“Great Indian MedInfluencers 2019”September 7, 2019
As a premier science media establishment committed to the improvement of medical and healthcare practice, it is our privilege to honour great contributions to this cause by visionaries across India.
The important roles played by these leaders have not only enhanced the quality of healthcare in India and set new standards, but also made it affordable to all classes of the population. This has often been achieved against Herculean odds such as lack of finance and resources and market challenges.
The “Great Indian MedInfluencers-2019” is this year’s list of 12 of the greatest contributors to Indian medical practice and healthcare, highlighting their spectacular contributions to inspire young and emerging leaders of Indian healthcare.
A model set for Indian eyecare
Gullapalli Nageswara Rao had a dream when he returned to India after his long stint at the University of Rochester School of Medicine: To create an institution that can provide the world’s best eye care to everyone in India, home to the largest blind population in the world.
Dr Rao, who has nearly 300 papers on ophthalmology in national and international journals to his credit along with several book chapters, could realise his dream with the founding of LV Prasad Eye Institute with the help of like-minded people. But it was certainly not an easy task to start, and operate, a not-for-profit, state-of-the-art hospital. It was his strong commitment and dedication that enabled not only the creation of an institution of this stature but also a culture that became a model for the nation.
LVP Eye Institute is a model institution for eyecare for the world. This centre of excellence in modern ophthalmology treats patients regardless of their capacity to pay. It has treated at least 17 million patients at its main hospital at Hyderabad. More than half of these patients were treated free of cost, in spite of their complex requirements, as the philosophy of the hospital is different. The patients’ ability to pay is never the criteria to decide his/her treatment here.
Today, LV Prasad Eye Institute has a network of three tertiary centres and 10 secondary and 86 primary centres across the country.
A former associate professor of ophthalmology at the School of Medicine and Dentistry at the University of Rochester and a Fellow of the National Academy of Medical Sciences, India, Rao has been a visiting Professor at several Universities in the US, Europe, Australia and Asia. He has also delivered many named lectures around the world. His areas of specialization include diseases of the cornea, eye banking and corneal transplantation, community eye health, eye care policy and planning.
In 2017, Dr Rao was elected to the Ophthalmology Hall of Fame instituted by the American Society of Cataract and Refractive Surgery. He has also been honoured with several national and international awards in recognition of his services to eye care and public health, including Padma Shri, International Blindness Prevention Award from the American Academy of Ophthalmology and the AEBA Award from the Association of Eye Bank of Asia.
Cancer care for the poor
The passion for inclusive and compassionate quality healthcare was the force that landed Dr Ravi Kannan at the Cachar Cancer Hospital in Silchar, the poor tribal region of Assam, leaving his comfortable urban practice at Adyar Cancer Institute, Chennai, 15 years ago.
At the institute, he used to visit in North Eastern states and was struck by the lack of facilities for cancer treatment. So he left his plush practice in Chennai and helped establish the Cachar Cancer Hospital, which provides free and subsidized cancer treatment to poor people from the North Eastern states, a place where oral and head and neck cancer is most prevalent.
Thus the well-known surgical oncologist from Chennai became the director of Cachar Cancer Hospital and Research Centre and built a global cancer hospital for the poor, undertaking multiple challenges ranging from the financial to human resources and infrastructure.
“The opportunity to make a difference prompted me to think differently or walk an untraditional path” says Dr Kannan, who used to head the department of surgical oncology at Adyar Cancer Institute.
A member of Madras Cancer Care Foundation before moving to Silchar, Dr Kannan had a vision to provide quality, comprehensive, and affordable care to marginalized patients. This inevitably led him to dedicate his services to the people who really needed such care. But it was not an easy task to transform Cachar Cancer Hospital in Assam’s Barak Valley, which was until then a rural cancer hospital, into a full-fledged hospital.
The biggest challenge that he faced during this pathbreaking journey was recruiting, training and retaining human resources while ensuring standard of care for the underprivileged.
Cachar cancer hospital has a 200-member strong team now and provides free of cost treatment, including patient and family accommodation, food, and an employment centre where patients and attendants are able to work. The Foundation’s palliative care project at Cachar Cancer Hospital and Research Centre was started in 2013.
