The Roots of a Growing Healthcare Ecosystem

Along the banks of the Kaveri, in the Temple city of Trichy, Dr. Manivannan Selvaraj recalls his childhood where his brother, cousins and friends would spend hours of euphoria splashing around or simply hanging out on its soft sandy banks. The warm nostalgic feeling of comfort and familiarity along the clear bobbling waters stuck to their minds and hearts when they became first-generation doctors and entrepreneurs that dreamt of bringing world-class healthcare to the tier-II cities of Tamil Nadu.

“My parents were neither in healthcare nor entrepreneurship,” narrates the doctor explaining that his passion for entrepreneurship stemmed from his father’s entrepreneurial instincts (a result of the frustration from the lack of autonomy as an engineer in a government job), “He strongly believed that we shouldn’t pursue a generic career.”

As a young high school boy, it was his dream to become an engineer. After all, the eighties were the Golden Ages of engineering. His passion for physics and chemistry landed him engineering seats at reputed universities, however, his father had other plans. “My older brother had found his passion in medicine and was already halfway through his degree in Chennai. My father believed that a medical degree would give me a better career,” with a hearty laugh the doctor proceeds with his narration, “Afterall, I saw how much fun my brother was having in Chennai, so I accepted his career advice on the condition that I get enrolled in a college in Chennai as well.” Thus began Dr. Manivannan’s career in healthcare.

Five years of medical school fled past in fun and frolic. His brother, Dr. Aravindan Selvaraj had moved to the UK to pursue orthopedics. Once again he found himself following his brother’s footsteps. He moved to Pune to specialise in anesthesiology.

“According to Darwin’s theory, species of lower evolution learn to look after themselves very young. The more highly evolved species are dependent on their parents for a large part of their lives,” he explains before breaking into another hearty laugh as he jokes, “Doctors fall under the category of highly evolved species. We remain dependent on our parents till we turn thirty!” All of a sudden the fresh graduate found himself contemplating what to do next.

In 1999, Dr. Manivannan and his colleague, friend and fellow anesthesiologist Dr. S. Chandra Kumar decided they would revolutionize the healthcare system in their hometown—which was either of poor quality or unaffordable. As anaesthesiologists, it was their duty to manage the ICU, emergency and operation theater—three critical areas of any hospital that would define its reputation and bring revenue.

Thus, Kaveri Medical Center (KMC) was established in Trichy as a humble 30-bed hospital. “My brother, my wife and my cousin—all first-generation doctors with different specialisations joined us at our center.”

For the first seven years, the founding anaesthesiologists ensured that at least one of them was available on call at any given time. In a town where people were forced to travel to Chennai, Coimbatore and Tanjore for better secondary healthcare facilities (pertaining to orthopedics and low-level neurosurgery), KMC managed to bridge the gap with their specialisation in services that weren’t locally available. Over time, KMC introduced Trichy’s first cath lab, cardiac center and radiotherapy center. The vast agrarian economy and small population ensured that affordability and personalised healthcare were ingrained within the hospital culture from the very beginning. As a result, within two years the hospital grew to accommodate 200 beds.

Owing to the lean operations, KMC managed to make profit margins despite a low tariff. This added value to the brand and enabled them to onboard the Piramal Group for private equity funding. By 2011, Dr. Manivannan moved to Chennai to expand—this time rebranded as Kauvery Hospital.

Constantly learning from their predecessors, the duo built a management team and invested in facilities with a focus on efficiency. Most of the employees were hired from tier-III cities or neighbouring villages and shared the core views of the hospital culture. “Today, out of about 4000 employees, 60% of our employees are being employed formally for the first time,” reveals the founder explaining Kauvery’s mission to increase employment opportunities for all.

While Kauvery grew as a brand, it built an ecosystem around its healthcare services with associated ventures in rehabilitation and pharmacy distribution. Though the doctor was now neck-deep in the medical industry, his passion for engineering and innovation did not fade. “Whenever someone mentioned new technology or software I would say—please come try it at our hospital,” he says with a smile as he gives insight into the atmosphere of innovation and experimentation that the hospital enables. “In the last two years we started an incubation center housing five start-ups,” he adds, “We guide them if needed and eventually plan to invest in ideas to take them to the next level.”

Today the Kauvery Group of Hospitals has five healthcare facilities located in Trichy, Hosur, Chennai, Salem and Bangalore. In the next three years, the founders expect to scale with 13 branches across tier-II cities in Tamil Nadu, Chennai and Bangalore—increasing the capacity from 1200 beds to 2500. The hospital group also aims to increase turnovers from 800 crores to 2500 crores in the next five years before potentially going for listing.

“Doctors are the biggest community of entrepreneurs!” laughs the founder, “Twenty years ago, when corporate hospitals did not exist and government hospitals weren’t as big, it was very common for doctors to move back to their city and start a clinic,” he explains, “Kind of like a mom and pop store.” These clinics would eventually grow into hospitals. Dr. Manivannan paints a picture of how doctors learn to fend for themselves along their journey. This was the inspiration behind a seminar he conducted in 2006, at the Medicall Expo, titled ‘Everything they Failed to Teach You at Medical College’ focused on hospital management. While practicing medicine requires skill, balancing it with entrepreneurship is a whole other ball game. “Make great healthcare affordable,” the founder reiterates his mantra as he urges young professionals in the healthcare sector to focus on the bottom of the pyramid where the scope is the highest.

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