Dr Sunita Maheshwari, Chief Dreamer and Loop Closer, The Telrad Group in an interaction with Ashwini Prakash, Managing Partner India, Asia Pacific Lead-Pharma, Healthcare, Life Sciences and Consumer products, Stanton Chase India talks about the importance of diversity and inclusion in science & Indian healthcare ecosystem
You are a renowned doctor. Was becoming a healthcare entrepreneur always a plan?
Never! From 8th grade, I wanted to be a doctor and work in rural India. Being a tech enabled health care entrepreneur did not exist in my thoughts, dreams or plans. I guess you could call me an ‘accidental entrepreneur’. My life kept moving down different paths and I went with the flow and made the most of opportunities that came my way. If you asked me when I was young if I would become an entrepreneur, I would have laughed. Today I give lectures to MBA students!
You had a successful career ahead of you in the US. What motivated you to move back to India?
I always wanted to work in a place where there was great need i.e. India or Africa. That is fundamentally why I went to medical college. So, when I was doing my Pediatrics and Pediatric cardiology training at Yale University in New Haven and decided to marry Arjun (Dr Arjun Kalyanpur, an AIIMS/Cornell/Yale trained radiologist and co-founder of our entities), I made him verbally commit that we would return to India once done with our training!! When we were finishing our training at Yale we had great job offers at Yale and Duke but I knew if we stayed on and started living the ‘American Dream’, it would get harder and harder to actually return to India. So, we made the move back early while young, with minimal needs and a willingness to work our way up the Indian healthcare ladder.
How do you define the Indian Healthcare ecosystem? As an entrepreneur how did you craft your way up?
I would define the Indian Healthcare ecosystem as vibrant yet paradoxical. What I mean by that is on the one hand there is a large growing health care ecosystem which is changing rapidly and adopting new technologies such as robotics, telehealth, artificial intelligence and building high end super speciality driven hospitals and start-ups with tech enabled systems. On the other hand, there is a sub-optimal primary care ecosystem around the country and resource constrained hospitals in rural and remote India.
As an entrepreneur I found certain gaps in India which I felt needed filling, e.g. I built out RXDX healthcare in Bengaluru which is a chain of tech enabled primary care clinics where the General Physician is the Boss unlike in hospitals where the super specialist is King. At our other venture Teleradiology Solutions we take a good diagnosis out to patients and hospitals across the world-using the night day time difference to cover nights in the United States and using the same domain knowledge and processes to cover hospitals in remote parts of India and Africa eg Ramakrishna Mission hospital in Itanagar.
PE and VC firms have become integral part of the Indian start -up ecosystem? What are your views?
Of course, money is needed to start or grow a health care enterprise, like any other enterprise. However, I do feel that too much money in health care is not a great idea. When health care enterprises have to make returns for investors, there is a pressure on the doctors and systems to generate more revenue. And how does one generate returns in healthcare? More tests, more procedures, more pharmacy items, more referrals, more commissions. If a doctor is able to work without considering revenue, either for himself or for the organisation, then he/she is able to practice medicine for the pure joy of making patients better, improving their wellness, positively impacting their mental health. I believe healthcare organisations must be viewed as social enterprises. They need to be sustainable and profitable but the profits can be pumped back into growth or patient value adds.
What conspired for you to come up with teleradiology solutions, which was a huge disruption in the healthcare sector?
A happy accident! An outcome of a No Job Situation! As I said we moved back to India to work as doctors. Sadly, Arjun could not get a job in Bangalore for over 2 years. So, he kept going back to Yale to do part time locums jobs and on one of those trips his chairman offered him to work from India. That was one of the first implementations of global teleradiology-from Yale New Haven Hospital to its medical staff Dr AK in Bangalore. After doing it for 6 months, we realised it was a novel idea and a much needed one. And so decided to turn the idea into a healthcare ‘company’.
Everyone is facing healthcare crisis created by COVID. How can homecare help minimize the problem?
One thing that has become clear is that one cannot manage COVID like just another virus. Fortunately, during this past year, it has become clearer to the medical community how to medically manage it with anti virals, steroids, antithrombotics, oxygen etc.
The good news is all of the above can be administered at home if the patient has the ability to isolate with a family member just outside the door in case of an emergency. The other good news is that now with telemedicine legalised, this assessment and medication can be provided by remote doctors via tele consultations. However, not just a single tele-consultation with a doctor will work with a wily virus like corona. It needs the patient to be longitudinally followed up by the same medical team over the entire course of the disease to readjust medicines prescribed and to monitor for any change in clinical status. “Hospital at home” i.e. pre-hospital care-is a solution whose time has come.
How critical is it to promote DE&I in the field of science? Do you think anything has changed in past few decades?
Diversity and inclusion are essential in any field of life. In the medical sciences things have progressively improved with now 50 percent of Med school admissions in India are women. Women bring a mix of empathy and a “detective” brain to science which definitely helps.
Alongside being a doctor and an entrepreneur, what are your other pursuits?
I feel that the more we all give back, the happier we are and the more impact we can make. So, I also run two foundations:
People4people: which has installed Over 450 playgrounds in government schools thus far
Telrad foundation: Over one lakh free reads, 30 rural clinics supported via telemedicine.
I also like to teach, I won Yale’s best teacher award. So I set up and have been running a pediatric cardiology e-teaching program for postgraduates since 2010 (much before corona and zoom sessions!)
What do you do to unwind and maintain your peace of mind?
A good nights sleep and daily exercise for 45 minutes are key to my well-being. I also love to dance (nick name is Dancing Doc!) and I find that a great stress buster.
I use humour to defuse stress and conflict. A good joke will sort out anything!
What advice would you give to the entrepreneurs venturing into healthcare space?
- Have Patience (My experience-ten years of one RXDX before scaling to 30; 10 years after Singapore ministry approval we win an Indian state tender for teleradiology)
- Get into it for the long haul- things take time, success doesn’t come overnight, being around long enough leads to brand recognition which is important in healthcare as well as patients need to ‘trust’ (My experience: Did not take funding, ploughed back profits into our entities for growth, no exit plan, so kept growing)
- Be clear on the purpose and way (My experience: We wanted to create impact so the robin hood model works for us-charge American/Singaporean hospitals for teleradiology services, do free or low cost for Indian charitable hospitals; Practicing clean medicine was important to us-so we focus on ethical sustainability at RXDX)
- Healthcare is god’s work. Aim to do good for your patients and staff-the rest will follow.