Dr. Kannan, who is a surgical oncologist specialized in head and neck oncology and bone and soft tissue sarcoma, has had many recognitions bestowed on him in the past for his selfless work. These include Dr. Kuppuswamy Oration at and Citation of Honour from Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad; The Telegraph “True Legend” award 2016 in recognition of the outstanding achievements and contributions towards society; Sixteenth Bhagwan Mahaveer Foundation Award for excellence in human endeavour in the field of Medicine and Award for Excellence in the field of oncology from Cancer Aid & Research Foundation (CARF), Mumbai.
His best advice for the young and aspiring is that every one of us has it in us to leave a positive impact on life on earth. We can choose to do this in our own ways.
Heart care for the masses
“My profession is giving hope to people suffering from heart disease and giving them a chance to start life in a fresh new way. I am essentially a technician who can cut and stitch people’s hearts; they call me a heart surgeon,” wrote Dr Devi Shetty a few years ago as he completed his 4,000th paediatric heart surgery—all without charge—in a letter to his patients and to the children of the world.
The Indian cardiac surgeon and entrepreneur, who founded Narayana Health, a chain of 21 medical centers in India, believes that the cost of healthcare can be reduced by 50% in the next 5–10 years if hospitals adopt the idea of economies of scale. The cardiac surgeon with magical hands, who has completed more than 15,000 heart operations, had always had his vision focused on affordable healthcare to make it accessible for the masses.
He initiated the concept of “micro health insurance scheme” in Karnataka, which eventually led to the Karnataka government implementing the Yeshasvini scheme, a micro health insurance scheme for rural farmers.
A recipient of several awards, including the country’s highest civilian honours such as PadmaShri and PadmaBhushan, ‘Rajyotsava Award’ and ‘Dr. B C Roy National Award’, he has also proved his mettle as a successful entrepreneur by founding Narayana Health and setting up the world’s largest heart hospital with 1,000 beds with the same vision of addressing the health needs of the masses. Narayana Health City, which performs more than 30 major heart surgeries a day, can today handle 15,000 outpatients daily.
Dr Shetty aims for his hospitals to achieve economies of scale to enable them to perform heart surgeries at the lowest cost. Committed to this philosophy, he has plans to expand the total infrastructure capacity to at least 30,000 beds with additional hospitals in the same model in several cities in India as well as other Asian countries and Africa. Shetty also founded Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS) in Kolkata and has set up a multi-specialty hospital at Ahmedabad though an MOU with the Government of Gujarat.
Invaluable contribution to diabetes care
Dr V Mohan, who had to pursue his taste for poetry and writing through scientific research and papers, has a world record in his name. No other practicing medical doctors have so far published more than 1,200 research papers and textbook chapters on the subject of diabetes and related branches of medicine. A pioneer in the field of diabetology in India, Dr Mohan has been close to this specialty practice from early in his life. He started working with his father, who started India’s first diabetology clinic, while he was pursuing his undergraduate degree in medicine.
One of the most renowned diabetologists in the world, Dr.Mohan and his research foundation — Madras Diabetes Research Foundation — have contributed tremendously to the field of non-communicable diseases in India by way of patient care, education and training and bringing standardization in diabetics care in India, a country that is on the brink of becoming the diabetes capital of the world.
Dr. Mohan’s Diabetes Specialities Centre, which is also a WHO Collaborating Centre for NCD Prevention and Control and an IDF Centre of Education, along with the Madras Diabetes Research Foundation have started several training courses for diabetes, including a two-year fellowship in Diabetology for medical doctors with an undergraduate degree and a one-year post doctoral fellowship in Diabetology for post-graduates in Internal Medicine.
Dr Mohan and his colleagues currently oversee 38 diabetes centres across India and one international centre at Muscat in Oman.
In collaboration with the Public Health Foundation of India (PHFI), Dr. Mohan’s Diabetes Education Academy (DMDEA) has started a certificate course in Evidence Based Management of Diabetes. In association with Indian Diabetes Educators Association, DMDEA also started a Certificate Course in Diabetes Education.
