Day 8: Ganga Style
Monday
We left the Hill Station at around 830am. We drove for about five hours to the town Coimbatore.
The scene that we saw when starting out it in Kodai Canal and ending up in Coimbatore was very striking. We literally went from dense forests and one windy road to slums and crazy taxi drivers. We wouldn’t have come to Coimbatore had there not been Ganga Hospital. As I told you before, both of my parents are doctors, so this trip we are going to be visiting several medical facilities’. We all ready experienced the story around Aravind, but now we are headed to the massive Hospital called Ganga.
At first I didn’t know what to expect. I did know what kind of innovation (if any) was going on in this facility. On the outside, the hospital look pretty ordinary. Seven stories, whitewashed brick that was turning brown over age. With meager windows, this building looked like an arbitrary hospital. This, I would soon find, was not the case.
Upon entrance, a woman with a clipboard tapped Heather on the shoulder, asking her if she was Lisa Reynolds. She was not, but Lisa was not far away. We followed the woman through the waiting room and into a small office where we would find a man-lacking much hair-in a dress shirt and tie over which he wore a pristine white lab coat. Stitched onto the lapel of his coat was his name: Dr. Sababathay.
Dr. Sababathay is the man who runs Ganga Hospital. His grandfather is Mr. Ganga. Mr. Ganga son- Sababathay’s father-started the hospital in the early 70s. It started out as a sixteen bed emergency care unit. Now-forty years later-Ganga is a 450 bed Hospital.
The first place that Raja Sababathay led us to the cafeteria. Let me tell you this much: food is not a large part of Ganga’s budget. However, it was interesting to see that in an American hospital the food consist of:
1. Biscuits and gravy (a favorite among my grandfather)
2. Bacon and eggs
3. Hamburgers
4. More crappy and very unhealthy American food
Although the food in Ganga was not great by any means, it was much healthier the then food that you will find in any cafeteria in the States.
We left the cafeteria and followed Raja to a large conference room where we would be discussing Ganga’s business model for the next two and a half-three hours. What is Ganga’s Business model, one might ask?
In a nutshell (like Aravind) this is Ganga’s model:
1. High quality care
2. Affordable price
Ganga’s Quality of Care:
Out of about 2500 people that, there is a .001% chance of failure. This is an extremely low number. This kind of quality makes Ganga a go to spot for people all across India to visit if they have a problem.
Affordable Price
Like Aravind, Ganga’s main objective is to see you. If you are in need of care, you will be seen no matter your socioeconomics. If you can’t pay, don’t. If you can, pay as much as you can. If you can pay the total amount (which-mind you-is lower than really anywhere else in India) then pay the whole amount. About 10% of all patients pay nothing, 35% pay some portion of the recommended cost, and then 50% of people pay the full recommended. Like I said above, the recommended price is one of the lowest prices in the market place.
So. Now that I told you about Ganga’s business model, now it is time to learn about what makes Ganga work. How is Ganga able to provide top of the line care at bottom of the line price range? Ganga did something that all great business do. They came up with a group of ideals. A style that allows the Ganga model to work. It is called “Ganga Style.”
Ganga Style is a way of thinking. Here are some other ‘ways of thinking’ Ganga Style brings to the hospital:
1. Don’t change what can’t be changed. Change everything else. Things that don’t need innovating on, don’t. Things that can be innovated on, innovate the hell out of it. For example, in the rooms lie all the top class gear (the same gear you would find in the States). Hp and Sony electronics, Dodson lights, (etc.) this stuff doesn’t need to be innovated on. But everything else, (i.e. patients flow, turnover time, recover time) needs that innovation. For example, while all the other Hospitals on the Indian market spend so many resources on finding sterile, clean water, Ganga sterilizes their own water in house using UV to kill the bacteria. This way of thinking keeps Ganga on track with what is really important spending resources on and what’s not. This prevents them from becoming caught up in their undies-as my Mom would say.
2. This job is great for some, but not for others + The top 10%. This first idea has to do with the hiring process. Ganga Hospital realizes that for some people in the workforce, working at Ganga is an awesome opportunity. You can earn a good wage, be part of an innovative care center, and truly day in day out help many people in a huge way. However, for some, working at Ganga is not a good opportunity. They want to be a bigger fish a smaller pond. They want to be part of a Doctor based practice, not a patient based practice like Ganga. Instead of trying to hire anybody who they think on the outside is a good fit, Ganga has a training program that is open to foreigners (foreign doctors). If Ganga sees a particular person as good fit for the Hospital, then they will ask the person to stay on the training program for another year. If after this time the person and the Hospital agree that it is a good fit, then the person is hired on. This allows the person and the business to test drive weather or not this is a good hire. After all, good people will make or break a company. The 10% idea is that 10% o of all of Ganga’s people would be willing to go to the facility at any time to see a patient who lost their scalp in a machinery accident. “This 10% number is a good number,” says Raja, “because you have to have people in your company who are willing to drop anything and work. But you don’t want too many people to come at a drop of a pin because then you will have too many people on your hands.” Raja went on to say that the willingness to go to the office and help others at any time of the day no matter the personal loss is something you can’t teach and can’t even reward. It is in these people’s veins.”
3. Volume, volume, volume, and then some volume. The key to the Ganga model of high quality for little is volume. Every year, Ganga Hospital sees 900 people. A large majority of these visits are surgeries. On a 25% margin, the only way to make the scenario work is do a lot of surgeries.
4. Availability then Ability then Affability. The “triple A” model is the idea that the most important thing is Availability. You can be the best practices in the world but if no one can reach you, then what is it for? On the other hand, you can be extremely available, but in order to actually be able to help people you have to be able. However, the way you receive lots of return visits is by being kind (affable). If you can do the three As well, then Raja says you will be great.
After Raja finished talking to us about the model, he brought us to the gnarly part: the photos. On the screen he showed us severed hand that then were reattached to the arm. He showed us legs that were missing chunks then being grafted back onto the person. He showed us countless other cringing photos before he-in his mind-decided that we were all ready for the big step.
Raja told us to follow him. He led us through the halls of the hospital. Then he told us to split up the women and the men. We followed him to a changing room were we put on scrubs and a hat and mask. The scrubs were just a tad bit big, but I wasn’t complaining. I like tunics and baggy sweat pants.
We met the women outside a surgery room. Through the window I could four people operating through on a man. Raja tried to get one of the nurse’s attention. Once the nurse saw him, she smiled and then opened the door for us.
We walked inside, and my dad instructed me to be silent. We walked to the bed and I quickly saw the bucket of bloody gauze. The surgeons were operating on a man who was missing part of his foot. The bloody heel was being sewed up by tiny that were only seen under a magnifying scope
I had never witnessed a surgery first hand. Being in a room where someones life on the line and seeing six or seven people putting in sweat and tears (no need to put in blodd) to help someone was an amazing feeling. These people are doing Yahweh’s work (btw this expression is way underused).
Ganga Medical Centre
Ganga Medical Centre
Today was one of the best days I had had so far on the trip because I learned so much and saw so much. I can describe to you the surgery scene as many times as you wish but it will never come close to the feelings of being in that room.
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