Dr. Devi Prasad Shetty (MS, FRCS

Heart Surgery for $800
Dr. Devi Prasad Shetty (MS, FRCS-England)
Chairman
Narayana Hrudayalaya Group Of Hospitals, India
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In a span of just 10 years, NH has expanded its operations to 11 cities comprising 14 hospitals
with 5000 beds
Jaipur
Ahmedabad
Kolkata
Jamshedpur
Raipur
Hyderabad
Dharwad
Kolar
Shimoga
Bangalore
Mysore
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NH Cardiac
MSCC
Sparsh
Nethralaya
MSRNH
CNH
Whitefield
Economy of the 21st
century will be driven
by the health care
industry.
3
Job creation for economic growth and
social stability.
•Jobs for extremely skilled, semi-skilled,
and unskilled.
•Healthcare and wellness industry is 4.5
Trillion dollars.
•US health sector: $ 2.5 trillion.
•IT> Health sector.
•NHS: England's largest employer.
4
• 75% of the fortune, 50 companies are in
health care, directly or indirectly.
5
India will become the
first country in the
world to disassociate
health care from
affluence.
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• We produce the largest number of doctors in
the world.
• We produce the largest number of nurses and
med technicians in the world.
• Outside the USA we have the largest number
of US FDA approved drug manufacturing
units.
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Of course by default!
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• Indians are genetically 3 times more vulnerable for
heart disease than Europeans.
• Younger age.
• We produce 28 million babies a year.
• We produce about 600 to 800 children a day with the
heart disease.
• India need 2.5 million heart surgeries a year.
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India does only about 90,000
a year
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100 years after the first heart surgery
less than 10% of the world’s population
can afford it.
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Global crisis in health
care
• Tax payers’ money can't pay for it any more.
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Yeshaswini Micro Health Insurance
Poor people in isolation are weak, but together are
strong
1.7 million farmers, members of co-op societies
11 cents per month
Government as a reinsurer
Yeshaswini trust manages the scheme
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How is it viable with 11 cents???
• Only 0.8% of the random population needs
surgeries.
• No fraud - nobody wants surgery even if it is free.
• Pays only for the surgeries (1650 varieties).
• No administrative costs.
• 400 network hospitals with under-utilized OT.
• Medical treatment at discount.
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Governments will
become health
insurance providers
• Rajeev Arogyasree of Andhrapradesh.
• Kalignar insurance of Tamilnadu.
• Vajapayee Arogyasree of Karnataka.
15
Politicians across the
world do the right
things for the wrong
reasons.
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750 million Indians pay about
Rs 150 / month just to speak on
the mobile phone.
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• World doesn't need another magic pill, fastest
scanner or new operation.
• World needs a mechanism to deliver what's
already developed to 90% of the deprived
population.
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Narayana Hrudayalaya Health City
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Why 5000 bed health cities
• More surgeries, better results, quick discharges.
• More you buy, less you pay.
• Number attracts the talent, and patients.
• Fixed costs get distributed.
• Academic activity builds the succession plan.
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Telemedicine with ISRO
53000 patients have
had tele-consultations
free of cost
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300 bed low cost heart hospital for $6 million,6 months by L&T
Only way to reach 30000 beds
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Dialysis for $ 10
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Daily P&L statement
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Charity is not scalable.
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Also largest employer of WOMEN.
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We fly a 30 year old plane and
junk a 7 year old CT scanner.
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Problem is not money,
it's manpower
• India is short of at least 1 million doctors, 2
million nurses
• WHO estimates global shortage of 4 million
health workers.
• Acute shortage of specialists. US>India
• Nephrologists.
32
Why India has high
MMR, IMR
• We produce 28 million babies a year.
• India runs a MBBS DOCTOR centric health
care.
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Crisis in nursing
• India is short of at least 2 million nurses.
• Admission to nursing schools have come
down by 50% in India.
• Nursing is a dead end job with no opportunity
for carrier progression in India.
• Nurses are not empowered even to give an
injection.