Dr. Mohan has established a rural diabetology service with a fully equipped mobile diabetes van and satellite connection with the initial support of the World Diabetes Foundation (WDF), Denmark and Indian Space Research Organization (ISRO) and National Agro Foundation (NAF). He and his colleagues have screened a population of over 50,000 people in 42 villages near Chunampet in Tamil Nadu in South India and provided free diabetes treatment to hundreds of patients through this service. He also provides free treatment to a large number of diabetic patients with the Sri Sathya Sai Organization, Tamil Nadu through 3 free diabetic clinics.
Currently his research interests combine clinical, epidemiological and genomic aspects of diabetes. His areas of work also include Epidemiology, Genomics of Diabetes and community-based projects on prevention of diabetes. A recipient of the Padmashri for his accomplishments in the field of diabetology, Dr Mohan has also been honored with the “Harold Rifkin Distinguished International Service in the Cause of Diabetes Award” by the American Diabetes Association. He is also a recipient of the Dr. B. C. Roy Award of the Medical Council of India.
Pioneering home healthcare
Even as an acute need has been felt at almost all homes to take good care of the old and sick as well as family members who have undergone surgery and hospitalization, arranging an organised home healthcare service was almost unheard of in India till recently. Finding a well-structured and sustainable business model to address this need was even more difficult. But when Meena Ganesh’s concept of an organized home healthcare got introduced in the country in 2013, it just felt normal for the industry and found many takers instantly.
Started with a concept of introducing and promoting professionally-run home healthcare services, Portea Medical can today proudly claim that it is the largest home healthcare company with more than 120,000 home visits a month and 75 hospitals across categories as partners.
Portea is currently spread across 16 cities and partners with top hospitals such as Jaslok Hospital, Narayana Hrudayalaya, Medanta, Manipal Hospitals’, Columbia Asia, Max Healthcare, Fortis and Cumbala Hill Heart Institute.The company currently offers services such as chronic disease management, post-operative care, cancer care, as well as geriatric and orthopaedic care. It has also built a critical care division offering complete hospital set-ups at homes of critical care patients by offering care at a lower rate than hospitals.
Home-based healthcare, that too at a cost lower than that offered by a hospital, is a significant addition to the improving healthcare scenario in India, where an increase in the geriatric population is imminent. Though competitors have come up with even more innovative models to capture the emerging opportunity, the pioneer’s work will always command respect and recognition.
Easy access to NGS
Precision medicine or personalised treatment is the future. The new methodology uses genomic data to help provide the right treatment to the right patient, taking into account his or her genetic nature. This is especially relevant for cancer and rare diseases for which effective medical intervention is not available under the current one-fits-for-all approach. Making Next-Generation Sequencing (NGS) technology accessible to the common man is vital to the development of such a person-specific diagnosis and treatment as the technology enables a rapid and accurate sequencing of many genes at once.
When one also considers that cancer is one of the leading causes of death in India and that around 70 million people here suffer from rare and undiagnosed diseases, one can truly appreciate the role of companies like MedGenome that are making NGS technology accessible.
“Precision medicine is the ultimate goal of clinicians and patients alike. This can be enabled through extensive biomarker discovery,” says Sam Santhosh, Founder and Chairman of MedGenome, which has established leadership in genetic diagnostics for cancer and inherited diseases in India.
An enthusiastic science entrepreneur, Sam Santhosh is also the Promoter & CEO of SciGenom Inc. – a genomic research and development organization that conducts research to understand the role of DNA sequence variation in all living things.
Santhosh started his entrepreneurial journey in 1992 by founding California Software (Calsoft), one of the most successful software ventures established in the US, which later expanded to several European and Asian countries through mergers and acquisitions.
