Insights for Doctors to Build Successful Businesses | Doctor’s Day | Ft. Shashank ND, CEO of Practo

Summary

In this special Doctor's Day episode of the Create Wealth Podcast, host Sandeep Jethwani engages in a deep conversation with Shashank ND, CEO of Practo and CII chair for Digital Health in India. They explore the nuances of running a successful medical practice, the intersection of medicine with technology and AI, and Shashank's inspiring journey from a young engineering student to leading India's only profitable health tech startup. The discussion reveals insights into the passion driving doctors, the importance of data in medical practice, and the transformative potential of AI in healthcare.

Takeaways

• 🌟 Shashank ND, the co-founder and CEO of Practo and CII chair for Digital Health in India, shares insights on running a successful medical practice and the role of technology in healthcare.
• 👨‍⚕️ The passion doctors have for their patients is a common denominator Shashank observed across the 12,000+ doctors he has interacted with, which inspired him to enhance their productivity through software.
• 🔧 Successful doctors often excel in teaming up with others who complement their strengths, especially in non-medical areas such as management, which they find challenging.
• 💡 A key differentiator for doctors is the ability to maintain a beginner's mindset, being open to continuous learning and improvement, despite their expertise and status.
• 📊 Many doctors lack a data-driven approach to understanding their business economics, which can hinder insights into profit margins and return on investment.
• 📚 Doctors often struggle with time management and learning new areas outside their medical expertise, such as marketing, technology, and consumer understanding.
• 🤝 Effective communication and patient experience are crucial for treatment outcomes, with some patients seeking other doctors due to misunderstandings or lack of connection.
• 📈 The adoption of technology in healthcare has been slower compared to other industries, primarily due to the critical role of trust in healthcare and the time it takes to establish it.
• 💡 Shashank emphasizes the importance of being data-oriented and using data to drive improvements in processes and patient experiences.
• 💰 Despite the potential for significant returns, healthcare spending on technology in India is significantly lower than in the US, indicating a vast opportunity for growth and efficiency.
• 🚀 Shashank is excited about the impact of data science and artificial intelligence on healthcare, foreseeing significant advancements in the next few years that will improve health outcomes and patient access to care.

Q & A

What is the main theme of the Create Wealth Podcast episode featuring Shashank ND?

The main theme of the episode is to discuss the success factors of running a medical practice, the adaptation of doctors to technology, particularly data science and artificial intelligence, and Shashank ND's journey as the cofounder and CEO of Practo and the CII chair for Digital Health in India.

How did Shashank ND's interaction with doctors inspire him to start Practo?

Shashank ND was inspired by the passion doctors had for their patients during his interactions with them while he was still in college. He saw the potential to enhance their productivity and decided to build software to assist them.

What challenges do doctors face when it comes to managing the business side of their medical practice?

Doctors often struggle with the non-medical aspects of running a practice, such as management and understanding the economics of their business. They may find it challenging to allocate time to analyze data and make informed decisions about their practice's financial health.

How does Shashank ND perceive the role of data in enhancing medical practice efficiency?

Shashank ND believes that data is crucial for doctors to understand patterns and insights about their business, including profit margins and return on investment for different procedures. He suggests that a data-driven approach can help doctors make more informed decisions and improve their practice.

What is Shashank ND's view on the importance of maintaining a beginner's mindset for doctors?

According to Shashank ND, maintaining a beginner's mindset is vital for doctors as it fosters a continuous learning attitude, curiosity, and the humility to learn from various sources, regardless of their experience level.

How does Shashank ND describe the common trait among successful doctors he has met?

Shashank ND observes that successful doctors share an intense passion for their patients, a trait that he believes is a significant reason for their choice of medicine and contributes to their success.

What are some of the non-medical skills that doctors need to develop to improve their medical practice, according to Shashank ND?

Doctors need to develop skills in areas such as business, marketing, understanding consumers, and empathy. Shashank ND emphasizes that while medical knowledge is essential, these additional skills can contribute to a more well-rounded and successful practice.

How does Shashank ND suggest doctors can improve their patient communication and experience?

Shashank ND recommends using tools and systems to collect data on patient feedback, which can help doctors understand areas for improvement in their communication and patient experience. He highlights the importance of doctors being receptive to this feedback and making necessary adjustments.

What is Shashank ND's perspective on the adoption of technology in healthcare, especially in India?

Shashank ND notes that the adoption of technology in healthcare has been slower compared to other industries, partly due to the importance of trust in healthcare and the time it takes to build and capture that trust through technology.

How does Shashank ND envision the impact of data science and artificial intelligence on the future of healthcare?

Shashank ND is excited about the potential of data science and AI to revolutionize healthcare by enhancing health outcomes, providing personalized treatment plans, and potentially increasing the efficiency and effectiveness of medical practices.

What advice does Shashank ND give to doctors who are looking to adopt new technologies in their practice?

Shashank ND advises doctors to invest time and curiosity to learn about new technologies, emphasizing that those who adopt technologies first and faster will gain a competitive advantage. He also encourages doctors to focus on the meaningful impact they can have on patients' lives through improved healthcare delivery.

Outlines

00:00

🌟 Founding a Health Tech Startup with Passion

Shashank ND, co-founder and CEO of Practo, shares his journey of establishing Practo as a health tech startup. Initially, as a young engineering student in 2007, he sought a product space and was inspired by doctors' passion for their patients. This led him to develop software to enhance doctors' productivity. Over time, he engaged with thousands of doctors, observing their entrepreneurial spirit and the challenges they face in managing the business side of their practices.

05:02

🚀 Adapting Technology and Embracing a Beginner's Mindset

The discussion highlights the importance of doctors adapting to technology and maintaining a beginner's mindset. Shashank notes that successful doctors exhibit a strong passion for their patients and a keen interest in learning, regardless of their experience level. They often face challenges in balancing confidence in their medical expertise with a humble approach to continuous learning and improvement. Shashank emphasizes the need for doctors to embrace data-driven insights to better understand and grow their practices.

10:03

📊 The Data-Driven Approach to Medical Practice Improvement

Shashank discusses the significance of data in understanding and improving medical practices. He points out that many doctors lack basic insights into their business's economics due to insufficient data collection and analysis. This leads to an over-reliance on intuition rather than strategic decision-making based on detailed understanding. Shashank suggests that by focusing on data, doctors can identify areas for improvement, such as profit margins and the efficiency of medical procedures, and make more informed business decisions.

15:07

🤝 The Human Element in Medicine and Business

The conversation delves into the human aspect of medical practice and its intersection with business. Shashank shares insights from an analysis of patient recovery and satisfaction, revealing that communication and the patient-doctor relationship play a crucial role in treatment outcomes. He emphasizes the need for doctors to not only provide accurate treatment but also to connect with patients on a human level, ensuring they understand and follow through with medical advice.

20:09

🛠️ Tools and Systems for Enhancing Medical Practice

Shashank talks about the importance of implementing systems and tools to collect and analyze data in medical practices. He believes that by trusting and utilizing data, doctors can identify areas for process improvement and enhance patient experiences. Shashank shares his experience with providing feedback to doctors, which has led to significant improvements in practice environments and patient satisfaction over the years.