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Global Trends in Supply and Demand
U.S. DEPARTMENT OF LABOR
BUREAU OF LABOR STATISTICS
TABLE 2. FASTEST GROWING OCCUPATIONS, 2004-14
1
31-1011 Home health aides
2
15-1081 Network systems and data communications analysts
3
31-9092 Medical assistants
4
29-1071 Physician assistants
5
15-1031 Computer software engineers, applications
6
31-2021 Physical therapist assistants
7
29-2021 Dental hygienists
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15-1032 Computer software engineers, systems software
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31-9091 Dental assistants
10
39-9021 Personal and home care aides
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15-1071 Network and computer systems administrators
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15-1061 Database administrators
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29-1123 Physical therapists
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19-4092 Forensic science technicians
15
29-2056 Veterinary technologists and technicians
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29-2032 Diagnostic medical sonographers
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31-2022 Physical therapist aides
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31-2011 Occupational therapist assistants
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19-1042 Medical scientists, except epidemiologists
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29-1122 Occupational therapists
15 of the 20 fastest growing occupations in the USA are in Health Care
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It's the insecurities of professional bodies
which perpetuates shortages
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India needs 500 new
medical schools
• If India adds 100 new medical schools a year
for the next 5 yrs we will adequate number of
doctors by 2025.
• It costs about $40 million to build one medical
school.
• Medical education is very expensive.
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Why is it so expensive
to build a medical
school in India ?
• Existing large hospitals cannot become teaching institutes.
• A new campus to be created on 25 acres of land with hospital, academic
block, hostel, auditorium, playground built according to specifications.
• Only not-for-profits can run educational institutions.
• Teacher retirement age of 60, no part-time teachers recognised.
• Archaic curricula requires 250 teachers for 100 students while GMC
requires 40 teachers.
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Global university for
medical, nursing and
paramedical education
• Global university to conduct training program across Asia, Africa, middle
east and Latin America.
• Best syllabus from leading universities of USA and Europe.
• Conducts entrance and exit tests.
• Accredits best hospitals across the world for training and periodically
monitors the standards.
• Degree recognised globally.
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Cost of health care will not get reduced
in US and Europe unless Asia and
Africa become a health care market.
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Why are mobile phones so cheap in
USA and Europe?
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750 million Indians keep buying mobile
phones
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Intent and policy mismatch
• Government spends 1% of GDP on Healthcare.
• 80% of the national expenditure on health is
borne out of pocket.
• 47% of the rural, 37% of the urban population
borrow money or sell assets to pay for health care.
• Health care costs are the most common cause of
rural indebtedness.
• Shortage of 3 million beds.
•No standard PPP.
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Harvard Business
School
“Cardiac Care for the Poor”
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THE WALL STREET JOURNAL - THE HENRY FORD OF HEART SURGERY
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Knowledge @
Wharton
“Narayana Hrudayalaya: A Model for
Accessible, Affordable Health
Care?”
“Patients at his hospital get cardiac
care at a cost lower than any other
hospital in the country and at a
fraction of what it would cost
elsewhere in the world, a feat
accomplished through what Shetty
refers to as "process innovation."”
http://knowledge.wharton.upenn.edu/india/article.cfm?a
rticleid=4493#
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Forbes
“The World’s Largest Heart Factory”
“Devi Shetty's doctors perform the most
heart surgeries in India. He is using that
scale to cut the cost of treatment.”
http://business.in.com/article/beyond-business/the-worldslargest-heart-factory/1442/1
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The Guardian, U.K.
“Indian heart surgeon and public
health activist Dr Devi Shetty's
Bangalore-based Narayana
Hrudayalaya hospital performs
more heart operations a day than
Singapore and Malaysia together.
http://www.guardian.co.uk/world/2010/mar/31/indiahealth
50
BBC News
“Production Line Heart Surgery”
“A simple business plan, but
potentially quite revolutionary.
Could this be a vision of the future
for health care, in Britain and around
the world?”
http://www.bbc.co.uk/news/health-10837726
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NH: Selected recognition
Television media
The
Discovery
channel
&
the
Australian
Broadcasting
Corporation
have
made
documentaries on Narayana Hrudayalaya, which have been broadcasted all over the world
http://www.youtube.com/watch?v=4r9R8B-p1Ok
http://www.youtube.com/watch?v=xsPic6PRCf4
- Discovery Channel
- Australian Broadcasting Corporation
Articles, Case Studies & Books
Forbes Asia
Harvard Business School
Reader’s Digest
News Scientist
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NCUMC
Artist’s impression
Thank you
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By 2020 India becomes a Superpower
But this will still 54be our customer