MedGenome operates the largest Next Generation Sequencing (NGS) lab in South East Asia, and a CLIA-certified, CAP-accredited sequencing lab in Foster City, CA. The company’s services are being leveraged by pharmaceutical and biotech companies across the globe. MedGenome’s diagnostics tests include many firsts for genetic diagnostics in India, including the first liquid biopsy, “OncoTrack”, for monitoring cancer treatment, the first non-invasive prenatal screening test (NIPT) for pregnant women, the first carrier screening test for couples planning for a baby, and the first whole exome sequencing test for identifying mutations in rare diseases.
Expansion of quality care
An academic enthusiast and affluent entrepreneur, Dr. Azad Moopen has built the largest network of healthcare facilities with over 323 establishments — consisting of hospitals, clinics and pharmacies in the Middle East, India and the Philippines. Having started his career as a medical lecturer at the Calicut Government Medical College in 1982, he currently leads one of the largest healthcare delivery networks in Asia.
As chairman and managing director of Aster DM Healthcare, a leading healthcare conglomerate in the Middle East, he has always prioritised a mission to bring quality healthcare to India, where it is needed the most.
Known as a visionary leader in the healthcare circle, Dr Moopen started his entrepreneurial journey from a single doctor practice in Dubai in 1987 after his relocation to that country. While he still remember the days of busy practicing in his small setting, often for more than 18 hours a day, the growth of Aster DM Healthcare as an Asian healthcare brand hasn’t really affected his passion to care for the needy. His key philanthropic activities under Aster DM Foundation and Dr. Moopen’s Foundation is focused on free healthcare in India.
India’s first NABH accredited tertiary care hospital—Malabar Institute of Medical Sciences (MIMS), DM WIMS, Wayanad and ASTER Medcity, Kochi, are a few of his outstanding contributions.
Dr Moopen is still an educationalist at heart and tries to bring about an academic perfection in each of his entrepreneurial projects, including healthcare services, pharmacy and medical education.
“I’m quite passionate about teaching and was quite happy guiding young minds in the medical field. In fact, I began my career as a medical teacher in the year 1982 and the profession is still quite close to my heart,” he says.
Dr. Moopen has also earmarked 20% of his personal wealth for charitable activities to help social changes and uplift the poor. Some of his ongoing non-profit activities include health education and safety awareness campaigns in GCC and India, healthcare charity in GCC, India, Africa, Afghanistan and the Philippines, stand-alone dialysis centres in Kerala for the underprivileged, free paediatric cardiac surgery programmes and early diseases and cancer screening centres in India.
“I strongly believe that everyone has a right to healthcare, but are not able to avail the services due to several reasons like finance, accessibility, availability, etc. As an entrepreneur, this has prompted me to walk the nontraditional path and set up clinics and hospitals across geographies,” he says.
Cracking the mysteries of medical negligence
Holding an MD in Ob-Gyn and a PhD in law, Dr Gopinath Narayan Shenoy divides his time between two careers.
“Law was initially my passion and now it has become an alternative career,” says Dr Gopinath N Shenoy as he reminisces about 41 years of Ob-Gyn practice. In his estimate, he must have conducted about 300 deliveries each year during those years, which adds up to a fantastic total of 12,000 babies! But the atmosphere around doctors and hospitals was then of trust and faith, as opposed to the suspicion and intrigue that is seen nowadays.
Medical negligence, still a grey area largely in India, is a double edged sword that falls on the profession with both positive as well as negative consequences. Dr Shenoy, with his unique combination of qualifications, has been able to demystify the intricacies of this enigma for the Indian medical profession.
Back in the 1970s and 80s, the doctor-patient relationship was excellent and doctors too were very sincere – the imperative to extract as much money as possible was simply not there, says Dr Shenoy.
“There was no Google and the threat of the Consumer Protection Act was still quite a few years away. Thus medical negligence litigation, which is more or less the norm in recent times, was almost unheard of!”
His legal career, which began in the late 1980s, has been equally illustrious. Not only has he brought relief to thousands of his medical colleagues who faced lawsuits for alleged medical negligence, but has also authored three books on medical negligence, apart from teaching in several law colleges in Mumbai. His books, which helped to bring much needed clarity on this complex subject, has always been a reference guide for the profession. Dr Shenoy has also served as a judge in the Mumbai District Consumer Forum for a five-year term between 1997 and 2000.