25:10

💡 The Role of Technology in the Health Tech Ecosystem

The discussion explores the slow adoption of technology in the healthcare sector, despite its potential to revolutionize patient care. Shashank explains that trust is a fundamental aspect of healthcare that takes time to build, which is why the industry lags behind others in technology adoption. However, he sees a bright future for health tech, particularly with the integration of data science and artificial intelligence, which he believes will significantly improve health outcomes.

30:12

🌐 The Impact of AI and Data Science on Healthcare

Shashank expresses his excitement about the current pace of innovation in healthcare, driven by advancements in data science and artificial intelligence. He shares his firsthand experience of incorporating these technologies into Practo's products and services, resulting in improved efficiency and patient care. Shashank predicts that AI will play a significant role in the future of healthcare, acting as a copilot for doctors and providing patients with access to AI-driven medical advice.

35:13

🎓 Navigating the Challenges of Continuous Learning for Doctors

The conversation addresses the challenges faced by doctors in keeping up with technological advancements and the need for continuous learning. Shashank advises that doctors, being among the smartest individuals in the country, should leverage their intelligence and adaptability to embrace new technologies. He encourages doctors to invest time and maintain curiosity to learn about and adopt new tools that can enhance their practices and patient care.

40:14

🚀 From College Founder to Profitable Health Tech Entrepreneur

Shashank reflects on his personal journey from being a college founder to establishing Practo as a profitable health tech company. He shares anecdotes about his early struggles, such as pretending to be older and more experienced to gain credibility. Despite initial challenges and skepticism from others, Shashank remained focused on solving problems for doctors and patients, which ultimately led to Practo's success and profitability.

45:15

💪 Lessons in Resilience and Capital Efficiency from a Health Tech Pioneer

In the final paragraph, Shashank discusses the lessons he learned about perseverance, focus, and capital efficiency throughout his entrepreneurial journey. He admits to wasting a significant amount of capital in the early years but emphasizes the importance of learning from mistakes and improving. Shashank's story serves as an inspiration for others in the health tech space, demonstrating that with determination and the right approach, it is possible to build a successful and profitable business.

Keywords

💡Digital Health

Digital Health refers to the use of digital technologies to improve health care delivery, health outcomes, and overall health management. In the video's theme, it is central to Shashank ND's mission as the CII chair for Digital Health in India, aiming to integrate technology within the healthcare system to enhance medical practices. The script mentions how doctors are adapting to technology, specifically data science and artificial intelligence, to run successful medical practices.

💡Artificial Intelligence (AI)

Artificial Intelligence, often abbreviated as AI, is the simulation of human intelligence in machines that are programmed to think like humans and mimic their actions. The script discusses the impact of AI on the medical field, suggesting that it can improve diagnostics, patient care, and overall efficiency in healthcare delivery. Shashank ND's journey with Practo also explores the integration of AI in healthcare startups.

💡Data Science

Data Science is a field that uses scientific methods, processes, and algorithms to extract knowledge and insights from structured and unstructured data. In the context of the video, data science plays a crucial role in healthcare by helping doctors make informed decisions based on patient data, which can lead to improved treatment plans and health outcomes.

💡Health Tech Startup

A Health Tech Startup refers to a newly established company that focuses on creating technology solutions for the healthcare industry. Shashank ND's Practo is highlighted as India's only profitable health tech startup in the script, showcasing the potential for innovation and success in the health technology sector.

💡Profitable

Profitable, in a business context, means generating more revenue than costs, resulting in a positive financial outcome. The script emphasizes Practo's achievement as a profitable health tech startup, which is significant given the challenges and capital-intensive nature of the healthcare technology industry.

💡Medical Practice

A Medical Practice refers to the work environment where healthcare professionals provide services to patients, such as diagnosis, treatment, and health management. The video discusses the factors contributing to a successful medical practice, including the adaptation to new technologies and the integration of data science and AI.

💡CII Chair for Digital Health

The CII Chair for Digital Health is a leadership position within the Confederation of Indian Industry (CII), focused on promoting and advancing digital health initiatives in India. Shashank ND holds this chair, indicating his influential role in shaping digital health policies and strategies in the country.

💡Patient-Centric Care

Patient-Centric Care is an approach to healthcare that prioritizes the patient's needs, preferences, and values in the decision-making process. The script illustrates the passion doctors have for their patients and how technology can enhance this care by providing more personalized and efficient health services.

💡Healthcare Economics

Healthcare Economics involves the study of the financial aspects of providing health services, including cost management, revenue generation, and resource allocation. The video script discusses the challenges doctors face in understanding and managing the economics of their practices, and how technology can aid in this area.

💡Entrepreneurial Doctors

Entrepreneurial Doctors are medical professionals who establish and manage their own medical practices, often treating them as businesses. The script highlights the entrepreneurial spirit of many doctors, who not only provide medical services but also manage teams, finances, and operations.

💡Health Tech Ecosystem

The Health Tech Ecosystem encompasses the community of organizations, technologies, and stakeholders involved in the development and delivery of digital health solutions. The script mentions the potential of the health tech ecosystem to grow into a USD 50 billion market, indicating the vast opportunities for innovation and growth in the sector.

Highlights

Shashank ND, co-founder and CEO of Practo, discusses the journey of building India's only profitable health tech startup.

Insights on what it takes to run a successful medical practice, including the adaptation to technology and artificial intelligence in healthcare.

The importance of passion for patients as a driving force for doctors and the inspiration behind Practo's creation.

Shashank's unique experience as a young college student starting Practo and interacting with thousands of doctors.

Observations on the common traits of successful doctors, such as their passion for patients and ability to collaborate.

The challenge for doctors to balance confidence with a beginner's mindset in both treating patients and learning new skills.

Discussion on doctors' lack of knowledge in the economics of running a medical practice and the importance of data orientation.

How the lack of data understanding among doctors can lead to missed opportunities for business growth and efficiency.

The significance of stepping out of the medical comfort zone to learn about business, technology, and other adjacent fields.

Analysis of patient recovery data revealing the impact of doctor-patient communication on treatment outcomes.

The role of technology in enhancing patient experience and the economic benefits for doctors who provide better care.

Shashank's perspective on the slow adoption of technology in healthcare due to the industry's reliance on trust.

The potential of data science and artificial intelligence to revolutionize healthcare outcomes and doctor's workflows.

Practo's experience as a pioneer in health tech and the evolution of digital tools for doctors since 2008.

Advice for doctors on embracing technology and the transformative impact it can have on their practices and patient care.

Shashank's personal journey and the challenges faced as a young founder in the healthcare technology space.

Reflections on Practo's path to profitability and the lessons learned in capital efficiency and focus.

The long-term vision for health tech's role in improving clinical outcomes and the significance of perseverance in the industry.

Transcripts

This is a very special Doctor's Day episode of the Create Wealth Podcast.

In this episode, I'm hosting Shashank ND,

who's cofounder and CEO of Practo

and the CII chair for Digital Health in India.

