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The King of Hearts

Besides being a renowned interventional cardiologist, Padma Shri Dr Kamal K Sethi is the creator of Delhi Heart and Lung Institute. He reflects on his journey and fallout with former Chairman Dr Ganesh Mani, in a conversation with Rita Dutta

One of the pioneers in electrophysiology and pacing and an expert in catheter ablation of arrhythmias, interventional cardiologist Padma Shri Dr Kamal K Sethi's name is taken with pride in medical circles. And to think that he attained most of the milestones in his 30s indicates his focused determination to take on initiatives and his razor sharp bent of mind. Some of his accomplishments are conducting the first dual chamber pacemaker at the age of 31, and conducting ablation and electrophysiology in his 30s. He also became the editor of the prestigious Indian Heart Journal (the official publication of Cardiology Society of India) at the age of 39. For all his early achievements, he was bestowed with the coveted 'DP Basu Young Investigator Award' by Cardiology Society of India at the age of 31. He was also a member of executive councils of several international cardiac societies such as Asia Pacific Society of Cardiology, Heart Rhythm society of USA, International Cardiac Pacing and Electrophysiology Society, all within his 30s. He has also been one of the pioneers of coronary angioplasty in India.

However, his greatness lies not in attaining success and acclaim early in life, but in envisaging and shaping a cardiac hospital that generations to come would remember him for. The 100-bed Delhi Heart and Lung Institute (DHLI) at Panchkuian Road in New Delhi is his brainchild and despite all storms blowing over the institute, Dr Sethi stands as strong as a pillar, steering its growth every single day.

At GB Pant

When teaching and academics are his second nature, it is no wonder then to know that Dr Sethi has dedicated over two decades of his life to teaching at Delhi's GB Pant Hospital. There, he last worked as a Professor of Cardiology imparting education to postdoctoral fellows, conducting research and doing tertiary level patient care. At the age of 47, when he achieved many professional milestones quite early in life, the determination to do something different took root. The need to give his children better education also made him decide on a more paying job than his job as a teacher, which fetched him only around Rs 26,000 per month. "I poured all my savings for my daughter's education at KLES, Belgaum and thus had a pressing need for more money then," he reveals, one evening at DHLI, slowly settling down in his chair, after a long day in the cath lab.

After leaving GB Pant Hospital, he joined Delhi's Gangaram Hospital to establish the department of interventional cardiology at the hospital. However, soon he was disgruntled and looking to do something different. "I felt rather restricted and perceived that it would be difficult to progress. So, after two years, I decided to go on my own, so that I could implement my own ideas and improve the quality of care," he recollects 59-year-old Dr Sethi.

His Dream Project

Out of this discontentment, stemmed the dream of erecting a comprehensive cardiology and lung hospital of repute, which would also offer affordable treatment. But why would a cardiologist want to also add pulmonology to his dream project? "For many cardio thoracic cases, there are associated problems of pneumonia and septicemia. Many cardio thoracic vascular surgeries also need lung surgery.

The principles of interventional cardiology and interventional pulmonology remain the same. Even the most successful international cardiology institutes, like the National Lung and Heart Institute, Washington offer both cardiology and pulmonology," he explains.

He realised that he needed support from other medicos in his venture, both monetarily and also for brand building. Thus, he called up his senior in college— cardiac surgeon Dr Ganesh Mani to join in his venture. "Dr Mani then brought a couple of friends to invest with him, informs Dr Sethi and after a pregnant pause, quips, "As a group, we decided to nominate Dr Mani as the chairman," as if pre-empting my question as how he was selected as the chairman.

So with investments from friends and relatives and another Rs 11 crore as bank loan, the hospital was established in June 2003. The land where the hospital stands now, used to house a hotel. That was demolished to build the hospital, which took two years for its construction. It took four years to attain breakeven.

Evolution

Receiving Life Time Achievement Award from Dr Abdul Kalam

Over the years, the institute has witnessed an annual growth of 10 per cent. The average daily number of patients in the OPD is 100. Employee and doctor numbers are 520.

"But we have never been driven by targets. We treat patients with compassion and practice ethically. We believe in providing affordable care and not billing patients unnecessarily," he asserts.

Training: Sin Qua Non

A voracious reader of academic-related books, Dr Sethi always emphasises on the significance of training and research in the life of a medico. Under his aegis, the institute started offering DNB in Cardiology and Pulmolonology and Post Graduate Diploma in Clinical Cardiology under India Gandhi National Open University. The institute is conducting research in cardiology and is already a part of multi-centric international studies to introduce new techniques in interventional cardiology and arrhythmia management. "In cardiac surgery, we plan to start robotic surgery soon," says Dr Sethi.

He also loves to impart training to his juniors. "It's important to delegate work and develop a second line," he muses.

Fallout with Dr Mani

It left the industry reeling under shock when Dr Sethi's long-term association with his business partner Dr Mani was terminated recently. However, differences between them were simmering from a long time. It is believed that the two cardiologists would often have radically opposite opinions on what treatment was best suited for the patient. It seems the management was also divided along these two lines and often board meetings would end in a war of words. Without much prodding, he reveals, "Today, even multiple blocks can be treated with angioplasty, but Dr Mani was not ready to accept that. He would dissuade patients from going for angioplasty. The idealogical differences reached such a stage that Dr Mani decided to step down from the chairmanship of the hospital."

Dr Mani has recently joined Indrapastha Apollo as a consultant cardiac surgeon. His stakes have been bought by Dr Sethi and other board members.

So, how did Dr Mani's sudden exit impact the hospital? "Yes, along with him five cardiac surgeons had also walked away. So, for some time his patients did not come and there was a drop in patient turnout. But that was only temporary. We immediately hired fresh talent like cardiac surgeon Dr Sandip Singh (from Max Healthcare) and his team. Patients are once again coming in droves,” beams Dr Sethi.

Then with a flicker of smile on his lips, he adds, “In fact, as more patients are going for angioplasty now, the ALOs has also reduced. This has made the hospital more profitable."

The Kind Hearted

Not only is Dr Sethi an accomplished cardiologist, but tales also abound about his kindhearted nature. For instance, once when a person working in the cath lab discovered that his bike had been stolen from the parking lot of the hospital, Dr Sethi not only organised for another vehicle for the employee, but also helped the person financially to buy another bike. He has often shown his softer side when some employees have been found lacking in skill set. In one instance, when one employee was about to be sacked for grounds of inefficiency, it seems it was Dr Sethi who intervened and asked the person to be given another chance. However, if employees are negligent of patient care, then Dr Sethi is not known to hide his anger.

When I recount these two episodes, Dr Seth is baffled. 'How do you know?," he asks me. Then he goes on to say, "It is difficult to come by good resource. So, if he can be trained a little bit and retained, then why not?"

The Road Ahead

Determined to fortify the DHLI brand, he is planning to start two more cath labs at DHLI, spending around Rs four to five crore, by the end of the year. Extending the brand of the cardiac and pulmonology hospital, he also plans to introduce a vascular department, an endo vascular thoracic surgery department and a department of cosmetic surgery. But why change the focus of the hospital? "Because we need to grow," he shoots back.

He wants to replicate the model of DHLI outside Delhi, mostly in tier II cities like Kanpur and Agra, where medical facilities are clearly non existent. These facilities would be secondary care cardiology centres and would function as spokes, with DHLI as the hub.

With him now single-handedly steering the hospital, let's expect an unbridled growth!

rita.dutta@expressindia.com