Doctor Insta is profitable at operational level: Amit Munjal

Introduced in December 2015, Doctor Insta is a telemedicine / healthcare consultation platform operating on the web and as a mobile application on android and iOS devices. Backed by investors like RoundGlass Partners (Seattle, Washington) and BrahmaX Ventures (Los Angeles, CA) the start-up has over one million users and around five lakh app installations at present. Amit Munjal, founder and chief executive officer, Doctor Insta in conversation with Ashish K Tiwari, speaks about the venture’s business models, telemedicine industry, uniqueness of the platform and so on. Edited excerpts…

Could you briefly tell us about Doctor Insta and the solution it offers?
Doctor Insta was started three years back and is today India's largest virtual healthcare platform. It’s a curated platform where people can come and get online consultation by phone, video and chat as and when they want i.e. 24x7, 365 days. We have two business models, one is business to business to consumers (b2b2c) and the other one is called business to consumers (b2c). In the former, large Indian companies avail the Doctor Insta solution for their employees and dependents. So there are like 1.2 million b2b2c lives covered and around 600,000 lives cover through the b2c programme.

Any names you can share on the b2b2c front?
Sure, American Express, FedEx both are large American companies in India, Concentrix, which is a very large BPO in India with 48,000 employees. Muthoot Finance, Future Generali, Bharti AXA, Tata Group, Amalgamated Plantation, Punj Lloyd all of them are currently clients of Doctor Insta.

How does one avail of the services through your telemedicine platform?
Under b2c you can download the app and choose to do the consultation on pay as you go basis or pay an annual subscription. In b2b2c employees don’t pay anything, it is the employer paying retainer ship, per employee per month fee. We also have separate model called consult your own doctor. So let’s say you have been going to doctor Kumar for your medical consultation then you can now consult with the same doctor on Doctor Insta platform from your phone, video or chat through the Doctor Insta app. All the prescriptions come to you electronically in five to 10 minutes post your consultation by email as well as inside the app in your ‘my health’ records.

So cutting the time in the entire consultation process is what it’s mainly about?
There are many problems and challenges when going to the out-patient department (OPD) at hospitals and clinics. People waste three to four hours and suffer in chaotic traffic, ordeals of public transportation, poor parking infrastructure followed by a long wait in the doctor’s waiting room. In the end, we spend just about five to seven minutes with the doctor. So yes, we are cutting it to the chase and saying you don’t have to spend those four hours of critical time and you can just do a on the go consultation with the doctor and then take it from there.

How are the prospects like for telemedicine?
According to reports by major scientists of the world, Stats show us that on net rated average basis 70% of the problems could be solved through virtual healthcare. Also if you look at the trajectory of virtual healthcare companies all over the world, like USA is probably seven years ahead of us and there are three large virtual healthcare companies doing hundreds of thousands of consultations on their platform. You move the spotlight from US to China that is probably four years ahead of us and again hundreds of thousands of consultations are happening through the virtual healthcare platforms there. All these four companies that are leading the pack there are large decacorns (private companies valued over $10 billion). In fact, a couple of them are now listed in Hong Kong stock exchange as well.

And that can be replicated in the Indian market as well?
We and our institutional investors feel that the same way cookie would crumble in the India market too and as India evolves more and more organised online consultations would happen. To put things in perspective if you would ask someone if they have done an online consult most of them would say no we haven’t? But if you asked them the question have you ever picked up the phone and spoken with your doctor and asked the doctor for a remedy to your problem or send an SMS or WhatsAap to your doctor asking the same, almost all of them would say yes we have done it. So in a disorganised manner in India hundreds of thousands of consultations are anyways happening virtually.

How significant is this opportunity in India?
About the size of the market, as a concept it is relatively new for India and Doctor Insta is definitely the market maker. The market for online consultation theoretically speaking is 70% of 50 million per day which is like 35 million consultations that could happen on the platform every single day. The other way to gauge is by adjusting the market for what we have seen in China; because that’s the closest precedent we have in developing world. We can’t compare it to US because the healthcare system is very different there versus in India. But India has a lot of similarity between Chinese healthcare system, so in china around 900,000 consultations are happening every single day and they are growing in double digits month over month. So if nine lakh consultations are happening between four players, India has probably 90% of the same population so you can apply the factor of 90% and say almost 800,000 consultations could happen in India every single day though the organised platforms.