We talk about what it takes to run a successful medical practice,

how doctors are adapting to technology

and specifically to data science and artificial intelligence.

We also cover Shashank's own unique journey,

that of starting Practo as a young college student

and taking it to becoming India's only profitable health tech startup.

I'm sure you'll enjoy this one.

I'm Sandeep Jethwani,

the host of the Create Wealth podcast and co-founder of Dezerv.

Shashank, you were telling me earlier today that you've interacted

with 12,000 doctors in the journey of setting up and building Practo.

Now one of the most interesting things is a lot of doctors

are also entrepreneurs in many ways.

They've set up their own business, hired a team, running a system.

What are some of the things that the best doctors have done really well?

So,

you know, it so happened that I met these many number of doctors.

But just to give you a little bit of backslide on how it all started.

I was in my 3rd year of engineering, and I was trying to figure out, you know,

in which space do I build a product?

This is back in 2007,

and I met a bunch of people,

you know, I met lawyers, I met people from very diverse backgrounds,

and then I met this one doctor in Bangalore.

I remember vividly because it was afternoon time,

you know, he's in between patients, and I go meet him

telling him that I have this product I want to talk to you about.

And I could see the, you know, even in that afternoon

he was sitting all alone by himself in this clinic office.

But the, you know, the passion he had for his patients, really inspired me.

You know, he was planning for what to do for the next patient.

He was excited about what he had done for his previous patient

and he was so worried about this patient that happened a few days before that.

And he was explaining all of these things to me,

and it was lunchtime.

Yeah.

So I got a really one or two hours with him and I could see the passion that he had

for patients.

And a similar thing happened to me just a few days later with another doctor.

You know, this was in Shivaji Nagar.

The first doctor was in a part of Bangalore called Malleshwaram.

And in the Shivaji Nagar doctor, right, it's a slightly more crowded space.

He has a slightly more tinier setup, but just the sheer passion

for his patients and how meticulously he was trying to improve their health

really kind of inspired me. I said

I want to help these guys. And I want to help these doctors

because they have so much passion for patients and patients don't see it.

Because you go meet them,

you know, you have this kind of a transactional relationship.

You have 15-minute conversation, or let's say you have a

On the other hand, you are worried about your own health at that time.

Yeah. Right? So it's all about you. Yeah.

But what you don't see behind the scenes is the passion - that sheer passion

that doctors have for patients

And I saw that up front,

and I got really inspired by them

and I said, okay, what do I build that will

enhance their,

you know, productivity?

And that's how the software

and that's how I ended up,

you know, going on to meet 12,000 of them,

or more actually.

I know that's just the back-of-the-hand calculation. But in the last 16 years,

I met tens and thousands of doctors all from different spheres.

I met

beginners. I met

doctors who have done 40 years plus.

I've done, you know, I've met

physicians. I've met surgeons.

I've met

doctors in India, outside India across.

And a couple of things come through -

they’re all doctors,

and one thing that's common is that they have sheer

insane levels of passion for their patients.

And genuinely, that is one of the reasons why they pick medicine,

I guess. And that's why they kind of self-select themselves into that cohort.

And it's a sheer pleasure to,

you know, view them because the genuine care

that they have for patient is something very motivating and inspiring.

And even it doesn't matter which level you are,

It doesn't matter if you're the owner of a,

you know, a 5-storey, 500-bed hospital or whether you are a single doctor

getting into practice.

So that was something that was common.

But something that I felt,

what differentiated doctors between 2 was,

I think there were a couple,

there were a lot of doctors who were very smart

and who knew their subject matter very well.

But when it came to the non-biology part, the non-science part,

which kind of went into the management and went into this thing, that's where,

you know, they would find it very challenging. Because it,

you know, it's similar to how I'm

more of math and computer science and I find biology more challenging.

So, the reverse. Sure

And the good guys I found, you know, kind of teamed up.

They found ways to team up with others who had those strengths.

Okay.

The second thing that I saw

was that there was, you know, in the doctors who succeeded a lot

I saw a sense of ability to,

you know, doctors,

you know, genuinely with patients,

I would not call it a

god complex, but they are god to patients.

Right?

So they are at all times, you know,

having a very different kind of a mindset when dealing with patients.

Now, how do you marry that with a beginner's mindset?

It's a challenge that a lot of doctors, you know, don't very easily

move into.

So, you know, as businessmen and as any professional

in any sphere,

having a beginner's mind, is very important.

Doesn't matter whether you’re a beginner, whether you’re,

you know, your 5 year in, 10 years

There's always more to learn.

Right? That curiosity is required.

and willingness to learn.

And you need to have that humbleness to know that you don't know enough.

Yeah.

Now, how do you marry that to a doctor? It's very interesting

Interesting thing. Right?

Because as a doctor at the receiving end of being thanked each day

for saving so many lives or

for contributing to so many people's betterment.

Sure. Now, how do you marry that

to a beginner's mindset?

It's a challenging one.

You need to have you need to be at both.

You need to

have the confidence to treat patients at the same time.

Have a beginner's mindset.

To be ready to learn even from somebody younger,

even from somebody outside your field, even from somebody else.

Yeah.

So that is the challenge

I've seen a lot of doctors face and the ones that have really always kept

a beginner's mindset right from college to starting their practice to

you know, going on and having that humbleness to learn,

balancing out there, is what I've seen, play out well for them.

I think you described it really well, Shashank.

I think it seems like, on one hand, you've got to be really confident

about dealing with a patient.

But at the same time, when it comes

to the economics of your business, you need to be willing to learn

a lot of new things or, probably even on the technology side,

be willing to sort of adapt and grow over a period.

You've looked at a lot of doctors up close, looked

at the economics of their business very closely.

What are some of the things that doctors get wrong

when it comes to running their business?

No.

I think, first of all, you'd be surprised -

when we started working in this field,

I was very surprised that

doctors

maintain very little

or have very little knowledge of the economics.

They in fact maintain very little data.

That's the first unfortunate part. Right?

I think I think there's also a challenge in time.

There's a challenge in

learning management.

So because of that, you know, they have to end up doing everything

and they don't have enough time allocated to understanding their business.

Like in a business, when you grow

the time you spend doing the

day-to-day activities

reduces because you are able to get other people,

and then you get more time to analyse data and see what you're getting right

and what you're getting wrong.

Unfortunately for doctors, it's their time

which is the most valuable precious commodity.

And so they are really not able to step back

If you look at the best surgeons today, they even today would be, you know,

spending those number of hours in OT because that's what's required of them.

So I don't know if there's a solution to it,

but maybe there are tools or products that they can use to do this,

or they can hire

better people. How do you get data?

That data orientation is something that I don't think doctors are really

equipped with. And without understanding data, you can't understand

patterns. You can't understand insights about your business.

Sure.

And the lack of data itself leads to a lack of insights.

And lack of very basic insights.

What's my profit margin?

What is my, you know,

they have a sense of how it's doing because they have an overall number.

But the breakup of that -

what is giving me ROI?

