There is growing concern about over-prescription of surgeries and unnecessary procedures in private healthcare, often linked to incentive-based hospital models. In your view, how deeply entrenched is this problem in India’s private healthcare ecosystem, and what does it ultimately cost the patient?
I think we need to take a step back and ask a more fundamental question.
Why does over-prescription happen?
The easy answer is to blame doctors. The harder answer is to examine the system we’ve built around them.
Most doctors don’t spend ten years training to wake up one morning and decide they want to perform unnecessary surgeries. The bigger issue is that healthcare today operates inside business models that create very specific incentives.
When a hospital costs hundreds of crores to build, somebody has to recover that capital. When beds, operating theatres and expensive equipment are measured through utilisation metrics, pressure gets created throughout the system. Not because people are bad. Because incentives matter.
The moment clinical decisions start living inside commercial frameworks, distortions begin to appear.
And this isn’t unique to India. Every healthcare system has its own version of the problem. In the US, you see it through insurance and reimbursement structures. In public systems like the UK, you see it through waiting lists. India has its own version because we are fundamentally a consumer-provider market. The incentive structures are different, but the underlying challenge is the same.
The patient ultimately pays three times.
First financially. Families spend money they may never recover.
Second clinically. Every surgery carries risk, recovery and uncertainty. Surgery is not a billing event. It is an intervention into somebody’s life.
But the biggest cost is trust.
Healthcare runs entirely on trust. The moment a patient starts wondering whether a recommendation is being driven by clinical judgement or commercial incentives, the system starts breaking down.
We’ve seen this firsthand. Through our Honest Second Opinion program, over 2,000 patients came to us with an existing recommendation for surgery. In 42 per cent of cases, our doctors were able to safely move them to non-surgical pathways.
Now I don’t think that means our doctors are smarter than everyone else’s. I think it means they operate inside a different incentive structure. Our doctors are on fixed salaries with equity participation. They don’t earn more if they operate more. They don’t have conversion targets.
When you change incentives, behaviour changes.
Trust follows incentives. Healthcare is no different.
Superhealth has positioned itself around transparent and predictable pricing in surgical care. How do you operationalise price transparency in a sector where hidden costs and last-minute billing surprises have become almost normalised?
I think we need to challenge one of the biggest assumptions in healthcare today, which is that transparency is somehow impossible because medicine is unpredictable.
Medical outcomes are unpredictable. Medical inputs are not.
No surgeon can guarantee how a human body will respond. But if you’re performing the same procedure multiple times a day, year after year, you should have a very good understanding of what it is likely to cost.
In fact, one of the things that surprises me is how comfortable the industry has become with variability. If a hospital has been performing the same hernia or gallbladder surgery for twenty years, why should the final bill be a surprise?
At Superhealth, we start with a very simple principle: the patient should know what they will pay before they are admitted.
So every surgery is offered at a fixed, all-inclusive price. That includes the surgeon, the room, diagnostics, consumables, nursing care and post-operative care. If our doctors decide a patient needs to stay longer for clinical reasons, the patient does not receive an additional bill because of that decision. We absorb the cost.
The reason we can do this is because we don’t believe healthcare costs are nearly as unpredictable as people often suggest.
I’ve said this before and I genuinely believe it. Maybe five percent of cases vary significantly because of genuine medical complexity. It certainly isn’t fifty percent.
A lot of what appears to be unpredictability is actually a consequence of how pricing structures have evolved.
For example, if you open many hospital bills, you’ll often find operation theatre charges moving in proportion to the surgeon’s fee. I’ve always found that interesting. If a surgeon with five years of experience charges one amount and a surgeon with twenty-five years of experience charges three times more, why does the operation theatre suddenly become three times more expensive? The theatre hasn’t changed. In many cases, the more experienced surgeon may actually complete the procedure faster.
These are the kinds of assumptions that have become normalised over time.
Operationally, transparency requires a different system design.
At Superhealth, every surgery comes with a fixed, all-inclusive price that the patient knows before they are admitted. That price covers the entire episode of care—from the surgery and surgeon’s fee to the room, diagnostics, consumables, nursing care and post-operative recovery. If our clinical team decides a patient needs to stay longer for medical reasons, the patient does not receive an additional bill because of that decision. We absorb the cost.
The reason we can do this is because pricing is not something calculated after care is delivered. It is embedded into the care journey itself through SuperOS. Clinical decisions, operational workflows and financial visibility are connected in real time. The patient knows what is happening clinically and financially at the same time.
Ultimately, transparency is not a billing feature. It is a design choice.
If patients can know when they will be seen, how long their care will take and what it will cost, healthcare becomes significantly less stressful. That’s the experience we are trying to build.
