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TAKE TWO
`We should go back to simplifying our lives'
PHOTO: VINO JOHN
When you meet the president and CEO of a top IT company, you expect him to talk big, act bigger. But Lakshmi Narayanan of Cognizant does nothing of that. In fact, the self-effacing man speaks of simple management mantras and a simpler lifestyle. That the blistering pace of his work has left him untouched is clear as he partners with Preetha Reddy, Managing Director of the Apollo Group of Hospitals, for a Take Two. There's a polished restraint about Preetha that belies her shrewd management instinct. Though instrumental in crystallising the concept of `Technology Leadership Care', Preetha speaks with modesty about the milestones in Apollo's history.
As the two meet at Hip Asia, Taj Connemara, Chennai, T. Krithika Reddy records their conversation...
Lakshmi: One of the things that the technology industry has been working on is to make healthcare more efficient. It might sound like a Western perspective, but it is true in the Indian context too. For every sum spent, very little goes to the direct medical care of the patient.
Preetha: Access is still a big challenge.
Lakshmi: But in most Western countries, it's the insurance companies — the payers — that dominate. The payers control the providers — the doctors. So the sufferers are the patients. The Indian advantage is that you don't necessarily go in for insurance.
Preetha: Yes, there's a distinct Indian advantage. That's why there's a steady flow of patients from abroad.
Lakshmi: Sometime back, we had an overseas visitor, who had a fall at a restaurant here. We took him to Apollo. Some suturing was required. When the bill came, the gentleman was shocked. He asked the doctor, if she had spent five years of education for Rs. 200!
He also promised to come back to her to remove the sutures, because it would cost him much more in his country! (Laughter) There, accountability is taken far too seriously and there's always the fear of litigation.
Preetha: We find a lot of doctors returning to India and doing phenomenally well.
Lakshmi: You may probably have to attract the older generation of doctors as well. They can build a rapport with the patients, who will automatically come — and then you have medical tourism.
Preetha: We call it value-added travel. Ten years ago, my dad, Dr. Reddy said India would evolve into a major destination for medicare. People laughed and asked, `Why would foreigners even think of coming here?' But it's happened.
Lakshmi: But isn't it sad that not much is being spent on research in the health sector?
Preetha: Yes, it's not enough.
Lakshmi: If we have a good medical system to collect data, the findings would be phenomenal.
Preetha: It is happening. At Apollo, we are looking at the impact of genetic factors on cardiac functioning. Indians are more prone to cardiac problems and diabetes.
Lakshmi: Doctors often say we are genetically pre-disposed to these diseases. Then we can't ask questions. (Laughs)
Preetha: Indians are said to have narrower arteries. The 10 a.m. saapad routine in traditional households is best suited for us. Modern food is a disaster. People should go back to simplifying their lives, and then, we will be a lot healthier.
Lakshmi: What about alternative medicine? Is it catching on?
Preetha: Yes. We are also trying it in a small way. Dr. Reddy believes it has a huge potential, if packaged well.
Lakshmi: Sometimes, medical studies contradict what we have traditionally believed in...
Preetha: We can't replicate or predict the human body. In all these studies, there's a certain percentage that's undecided. When a patient comes in, we know that the doctors and the infrastructure play a role in the treatment.But most important, it's the director above! The human body constantly throws up contradictions. I'm a firm believer in God and Karma. Everything else is incidental. But that's not an excuse. Tell me, it must be a huge challenge for you to get the right people...
Lakshmi: Getting good hands is a challenge. Our people policies are good and the team, excellent.We have the Cognizant Foundation to help needy children — in their education.
We call them PSD - Poor, Smart with a Damn good appetite for making money. Identifying such youngsters is a challenge. But tell me, not many youngsters are interested in Medicine these days.
Preetha: (Smiles) That's because of IT.
Lakshmi: To them, comforts have become more important. They want regular work hours. They perhaps don't know how it is in the IT sector!
Preetha: I've come across MBBS students wanting to get into Management. Okay, how do you set parameters for your HR Department?
Lakshmi: The rules are simple - client satisfaction, client loyalty (that reflects on growth) and employee satisfaction. The person who scores the most in these is made group or project leader. We want some competition among our technical people. I'm sure you don't want it among medical professionals. (laughs).
Preetha: No way. We want our team to work together. Even a member of the housekeeping staff plays an important role. If he doesn't ensure an infection-free environment, a surgery might just not work! Now, we are introducing the Six Sigma management mantra. And the workers are so excited about it. I hear you are fitness-conscious.
Lakshmi: I eat right and exercise. There are a lot of obese people in our line. I keep advising them to exercise and go for regular check-ups. Lifestyles have changed. And there's this universal excuse — stress.
Anything that can't be explained is attributed to stress. Look at the increasing rate of heart disease and depression. I hear there are many youngsters who take anti-depressants.
Preetha: It's frightening.
Lakshmi: Recently, a doctor told me the scene is worse in Bangalore, where there's a sizeable floating population. In Chennai, there's a social fabric, people are connected — to families and relatives. What about your sons, didn't they want to get into the medical profession?
Preetha: No, they come to the hospital and think it's chaotic. They are studying abroad. The elder one has just completed his under graduation. The younger one is doing his Engineering.
Lakshmi: When I lecture in the U. S. universities, I often tell them that the reason why they have so many bright youngsters from India is because Indian children have no choice but to study hard. Parents make so many sacrifices to make them study.
So they follow a certain direction, whether they like it or not. But in the U.S., children are offered so many choices. It's painting one year, humanities the next.
If Math gets tough, they switch to some other subject. Generations have gone that way. And if it continues, I tell them, `You will continue to depend on India. It's good for us, but may not be good for you in the long run.' Now, tell me about your expansion plans in Chennai.
Preetha: Apollo is launching an exclusive clinic for women in Kotturpuram. Besides, we are planning to come closer to you (smiles) somewhere on the Old Mahabalipuram Road.
Lakshmi: That's nice. That's where all the development is. If you venture into the streets, you'll see haphazard development — apartments and houses in thousands. In the next three-four years, the population beyond the Tidel Park will be much more than the city's.
But I'm not sure how comfortable it's going to be. My point is, if you can provide connectivity at a much lower price and ensure that the networks are secure, then one can work from home.
Preetha: (Smiles) I can't say that of ours. Cyclone or Sunday, people have to report for work.
Lakshmi: Working from home will happen someday for us. Even now, nobody leaves without taking work home! All the time, youngsters in the IT sector are teleconferencing or using their Blackberries. It's a 24X7 job.
Preetha: Then, will not the burn-out be fast?
Lakshmi: IT is mentally stressful. People work very hard for the first 10-15 years and then take it easy. But there are simple rules we teach them. Dr. Mohan Rajan, ophthalmologist, introduced us to the 20-20-20 rule for the eye.
That's every 20 minutes, turn your eyes away from the monitor and focus on an object that's 20 feet away — for 20 seconds. That prevents dry eye problems. In the U. S. artificial tears is big business. People buy bottles by the dozen.
Preetha: What about work ethic in your field?
Lakshmi: It's high. It's words = actions. What you commit, you have to deliver. Since companies pay high, employees know they have to perform exceptionally well.
Preetha: You're lucky. You are dealing with a young, passionate group. That makes a huge difference.
Lakshmi: True, what's exciting to them is not the compensation — but the challenge. The challenge of solving problems with technology. And they move from one challenge to another.
Preetha: I've learnt a lot from you. But one thing hospitals never say is: Come and visit us.' (Laughter)
Lakshmi: I enjoyed the interaction. And I can boldly say, `Please do visit us.' (Laughter)
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