What is not giving me ROI? ROI is a bit of an investment.

How do they break all this up and understand this,

and then focus on things that are helping them

for the things that are not helping them?

They go by intuition a lot.

That's because that's how they treat patients

They treat them based on their experience.

Now, running a business, you know, you need to marry that intuition

with the data.

And that lack of data, I feel is one of their weakest points.

Right.

So they don't get deep into their data

to understand which procedures have what kind of margins.

They go by gross numbers.

They don't go into the details and understand, okay,

even though I'm earning so much on this procedure,

if I take out all the costs, what am I actually left with?

And how much time am I spending on that procedure?

And is it really my skill set or not?

Which are the treatments for which

I am really good at?

Just because, take an example, just because I'm an orthopaedic doctor,

am I good at all things orthopaedic or am I good at a few things orthopaedic?

Should I specialise?

Those are the things that, you know, get missed out.

And so because of this lack of data,

that impedes their growth in my opinion.

That's one thing that I would think that, you know,

this thing that I think that gets missed out.

Apart from this,

the second thing I think, you know, is that

there is a sense among doctors that

it's only the seniors that they learn from.

But growth and learning is everywhere. Right?

It's in every book.

It's in books, it's in their field and other fields.

I feel like this -

them stepping out of their

core comfort zone of biology

is not really there.

They love to go deeper and deeper in their field.

They do CME programs

but in adjacent areas, they don't.

And the ones who do

kind of benefit.

And by adjacent, do you mean in the medical domain or

in the commercial side of things?

I would say that, you know, in a commercial, in a technology, it could be

I mean,

commercial, we mean business. Yeah. It could be marketing. It could be

you know, it could be how to understand consumers.

It could be empathy.

It could be there are so many different aspects that you need as a doctor.

The biology part is an important one.

It's the core competence.

But that's not just enough.

Like, I mean, if you know, you are probably phenomenal

finance, and that's why you picked up the Fintech space.

But then, to run a business, you need to know so many other domains.

Sure.

You need to be, you know, maybe not phenomenal at, but at least good at.

Yeah.

And so those are the areas where I feel that they missed out on and

I'm not seeing enough doctors taking the initiative

to learn and equip themselves with that.

I will give you a small data point.

We did an analysis of patients who did not recover

because we have so many patients who come to us.

So we're able to send them a request after a few months of treatment

and say, hey, you met this doctor so many months back.

Let's look at whether you recover

or not recover. Right?

And if you do not recover, what are the reasons?

And if you recovered, how are you doing now?

Yeah.

And also, did you end up going to some other doctor?

Because, you know, for some reason, you didn't recover.

Neither of the 2 buckets or the 3rd bucket.

The data was quite surprising.

The data was surprising to the tune that,

you know, there were a lot of patients

because they couldn't understand the doctor.

ust because of that reason,

they went to somebody else.

The treatment was

right.

But then there was some level of connect that did not have the doctor.

The trust did not go to

the doctor. The doctor spoke too fast. The doctor gave me too short time period.

He didn't answer all my questions.

He spoke a little rudely. He didn't I don't know

You know, those those human signs, right,

of saying, how do you communicate the right thing in the right way?

That was not this.

I haven't met the doctor. That's, you know, almost under,

you know, like a good percentage of consumers.

And the other consumers who did not recover did not follow the instructions right.

The treatment was right, but they just didn't follow the instructions right.

And all this data put together,

we’re publishing a paper

very soon, we found that almost 8-10% of the patients didn't even,

you know, were in the bucket of not recovered.

And so when we go deeper into this bucket, we realise that it's very little

of actual treatment, but it's a lot of the non-treatment part,

which in communication, in conversation gets missed out

because of which they don't recover or, you know, they go somewhere else.

So all

of the, you know, out of the 8-10% that did not recover,

there was just about 2 to 3% where the treatment would have been,

you know, maybe a little different maybe.

And the remaining 70 to 80%, who were more

non-biology oriented, things that

could have been explained better to the patient or dealt with the patient better.

And even in the treatment portion, it wasn't the knowledge

being a problem. It was more about not taking of medical history.

If the doctor had taken enough questions

or the treatment could have been slightly more customised or personalised,

which would have been more effective.

So

Yeah

So those are the things that, you know, where

the doctors could, clearly add on to. Now again, you know,

this nitpicking. Right?

Because I know I want to definitely put the disclaimer that, you know,

they do probably the biggest service and profession.

Now, I'm just trying to put out data.

That'll help,

you know, take that 90 - 92% to 99 - 100%, which is what they want to do.

And that's what I wanted to partner with them for.

Absolutely.

And I think,

you know, you said it very interestingly that it's the human side of things

because you're so passionate about your craft,

the job that you do,

that sometimes these ancillary things

which actually are the last mile of closure.

Right?

So the experience that the customer gets or the patient gets

when they walk into the clinic, I think is one of the most important things. Right?

I've seen this, up close that you'll go to a clinic

where you feel that overall everything feels good. Right?

There are so many times

when their doctor or their assistant calls and checks in on

you one day, 2 days, 3 days later. And then you, by

default, will go back to that doctor because you feel cared for.

Right?

And that treatment might be exactly

the same between somebody who does that and somebody who doesn't.

But the economic outcomes might be so much better for the guy who does it.

Yeah. Absolutely. Absolutely.

And you should see how difficult this job is.

Right? Imagine you're in the front line

all the time.

And I can't even imagine even if,

you know, even if they have a bad, you know, let's say

there's some bad news or there's some bad outcomes.

It affects your mindset. It passes on to the next patient.

There are so many things

hat goes into them, and I'm sure it's I'm not one.

So, I can tell you for one that I'm, you know, it's

I'm only speaking of data. Yeah. I'm sure the experience would be very….

No. No. Sitting here, in a recording studio

is very easy for us to say this, but when they are actually living it

on a day-to-day, hour-to-hour, patient-to-patient situation,

it's very difficult.

How do you think doctors can solve this challenge?

Is that through tooling?

Is that through getting a commercial person into their organisation?

How have some of the guys who’ve done it well addressed it?

I mean, any problem has 3 components - system, process, people.

And so this also requires that. It requires all 3. You need,

I would say, people is the last. I think you need

a system, a system that collects data.

That system could be any system that collects data.

So you should trust in data.

That data should lead to processes that you fix.

It could be a clinic, hospital or it could be in your practice.

And then you have people who oversee those processes if required.

Right. So, it flows in this way.

So, you know, I think being guided by data

is the most important, and the collection of data is the most important.

And I've seen that you know, what I just mentioned to you is all data

that we collected from thousands and thousands of patients.

We were the first ones 10 years back, who started taking, you know,

feedback about patient stories from patients after their treatment.

And started sharing that with the doctors. The first few years are very hard.

We were the first ones to do it. Right?

And so they, you know,

there was like this pushback saying, why are you showing me all this?

Because 95% of them were positive, but 5% showed what they could improve.

And the improvement was usually around could have the like you called out.

Right? The environment could have been better.

It was too noisy.