You advocate for removing commissions and sales targets from clinical decision-making. Given that many private hospitals rely on these structures to sustain revenue, what alternative incentive model do you believe can work without compromising financial viability?
I think the question assumes that commissions and sales targets are necessary for a hospital to be financially viable. I’m not convinced that’s true.
If you look at most industries, we generally try to align incentives with the outcome we want. In healthcare, the outcome we want is better patient care and better clinical judgement. So the question becomes: why would we design incentives around procedure volumes rather than patient outcomes?
At Superhealth, we’ve taken a different approach.
Our doctors are full-time salaried professionals with equity ownership in the company. They don’t receive commissions. They don’t receive referral fees. They don’t have targets linked to procedures or billing.
What we’ve found is that this changes the nature of the doctor-patient relationship quite significantly. The doctor is free to focus on making the right clinical decision without having to think about the commercial implications of that decision.
What’s interesting is that many doctors find this model incredibly liberating. Most people don’t spend a decade training in medicine because they want to optimise conversion ratios or revenue targets. They want to practise medicine.
The argument we often hear is that hospitals need incentive-led volume to remain financially sustainable. But I think that assumes the only way to improve economics is through increasing revenue.
Our view is different.
Healthcare has a very large operational efficiency problem. If you can reduce the cost of building hospitals, improve utilisation, automate administrative workflows, shorten unnecessary delays and use technology to remove operational friction, you can create a very different economic model.
That’s the approach we’ve taken. We built our hospital at significantly lower capital cost than traditional corporate facilities. We use technology to simplify operations. We focus heavily on reducing unnecessary administrative overhead and improving throughput without compromising clinical quality.
The result is that we don’t have to choose between doing the right thing for patients and building a sustainable business.
In fact, I would argue those two things are increasingly aligned.
Trust is not separate from economics in healthcare. Trust is the economics. When patients trust the system, they come back, they refer others and they stay engaged with their care.
That’s a far more durable incentive model than asking doctors to behave like salespeople.
I think discharge is one of the most visible operational problems in healthcare today, but it isn’t the root problem. It’s simply where all the underlying inefficiencies become visible to the patient.
Almost every family has experienced this. A doctor tells them they are medically fit to go home, but they end up waiting hours for billing, insurance approvals, pharmacy fulfilment or administrative clearances. By that point the clinical journey is over, but the operational journey is still unfinished.
The interesting thing is that none of these delays are really medical problems. They are coordination problems.
Traditional hospitals have evolved as a collection of separate functions. Clinical care, pharmacy, billing, insurance and administration often operate independently of one another. When those systems are not connected, the patient experiences the gaps between them.
The same thing happens much earlier in the care journey.
Patients wait for appointments, wait for diagnostics, wait for doctors and wait for procedures. Much of that waiting is not because medicine is inherently complex. It is because hospital systems are not designed to coordinate resources efficiently. Patients experience that as uncertainty.
At Superhealth, we approached this as an operational design problem.
Our goal is simple: patients should know when they will be seen, how long their care will take and what it will cost. Healthcare should be far more predictable than it is today.
To make that possible, we built SuperOS to coordinate clinical, operational and administrative workflows in real time. Instead of waiting for discharge to trigger billing, insurance and pharmacy processes, those workflows run continuously throughout the patient’s stay.
So when a doctor determines that a patient is medically ready to leave, most of the operational work has already been completed.
We call this Magic Discharge.
But the broader point is not discharge itself. The broader point is that healthcare has historically accepted a great deal of operational friction as inevitable. We don’t think it is.
If systems are designed differently, patients spend less time waiting, less time navigating complexity and more time focused on recovery. That is ultimately the experience we are trying to build.
Technology is often cited as the solution to healthcare delivery challenges. But how important is systems integration across diagnostics, care coordination, and discharge planning in actually improving patient outcomes, rather than simply digitising existing inefficiencies?
I think one of the biggest misconceptions in healthcare is that digitisation and systems integration are the same thing.
They are not.
Most hospitals today already have technology. They have software for diagnostics, software for billing, software for pharmacy, software for radiology and software for patient records. The challenge is that these systems often operate independently of one another.
As a result, a clinical decision made by a doctor frequently has to be translated across multiple workflows before it is actually executed. That creates delays, duplication and opportunities for error.
So when people talk about technology in healthcare, I think they’re often asking the wrong question.
The question isn’t whether a hospital is digital.
The question is whether a clinical decision can move seamlessly through the entire system.
If a doctor orders a test, does diagnostics know immediately? If the treatment plan changes, does nursing know immediately? If a patient is ready for discharge, do billing, pharmacy and insurance workflows move automatically? That is what ultimately determines whether technology improves care or simply digitises existing inefficiencies.
