The return of the family physician

India’s healthcare industry is estimated at $50 billion and growing annually at about 15%.

Of this, the primary sector is worth $39 billion, however, it remains highly fragmented. For instance, while some 26,000 government-run primary healthcare centres and 615 district level hospitals are relatively underutilised, about 200,000 privately-owned health centres are run by single physicians with typically a basic medical qualification. This results in a system that seriously lacks standardization of processes, quality and service levels. Furthermore, it is estimated that more than 80% of the Indian population now turns to tertiary care hospitals for even the most basic of healthcare treatments.

Responding to this, a number of companies are boosting community healthcare services, aiming to re-establish the bond between patients and physicians. About a handful of companies have attracted the attention of private equity and venture capitalists, who have invested heavily into tertiary care hospitals and diagnostic labs.

The aim of these new clinics is to provide an affordable and accessible patient-centric system, based on a simple model and counting with a team of doctors, nurses, support staff and an extended network of consultants. They typically count with most facilities and equipment needed to offer basic healthcare services including consulting rooms, diagnostics laboratories, vaccination services, health management, elderly care and pharmacies. The use of technology is essential in order to maintain electronic medical records of their patients, offering round-the-clock support via telephone and coordinating with their health specialists’ professional network. Charges per visit vary from $3 to $6, and some centres also offer an annual membership option for families. These type of systems are helping ensure that a standardized set of protocols and processes are followed.

Home-grown brands of primary healthcare clinics

A primary healthcare clinic in India that has gained considerable recognition through patient reviews and private equity investors is Healthspring, founded in 2009. Healthspring operates primary healthcare community medical centres, and it borrows its concept from the US-based model of medical centres such as the Cleveland Clinic and Mayo Clinic, which aim to revive the concept of a neighbourhood family physician by employing their own physicians and creating teams of specialists that collaborate in treating each patient. Another feature of Healthspring clinics in India is that it has removed the commercial incentives of doctors, thereby ensuring their focus is exclusively on patient wellbeing. According to Healthspring’s CEO, Kaushik Sen, the brand has treated about 50,000 patients across four clinics between 2011 and 2012.

Healthspring has raised $3.5 million through Reliance Ventures, BlueCross BlueSheild Ventures, Narayan Murthy’s Catamaran Ventures and most recently a further $3.7million through the Asian Healthcare Fund. With already 8 clinics in Mumbai, the company has plans to set up 15-20 centers in metro cities and eventually branch out to other tier II cities.

Similar to Healthspring, NationWise Primary Healthcare Services was set up in Bangalore by two doctors with experience in healthcare provision in the UK. This venture counts with a network of 14 family physicians and paediatric clinics and has ambitious plans for expansion to reach a pan-India network of 250 clinics. They have raised investment through Norwest Venture Partners.

Yet a further venture, Modern Family Doctor was founded by Naresh Malhotra, which runs 20 primary healthcare clinics in Bangalore and Pune. As the former CEO of Café Coffee Day chain, Mr Malhotra is well versed with the way retail outlets are rolled out, and he has applied this model to his network of clinics.

Opportunities for UK providers

Universal healthcare is one of the main priorities of India’s government, and the UK is increasingly proving to be a natural partner in the primary healthcare domain. The NHS’s reputation is very well regarded in India, and as a result, many British companies are exploring opportunities there.

West Midlands-based health services provider, Pathfinder Healthcare Developments, is an award-winning Community Interest in the UK which set up its India subsidiary in 2011 with the intention of reviving the role of the GP and strengthening primary healthcare services. Pathfinder Healthcare’s first centre was set up in New Delhi and they now operate many more in the capital. More clinics are planned to be set up in the cities of Hyderabad, Bangalore and Amritsar.

“We are working with partners and training institutions in India and in the UK to establish an effective training programme to bring back family doctors and develop nurses and healthcare assistants further”, Dr. Niti Pall, Chairman and MD, Pathfinder Healthcare Developments

The development of universal healthcare in India is promoting collaboration with the UK across segments, including training, infrastructure and technical cooperation. Opportunities are most notably in areas of m-health, EMR, data recording, medical equipment and devices to get clinics up and running.

References:

http://knowledge.wharton.upenn.edu/india/article.cfm?articleid=4719http://timesofindia.indiatimes.com/business/india-business/VCs-bat-for-revival-of-family-doctor-networks/articleshow/12697964.cmshttp://zeenews.india.com/news/health/health-news/family-doctor-to-open-300-clinics-for-primary-healthcare_17212.htmlhttp://articles.economictimes.indiatimes.com/2012-08-11/news/33153218_1_clinics-local-physician-malhotrahttp://pathfinderhealth.in/default.aspx