It was, you know,

you know, these small small things could have been better.

And there were other things also.

But getting that data to the doctor, it was it was it was

we have done analysis.

We've seen year-on-year how this feedback has completely changed. Mhmm.

How

things that people used to complain about 10 years back are no longer

even relevant today.

Like, just to give you an example,

here were a couple of doctors who because of their stress levels

and because of so many things they manage, sometimes would be rude to patients.

And they were not knowing that they were actually rude.

But they're coming across that way because patients

never go back to their doctor and tell them that.

But through this feedback, they would, you know, share that. It could

be because it could be anonymous. It could be,

and they found a mechanism to pass that feedback back.

And maybe the team that the doctor had was not, again,

strong enough

to pass on this feedback earlier. But we were just showing them a dashboard

where it would in real time, they would see the feedback.

Yeah.

And before publishing, we'll show it to them. Right.

That, hey, this is the feedback. Would you have any comments?

And if they had anything, you would publish with it.

And so this kind of data really helps the doctors understand

where are they,

you know, where could there be areas of improvement because everybody wants to improve.

And that's how they grow.

And so, you know, you're already doing well.

You know, every doctor is doing well,

but how can you focus on the things that you personally need to change?

And you can understand that better.

So it starts with data,

nd then that data through a system will allow you to understand

which processes to improve,

which areas to improve, and then you can have people to solve that.

This seems like an expensive affair, right?

Because building these systems, first of all, data collection,

the analytics and then the people around it

to be able to deliver the improved experience or outcome.

It seems like you'll have to put, as a doctor, more money into it,

which potentially means that in the initial part of making the shift,

you are actually, sort of making much lesser

than you would earlier and

only over time, it sort of results into better outcomes?

I don't think so.

At least when we look at our data about why do doctors adopt technology

or do not opt for technology, the cost is not a factor.

It's usually mindset,

which is, do I have the need?

Do I understand the benefits? And 2 is time. Right?

Do I have the time to involve myself, to take myself out of…

and being in India, you know, India is a capital for technologies.

And just to use some more numbers,

the amount of money spent by in the US on technology is usually around 5-

10% of the revenue, they spend it on technology.

In which segment?

In healthcare.

Around 5%. In some, it goes up to 10.5. In India,

if you take the PNLs of all publicly listed companies and look at how much

they are spending on technology, you'll be shocked. It's less than 1%.

Okay?

And if you go to others and that's not just in the large

public ones, but across this thing. Less than 1% of the revenue goes into IT

and, or, you know, picking up tools, any tool.

Right?

And I think that's where there's an opportunity.

Of course,

you know,

I might sound biased because I come from that domain of IT,

but I think that it can give a multifold return. If understood

well, how to use and if implemented well how to use it can give a multifold return.

And that's where I think that is a mindset that you need data.

Now that data could be from any system, but, you know, being data-oriented

is something that any business will see itself as a strength of theirs.

And that's one area where healthcare is, you know, they measure a lot of

data around health outcomes.

I mean, clinical outcomes like when a hospital will measure

how many times did the patient come back, what's the length of stay.

But treatment outcomes, that is what happened after after 6 months,

what happened after 12 months, that longitudinal data and more

analysis on that? That is still starting off now. It's beginning

to start. And when I was reading about, the health tech ecosystem,

it seems like over the next few years, it will be a USD 50 billion market.

At the face of it, there's enough to prove that

this is a very, very large opportunity.

And yet, it's not progressed

at the pace at which it probably should have.

What caused this delay,

Shashank? Because this 1% versus 6-7% in terms of spends -

is it a function of our mindset, or is it that the fundamental tools around

his were not built like the data systems were not there.

Ayushman Bharat has only just started happening

What were the sound issues?

See, I think this was, I would say, expected

Some of it is unexpected, and some of it is expected.

I'm taking the whole health tech ecosystem primarily. Because if you look at health care,

health care is the last to adopt technology.

And that is worldwide, even though the US is where it is, it's because it's taken time

and it's, you know, we are probably

a few decades behind, but, you know, we'll catch up.

But worldwide,

health is the last to adopt technology.

And the reason for it is because health care runs on a single thing

that's most important. That's trust.

Trust is the most important thing in health care.

Efficiency is not. Right?

You know, that's why people love to wait for 3 hours for a good doctor

than get the next one-minute available doctor.

Right? People don't mind spending a little bit more on health

care versus finding a discount coupon for a doctor. Right?

So health care works differently because it works on trust

and trust is something that you can't replicate through technology,

you know, overnight.

It takes time.

So trust as a fundamental concept takes

time to build and decades to build.

So doctors do that, you know, by word-of-mouth.

They treat the patient, the patient says a good word, etcetera.

So then tools and technology and health tech have to factor in 2 things.

A.

how do I build products and services that can understand

this concept of trust and amplify it, incorporate and amplify it,

and second, factor in the time it will take to capture this trus

and then amplify it.

Right?

That's why the best hospital usually is the oldest hospital,

right?

Or the one that has tenure.

The newest shiny building next door is not the one

that you will step into. Whereas, it’s the complete reverse in other industries

where you'll say, hey, there's this really great place for entertainment

or a very good new restaurant that's opened up.

Yeah. But when it comes to health care, trust is more important.

Right?

And so that's why, you know, two factors.

1, build products and services that encapsulate this trust.

B, factor in the time it will take.

It will take decades.

But then the good news is that those are also moats.

Which means that, you know, as they say, a doctor, as he ages,

his earning capacity only increases. Right?

And that's how even brands in health care work. Dettol is a 150-year-old brand.

Like all the brands around us in health care are decades old, right?

Are like, people don't even realise it. They're decades old.

Like even MRI. You think of MRI.

Which year do you think MRI first came into being?

1940s? I don't know, maybe.

I mean, it's that old, right?

I mean, it's actually the 1980s, but it's still 40 years.

The latest technology we use today in diagnostics,

which is imaging technology, which is CTN, are like 40 years old.

Right?

But your UPS, how old how old are even credit cards?

Yes. So finance, and others adopt technology faster.

There are other industries that adopt later.

Last is health care. But it's also more sticky.

Right?

So there are a lot of good things about it that it's recession proof.

It is, you know, evergreen, all of those things,

but it's also the last to adopt technology.

So, I think health tech has a role to play.

I personally believe, and

we’re putting a paper out on this also, that health-tech,

adopts a branch of science which is data science, computer science,

which I think will enhance health outcomes for the entire world.

And this is the century in which it'll happen. There's no doubt about

it. It's just gonna take time.

So if you're going to apply the same timelines

of other industries on health, you know, that's being unreasonable.

I guess so much of what you you say is very familiar

when it comes to wealth management also.

Right?

There's so much of that interpersonal understanding and the reluctance,

therefore, to adopt to technology where, you know, a human being can do it.

I've seen I mean, we were surprised

when we did analysis, you know, finally and funnily enough, wealth

advisors were similar to doctors because it's all about trust.

Yeah. Right? And because there's a lot to lose.

Yeah. Right?

There is, you know, the phrase we constantly heard in our consumer

research was “Risk kyun lena hai?