He has been awarded a number of prizes by the legal fraternity; prominent amongst them are the prestigious ‘Bar Council Silver Jubilee Prize’ and ‘Sir Chimanlal Setalvad Golden Jubilee Prize’ awarded by the Bar Council of Maharashtra and Goa. The Jawaharlal Nehru Memorial Fund Award was bestowed upon him by the Jawaharlal Nehru Memorial Trust, New Delhi.
The education reformer
Aspiring medical graduates from this academic year in India will be taught a new syllabus, thanks to the first revision in medical curriculum in 21 years. The new syllabus, approved by the Board of Governors of the Medical Council of India (MCI) in February, has been designed by a committee of eminent medical educationists, headed by Dr Avinash Nivritti Supe, a leading figure in the field of medical education in India. The revision, though not very extensive, was critical as medical science and practice had undergone the most revolutionary changes in the last two decades.
“Though I retired last October as Director of Medical Education and Major Hospitals for Municipal Corporation of Greater Mumbai, I am still very active as the Chairman of the nine-member MCI Expert Group for the implementation of the new curriculum,” says Dr Supe.
At the age of 63, when most people would look forward to a comfortable retirement, Dr Supe still maintains a gruelling work schedule of 12 hours a day!
He wears two professional hats with equal felicity – that of a highly accomplished hepato-biliary surgeon as well as a leading medical educationist. Secretary of the Asia-Pacific Hepato-Biliary Association and president-elect of Indian Association of Surgical Gastro-enterology, Dr Supe is also currently chairman of GI Surgery in National Board of Examinations (NBE).
Besides, his illustrious record includes 263 publications in national and International journals, of which 121 have been in journals indexed in PubMed, apart from having authored five books. Among the best known of these books is The Art of Medical Teaching, the first edition of which came out in 1996-97. This was also the year in which the previous major revision of the MBBS curriculum was made, and Dr Supe had made important contributions to that document as well.
His interest in medical education was first kindled when Dr Pragnya Pai was the dean of Seth G S Medical College (also known as KEM Hospital), Mumbai. Back in 1992, she formed a Medical Education Unit and sent her colleagues to JIPMER for a 10-day course in new techniques of medical teaching. A few years later, the Maharashtra University of Health Sciences (MUHS) was formed and the first dean, Dr Dayanand Dongaokar, invited Dr Supe and others to develop guidelines for teaching the students. Dr Supe himself completed two courses in Education Management, one through TISS and the other from Mumbai University. Then he got associated with FAIMER (Foundation for Advancement of International Medical Education and Research), after which he helped to set up a number of regional centres of medical education in India and the neighboring countries.
Two outbreaks of the deadly Nipah virus infection in Kerala within a period of 11 months between 2018 and 2019 was the most shocking health threat that India faced in recent times. This most contagious and dreaded infection, which broke out in the Northern district of Kozhikode in June 2018 and the central district of Ernakulam in February 2019, came out of the blue in a state that had never heard of the virus. The nation and the world looked at these incidents with the same foreboding and helplessness that was felt at the earlier outbreaks of Nipah virus in Malaysia and Bangladesh, which had killed thousands of people and several times that many livestock.
The state machinery, though shocked by this sudden outbreak and unprepared due to lack of established safety and treatment protocols, however, swung into action with the determination of an effective intervention within minutes of confirming the virus.
It formed an emergency infection control and treatment protocol instantly. While the infected people were securely shifted to the quickly arranged isolation ward of the district hospital, an expert team, set up within hours of the outbreak, could trace the potential carriers as well as the source of infection. The affected locations, surrounding areas and even neighbouring districts were quarantined to prevent the spread. Another medical coordination cell was created to contact all sources of information and help to gather potential treatment options and suggestions from across the world.
A well-coordinated health emergency management by an alert state machinery — that can serve as a case study for the world — was able to bring the situation under complete control within a few days. A measured treatment regime, even with the limited medical options, could also help many survive the infection and limit the deaths to only seventeen, unlike the massive death toll and zero survival in the Malaysian outbreak.
