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Hot Seat
The Enterprising Entrepreneur
Dr Dharmindra Nagar, MD, Paras Hospitals, Gurgaon
returned to India from England to follow a different path from his peers, that
of an entrepreneur. He shares his learnings and vision with Rita Dutta
 Call
it patriotism or returning to roots, many cash-rich NRI doctors after relishing
a fulfilling career abroad wish to return to their motherland to continue in
the same field. Dr Dharmindra Nagar, MD and Chairman of Paras Hospitals, however,
left England in 2003 to carve his career in the Indian healthcare industry as
an entrepreneur.
Despite his deep love and fondness for London, Dr Nagar was determined to make
the journey back home. "It was never a question of ‘if’ I would
come back, it was more of ‘when’ I would come back," he reveals,
sitting in the 250-bed hospital at Gurgaon, sprawling over two lakh square feet.
Propelled by this leader's unswerving zeal and passion, the Hospital, which
was set up a year ago, has attained operational breakeven in the ninth month
of its operations.
Back-end Background
The seeds of Dr Nagar's entrepreneurship were sown in London. He had initially
gone there to do PLAB, before moving to work as an SHO in West Middlesex Hospital.
He nurtured a dream of becoming an accomplished physician, but soon realised
that medicine was not his calling. "After practising as a junior doctor
in England, I realised that I was not going to become a great doctor, and had
no intention to continue as a mediocre one. This was followed by the realisation
that I was more interested in the back-end of the hospital than the front end.
I was curious about how medicine was delivered to the ward, who was delivering
it, what was the role of the pharmacists, structure of the national health services
and its organisation," recollects the soft-spoken leader.
After he understood what his inclinations and forte were, the astute Dr Nagar
immediately enrolled in Imperial College, London, to study health systems and
hospital management. Much like his father, who founded Paras Dairy in India,
Dr Nagar put his entrepreneurial skills to the test. In 1998, he started his
first entrepreneurial venture with a group of friends in London. The plan was
to set up a chain of six lasik eye surgery centres, with Dr Nagar as a 60 per
cent stakeholder.
Lessons Learnt
But the young and inexperienced entrepreneur burnt his fingers badly. Neither
was the market ready for a new chain of lasik eye centres, nor did the group
share the same passion, nor was the approval from the Government for the proposed
centre in Richmond, West London granted.
"After waiting for nine months, when the permission was rejected, I learned
many important lessons in business," he says. The lessons he learned were
to analyse the market before you start a venture, to team up with the right
set of people and never wait for a single opportunity to materialise. Rather
than being disheartened, Dr Nagar quickly moved on. Perhaps it was this debacle
that strengthened his determination to become a successful entrepreneur.
Accountable Above All
He came back to India full of optimism and fresh ideas. He wished to sculpt
a modern corporate hospital that would be managed efficiently and thus would
deliver healthcare at an affordable cost.
He started scouting for land in NCR, as his roots, business, interests—both
social and political (one of his brothers is an MP)—lie in that area. After
having a feasibility study of the healthcare market done by Medicontrivers,
he looked for land in Ghaziabad, Noida and Gurgoan. "It was just that the
opportunity for Gurgaon arose first and we acquired the land," explains
Dr Nagar.
Unlike other groups, he did not buy the land at a discount.
"I wanted to build a corporate hospital that was accountable and thus did
not wish to get into the trend of getting discounted land from the Government.
I foresaw that the Government would soon clamp down on this trend," he
states. The only help he claims to have taken was from his brother Harinder,
MD, Paras Buildtech to locate the right land. The fund of Rs 70 crore required
for his dream project was managed by a Debt Equity Ratio of 2:1.
 This
suave leader was born in Gulaothi village in Ghaziabad in 1970. The large
family of six brothers and four sisters is close-knit. Dr Nagar declares
that playing with his nieces is one activity that he enjoys a lot. With
his father Vedram Nagar being an entrepreneur in dairy and setting up one
of the largest private diary development firms, he had a happy childhood
without any financial constraints.
His father and eldest brother, the Chairman of
Paras Dairy, have influenced him in more ways than one. "My father,
who could not complete his education because of my grandfather's early
death, was a self-made man. He single-handedly founded Paras Dairy. Though
he was quite a successful businessman, he was equally at ease with rich
businessmen, politicians and poor villagers," recollects Dr Nagar.
He has fond memories of spending summers in the
mango orchards and diving in the ponds with his siblings. "I am close
to my roots and often go to our village house and meet our extended family,"
says Dr Nagar. He did his schooling from GMFCH in Mussoorie, MBBS from
JJ Medical College of Mysore University, and residency in Safdarjung Medical
College, Delhi, before he went to England. In 1999, he married his classmate
Dr Gurdeep. The couple is blessed with a beautiful three-year-old daughter
Ranya.
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Essentials of an Entrepreneur
Peter Drucker had once said that innovation is the specific instrument of entrepreneurship...the
act that endows resources with a new capacity to create wealth.
So, what are the attributes of a successful entrepreneur, according to Dr Nagar?
"First, he should know what he wants and be passionate about his goal.
Unless the leader is passionate, he cannot motivate and convince others,"
he elaborates.
"Second, he should have a thorough understanding of the business. It is
desirable for one to have qualification or experience in the field one is entering,"
he elucidates. He rates risk-taking ability as another essential attribute.
"By that I don't mean impulsive decisions, but taking studied and calculated
risks," he says. As an entrepreneur, he showed courage when he dared to
venture into the Gurgaon market with the full knowledge that other healthcare
giants had already set their eyes on the same market. A healthcare player even
displayed a hoarding, just 800 yards away from Paras, about an upcoming hospital.
"But as is the case with most Indian players, most did not materialise
eventually," he says, gleefully.