Risk nai lena hai.” Right? Because this is something that

you know, is going to ruin my life. So, it's funny that, you know, we have a similar problem.

No. And, you know, to that end,

the businesses, therefore that we were speaking briefly before we started,

have generally longer gestation in this space.

And yet,

you know, when you talk about the lack of adoption of technology,

there seems to be this whole thought process around using data science better.

You know, when I was talking to a health-tech entrepreneur in the US,

and he was telling me about so many of these creative ways data is

being used, where reports are being scanned, doctors are getting inputs ahead of time

before the patient even sometimes walks in.

What is happening on on that side

and the next phase of that is probably artificial intelligence.

How is that likely to impact the doctor's

business or the profession of medicine?

Yeah, if you, you know, if you ask me

16 years back when I was in my 3rd year of college of engineering

and that I'll be doing what I'm doing 6 years later, I'd be like,

odds are very less, and that won't happen.

But if you told me that I would enjoy it more now than before,

I would be like, you know, that's just,

a fairy tale. Right?

And unfortunately, or, you know, maybe fortunately for me, it's true.

I've never been more excited about the role

technology and data can play in healthcare than ever before.

And thanks to, you know, whoever wrote that paper in Google

on ‘attention is all you need’

and whoever I mean, and whoever I mean,

whoever at Nvidia who built those H100 and whoever in, you know,

OpenAI, who figured out, how all this can be

put together to create LLMs. Oh, man. They've changed the world.

And it was beginning to get a little stale, I'll be honest.

I know we started off in 2008 and we built India's first,

and even sometimes I think it's also the world's first online software for doctors.

We were online in 2008, so we built SaaS in 2008.

And then, in 2012, we built the first doctor discovery platform. Right?

And then in 2000 and

I think few years later, we built the first mobile app. Right?

And so after mobile, there was really nothing

major tectonically happened. Right? There was the Internet where SaaS came in,

then there was Internet penetration through mobile,

and then there were mobile apps through play stores like Apple Store.

But after that

and then the last 2 years

and especially last year, it's unbelievable.

And I'm, The pace of

change is incredibly high. Yeah.

But I'm just very specific about this innovation. Right?

And what this innovation can do for health care is phenomenal.

And I, in all honestly, used to hear a podcast,

you know, read headlines, and they're like, you know, one more,

you know, some kind of frenzy and, you know, media frenzy, etcetera.

But now I'm using it on a daily basis.

I'm not talking about using ChatGPT for my personal

or professional use. I'm talking about using that data science

or rather those those models in our products and services.

And I'm truly blown away.

Give me an instance of, like, some of the surprising stuff.

I'm trying to not reveal too much because I need to

keep some, you know, as you can see,

you know, I think I'll give you an example.

We did this,

a human brain can only consume so many papers.

Let's take a doctor,

and doctor has done, has studied X number of books and has passed

and on NEET, today's NEET exam and then goes on to do a NEET PG

then, you know, meets a bunch of patients, gets those knowledge

and then throughout his years of

experience each year, learns/reads up on CME programs,

attend CME programs, reads up on journals,

does all of this. And he accumulates knowledge. Right?

Now,

that same knowledge can be accumulated within 3 months.

Right.

Of course,

you know, what I'm talking about doesn't encapsulate the surgical part yet,

but just the physician portion, which is what

I spoke about, like understanding.

It's there

now - the technology to understand

data and

convert it into intelligence is here.

It's not in the future.

So it's not,

you know,

while this word of artificial intelligence

is, you know, intelligence

is, you know, different IQ levels, but the basic knowledge is there now.

And it is getting better at an incredible pace.

And just to give you the number of journals released each year is

at least 1000 times more

than the amount of journals a person can read and understand.

So, by default, the knowledge that a doctor needs to have

is being outpaced by the supply of knowledge by a

ratio of 1:1,000. Because you can't read everything.

Yeah.

So this is creating a way to funnel it and, like, analyse it since

then. All of it. Right?

So what I mean, I feel the closest I can get to, and I'm

this is just something I'm just thinking of right now

is that what quant did in trading, for example.

And it's gonna get smarter

now. I'm sure it's something that's gonna enter into health care now where,

through data, we can, for the first time, show much better health outcomes.

And I've told you offline about some of the results

we have seen in our lab of this product that we are building

and its efficacy.

It's truly outstanding.

It's something that I've never seen.

And we are now putting some papers together,

which hopefully we’ll get peer-reviewed

and we'll publish them on ‘how factually we are able

to correlate data science and its impact on health outcomes.’

It is and also because one good thing about health care

is that nobody wants to take any risk. Right? Right from the patient or even doctors.

So they don't want to use anything that is not peer-reviewed and doesn't have (validity).

So every product that they, you know,

prescribe or test they prescribe has been peer reviewed

and then they have the confidence that I can now trust this review. Right?

They believe deeply in science.

So we want to use the same methodology to share with them

how data science can really impact health outcomes,

clinical outcomes,

how clinical outcomes can be better off with computer science and data science.

And when that empirical data, which we already have, and we are

now in the process of publishing, it will then become crystal clear

on this being true science leading to clinical outcomes.

Not just convenience and, you know,

superficial

impact on consumers, but actual health outcome impact on consumers.

And I think it's only going to get better.

So 16 years into the space

and I'm extremely excited

about the next 4 to 5 years, what we can build. Some absolutely kick-ass

products are gonna get built. Some very

fundamental changes

are gonna happen in the way people are going to receive health care.

There is absolutely no way that the person, I see that in

after a few years, will not be able to get the best health care advice

in any language they want anywhere in the world at the tip of their fingertip.

And I'll be surprised if, the clinical outcomes don't

significantly improve by providing copilots

to doctors and by providing access to AI doctors to patients.

I don't see how that's gonna happen in the next 5 years.

So I'm in probably one of the best seats.

So I'm very grateful that it's happened now and I'm here. It's exciting,

and the kind of impact that you can you are creating is, I think fantastic.

Shashank, you know, it's great for, I guess, a patient

to have all of this available and therefore, they will heal faster,

probably have more certainty of, healing, etcetera.

But now, when you look at it from a doctor's perspective, somebody,

let's say, who has 15-20 years ahead of them in their career.

We are saying that they need to be good doctors.

They also need to be good at understanding commercials.

They need to be good at interacting with patients.

And now we are saying they also need to be good at adopting technology

in a way that, they can deliver better outcomes.

Now, it seems like very intimidating for somebody who's been around

for a while to figure out how to consume all of this change that is happening.

So, what's your advice to doctors on how to adopt

some of these new technologies?

I mean, you know, if you look at the people who actually become doctors,

they're some of the smartest people in the country.

So, if you look at the ratio of seats to

the scores and you're talking to some of the smartest people in

the country.

So I don't think there's any,

you know, I'm sure they'll pick up this and more.

As long as they believe that it is gonna be important,

then I'm pretty sure that, you know, they'll pick this and more.

I know most of the best hospitals are run by doctors.

