offices in India and the Middle East and has 150 employees and is considered a pioneering name in the Healthcare Consulting arena in India.

He has worked as an advisor to the World Bank, USAID, Indian Ministry of Health, etc. His major areas of interest are strategic business planning, macro-level project coordination, and incubating new business ideas

Changes and contributions witnessed by HOSMAC 

Dr. Vivek Desai says, “When you look back to Indian healthcare 25 years ago, and now see change. So, when we began healthcare in India was not corporatized. Most of the healthcare that was getting delivered was through the government or through private charitable trusts. It was in 1986, that Apollo, began the journey of a corporate hospital. So from a charitable trust to subsidized health care, we moved on to a very aggressively marketed, packaged very glamorously, which adds to the cost of the patient. There is no doubt about that. And also, from a small moment shop, nursing home, kind of care, you're moved into an institutionalized kind of a framework. So, if you will recollect whenever you used to fall sick in the past when you were young, probably you visited a GP. Alright, nowadays that practice has gone, first thing happens and you straight go to the hospital, which actually is not required, but that's now become the way that healthcare is getting delivered. So, and of course, now the recent changes of digital and all have made it because of COVID. You are able to get health care at your fingertips. That's a big change. 

Challenges faced by Hosmac 

Dr. Vivek informs, “ HOSMAC has been a very interesting journey. For me also, you know, I am a medical doctor. So I was probably not supposed to be in the line of business that I am now. So HOSMAC, if you look at our trajectory of growth, we began with what you know, most of the consulting companies do in terms of making project reports, trying to probably consult with the owner wants to set up a hospital and titbits around that. 

In about three years since we began, in 1998 we got a project in Gujarat, where we were asked to help an architect to design a cardiac hospital. So working with the client, who was Dr. Ramakant Panda was Asian Heart Hospital in Bombay, he saw us working there and he realized that there are lots of things that architects need to know, such as how to plan and design a hospital. So he was then appointed to design his hospital. I had never designed the small premium forget, 400,000 square feet Cardiac Hospital in collaboration with Cleveland Clinic in Bandra Kurla Complex in Mumbai, which is the commercial capital. I think we had that zeal and he could see that. So I think from there the journey began, so we created one of the best hospitals in the country today. Asian heart Hospital ranks as one of the best cardiology hospitals, this also changed the way Mumbai looked upon hospitals, it was more like a hotel come hospital kind of feel you got once you get it, and that led to other hospitals also change. 

While we were doing that kind of work, he also only actually appointed us to do construction management, and project management for the whole project management company called Bovis LendLease, which is one of the world's biggest project management firms. 

So, one thing we did was we never let our client down, you know, quality was topmost money was not the criteria when we were in early stages, even if it costs, you know, we will work but we will give a good product. So, we were able to build that 400,000 square feet Hospital in 20 months, the patient was in a cath lab and it was inaugurated by the CEO of Cleveland Clinic. 

So that actually, gave us a hard work of two years and paid us back, and from there on, there was no turning back because we created something which was there. So we began with management consulting, architecture, project management, and then we got taken up by Hiranandani Hospital, Tata memorial, and the journey began. 

Later on, we added two more pieces to what we do, and one was equipment, procurement, and planning. 

So, we got with Max as our first order in Delhi, you know, and we did a good job and then we added a service which is like towards the end of a project so you need to set up systems policies for these procedures, data structure, hospital Information System implemented properly, hire manpower, salary structure and all of that.

So, we started to give that also as a service, so that actually completed our book. So it was end-to-end services and we would handhold the client for one year after the new project is started. So, that is something that is difficult for any other consulting firm to do unless you accelerate all of these activities that you do. 

So, HOSMAC today is a group of professionals from medicine, administration, MBAs, chartered accountants, architects, engineering design for air conditioning, especially because of COVID, negative isolation, electrical, interior designing equipment, hospital information, software, everything under one roof, you won't find anyone, so we actually grew and we took care to excel in all of these verticals so that it sets us apart, so we are a one-stop-shop.

Plus, we integrate, seamlessly integrate these services, so for someone that becomes actually sort of a USP, you know, that you come to one company and everything gets delivered. So, we always also kept software and technology cutting edge. So, the kind of designs that we design hospitals in three dimensions, using software called Revit. So, you know, you can see the building as it gets built. So that helps the client to make decisions faster."

Upcoming projects of HOSMAC in the healthcare sector 

Dr. Desai states, “ Tata Memorial Hospital- Everyone knows about Tata Memorial Hospital which is a 1 million square feet giant building in Bombay, which we are engaged with. We created India’s First school of medical research and technology. Indian Institute of Science in Bangalore- This ranks as one of the best institutions. We have already prepared the first project report and our next stage is to get the design approved. So, this will be a dual degree program for the first time in India. It's an idea of making a doctor and scientist where you will be spending a good 5 - 7 years in the institute. 

There are other projects as well- 

Tata cancer hospital  Vedanta hospital where we have set up 11 hospitals in the time frame of 50 days with fully air-conditioned, oxygenated pipelines, ventilator, and supportive ICU for 100 bedded hospital 

The third wave of COVID 

Dr. Desai informs, “The government is very proactive and they have understood the problem. So, it's commendable what the government has done. The most inquired have come for towns like Arunachal Pradesh and Jammu Kashmir where it is easy to set up a hospital. It is easy to put up hospitals but we need to be trained staff to operate the ICU and ventilators. So, we collaborated with Mckenzie to come up with a training program with nurses and paramedics. 

From 2014 to 2017, India was able to add 50% more medical seats for undergraduates and 80% more for post-graduation. So, the idea is to promote academic research. In terms of infrastructure, it is about 50 to 75 lakh rupees, just into building a piece of equipment it might go to 50 to one crore also.

So, that's kind of investment which is required, then also there will have to be some government on its own have started giving up 200 crore loans, there is some guarantee which is given by the Government of India, interest rates have been dropped for this kind of projects, two from saying it was 10, it is now about seven 7.5. And even lower, if the credential is good, so, that is good because funding is required to set up you know, these kinds of infrastructure, there is a fair amount of digital play now into the thing telemedicine has shown us that it's not necessary for you to be in the hospital, you can do the same thing sitting from where you are. I was part of a CIO jury, you know, as a mentor to startups, and I've seen a lot of startups getting into this kind of space. 

Dr. Vivek Says, “ Taking risk is not bad, but the important thing is to take a calculated risk. So planning is, 50% of your time should go into planning. So, risk-taking is good, in fact, that is what will propel growth also, but it should be calculated, it should not be, something, which is what we call a rash, kind of, there's a lot of startups actually fail with this, because of that they have not thought through, how to find them in the long run. 

Take calculated risk  Try to Be a financial professional  Understand profit and loss  Don't shy away from technology  Technology leverage is the key Planning  Sensitive analysis  Business projections  Networking is important 

Rapid Fire with the expert

Dr. Desai informs, “ Success means Narayan Murthi

Life- Narendra Modi 

Entrepreneurship- Steve Jobs

Team- Saurav Ganguly 

India- Best democracy 

Healthcare- Growth 

Motivation- Every day is a new learning

(Edited by Dr.Rati Parwani)