Hyd’s Srikara Hospitals Targets Pan-India Expansion, Eyes 20 Branches In 10 Years

The healthcare industry in India has caught up with the advancements followed in the West. In fact, the recent trend witnessed here is patients from the West, in the absence of a health insurance, are visiting India seeking access to affordable healthcare treatment and surgeries. The only Group of hospital in the world to have made a mark in the joint replacement space with seven Robotic systems is Hyderabad’s Srikara Multispecialty Hospitals, and it is the only hospital in Asia that uses robotics for knee replacement surgeries. In conversation with Bizz Buzz, Dr Akhil Dadi, Chief Joint Replacement Surgeon, Founder, and Chairman-Managing Director of Srikara Multispecialty Hospitals, shares his 11-year-long entrepreneur journey, India’s prowess in providing the best healthcare, and increase in awareness about pain-free knee replacement surgeries

Who is your inspiration for setting up the first hospital?

Dr GS Rao, the Executive Director of Yashoda Group of Hospitals, as well as another hardworking entrepreneur is Dr Gurava Reddy sir at Sunshine Hospitals. I have worked with both of them at these hospitals. Before joining Yashoda in 2004, I was with APSRTC Hospital where Dr Padmanabham was the Executive Director. They are my major source of inspiration to start Srikara. They are a source of hard work, discipline, focus and commitment.

What was the reason behind venturing into business?

If we are working in some other hospital we cannot take matters related to food or beds, into our hands. Also, to an extent the pricing of healthcare was an issue in some hospitals. At that time, others ideas about patient hand-holding and care were not in-sync with mine. Everyone who is running this 365 days 24x7 industry is dealing with someone’s life and family emotion. As an entrepreneur we get the opportunity to gain lot of new learning’s too. We learn about equipments needed to treat various causes, the cost at which it comes, and so on. A business owner is always cautious and on the learning track to make sure that what has been created does not face a down-fall.

What are the challenges in running a hospital?

Firstly, as it is 365 days 24x7 industry, there is a huge capex involved. The money needed to set it up is huge, and for running it daily is way more. Oxygen line, biomedical waste management, live power systems, high-speed internet, and others, not only come at huge cost but also has huge maintenance cost. Either we need great investments flowing in or we have to do really well for the hospital to survive. Every hospital is now going to take 18 months to two years to break even, which used to take 12 – 18 months earlier. The second challenge is the quality. Every service provided is right in front of the patient, from putting an IV line to giving their medications, anything goes wrong then it is finished, and nothing can be covered up. Constant diligence on the treatment given to the patient is needed. Thirdly, is the presence of stringent statutory…but it is required, fourth is dedicated team to work beyond nine hours as it is war footing on a daily basis. There are plenty issues, but the inspiration of being an entrepreneur drives us towards success.

How would you sum up your achievements?

Our biggest achievement is that we put down our foot very strongly if a person does not require surgery, and we extend the same principle to all the specialties in our hospital. With this policy we stand first in South India and second or third in India for knee or joint replacement surgery. Moreover, I have been able to manage the finances of the hospital in a balanced way, while bringing in the best technology. Probably, we are the only Group in the country and in the world who has deployed seven Robotic systems for knee replacement, and the only in Asia using robotics for knee replacement surgery. We are also top in the world for doing the highest number of Oxinium implants. In the past 11 years, I have done about 10,000 Oxiniums and 22,000 knee replacement surgeries in Srikara Hospitals, and last year itself we did 4,500 knee replacements, which is second or third highest in the country.

Our other achievement is that we are pocket-friendly local neighborhood hospital as we have seven hospitals in Hyderabad and two in Andhra Pradesh. We are also known for our Cardiology treatment. 55 per cent of our revenue comes from Orthopaedic, while 45 per cent comes from other specialties, which indicates that we have succeeded to develop the other departments also. By and large, except Cancer, we offer a holistic package to middle class and lower income groups as their neighborhood hospital in proximity of five kms of their reach.