At Superhealth, we approached this differently.
Rather than connecting multiple independent systems together, we built SuperOS as a single operating system for the hospital. Clinical workflows, diagnostics, inpatient care, operating theatres, pharmacy and discharge planning all operate on the same underlying platform.
The objective was not to give doctors another screen to interact with. The objective was to reduce administrative burden so doctors can spend more time focusing on patients.
That’s why we invested heavily in ambient AI and workflow automation. Documentation, coordination and operational execution happen in the background as much as possible.
But technology alone is not enough.
One of the lessons we learned very early is that healthcare happens in physical environments, not just digital ones. Clinical rooms, acoustics, workflows and care delivery processes all influence how effectively technology performs. So we designed the physical environment and the digital environment together.
Ultimately, I don’t think healthcare’s biggest challenge is a lack of technology. It’s fragmentation.
When diagnostics, care delivery, pharmacy, billing and discharge operate as one coordinated system, patients experience faster care, fewer delays and better continuity. That’s where technology starts improving outcomes rather than simply replacing paper with software.
India’s maternity care space has seen rising C-section rates, often attributed to clinical and financial incentives rather than medical necessity. How does Superbirth’s fixed pricing model address that bias, and what has the response been from clinicians and patients so far?
I think we need to separate two things.
The first is that C-sections are an incredibly important medical intervention. They save lives every day. The problem is not the procedure itself.
The second is that when you see C-section rates rising significantly above what clinical necessity alone would suggest, it is reasonable to ask whether the system’s incentives are influencing outcomes.
Across India, we’ve seen C-section rates increase steadily over the last decade, particularly in the private sector. That’s not a criticism of individual doctors. It is a signal that we should examine the environment in which decisions are being made.
At Superbirth, we started with a very simple question: what happens if we remove the financial difference between a natural delivery and a C-section?
So we created a fixed-price model.
Whether a mother has a normal vaginal delivery, requires an emergency C-section, needs a longer stay or additional support after delivery, the financial outcome remains exactly the same for both the doctor and the hospital.
The reason this matters is because incentives shape behaviour.
Once the financial incentive is removed, the conversation changes completely. The only question left in the room is: what is the safest and most appropriate clinical decision for the mother and the baby?
But over time we realised something else.
The challenge facing modern families isn’t just the delivery itself. It’s the entire journey leading up to it.
A generation ago, many couples went through pregnancy surrounded by parents, grandparents and extended family members who had lived through the experience before. Today, particularly in cities like Bangalore, many young couples are navigating pregnancy entirely on their own. They are often living away from family, managing demanding careers and becoming parents for the first time without a support system around them.
What we see repeatedly is that first-time fathers want to be far more involved than previous generations. They want to attend appointments. They want to understand labour. They want to support their partners. They want to participate in decisions. The intent is there.
What has been missing is the infrastructure to help them do that.
That’s why Superbirth was designed as much for families as it was for mothers.
It includes birth preparation classes, lactation support, nutrition counselling, labour coaching, postpartum recovery support and continuous guidance throughout the journey. We actively encourage fathers to participate because childbirth is not something happening to one person. It is a transition the entire family is going through together.
In many ways, Superbirth is less about delivery and more about confidence.
When families are informed, prepared and supported, they make better decisions. They enter labour with less anxiety. They feel more in control of the experience. And doctors can focus on providing the right clinical care rather than compensating for gaps elsewhere in the system.
The response from clinicians has been very positive because it removes unnecessary complexity from decision-making. And for families, the biggest benefit has been trust and clarity.
Ultimately, our goal isn’t to reduce C-sections for the sake of reducing C-sections. Our goal is to build a system where every intervention happens because it is medically necessary, every decision is made transparently, and every family feels supported through one of the most important journeys of their lives.
The Care Squad model under Superbirth brings together a gynaecologist, birth coach, nutritionist, lactation counsellor, paediatrician, and others as one team across the entire maternity journey. What were the challenges in building this model, and how does that continuity of care reflect in outcomes for mothers and newborns?
I think the biggest challenge wasn’t operational. It was changing how people think about maternity care.
Traditionally, healthcare is organised around specialties. The obstetrician manages the pregnancy. The paediatrician enters closer to delivery. The lactation counsellor becomes involved after birth if there is a challenge. Each specialist does excellent work, but they often engage with the family at different points in time.
The problem is that pregnancy doesn’t happen in specialties. Families experience it as one continuous journey.
What we realised very early is that many of the challenges mothers face are not purely medical. They are emotional, behavioural, nutritional and educational. And those challenges don’t neatly fit into departmental boundaries.
