Shalby hospitals creating a world class multispeciality tertiary healthcare chain

Shalby Hospitals (Shalby Limited), established by Dr Vikram I Shah in 1994 in Ahmedabad, Gujarat, operates a chain of multispecialty hospitals across India, holding an aggregate bed capacity of over 2,000 hospital beds. Shalby's recognition as a multispecialty tertiary hospital chain in the Indian healthcare industry was envisioned by its founder Dr Vikram Shah - CMD, who is also the inventor of the 'Zero Technique' of Total Knee Replacement (TKR) surgery. Shanay Shah, President, Shalby Hospitals in an exclusive interview with Bizz Buzz talks about the growth of Shalby Hospitals and how the company has evolved over the years.

Shalby has grown from a small 25 bed hospital to a chain of 11 hospitals with bed capacity of more than 2,000. Our CMD Dr Vikram Shah set it up as a specialty joint replacement centre. His vision was to develop Shalby into a world-class joint replacement hospital and scaled it up to that level. Shalby applied those learning into multispecialty segments and is today a world-class multispecialty hospitals chain. This is our USP, world-class multispecialty hospitals committed to quality healthcare

How has the Shalby hospital chain grown over the years?

We began with a 6-bed hospital in Ahmedabad in 1994 as India's first centre focusing just on joint replacement surgeries. Soon its capacity was expanded to 25 beds. However, with Shalby's spectacular success in joint replacement we needed a bigger hospital. Thus, we established a 200-bed multispecialty hospital in Ahmedabad. We grew very fast from 2012 onwards and today we have 11 hospitals with a total bed capacity of more than 2,000 in eight Indian cities; Ahmedabad (four hospitals), Jaipur, Indore, Mumbai, Surat, Vapi, Mohali and Jabalpur. We went public in 2017. Today, Shalby is renowned world over for joint replacement and complex orthopedic surgeries. We have performed 1,25,000 successful joint replacement surgeries, which is sort of a record world-wide. We command 15 per cent of organized joint replacement surgeries market share among private players in India. We have leveraged our leadership in joint replacement to grow into multispecialty domain strongly with significant growth in key specialties like cardiology, oncology, spine and neuro. From a team of handful, our clinical and support staff today numbers more than 3000. Financially, we have grown consistently through years.

What is the current revenue?

As stated above we have achieved total revenue of Rs4,400 million for FY21. Besides, we are a net debt cash positive of Rs 598 million as on 31st March 2021.

What is the target audience you cater to especially in the income segment?

We cater to all income segments and aim to provide world-class healthcare facilities to all segments of the society. 30 per cent of our hospitals are empanelled with various state and central government health schemes such as ESIC, CGHS, ECHS, Ayushman Bharat, Maa Yojana, etc.

What is the patient feedback regarding your health services?

We take patient feedback through a feedback survey form at our hospitals. The feedback is obtained on a score of 0 to 5 on four parameters: medical services, support services, front office, and billing and discharge. We regularly analyze this feedback for continuous improvement. The feedback we receive is very positive. All our hospitals consistently score over 4, with medical services getting highest score. Besides, we get a huge number of new patients as our patients share their experience with people they know. Through this word-of-mouth publicity we get a great number of knee replacement patients from across the country. Besides, all our hospitals are rated over 4.5 in Google reviews. In most cities we operate, we are rated as number 1 in rating, and we get the highest number of reviews on Google.

What is the unique selling proposition for the hospitals?

Shalby has grown from a small 25 bed hospital to a chain of 11 hospitals with bed capacity of more than 2,000. Our CMD Dr Vikram Shah set it up as a specialty joint replacement centre. His vision was to develop Shalby into a world-class joint replacement hospital and scaled it up to that level. Shalby applied those learning into multispecialty segments and is today a world-class multispecialty hospitals chain. This is our USP, world-class multispecialty hospitals committed to quality healthcare.

How closely do you work with insurance companies?

We work very closely with all the major insurance companies of India. We believe that having health insurance is need of the hour for every Indian, and our association with insurance companies as well as TPAs is very strong. This enables maximum number of patients with health insurance access our services.

What are your expansion plans, and do you have a pan India presence?

Hospital business

• We have always been committed towards our capex plan

• We will be adding additional 321 beds to our current capacity

• We are going to incur cost of Rs 1910 million to add above capacity beds

We will be adding two hospitals in our hospital business. These will be located at Nashik and Santa Cruz in Mumbai and will be operationalised by FY23 and FY24 respectively. Santa Cruz Hospital will have 175 beds capacity and Nashik will have 146 beds capacity.

Franchise business

With the future strategy consideration, we have been focusing more on asset light model and going with franchise options with SOCE - Shalby Orthopedics Centre of Excellence. Under this, we are rolling our two separate models i.e., Franchise owned and Franchise Operated (FOFO) and Franchise Owned and Shalby Operated (FOSO). The objective is to leverage Shalby's core competency specialty i.e., orthopaedic and providing technical expertise to these franchises, which will be mainly focusing on orthopaedic branch of specialty. One SOCE franchise was launched in Udaipur this September. One more SOCE franchise will start in Rajkot in Gujarat in some months. In total, we are aiming to add more than 50 such franchises across India in next 3-4 years.

Besides, we have recently made an asset purchase by acquiring the implant assets, inventory and patents of consensus orthopaedics located at Sacramento in USA, which will eventually create a backward integration and produce more synergies to our existing business.

Can you tell us something about the Zero Technique?

Zero Technique of Total Knee Replacement (TKR) surgery is the minimalist approach of performing TKR in terms of incision, operative time, antibiotics, need for blood transfusion and need for long rehabilitation. It was developed by our CMD Dr Vikram Shah in 2012. To give you background, till early 90's TKR surgery was one of the most dreaded surgeries globally. It lasted hours, recovery was painful and slow, and patients had to be in hospital for 10-15 days. Dr Shah played a key role in improving and popularizing this surgery in India with his innovation of OS - Operating Surgeon's Needle, a strong, triangular needle which can easily pass-through bone, and then of Zero Technique that reduced surgery time from hours to just 8-10 minutes with added advantages of minimal blood loss, speedy recovery, near to nil infection rate and reduced hospital stay from 15 days to just 3-4 days. It is called Zero Technique as everything comes to almost at 'zero' level, be it surgery time, method, recovery, hospital stay, drugs, blood loss, patient and relatives' mental stress, etc.

What cutting edge technology do the hospitals offer?

Our hospitals are equipped with state-of-the-art technology. We believe in continuously upgrading the technology at our hospitals. We recently introduced four latest cardiac care technologies for the first time in central India with the launch of SICS - Shalby Institute of Cardiac Sciences at our Indore hospital. These are IVUS (Intravascular Ultrasound), rotablation, fractional flow reserve and MICS (Minimal Invasive Cardiac Surgery) and endoscopic vessel harvesting. These new technologies have distinct advantages in cardiac procedures.

Besides, we also launched digital navigation spine surgery operation room at our Ahmedabad hospital. This digital operation room is equipped with high-end ultra-modern technologies like the high-precision Zeiss Pentero 900 microscope, intra-operative neuro-monitoring, and stealth-station intra-operative navigation. Shalby is one of the very few hospitals with such a comprehensive and dedicated digital spine operation room, with cutting edge digital technology supported by an equally efficient in-house surgical team.