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Affordable Healthcare for All

Dr S Manivannan, Founder and Managing Director, Kauvery Hospital

Kauvery Hospital was started in 1999 as a 30-bed hospital in Trichy. Today, twenty years later, they have seven branches across five southern town – a testament to the success of the Kauvery brand. Their mission statement sums up their policy: To make great healthcare affordable. And their Vison is: To become the most respected and trusted healthcare provider.

Dr S Manivannan, Founder and Managing Director, is passionate as he talks about the hospital and its outstanding growth trajectory. The hospital was the brainchild of him and his brother, both doctors hailing from a non-business background. Their parents were government servants with no wherewithal to support them in their fledgling attempt. But the brothers were determined. Dr Manivanan says, “We were first-generation doctors born and brought up in Trichy in a middleclass family.” While Dr Manivanan is an anaesthetist (though he doesn’t practice anymore), his wife is a gynaecologist, his brother an orthopaedic surgeon, and his cousin a paediatrician.

Their initial plan was to start a 50-bed hospital but they didn’t have the requisite funds. “At that time, there was no tertiary care hospital in Trichy. We thought we’d offer that,” says Dr Manivannan. So they began with a 30-bed hospital, and from there, they only grew from strength to strength. He says, “By 2003, we had a 200-bed hospital and by 2009 we had 110% occupation in the hospital.” Today, they have an average of 700 to 800 patients across the group and at least 5,000 outpatients.

“We are probably the only hospital coming from a tier 2 city to a tier 1 city that succeeded,” he says. He believes, “It is our values and our fundamental mission of making healthcare affordable that has helped us succeed. This is core to us.”

Talking about the primary reasons for why the public has embraced their hospitals, he outlines three main factors – personal touch, cost-effectiveness and ethical treatment. And they have taken meticulous care to ensure that these parameters are in place and delivered to every patient consistently.

Talking about the personal touch aspect, its roots go back to when they started the first hospital in Trichy. Dr Manivannan says, “We were born and brought up in Trichy. Everyone knew us – friends, relatives, people who worked with my parents… So there was a personal touch involved in treating patients.”  And that ethos has continued to date. “Healthcare is a business where personal touch matters,” he points out. “That is the main thing patients want. We are good at it and can replicate it.”

With affordable healthcare being at the core of their mission, cost-effectiveness plays a very significant role in their operations. He explains, “Trichy is more of a lower middleclass agriculture-based economy and 80% of our patients come from villages. So we had to make our care affordable.” Attention to detail and meticulous planning has helped in making this possible. They’ve gone into each and every aspect to see where costs can be cut, including their purchase practices where they are able to negotiate prices through a transparent process. “This has helped us maintain our bottom-line in spite of spreading out,” says Dr Manivannan.

Technology too has helped the institution to streamline procedures. “I’m very passionate about technology,” declares Dr Manivannan. “We monitor close to 150 key performance indicators automatically, including operational, financial, clinical and supply chain. This helps us to keep track of key areas in our day-to-day operations. In the last two years, we started developing clinical triggers where the system will flag if certain patients are not getting appropriate treatment according to accepted clinical protocols.” Apart from their treatment protocols they also track inventory and medicines. If there is a deviation, the system automatically throws them up. “This has reduced clinical errors and costs for the patients,” he states. “This is something very unique to us. I read about it ten years back in a US journal and wanted to implement it in our hospitals. This is going to play a significant role in the coming years to control costs and errors.”

At a time when there is so much mistrust against hospitals and doctors, patients who visit Kauvery Hospital have total trust in the doctors and the institution. This is because ethical treatment is one the most important foundations on which the hospital’s ethos is built. Dr Manivannan says, “We are a doctor-driven hospital. Even today, all our units are headed by doctors. What we did was to ensure we recruited doctors who are ethical, who don’t recommend unwanted procedures. Many of our doctors, especially in the tier two towns, are from a lower middleclass background. They are aspirational and work hard to align to our principles.”

To enhance their treatment of patients, they’ve introduced ‘clinical leadership’. Dr Manivannan smiles and says, “We were taught to treat patients during our MBBS, but not how to run a practice, manage departments, etc. Now we focus on giving leadership training for doctors.” They were doing it on an informal basis earlier. “We’re going to do a six-month module with IIM Trichy. Now it will be done in a structured way. As a result, firstly we will be able to retain our doctors for a longer period and, secondly, clinical leaders will take a role in running the hospitals.”

On a final note, Dr Manivannan emphasises, “Transparency is very important for us. Corporate governance is what we focus on. And patient communication; every inpatient is seen twice a day by their doctor.”

Treatment based on ethics, top-notch doctors and affordable care with a forward-looking vison have contributed to Kauvery Hospital’s phenomenal growth and success, and to the implicit faith patients have in the institution.