Where do you see Srikara Hospitals 10 years from now?

We are nine branches today, hopefully at 20 branches. We might need a bigger size hospital too. Today we are at less than 1,000 beds this will go up to 4,000 – 5,000 beds, at various locations. If we are able to cross South India and become pan India, a team of dedicated people is a must. Over the next five years the number of doctors and employees will go up to 4,000. We started with over 100 employees and 20 doctors. Today we have crossed 2,000 employees and 350 doctors, across the nine branches. We mainly focus on Orthopaedic, ICU, General and Laproscopic Surgeries, we are not great at Gynaecology, in Cardiology we are present in few sectors, we are also not into cancer treatment. In the existing facilities we are looking at expanding with Neurology, and taking in more doctors for Cardiology. And, probably add Gynaecology in the few available centres. In FY14-15 we did a revenue of about Rs 30 crore. This FY24-25, we will be closing above Rs 330 crore. So, we have grown 11 times over this period, which is reasonably good for us.

What is the current business model and the one for expansion?

Srikara Hospitals is a private-owned company. We have few small and big investors. We will not get into the franchise model. For the expansion plan we are thinking of starting off with either Bangalore or Chennai. With the present bandwidth we will not be able to enter there. We are on the pathway to invite private equity partners - one is for growth fund, but they also come with lot of checklists and guidelines, which is required. Mostly in the next six months we will be inviting PEs and enter a new geography.

How much investment is required to set up a hospital?

The investment amount we will raise is need based. If we are taking up a rental place today then each bed will cost Rs 25 lakh. If we are lucky and get a property for sale then each bed will cost a little over Rs 50 lakh. The total investment is based on how many beds we want to expand. If we want to expand by another 500 beds and opt for all rental then we will need Rs 125 crore. If all the 500 beds we buy with the property then it will cost Rs 250 – 275 crore.

What is the current new innovation making wave in knee replacement?

The new innovation is titanium gold knee replacement, a knee implant that has a titanium-based coating on it. It gives more stability, more anti allergic, and increases longevity. The price is about Rs 1 lakh, the same as other implants. Bionic gold is for anti-allergic, Vitamin E Poly increases the longevity and medial pivot brings in higher stability. When it comes to patient care, we do feel the need for introducing central monitoring system of patients, and an alarm system if something goes wrong while the patient is asleep.

How successful Srikara is in terms of medical tourism?

We have very few patients visiting us from African countries. It is in single digits per year, so we are not fully into boosting medical tourism. Government has to support a hospital of our size if we have to get into it. It is a part of our plan to increase the numbers…if there is a possibility. If their government has a tie-up with the government here then we can look into it.

How has new emerging tech like AI, ML enhanced healthcare system?

In most of the fields these new emerging technologies can support healthcare and patient care. Right from diagnostics…sometimes a doctor might miss a provisional diagnosis, but with AI that will not happen. At Srikara, AI will continue to play its role in accounting, auditing, and operational systems. That dependence on humans and the errors associated will be eradicated through AI-based applications.

What is your take on doctor to patient ratio in India?

The basic difference can be seen in the periphery compared to the main cities. We have to bring in public private partnerships in the peripheries to address the lack of doctors there. We have to strengthen atleast the government hospitals, the availability of facilities, timing contributed by doctors. It can be started with good government colleges who are working in disciplined manner and then work on multi-specialty hospitals there. Yet, availability of doctors is not much an issue in India as seen in the Western parts or Australia. Doctors and super specialists are easily available in India. We should not expect an increase in the doctor to patient ratio as it will bring down the quality. The number of doctors who are not going to diagnose or perform well is likely to increase in such cases.

How can healthcare be made accessible for all at an affordable cost?

Healthcare is affordable in India. Our patient-mix includes 60 – 65 per cent insurance holders, 20 per cent are associated with government schemes, and only 10 – 15 per cent patients pay by cash. Rather than talking about making it more affordable, everybody should get themselves a health insurance. Even those people who are enrolled in a government scheme should buy insurance.