Anyway, he has never cared a hoot about competing with the
big players. "If Richard Branson could take Virgin Airlines to the zenith
of success as a new entrant, I believe anybody can make a new venture successful,"
he states. And lastly, one should choose to work with the right set of people,
he suggests. "Building a team who shares your passion and conviction is
essential and also very difficult. I took a lot of time to do that in my Hospital,"
he shares.
 Hobby:
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One-man Show
Dr Nagar during the inauguration of the blood bank |
Dr Nagar, who is 100 per cent owner of Paras Hospitals, puts
in 16 hours a day at work, dabbling in all aspects of hospital functioning—administration,
planning or strategy. Why does he not believe in delegation, I ask. "You
may say that I am the acting CEO. Actually, right now, I am the most qualified
person to do the job. Also, I am the most qualified promoter in healthcare,"
he beams, at the risk of sounding arrogant. But this is no bragging. Despite
his command over various aspects of healthcare management and business, this
leader regularly undergoes training programmes in healthcare. Even after starting
the Hospital, he did MPhil from BITS, Pilani in 2004-05.
He insists that he holds the reins of everything, as he wants to learn about
every facet of this business. "And, of course, I have my vision to fulfil.
I think I am quite possessive about my vision," he divulges. After a brief
pause, he says often in the team meet he motivates his group by saying that
they should excel enough to make him redundant. "I have told three people
in my Hospital that they can become the CEO. Let's see who scales up,"
says the strategist. Then casting a long glance out of the window, he muses,
"A few years down the line, I don't see myself doing the same kind of work.
Then, I would concentrate more on expanding the business."
He is also a meticulous and methodical planner. Proof of this is the fact that
he took two-and-a-half years just to plan and design the Hospital. He still
regrets not having enough time to plan various aspects of the Hospital architecture,
like paintings, colour schemes and a clear demarcation of various zones. "I
will address them in future projects," he hopes. In another instance, he
took almost a year to come out with the tagline for the Hospital—'Partners
for Health'. "Yes, I considered a hundred taglines and finally settled
for the current one, when I was convinced about its significance," he says.
Against the Current Craze
Architecture being one of his pet topics, he dismisses the current craze for
glass buildings and decorated ambience. He rather lays emphasis on patient convenience.
"You may have noticed our building does not look that flashy from outside.
I believe in European conservativeness than American flashiness," he says.
According to him, Fortis Mohali has an appealing architecture.
He is completely averse to using glass for hospital buildings. "Using glass
leads to increase in temperature requiring more ACs and thus costing more. It
should only be allowed in places which already have a soothing atmosphere."
The architecture of the Hospital is unique as there is ample light in all sections.
The traffic flow is segregated in different sections: day care, critical care
and wards.
While building the OPD consultation rooms, he nixed the convention of having
a table between the consultant and the patient as he felt that the setting needed
to be less formal. "When you have a table, most of the time, the doctors
are in the dominating position. I wanted that barrier to go and the communication
to be more free," he explains. Of course, his ideas were mostly met with
doubt and scorn. "People would feel that this guy from England is coming
up with weird ideas, but I always stood my ground and knew what I wanted,"
he states.
Protecting Privacy
Another unique aspect that he introduced in the Hospital is the way patient
rooms were designed. No two doors of these rooms face each other—they face
either a wall or service area. "It is a transgression of privacy of the
patients when the doors face each other. We did this even at the cost of losing
crucial space," he opines. While most hospitals are reluctant to spend
on marketing, Dr Nagar once again stands out because of his belief in spending
substantial amounts in marketing. The stretch leading to the Hospital is dotted
with innumerable hospital hoardings. "Though most hospitals spend around
one per cent of the hospital budget on marketing, I strongly believe that it
has to be increased to around three to four per cent," he says. Besides
print and radio, where hospitals are already advertising, he feels that the
next medium that the industry would target is regional channels in television.
However, he quickly points out that he is a conservative marketer. "Only
when the Hospital was ready by 50 per cent did I let people know. I opened the
doors to the media for this Hospital, only when I was sure that the product
was close to what I had visualised," he informs. He then adds, "I
believe in doing and then talking. Sadly, in India people talk about projects
that never fructify, just to gain publicity."
Proud of his Roots
He says his rural background has helped him in his appreciation of the fact
that his role as a business leader should not limit his social responsibilities.
Thus, he subsidises treatment for children with the help of two NGOs. When abandoned
babies need medical help, Paras Hospital provides it. "We waive off 50
per cent and 50 per cent is borne by them," he reveals.
Proudly wearing his rural badge, he claims that he often subsidises the treatment
of rural patients on a need basis. "After checking the authenticity of
the cases, we provide subsidies. Whatever charges can be waived from the Hospital's
side, we do that. We just let the doctors charge," he says.
New Summits to Scale
If he has achieved his long-cherished dream at the age of 37, then what more
is there to look forward to? Dr Nagar is in the throes of a new set of projects
and expansion. At the current facility, he is looking at introducing interventional
cardiology and onco-surgery. In the pipeline is another super speciality centre
in NCR, the land for which (two acres) has already been acquired. It would be
around 300 beds and construction would start next year and be commissioned in
18 months. The funds for the over Rs 100-crore project would come from private
equity and FIs. "I am looking at firms who would add value in terms of
improving our operational efficiency with their expertise in healthcare or managed
by people with healthcare background. That way, they can work out benchmarks
for us," he reveals. Five years from now, he wants to be perceived as a
respected top-line healthcare professional, having built an empire of at least
2,000 beds across India. He would expand via a mix of greenfield and acquisitions.
Like a true entrepreneur, he is always looking for newer opportunities to tap
and newer challenges to take on.
rita.dutta@expressindia.com
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