Organised healthcare splinters into niches

There was a time when only corporate hospitals, modern diagnostic centres and retail pharmacies defined organised healthcare in urban India. Now,  ‘family doctor clinics’, ‘dialysis centres’ and such are also seeking to harness India’s healthcare industry which will touch $79 billion by 2012-end.

Health experts and doctors are turning entrepreneurs, setting up niche centres needing initial investment of Rs20-25 lakhs, far less than what is required to set up large-scale hospitals.

Like corporate hospital chains including Apollo, Fortis, Max, Manipal, such niche centres are everywhere — in Bangalore, New Delhi, Kolkata, Chennai, Hyderabad, Pune, as well as tier II towns like Shimoga, Hassan, Kakinada...

Don’t run to super-specialty hospitals for everything from viral fever to asthma to blood pressure or even kidney stone---come to us, is what such clinics are emphasizing on.

“Typically severe heart and neuro ailments, gastrointestinal problems, chemotherapy, birthing and delivery and surgeries require hospital visits and stay. Rest can be tackled through niche centres,” said a doctor from a Bangalore-based hospital chain.

More so because about 70-80% of all medical cases resulting from infectious diseases like malaria and typhoid to lifestyle disorders like obesity and hypertension can be addressed by the family doctor, experts said. It has been found that in 75% of cases, however, people run to super-specialists or visit hospitals unnecessarily.

Similarly, every time kidney dialysis is required does not mean getting admitted to a hospital, said Vikram Vuppala, co-founder of Hyderabad based kidney care chain NephroPlus. “Patients can get the dialysis done through specialised centres and head home within hours.”

Typically, niche centres like a modern family doctor clinic, measures 600-1,200 sq ft, and houses up to four general practitioners (GPs) and a paediatrician, nurse and pharmacist each.

On an average, each patient spends between Rs150 and Rs400, thus fetching each centre between Rs1 lakh and Rs3 lakh in revenue per month.

While kidney care and dialysis centres are usually spread across 1,500-2,000 sq ft. Demand for them has risen as an estimated 2-3 lakh people develop kidney failure every year in India.

Charges per session of dialysis average around Rs1,200. Some dialysis centres’ services are used by up to 60 people per month.
Experts say innovative healthcare services are lucrative, though the first six months tend to be quiet with barely 10-15 patients coming in per day. “Later on, we start seeing 25-30 patients per day,” said Naresh Malhotra, director at Modern Family Doctor (MFD), a Bangalore-based chain of GP clinics.

“Each person comes twice or thrice a week,” said Vikram. Agreed Malhotra. “Often, 60% of the patients are repeat visitors.”
So, firms like MFD and NationaWide Primary Healthcare Services (NPHS), another chain of family doctor clinics, are gearing up for expansion.

Currently, MFD and NPHS have about 11-15 centres each in Bangalore. But they are investing Rs20-25 lakh per unit to set up 300 and 500 clinics respectively over the next five years.
“We will focus on office complexes and apartment blocks where satellite clinics can be set up to cater specifically to employees and residents,” said Santanu Chattopadhyay, MD of NPHS.
NephroPlus will set up about 75 units in three years, 70% of which would be based in Tier II and Tier III centres like Visakhapatnam, Mandya and Hassan. “Each unit will have 8-10 paramedical staff and 1-2 nephrologists,” said Vikram.