Dr. Gurushankar is the 37-year-old speculator plugged leakages let by legacy assets, and without pity, he removed people who did not want to follow with his vision. While driving into a Madurai district, we are likely to see a couple of Meenakshi Mission Hospital buses by the way. These buses, in point, house the hospital’s telemedicine units and anytime we can find them interacting with doctors at the Madurai command centre. These connected buses are around 1,50,000 people every year to serve and that are the brainchild of Dr. Gurushankar S. He made the hospital with most sought-after centres in Southern Tamil Nadu. Unenviable past filled in Hospital with infatuation and drama.
N Sethuraman, a Urologist established the Meenakshi Mission Hospital in 1985. He wanted to have a modern hospital in a tier-2 city like Madurai.
Politicians belonging to the Devar Community helps to identify the hospital with the 100-bed hospital in 1991. Devar community makes a dominant clan in Madurai district and their politics. In South side of India, politics, and business tend to have powerful community and clan-based association that is even stronger than the caste system. Even late APJ Abdul Kalam and late Jayalalithaa has visited this hospital.
By 2005 Sethuraman had lost the control of the Hospital. Built with the individual purpose of making healthcare affordable, it was becoming a business running political favors during elections.
To save the place, Sethuraman turned his youngest son, Dr. Gurushankar. He was concerned that the agreement with politics and the power centres that were running the hospital would finally execute the place down. Though it had become a Rs 100-crore company and the hospital offered 250 beds, its margins had dropped significantly with cronies making money, and its business ethics settled. The standards had dropped so much that the hospital needed help. When Gurushankar stepped in, he had just turned 25 and had no prior experience. Gurushankar, Chairman of Meenakshi Hospitals, says,
“At the time I was never prepped to take over the business. It was when I was going abroad to study that I realised that dad was going through a lot of trouble and he needed my help. The decision to stay back changed my life.”
Although he had always planned on turning after his education abroad, nothing could have prepared him for the 12-year rollercoaster ride at his father’s hospital. This journey involved bankruptcies and end of friendships. But it saved Dr. Gurushankar’s family and business, which is now a Rs 350-crore business and poised to develop revenues to Rs 500 crore in five years.
Also, There are plans to open three more hospitals by 2024 and by building a telemedicine practice for Africa. Recently the hospital serves more than half a million patients every year.
“Guru was a brilliant student. He would teach us physics and always read a lot,” says Adel, a childhood friend who now heads marketing and projects at the hospital. He adds that he was the kind of kid who would succeed in whatever he did. “While everyone was being studious, he would just understand concepts very quickly and would ace exams with very little effort,”
Gurushankar says he owes it to his mother for making him read and the capacity to understand concepts from a young age. But he was never part of the business, and his elder brother was supposed to manage it. However, his brother was “impressionable” and “it is very hard to time dealing with the power centres that had run the business during my father’s time.”
The power centres were the finance department and the purchasing department with the doctors’ nexus, the political impact in the region including the marketing department.
Dr. Gurushankar entered the business in June 2005 and declared a board meeting, where his father published that his son would be the vice-chairman for a few years before taking over as chairman. The announcement was met with a lot of dissatisfaction. Some of the senior, members of the company’s trust and they wanted their nominee to be appointed. But everyone abandoned to Sethuraman’s move.
Still, that did not stop the power centres from moving things their way. Gurushankar called each of them in and motivated them. While the company’s management structure started to be realigned, Gurushankar also went in for development. He brought in young people to control key departments. He advised them to merchandise better with pharma companies. But he still had couple power centres to release doctors who had a powerful say in the business and politicians who would use the hospital as a scaffold area for clannish politics.
Gurushankar introduced a plan to the doctors, which need of every big consultant to give up consulting on the outside and dedicate themselves entirely to the hospital. He promised that the doctors would get massive compensation from the organization’s profits.
Many doctors left him, but the young ones stayed behind and bet on the future development. Today, around 330 doctors are on the rolls of the company with over 150 of them being MD-level and MS-level doctors. Gurushankar says,
“Such a business model takes away the business-minded nature of the doctors who use hospitals to get patients into their personal profit centres. This destroys healthcare service, which Madurai cannot afford.”
Then came the turn of politicians. “I have learned to say no to people. I made sure my business did not have political leanings,”.
Rather than, Gurushankar used politics to his advantage and started performing charitable operations. He accompanied, with an NGO, 10,000 free cleft lip and palate operations. All these operations were performed on children, so he had the late APJ Abdul Kalam, the former president, to support the good work of the hospital. Gurushankar says,
“I ensured that I removed the clan-based association that my hospital carried because of my dad’s association with politics. I kept them at a distance,”.