How do you identify doctors for your platform?
With Doctor Insta we have a curated platform. What we do is selection, screening and training of the doctors before putting them on the platform. First of all the Doctor Insta itself has cherry picked doctors and owing to crowd sourcing of the ratings and reviews if a certain doctor rating drops below a certain threshold, then they get decommissioned. So the platform is a huge success and survival-ship biased because only those who are continuously making their patients, happier, stronger and healthier would survive. That's why we are the company of first choice for almost all of the large companies in the Indian market.  As I was saying earlier, we have 1.2 million employees covered through Doctor Insta across 107 large companies.

How many doctors as of now on board?
The largest platform in this space worldwide is Teladoc that has around 350 doctors.  Any platform which has tens and thousands of doctors cannot succeed because if you are not feeding tens and thousands of doctors they will not be regimented about keying in their hours. The key here is having a core group of doctors and giving them enough number of consultations in a day or in a night so that you could carry forward. And lastly, the point is standardisation of pricing wherein all the doctors on the platform agree of Rs 400 for our b2c users. On net basis info we have around 100 doctors offering the consultations day in and day out on the Doctor Insta platform.

Additionally, we also have a service wherein existing patients can also see their doctors (if they are on the platform) and such doctors set their price for their own patients. It's basically a free technology platform given to the doctors to use for the respective patients. It’s relatively a new solution from our side for the doctors.  In ‘see your own doctor’, we have around 150 doctors now who are consulting their own patient through the app. You can find them on our platform through the doctor’s code on their prescription. There is no revenue for us from this service.

Between web to mobile application what is the interaction like?
India is primarily an Android based nation, so 60% of our volume comes from Android phone, 25% from iOS devices. That’s’ because the product is more amenable two bigger cities. Approximately 15% of the business comes through the web driven primarily by companies where they don't let you take the smartphone inside for privacy reasons.

Is there a rural service model too?
Doctor Insta is more prevalent in urban India than in rural. But we do have rural India presence and it works differently through ‘Doctor Insta Inclusion’. In this service offering, the paying capacity is not much and a good MD doctor would expect a good compensation for the time spent. Hence the ‘Doctor Insta Inclusion’ plan works through the third-party assisted e-commerce companies.  We offer the services through a MBBS doctors because the math doesn't work out for an MD doctor. The way it works is that we have village level entrepreneur (VLE) who can be reached out for facilitating the consultations. Here the VLE would enable the consultation between the MBBS doctor and patient. While the VLE would collect the money from the patient, the payment would get deducted from the VLE’s wallet and then the parent company would settle it with Doctor Insta every month. The consultation charge in this case is around Rs 120. We offer only MBBS level consultation.

How much have you invested in the business and what kind of revenue is the platform doing annually? Is the business profitable?
We invested a few million dollars and we are also backed by some leading healthcare specific venture capital funds. One of them is RoundGlass Partners based in Seattle and the second one is BrahmaX Ventures in Los Angeles. Collectively investors have put $3 million and in Doctor Insta and they own around 30% of the company.

We are growing in double digit month over month and our revenue this past year i.e. March 2018 would be under $2 million dollars. We are profitable on operating profit level clearly. But if you take into account all the indirect cost, we are still in the growth phase. So we are in the red but at operating level we are profitable.

Are there any fundraising plans in the near future?
We are well-funded and also have the backing from existing investors to keep on bankrolling us in our next phase of evolution in India market.  But in the next few months we will also formally be doing an additional round of fundraising. Small fundraising would not matter at this juncture so the next fundraising would be between $5 million and $10 million. This would definitely happen in this year.

Do you also have association with the pharmacies and the test laboratories?
Yes we have tie-ups with all the leading pharmacies of the country from Apollo Pharmacy with 3,000 stores to all the leading online pharmacy stores like 1mg, NetMeds, PharmEasy.  The pharmacy partners offer between 35% and 40% discounts on medicines. We also have aligned with all the leading diagnostics labs like SRL, Dr Lal, Metropolis and Thyrocare. Discounts offered by laboratories are in the 45% to 50% range. This apart, we have tie-ups with all the leading insurance brokers of the country.