Controlling an epidemic of this nature within days through an effective and spot -on intervention by state machinery, and that too with minimum casualties is perhaps taking place for the first time in India. Actively leading this difficult mission from the front was none other than the State Health Minister KK Shailaja.
KK Shailaja, the lady with courage and commitment, has proven to be one of the most efficient health ministers in the country with this extraordinarily successful mission. Having proved her mettle as a student leader and strived for social justice and women’s empowerment, Shailaja Teacher (as she is popularly known in political circles) has set proven to the nation that government machinery can make such effective interventions in times of crisis, and given the people of the country a new confidence about the strength of the public health administration. The Kerala healthcare system, which already scores high on the national index, has also achieved new milestones under the able leadership of Shailaja after seven primary health centres (PHCs) from the state recently secured National Quality Assurance Standards certification.
Disrupter in the diagnostics market
Scientist and aspiring entrepreneur Arokiaswamy Velumani quit his secure job at Bhabha Atomic Research Centre (BARC) in 1996. As an experienced biochemist who had also worked at the BARC Radiation Medicine Department at Tata Memorial Hospital, he knew how important it was to poor patients to get cheaper access to good care, especially when costly tests and medicines were prescribed. Having opportunities to clearly understand the tricks of the trade and how brutally middlemen used to make money at the expense of poor patients, he decided to make a meaningful intervention.
Velumani founded Thyrocare as a tiny thyroid testing lab in 1996 and offered the tests at a cost that was less than the prevailing market rates of reagents used in that test. Realising that there is no dearth of demand for such diagnostic tests in a country like India, he aimed at bigger volumes rather than robbing a few, who can anyway afford costly care.
“I knew how much the material and the test actually costs to the provider and how big their margin is. So, I decided to disrupt the market for the benefit of the poor patients,” says Velumani.
Targeting mass volumes, Thyrocare was the first diagnostics lab in India to introduce a franchise model of business to sustain its low-cost healthcare vision. This affordable healthcare model not only helped the poor to access specialty diagnostics, but also created jobs for many across the country. Before long, Thyrocare became the largest thyroid testing laboratory, with a network of more than 1,000 outlets across India, Nepal, Bangladesh and the Middle East.
Thyrocare expanded from testing for thyroid disorders to preventive medical checkups and other diagnostic blood tests later. The radiology diagnostics company, Nueclear Healthcare Ltd. (NHL) founded by Velumani currently offers cancer-related imaging services at half the cost of other providers. Thyrocare, which conducted a very successful IPO and public listing in 2016, is also now looking at opportunities to bring in new-generation tests, which are typically not quite accessible to the poor, under its affordable model.
When she took over her father’s pathology business in 2001, it was a single diagnostics lab in Mumbai with a gross turnover of about $1.5 million and around 40 employees. She subsequently transformed this single laboratory, known as Metropolis Lab, to a multinational chain of 125 diagnostic labs with $90 million in revenue and 4,500 employees. Metropolis Healthcare Ltd—the second largest pathology chain in India, with a significant international footprint, was successfully listed on stock exchanges of the country and has a market valuation of Rs 5,065 crore today.
“Metropolis, as a healthcare services company, has always believed in constantly focusing on innovative models that can benefit the patients as well as the organization. This strategy has made us different within the industry, which has always been stodgy and traditional,” she said in a recent interview with Future Medicine.
The pathology chain, which is currently present in seven countries, has one of the largest portfolios of tests in the world and wants to move into the next stage of growth as a scientific organization that is medically relevant, not only for India, but in the international arena. It is now focusing on showcasing its unique tests and case studies at international conferences.
Shah, as an industry spokesperson, has been quite vocal about many reforms in the Indian healthcare sector. Metropolis, as a key industry player, is also planning several initiatives such as supporting brilliant minds in the medical profession to undertake innovative research, and training industry professionals to improve technical and service quality standards in the diagnostics industry.
Shah has also served as the secretary of the Indian Association of Pathology Laboratories (IAPL) and co-chairperson of Federation of Indian Chambers of Commerce and Industry (FICCI) Health Services Committee in 2012.