They are so they have, you know, they are phenomenal at picking up,

you know, all the different, components and and running with it.

And, you know, like any person, take an example of me.

I just knew computer science when I graduated.

Then, I had to adopt sales skills when I started a business /

started a startup. Then I had to adopt, you know, commercial sense

when I started getting investors. Then I had to adopt, you know, HR skills when I started,

adding team members.

I needed to adopt finance skills, and I started, you know.

I need to have good knowledge, of everything to grow.

And I think that's the innate evolution

of humans that we are able to build tools and services

for each other that make it easier for each other to grow.

And each generation of generation, we pass on that knowledge,

and we build tools for the next generation to make it easier. And that's what, you know,

so I don't see it as a challenge.

I just see that the people who adopt first and faster,

you know, get ahead. And the ones who are later than, you know

will also go forward, but, you know, it'll be at a slower pace.

And they might feel a sense of being left behind.

But I think it's just about, you know, investing the time

and curiosity to learn.

And this is what the world needs.

And so, you know, the people who do it will move forward,

and those who won't will step back.

I don't think it's intimidating.

I don't think it's more complex than biology.

At least for me. I was I wasn't one of the best biology students.

So I think they will quite easily, move forward.

And the best thing about health care is there's no limit.

There is no limit set

that people have to live to 80 or 90 or 100 or 110.

So this job is the best job because it has an infinite horizon.

Right?

And today, they're talking about the 1st person

who’ll live up to 150 years has been born.

So the best, you're in the best business that you can be in

because there's no limit. Right?

Unlike wealth, where you can say, okay, “You know what, itna kaafi hai,”

I've not heard of somebody who says, “You know what? 60 kaafi hai.” Right?

I think if they're ever in good health,

everybody wants to live and experience this world

and, if Elon Musk is successful, more worlds, in his lifetime.

So, we’re in the best business, and tools can only help us get better

at what patients want,

and patients want to live healthy lives for a very long time.

So, I'm sure people will pick up the skills required to deliver that.

You know, when you were saying this better health care is actually

putting more pressure on wealth management because folks will live longer,

the money will have to last longer,

nd therefore, the portfolio needs to do better than before.

Of course. I'm sure you'll figure that out.

That sounds easier than making people live longer.

I'm sure. I'm sure. That's for sure.

Your own personal journey has been fascinating.

You talked about how you learn different things

at different points in time, but sometimes you forget that you were a founder

right out of college and in an area

which is defined by trust.

And I can't even imagine how doctors would engage with a founder

right out of college who is trying to tell them how

they can do their job better because of tooling and so on.

How is that initial experience of setting up?

Yeah. I mean, I know. I had to pretend a lot,

so I remember. I was in college when I started. I was in my final year,

and I used to take my father's shirt, which are outsized shirts.

I was trying to grow facial hair.

I was trying to look

older, and then I would borrow my friend's laptop

because I didn't have a laptop and then I would borrow

you know, all of this.

And the only thing I had was a two-wheeler,

which my parents had, you know, gratefully given to me.

So I had that one thing, and then I would take that and go off

and I'll print a card which would say I'm the sales executive.

And I would pretend I'm working for this, you know, big company,

which is very reliable.

If you said CEO and founder, that wouldn’t work.

They would be like if the CEO and founder is this, then company toh gaya!

So I would have a card. I'd have 2 cards. Right? I would have one

card, which would say CEO and founder and one card that would say sales executive.

And as a sales executive, I would speak highly of my management. And I was like

management badhiya hai.

I never say anything wrong. Like, I never say that to somebody else.

And if they figured it out, then I would, of course, tell them. If they

really asked 3-4 levels, I would definitely tell them.

And then, if the next meeting

was an investor meeting, I would give the CEO and founder card.

If the next meeting was the same, I’d give the sales executive card.

But for me, most importantly, when I was in college,

I was not really looking to start a company per se.

I was trying to solve problems. I was trying to solve,

like, for some reason, I just wanted to use my computer science skills to solve a problem.

And I was just trying to find who would, you know, engage with me. And doctors did,

and they had problems

They had problems in keeping track of their patients.

They had problems

in, you know like they called out

in sending reminders to the patients about their appointments.

Patients are missing their appointments.

They had problems with keeping track of their patients' health records.

They had a challenge in answering their own time

and where they'll be, what they'll be.

So, I saw an opportunity there and

I saw an opportunity in how patients' lives can be improved.

If the doctor would adopt this, the patient's life would improve.

I mean, I would want my doctor

to use the tools that I'm using so that he would treat me better.

So I saw a lot of synergy there, and, you know, it just kept going on from there,

solving one problem to the next, to the next, to the next.

And it's kind of a rabbit hole that I got into.

I would say that, you know, when I was in college, it was much more easier because

I had known, you know, there's really no…..

I knew that, you know, when if it did not work out, I'll always,

you know, get a job. That is not a challenge,

but there were no dependencies.

So, you know, even if the startup was generating a few lakh rupees,

you know, it's great. So we had very little to lose.

I remember also going to business plan competitions.

That was my fundraise.

And I would go to a business plan competition, submit my actual business

as a business plan, and then, you know, go tell them that.

And then I would, I would get the 3rd price.

I'd be like, the first two

are not even running a business, you know,

I'm actually running a business!

And you'll be surprised how much of my initial capital

came from business, business plan competitions.

The only time I went to MBA colleges was to present business plan competitions

because they used to have business plan competitions.

And so the weirdest moment used to be when they would,

you know, I would submit my business plan,

and I would get shortlisted in the top 5,

and then they would come and pick us up. Right?

And the students are gonna….and they were like, you are the one?

And I'm the one.

And because I'll be younger than them. I'll be younger than the people, you know,

conducting the event and they would have to call me sir.

Which is also very weird. Right?

And, then I would win the business plan competition.

Some of them, not all of them.

I think I think IIM-B one

I did not win.

You shouldn’t hold that against us.

I should I should go and check up on my records.

I won a couple. I think in Delhi I won one or two.

So anyway, so we won those competitions and that became capital for us.

They’d give you INR 50,000 for business plan competition.

Yeah.

So at which point did you realise that this is now a serious thing

that's happening? Because you said, there was a plan B in the sense

that if it doesn't work out, you'll go and get a job.

But at some point, you felt, okay, now this looks like a real company happening.

What were some of the metrics or some of the indicators that you felt like

now Practo can be a large business?

I don't think that,

and I think at the start it was not about, it'll be a large business,

and I was 21. We were in 2008 after the meltdown

- financial and global meltdown. Lehmann Brothers had gone out.

People were giving pin slips everywhere,

and I had not sat for my college placements.

So I decided very heroically that I’ll not sit for it.

I don’t want to have a plan B because if you have a plan B, there’s no plan A.

Then, after 6 months of all companies coming and going

and all my friends being placed and everybody

in my batch being placed and going off to Goa and other places to party.

I was sitting in Bangalore trying to sell this product to doctors.

And then after 6 months, I thought, you know, what's the harm?

So I went to college. I took the 1st overnight bus to college.

