Interview with Devi Shetty, interviewed by Tarun Khanna, Boston, MA

de Devi Shetty, Tarun Khanna, Harvard Business School

In this interview, Dr. Devi Shetty, founder and chairman of Narayana Health, describes some of the early influences that motivated him to pursue a career in the healthcare industry. He explains that, from a young age, he felt an acute awareness of the lack of access to medical services in India, and that this played a major role in his decision to become a doctor and, specifically, a heart surgeon. After completing his education and training in the 1980s, both in India and in the United Kingdom, he returned to Kolkata in 1989. At that time, he says, "I was perhaps the second heart surgeon in that part of the world." Dr. Shetty goes on to discuss the poor state of the Indian healthcare industry when he began his career, and some of the strategies he devised to improve both care and access with very limited resources. He explains how, in the 1980s and '90s, more than two million people a year needed heart surgeries in India--and not just elderly retirees, but young heads of household who were relied upon to support their families. At the time, there was only infrastructure to support roughly 150,000 heart surgeries a year. "It was a tragedy," he says. "It was needless death." It was also one of the primary motivations behind Dr. Shetty's decision to found Narayana Health in 2001. As Dr. Shetty explains, from the outset, his goal in founding Narayana Health was to expand access: "Our idea was that we should be able to do sixty major heart surgeries in a day." He discusses some of the innovations that he implemented to make this goal a reality, including financing options given to patients to make procedures affordable, methods of controlling hospital expenses, and unique strategies of recruiting and training surgeons, nurses, and physicians. Shetty identifies this last hurdle--a shortage of skilled workers--as one of the key reasons for India's underdeveloped healthcare industry: "[we're] held hostage by a limited number of surgeons or very skilled physicians." In Dr. Shetty's opinion, the only way to overcome this shortage of workers--estimated to reach 80.2 million by 2030 by the World Health Organization--is to use non-traditional methods of training. In the interview, Dr. Shetty describes some of the methods already in place at Narayana Health and his thoughts on why they have been so successful. Dr. Shetty goes on to discuss the growth of Narayana Health over time--how it grew from its first location in Bangalore to more than a dozen locations across India and beyond (for example, to the Cayman Islands). He explains how, early on, he realized that "charity is not scalable" and that in order to survive, he would need to raise money from a private equity company. Although he admits he was initially hesitant to list the company and have to deal with investors demanding returns, Shetty explains that, after "a lot of introspection," he realized that if he wanted to do something big, he would have to take risks. "I took the dive," he says, "and I have had no regrets since then." He concludes the interview by sharing his thoughts on how intelligent policy can help developing countries around the world to provide affordable healthcare to their citizens.