The politicians opposed to his father, who again said that his time was done. Filling the leakages took Gurushankar a good three years. By 2016, he became chairman of the company and lastly, things were in his grip.
By now the hospital had developed into a 1,000-bed hospital. Gurushankar opens to lay out his expansion plans around the Tamil Nadu region. He started to study the Thanjavur region which had small 100-bed hospitals. He understood that none of them had multiple specialties in the region. In 2009-2010, Gurushankar bought land and began construction of a 250-bed hospital which could assist six million people in the Thanjavur region. Raising of Money is not easy.
Gurushankar’s first step is that don’t want to take money out of the hospital in Madurai. Alternatively, he invested Rs 70 crore of his money and another Rs 80 crore was loaned from the bank. He says
“I remember in 2013, I had Rs 80,000 in the bank account and I was worried that things may not be as good,” .
In the first month of opening, around 10,000 people showed up in the office thanks to the free treatment offered. But it was the specialties along with the state-of-the-art cancer treatment conveniences that did the trick for the hospital. Today it operates close to 1,20,000 people on a yearly basis, and its revenues have crossed Rs 100 crore in the financial year 2017. With success in spirited, Gurushankar opened to take on bigger challenges. The connected revenues of the hospitals stand at Rs 350 crore.
Business Strategy for Future
The modern hospitals have developed because they have branded themselves and offered premium services. One of them that grew in less than a decade was Cloud Nine Hospitals. Rohit MA, MD of Cloud Nine Hospitals, it generates more than Rs 1,000 crore of revenues with 12 centres across the country. He said,
“A business needs processes to be managed efficiently and the brand must resonate value with its customers,”
Earnings have improved fast because of the pricing and the operating model of it. Doctors are on a fixed salary, and the hospital decides the medicines to be stocked in pharmacies and the machines to be purchased. It sets the cost of treatment based on the finance of the region. There is much competition, like Apollo Hospitals and other smaller hospitals in the region. At half the cost of an Apollo, it helps the common man and not a premium hospital.
Gurushankar prepares to set up a premium hospital in Madurai that will be concentrated on serving the upper crust in the region. The company is going to focus on growth in Salem, which is a tier-3 city, with a 250-bed hospital. There are plans to set up a hospital in Chennai also between heavy competition. He has prepared a Rs 300-crore investment plan to set up a nursing college too in Madurai and is starting to rope in a New Zealand university to support the college.
He intends to use the university to train African students only who can go back to their countries and assist as nurses in telemedicine centres set up by Meenakshi Hospitals. The first stop will be Kenya where Gurushankar is planning to produce a tie-up with a hospital in Nairobi.
The telemedicine practice was born out of an experiment in Madurai at now. A few years ago, the hospital management formulated a plan where they would convert a bus into a treatment centre. The bus would visit each village across Madurai district that shows how they treat the people. A nurse would monitor the vitals of the patient, and a doctor does a video interface to support treatment. All this information would be directed back to the hospital by ISRO.
Late Former President APJ Kalam got the hospital to join with ISRO and to deliver this service. Gurushankar does well in one thing that he is not shy about asking people what he wants to make his hospital shine. He says,
“I want to apply the same model abroad. But this time I might want help with a clever startup platform or anyone who can make this dream of serving Africa from India a reality.”
He is also not saying to investors by talking but suggests that he will only sign up with those who share his vision of affordable care and long-term growth. Gurushankar says,
“I cannot chase short-term profits. I do not work in that fashion and it will be a nightmare if I sign up with profit seekers,”
He wants to build things on his terms. He is a fan of the book, Seven Habits of Highly Successful People and the movie, The Godfather. His favorite quote is from the Tamil classic Thiruvalavar.
“Who can harm a king with counsellors who are free to rebuke him roundly. A king unguarded by trenchant counsel needs no foes to come to grief. The earth bears no heavier burden than a tyrant hemmed in by fools.”
Few things matter for an entrepreneur to succeed said by Gurushankar:
- Knowing what you want and sticking with your core idea. Never go away from the core and know what you want.
- Getting rid of power centres in the organization.
Mohandas Pai, Founder of Aarin Capital, says,
“Family businesses grow when they align their goals to the growth of the business and the management and not personal growth,”
The hospital’s joined revenues like Thanjavur and Madurai that grown by 13 percent to Rs 350 crore in 2015-2016 from Rs 316 crore in 2014-15. It expects to maintain this growth for the next five years. At least Gurushankar has his sights set on the success of the company, and not going to stop writing down ideas.
While the interaction with his wife Kamini and she will tell you that he thinks of ideas in the bath even, which he lists down immediately and tries out at the hospital the next day. Honestly, an entrepreneur who has the potential to grow pan-India some day. But he tells the Story, “I’d rather become the best healthcare provider in Tamil Nadu first.”