We also realised something else. The structure of the Indian family has changed.
A generation ago, pregnancy often happened within a large support system of parents, grandparents, aunts and relatives who had been through the experience before. Today, particularly in cities like Bangalore, many young couples are navigating pregnancy entirely on their own. They are living away from family, balancing careers and preparing for parenthood without the support structures previous generations relied on.
What we see repeatedly is that first-time fathers want to be far more involved than ever before. They want to attend appointments, understand labour, support their partners, learn about breastfeeding, prepare for childbirth and participate in decisions. The intent is there. What has often been missing is the infrastructure to help them do that.
That’s what led us to build the Superbirth team differently.
Instead of families interacting with disconnected specialists at different stages of pregnancy and parenthood, the Superbirth team brings together the gynaecologist, birth coach, nutritionist, lactation counsellor, paediatrician and care coordinators around one shared journey.
In many ways, the Superbirth team becomes an extension of the support system modern families no longer have access to.
For young couples navigating pregnancy on their own, particularly in cities like Bangalore, it provides continuity, guidance and reassurance through every stage of the experience. Mothers feel supported. Fathers feel involved. And families don’t have to wait for a crisis before they know who to call.
What becomes interesting is the continuity this creates.
A birth coach who has worked with a mother throughout her pregnancy understands her fears, preferences and expectations before labour even begins. A lactation counsellor who has already built a relationship with the family can provide support proactively rather than reactively. A paediatrician is not meeting the parents for the first time after delivery but has context around the pregnancy and preparation leading up to birth.
That continuity reduces uncertainty for families and improves coordination across the care team.
Technology plays an important role here, but not in the way people often assume.
The value of SuperOS isn’t that it digitises records. The value is that every member of the Superbirth team is operating from the same source of truth. Clinical observations, maternal health data, neonatal information and care plans are visible across the team in real time, creating a much more coordinated care experience.
Ultimately, I think the best way to describe Superbirth is that it restores continuity to a journey that has historically been fragmented.
Pregnancy, birth and early parenthood are deeply connected experiences. The care model should reflect that reality.
What we’ve found is that when families feel supported by one team throughout the journey, they are more confident, more prepared and better equipped to navigate the transition into parenthood. Mothers feel less anxious. Fathers feel more involved. And parents enter one of the most important moments of their lives knowing they don’t have to figure it all out on their own.
As private healthcare faces growing scrutiny around accountability and patient trust, where do you see the sector heading and what will it take for more hospitals to move toward transparent, patient-focused models of care?
I think the healthcare industry is approaching an important inflection point.
Patients today are asking more questions than ever before. They want to understand why a test is being recommended, why a procedure is necessary, how much something will cost and what alternatives exist. I think that’s a healthy shift.
At the same time, India is facing a significant healthcare infrastructure challenge. We are still millions of beds short of what the country needs. Demand for healthcare continues to grow, but supply has not kept pace. As a result, patients have often had very little choice. If you need surgery, you proceed. If you need treatment, you proceed. Even when the experience is frustrating or the pricing is unclear, healthcare is not something most people can simply walk away from.
The interesting question is whether the industry responds with superficial changes or structural ones.
I don’t think transparency is created by publishing a price list or updating marketing materials. Transparency is a consequence of how a system is designed.
If patients consistently know what they will pay, when they will be seen, what their options are and why decisions are being made, transparency tends to follow naturally.
I also think India has an opportunity to build healthcare models that are uniquely suited to India rather than simply replicating models from elsewhere.
Our median age is around 28. In many Western countries, it is closer to the late 40s or 50s. Our healthcare needs are different. Our cities are different. We live in some of the densest urban environments in the world. That changes how healthcare should be delivered.
In low-density cities, a few large destination hospitals may be enough. In dense urban centres like Bangalore, people increasingly want high-quality healthcare closer to where they live. Accessibility, convenience and continuity of care matter far more than they did in previous generations.
That’s why I believe the future is likely to be more transparent, more technology-enabled and far more hyperlocal than the industry has traditionally been.
Ultimately, I don’t think the challenge facing healthcare is a communications problem. It’s a systems design problem.
If incentives are aligned correctly, if doctors are free to focus on clinical care, if pricing is transparent and if operational friction is reduced, better patient experiences become a natural outcome of the model.
The question is not whether healthcare needs better communication. The question is whether healthcare providers are willing to redesign the underlying systems that create the patient experience.
Healthcare delivery should be predictable. Patients should know when they will be seen, how long it will take and what it will cost. If we can deliver that consistently, transparency stops being a promise and becomes a property of the system itself.