ISSUE 12

DR. UMAPATHY PANYALAManaging Director- Omni Hospitals Group

Joined the Omni Hospitals group as their Managing Director with a clear mandate of wanting to be market leaders and opinion makers in the field of healthcare service delivery. The geography spans indonesia phasing into the ASEAN

Having worked as the Regional CEO for the Apollo Hospitals Group for the last 7 years, where the assignment was for strategizing and establishing the network of hospitals across the state of Karnataka and developing markets in the US, Europe and South East Asia. He served 17 years at Apollo, which like India’s economy, has seen incredible growth. Since its modest beginning in 1983 as a 150-bed hospital in Chennai, Apollo now in one of Asia’s largest healthcare group with over 8,500 beds across 50 hospitals in India and overseas.

One of the toppers from the the prestigious Hyderabad Public School, rated amongst the top 10 schools of India. He was a distinction student and recipient of the National Merit scholarship, an accolade given by the Indian government to only the top 100 students.

He took over as Chief Executive Officer of the Rajiv Gandhi Super Specialty Hospital in 2002. The hospital is a public-private partnership- a joint venture between the government of Karnataka and Apollo. It is the only successful public-private partnership venture in the country, and has been model for study by the University of Helsinki and the Management School of the University of Delhi.

Since 2005, He has served as the Chief Executive Officer at the 300-bed Apollo Hospital Bangalore. During this time, it underwent one the most successful Joint Commission International (JCI) accreditation processes, which has become the benchmark for the rest of the group’s hospitals to follow. JCI is the gold standard of accreditation for healthcare organizations and Apollo Hospital, Bangalore is one among only 70 hospitals in the World to be JCI-certified, an accolade any healthcare marquee can be proud of.

1. What was the mandate given to you by the Board when you took over in your role?

The mandate was to grow the organization from the present two hospital group in Indonesia to having a footprint of 10-12 hospitals over the next four years within the country and a possible ASEAN presence post the Indonesia story

2. How much of that has been achieved? What were the challenges faced?

The third location in greater Jakarta will go live in the first week of April, the construction for the fourth site, in Kalimantan Island will begin by April, stated for Launch in the first quarter of 2017, and ongoing negotiations for two more locations are on. Indonesia’s health care system is currently unable to serve its more than 250 million citizens and residents adequately, as the following facts suggest. There are:

3,333 people for each physician

1,000 people for each nurse

More than 900 people for each bed

There is a huge gap in terms of the number of doctors and nurses available and the Indonesian healthcare system, controlled by the old guard and a hierarchy, is closed to foreigners, with multiple layers of non-tariff barriers

3. How do you respond to the needs of changing market scenario (with an example)?

The government of Indonesia on January 1, 2014, launched its UHC program, locally known as BPJS, to improve access to basic health care for Indonesians and to help achieve the UN Millennium Development Goals. This very ambitious program envisages that the Universal Health Cover will encompass all citizens and residents

Universal healthcare is modeled after the disease package system, which typically means that the hospital would be paid a fixed sum for the treatment of a disease; this fixed sum includes the hospital stay, drugs and doctor fee. This was an alien concept to the medical community habituated to have their way.

The whole system was explained to them and their buy was obtained once the merits were explained

4. How has the market evolved in the last few years?

The last question answers to a certain extent, With the introduction of the BPGS the market is evolving into a low margin, high volume growth pattern and by 2019, with the whole country covered by this scheme, an evolved DRG system would be in place, putting a huge pressure on the margins and the resulting stakeholder expectations

5. What are the key challenges your organization is facing currently? And what are the steps you are taking?

The key challenges are as below

  • Doctor availability
  • Nurse shortages
  • Expensive land banks
  • High interest rates on an IDR debt
  • FX fluctuations

The organization has leveraged its doctor pool and the hierarchical structure to get in more doctors and nurses, tied up with universities and colleges to tap into the fresh graduate pool. We have held investor road shows for a possible rights issue by the end of the year, looked at the Japanese yen denominated loans to mitigate the USD fluctuations. Converted the IDR existing loan into a hedged USD loan with a longer tenure

6. How have the changes in technology/globalization/economy affected your sector?

Indonesia has yet to comprehend or is closed to the technology shifts that are taking place around the globe. As an example it is only now that hospitals have started implementing the HIS and the electronic medical records and the law is still not clear for this One such initiative is the formation of the AEC or the ASEAN economic community, which seeks to establish the ASEAN as a single market and this was formalized in December 2015. Indonesia is an example of particular interest, with its insular nature, barriers to entry at multiple levels, leading to a situation where inspite of the government allowing 67 to 70 percent of FDI into healthcare, very few players have chosen to come into the country. AEC would impact Indonesia profoundly. On one hand this move would allow comprehensive, advanced medical care to seep in and on the other would probably disrupt the practice of the existing hospital and doctor systems in the short term

7. What is your talent strategy? How do you draw the balance between home grown vs lateral hiring at the leadership level?

