Hot Seat

The Ace Reformer

R Basil, Managing Director and CEO of Manipal Health Systems, is renowned as much for being a harbinger of change as for radical reforms. Rita Dutta chats up with the self-confessed reformist.

Every time I meet him, my impression of him as the Jack Welch of Indian healthcare industry is re-enforced. Much like the legendary CEO of GE, R Basil, MD and CEO of Manipal Health Systems, turned around Manipal Hospitals (Bangalore) by introducing transparent and modern professional management systems. Similar to Welch's method of differentiation of 20:70:10, Basil is known to cleanse the hospital of non-performers, nurture young and fresh talent, give appraisals based on performance and does not mince words. He has adopted the same set of reforms at the other 14 hospitals that he manages.

What makes Basil's odyssey interesting is the professional risk that he took in April 2002 (he was 43 then) by joining Manipal Hospital, Bangalore, which had a reputation for its cold, indifferent employees than for advanced care. Doctors kept patients waiting for hours, employees did not exude empathy towards patients, delays at various counters were frequent, infrastructural issues like poor air conditioning and lack of cleanliness were prominent, while senior administrators would play up by skipping visits.

In short, it functioned like an apathetic Government hospital. And Basil knew all this through his personal experience of earlier visits to the hospital.

As the then VP of Wipro GE, he had numerous choices before him. But he joined Manipal Hospital for the sheer challenge that it offered him. "After completing ten years in Wipro, I wanted to work in another industry. When the Manipal job was offered, I took a year to make up my mind. I always saw the opportunity in healthcare to transform and I wanted to lead the change. In that way, I am a reformist," says Basil.

The Plunger

For starters, he made every business transaction transparent, everybody accountable, changed the doctor-driven hospital to systems-driven, introduced morning and evening OPDs for convenience of office-goers and kept the hospital open on Sundays and public holidays. He made it clear that the regime of deification of doctors was over; it is the era of accountability and patient-friendliness. Everybody was issued notices of punctuality and friendliness. He even installed cameras to check whether employees were treating patients kindly. However, people who were caught on camera being rude to patients did not face punitive action; they were asked to rectify their behaviour.

He elaborates, "The biggest challenge was imbibing organisational thinking in the minds of consultants and to inculcate a feeling of loyalty. Consultants wanted agreement on every point they made. But if I chose to disagree with them, I made them see my point of view. The decisions were always process-driven and patient-centric."

A strict disciplinarian, Basil is also a stickler for punctuality. When he noticed that consultants were seldom coming to the OPD by nine and kept patients waiting, he devised a unique system. "I introduced morning OPDs at 7:30. When consultants said they cannot come at 7:30 because of family engagements, I saw an opportunity of introducing fresh consultants, as old consultants are generally against taking in new ones. Now, if a consultant at nine came late, his patients were seen by those who were managing OPD since 7.30 am. Because of this inherent pressure, consultants became punctual," he elaborates.

Stringent action was taken for bypassing Basil and routing queries, request or disputes, through the management, an old practice among consultants. "Established doctors were against me for not giving in to their ways. I requested the management to allow me to take the final call about every decision that needed to be taken. In any industry, it is important to have one person taking decisions," he asserts.

He even looked at the faulty parking facility at the hospital. Earlier prime spots were kept for hospital employees and patients were asked to park behind the hospital, a service which he outsourced to an agency and ensured that the prime spots were given to patients.

His radical measures created an anti-Basil lobby, which even went up the management. The lobby was soon crushed.

The Reformist & Humanist

Basil with Dr Ranjan Pai, CEO of MEMG

In Basil, there is a rare combination of a tough taskmaster and a humanist. When he sought to remove about a dozen senior consultants and managers, he ensured that they got jobs at some other organisation. "I had to ask them to go as they were not transparent and had an overbearing attitude. I expelled only one. For others, I found alternate jobs," he reasons.

Basil also brought in professionalism by introducing performance appraisal system, along with decent hikes. Earlier, employees were used to receiving trivial hikes.

The humanist in Basil comes to the fore once again, when he makes it a point to attend personal functions of employees in Bangalore. ''My gesture makes employees happy and that motivates them to work sincerely. We also give financial compensation whenever required," he informs.

But travelling 11 days a month, how does he find time to attend functions of over 2,000 employees? "When I cannot do it, I send personal letters," he replies.

Basil started the concept of budgeting for various departments. As expected, people argued that budgets are not a feasible concept in hospitals. "If you have money in the pocket, you would plan and spend it. Budget is planning for the future. Budgeting allowed us to have 44 specialties from the earlier 22," he explains.

He encouraged spending on technology only when necessary.

Moreover, Basil did not approve of the fact that key Manipal consultants practiced in other hospitals, and convinced them to resign from rival organisations. "I travel all over the country and also stay in regular touch with good Indian NRI doctors to attract good professionals," he explains. Poaching is another concept that he does not approve of. "Recently, some cardiologists abruptly left one of our Bangalore hospitals without proper notice. This sudden departure disturbs our work," he avers.

Fruits of Labour

His efforts have borne fruits. While he extended the previous OPD time (9 AM to 5 PM) to new ones (7:30 AM to 8:30 PM), the results were immediate. In the first year itself, corporate clientele grew by 97 per cent.

When Basil joined Manipal, the cumulative losses ran into crores. "In the first year, as the institute started breaking even, we started paying loans on time, suppliers started respecting us and number of patients increased. Employees got more money. Employees who did not own houses, now own one; those who travelled by two wheelers now come in four," he quips.

Along with the growth of the organisation, Basil also witnessed fast growth. From CEO of Manipal Hospitals, Bangalore, he was made Director and CEO of Manipal Health Systems when it was formed. He is now the MD and a member of the MEMG board.

For a man known to speak his mind, those in the know say he is quite pushy with his demands in meetings. "I express with lot of passion and clarity. People who are close know that whatever I express is the truth, there is no vested interest in what I say," he asserts.

How does he handle disagreements with the management? "There has to be a reason for refusing something. I am flexible," he reveals.

As much as he is respected for his professionalism, he is criticised for being unwaveringly aggressive when it comes to competition. When he found some flaws with a health insurance scheme, he created a furore. "There is a basic instinct in me to fight," he laughs and then adds, "When it comes to competition, I believe that competitors are our enemies. Whenever I see something wrong, I feel that you should never shy away and explain. For that particular scheme, I went and met top Government officials and ministers and told them that this is Government money, it should not be used for favouring somebody's own agenda."

His Vision

His vision for Manipal is to widen its presence. "We are looking at Chennai, Kolkata and Delhi, where we already have selected the land in Pitampura. And we are not looking at just Metros, we now have a presence in Vijaywada and are building a hospital in Hunsur," says he. What about Mumbai? Why did their bid at acquiring a 200-bed Mumbai-based hospital fail? "We are still looking around in Mumbai," he says. Even as Basil might leave healthcare industry someday, his initiatives, principles and processes may soon become valuable lessons in managing a hospital.

rita.dutta@expressindia.com