I landed up, which was the first company that came in,

I sat for it. Luckily, I got through the evening bus I took, I came back.

So I had that option

after 6 months of placement.

So luckily that company came.

But, what gave me confidence

was after the 1st year, just as I was going to join that company,

sitting and I was thinking, hey, I really enjoyed this. Right?

There's a lot of hard work. You know, and I used to go

I used to see my, you know, my seniors, and we used to go meet them.

And everybody would come to this Pecos on MG Road. Right?

And they would always complain about their jobs. Right?

They'll say, “Ye kharab hai, vo kharab hai,

vo ho raha hai.” And i was like “Agar ye hi karna hai toh

this what what I’m doing sounds

not too bad.”

Yes. You know, I you know, it doesn't earn money but I don't have too much.

I'm just coming out of college. Right?

So I don't have, you know, too many ambitions.

The only thing I had to do was switch off Facebook, switch off all these places

which would show how others are doing, and just focus on what I'm doing.

And I just generally enjoyed what we were doing.

I was learning new things while coding. I was learning new things while selling.

And doctors really

and the one thing I remember, a couple of doctors when I sold them

the product in my final year told me, I remember there were 2 doctors, who

told me that, and and this one dentist,

he told me that “Shashank, you're too smart for this. I've seen many come before you.

And they've all, you know, like, gone away.

They've taken my money and ran away.

I'm sure you're one of them. You'll be like that because….”

And yet he gave you money. Yet he gave me the money. Right?

And that's the large-heartedness of doctors. Not just one, 3 of them.

They said, I have bought 5 softwares before you.

They've all come and gone away.

They've all sold me this pitch and gone away.

You are smart. You'll go to the US.

It's 2008. You know,

you'll clearly go to the US.

You're starting from a good institute, so you'll definitely do your masters

or whatever.

Yeah. You're gonna go away then.

Actually, some of them and I still pay you. Some of them said you should go away.

Don't do this.

Some of them called me to the site.

Doctor Jagdish, I remember he called me to the site. He said that see,

I have paid you for a year. You've done this for a year

now. Don't do this.

You're too good a good a person. Right? Go.

Because this is not a good business.

Right?

And so that was also in the back of my mind. Right?

And I was like, hey, you know, they've trusted me. Right?

And, by that time, we had 100 doctors, right,

who were using our software.

And I was having fun learning.

So I was like, what's the worst thing that can happen? Let me

let me keep, keep pushing. And there were hard times.

There were really hard times. Like, this is before any funding.

And this is when in 2009 startup was not even a word.

Right. It was,

you know, money would be given

to large established people. Then we were 21-22 years old.

Yeah.

I had no hope. But I was just enjoying myself

and I was doing it just from that standpoint.

Never really thinking it'll become big or whether it'll become….

I just generally enjoyed meeting doctors, solving their problems, building

a good product, getting good feedback, and solving the patient's problem.

I felt there was meaning in that.

And naturally, what happens happens.

And so there was no hope and I also used to meet investors,

which would be even more demotivating because they're like, “What is TAM?”

I would say,”What is TAM?” They’d be like,

“You're not even an MBA?”

I'm like, “No. I'm not an MBA.”

So they're like, “You should know your TAM.”

I know literally, you know, you've seen Silicon Valley or

you've seen these sitcoms.

It literally, you know, used to be like that where I really like puzzled.

You know, these buzzwords will be thrown at me and I would feel very awkward. I was like

‘Nahi chahiye yaar tumhara paisa. Main bechta hu, main bechke paise bana leta hu.’ So

we we got about 1000 customers or something like that without a

single investor.

And, so we would have continued

and, you know, curiosity was also driving us.

It wasn't any large outcome or let's build a large company.

It was just curiosity.

The other fascinating thing is that given

how much capital it takes to build trust,

for you to now turn

probably India's 1st profitable health tech company.

Right? And certainly in the VC-funded ecosystem.

What are some of the learnings from that particular journey?

That what is it that worked

at a certain point of time?

Was the CapEx sort of played out, and therefore, the profitability came

or some optimisation on marketing, etcetera?

Yeah. There are 2 ways to see this. Yes. We are one of the

first few to turn profitable

in the health tech space,

and, you know, we wanted to show that health tech can be profitable. It

can, it can grow and be, you know, profitable

at an all the way down to the EBITDA level and cash flow level.

But I don't think you know, I think I could’ve done a much better job

for sure.

I think I ended up raising much more than I needed.

But all this comes in hindsight.

Sure. I made a bunch of mistakes, and I think my capital efficiency,

you know, before 2018.

Was like, I wasted 80%. And after 2018, because I wasted 80%,

I, you know, I've been, like, 100% right after 2018, or maybe 95% plus. Right?

The efficiency of use of capital, wastage

has been, you know, maybe 5% or so.

But that, you know, still hurts me, that I could have done a better job

between the 2016-18 period. And

that those learnings are what I take forward.

I have failed in so many ways that, you know,

I find that failure is a learning if done once.

It's a failure if done twin twice. Right?

So luckily, I feel I've not repeated a failure or a learning twice.

But yeah, I've had those learnings and so those learnings have been helpful.

So I feel even those companies today which are going through a similar phase

where they might have raised a lot of capital and they have,

they're a little ahead, you know, on the valuation.

I think there's hope. Right?

I think I've been there,

have had that in 2017-18 where

there was too much capital that had been raised,

valuations were high.

But then, if you put your head down and focus on what is truly worthwhile,

you can turn the company profitable.

I mean, you know, you need to have the right products and services for which.

So the learning for me was that, you know,

perseverance is a very big component of it.

Don't get distracted. Even during 2009-10,

I would not get distracted by Facebook or any of these tools.

Same thing in 2018-19,

cut out all the noise from outside.

There will be a lot of noise.

Yeah.

People will push you up

and then they'll pull you down and then push you up again.

Put you on magazine covers and all of that.

So those are all need to be, you know, distant from.

And yeah.

And then,

I think health-tech is one of my, you know, like,

I feel that you know, where do

you get a sector where you can make an impact

on your family members and earn money from it.

Right? Very few sectors that allow that.

You're literally increasing the lifespan of your family members.

Like, who doesn't want their parents to

live longer? Your grandparents to live longer? Your children

to live longer, your spare friend to live longer.

And you're doing that on a day-to-day basis. And you're also creating,

you know, value for all the shareholders.

So it's an absolutely brilliant space.

I think it just takes more time.

So, if you thought that a startup takes 5-

10 years, this one takes 15-20-25 years.

But the good news is that the extra 10 years

you need to put in because

it gives you some extra, it gives you a lot of meaning and value.

And creates moats like you’d earlier said.

Yeah.

You know, it's been a fantastic journey.

I was reading your letter, and it's very well written.

I must say

it's covered like how medicine has evolved over a period of time.

You have over 2 lakh doctors, crores of patients.

God knows how many consultations. Shashank,

it's been fantastic seeing the journey from the outside.

And I remember meeting many years ago and being fascinated

by what you're building and continue to be.

Thank you so much for doing this.

Thank you so much for having me over.