At this time, Indonesia has restrictions on the import of people into the healthcare sector into the mid and lower positions. Expats are allowed into the positions of Directors and above, and that too for a limited period and the visa requires to be extended every 6 months or a year, hence most of the talent requires to be selected from within the country, and this by itself poses a huge challenge

As a result of these restrictions, and a very limited talent pool, attritions tend to be very high, sometimes going as high as 60 percent. A combination of a working environment, salaries with incentives and special packages are involved in reducing attrition

Our strategic workforce planning, because of the planned growth, combines supply and demand calculations to determine the risk and its immediacy. As the capacity risk may be quantitative or qualitative with regards to the competencies and qualifications of available workers, the risk is assessed, and can be addressed by a variety of measures, including recruitment, retention, cross-training, transfers, and outsourcing. The organization pays special attention to leadership positions, generally the top 50 executives, as well as by critical positions, wherever they occur in the organization, and the capabilities and skills that will be required throughout the organization.

Indonesia, because of its limited talent pool, has very severe attrition issues and people tend to be poached, sometimes getting offered 60 percent more than the last drawn salary and this occur across industries, posing a serious challenge

8. How does your organization identify and develop future leaders?
  • Established a recruiting and On boarding engine
  • Creating a compelling employee value proposition
  • Creating an internal talent program
  • Establishing an accelerated training and development program
  • Career development councils
9. What are the 3 key aspects you look at when you hire your direct reports?
  • Integrity
  • Positivity
  • Commitment
10.How does the growth prospect of your organization look like for the next 12-24 months?

Establishing a footprint of between 10-12 hospitals and grow Omni Hospitals group to be one of the largest players in the region

11. Will there be any significant change in the market dynamics in next few years? If so, what steps are you taking for the same?

Market dynamics will change significantly and the third part of question one answers this.

12. In a world full of volatility, Uncertainty, complexity & Ambiguity (VUCA), innovation has become one of the most important factor to transform a crisis into an opportunity. How do you promote Innovation?

In my earlier organization, the Apollo hospitals group, I could not have had a better mentor than the legendary Dr Pratap C. Reddy, who redrew the way healthcare was practiced in India. Innovation and creativity have always resulted in phenomenal products in the business world. We have established an environment for an early start to the innovation process by establishing

  • Autonomy and space to think as an individual, as well as time to collaboratively brainstorm.
  • Providing incentives and a forum for employees to present new ideas.
  • Soliciting ideas from all employees for the most complex problems.
  • Eliminating constraints to creativity, and too much focus on hours clocked, rather than performance
13. How Indian leaders can become Global Leaders?

Indian leaders are more confined to working within the local system to an extent, and they would require having an open mindedness and a little less of an expectation of subservience. An open mindedness to be questioned by a co-worker in a lower position and a focus on process driven and outcome driven endeavors would make our people more amenable to the global ecosystem, Added to this is an exposure to the global ecosystem, at least for some time in their career

14. What are the shortcomings and strengths of Indian Leaders?

Our strength comes from the fact that we have learnt our business success stories and pathways within one of the toughest business environments and we would be in a unique position of finding success pathways in relatively easier business environments. I believe the biggest weakness of our leaders is, “Jugaad”, and I may sound controversial in this statement, but the very fact of this attitude to make do with what we have, does not make a leader. Leaders need to find ways to improve, through new processes, new ideas, innovative thinking

15. What are the 3 most pivotal moments in your career that you either learned from and/or that got you where you are today?
  1. In 1999, when I was moved to one of the smaller centers as an administrator and discovered the flair of management
  2. In 2004, went to the National University of Singapore for my MBA, having realized the need to reskill myself and met with Global peers and Faculty, who gave a new meaning to Global exposure
  3. In 2006, went on to become the Chief Operating officer of the Apollo Hospitals in Bangalore, with a mandate to establish the presence of the brand there and grow the business
16. What key lessons have you learnt from any mistakes, if any, made in the past? How would you do it differently?

I firmly believe in Participative management, with a de-centralized approach, people who report into me have a clear mandate to speak their mind and disagree if required. I encourage people to come up with ideas and actively support the execution

17. What message would you like to share with young professionals at the start of their career?

To have a clear path to where you want to be and work towards that. Reskill on a regular basis, this is the age of the knowledge economy.

The famous adage, “a rolling stone gathers no moss” applies really well today, in terms of constant job-hopping. By all means change your jobs; built change when you think your learning process is done- not for an incremental salary increase- at least not in the beginning of a career