Editorials

Friends, Becoming obese for a human being is natural but making efforts to become lean is essential for good health. So is the same in any business. Costs of marketing, getting a lead, resources traveling to close the deal, redundant work, an unutilized capacity – all will happen by default and these need to be identified by business heads who needs to make it as lean as possible for a long term sustainability of business and the brand. With an enlarging 4G network, paving way for emerging digital India, with more than 500 million youth having a smart phone in hand – all businesses should fantasize and persuade to make their processes lean to reduce the costs of selling and cost of reaching minimized. Imagine what differences portals of marriage or job or travel or a call taxi; for that matter today’s Snapdeal or Flickr or Amazon are doing to our youth (and old)? In an emerging market, with every year millions of youth entering to adulthood, what people did in 1970 to 2000 would be “unbelievable” for those who are in their 20’s. I remember in 1977, the 21 long hours of standing in the queue that I did to get a ticket on the 10th day of the movie, in Coimbatore, when the first movie of Rajnikant, Kamal Hassan and Sridevi hit the screen! Ticket in the counter was 20 paise, and from touts it was Rs. 100. Today ‘my son’ gets a ticket using bookmyshow.com and decides my seat on an android for a movie in which ‘Rajinikant’s son-in-law’ and “Kamalhassan’s daughter” are acting, while we were in a car driving towards the mall! Like all such fields, even healthcare would be different if it explores digital strengths. With 60,000 laboratories in the country, 100 PET-CTs, 5000 MRIs and 8000 CT centers, I clearly see a makemytrip.com and bookmyshow.com kind of revolution in next 5 years to come. I wrote about “Operation Jonk” last month which explains the evil of “Cuts and Commissions” (by the way, all centers found to have got involved in commission system by that sting operation are derecognized for CGHS). Let those who need cuts learn lessons in long run, but we still need to help out those 60 plus % of honest doctors to help their patients to identify “Lean” diagnostic centers for their needs. Imagine a www.bookmyscans.com, which connects all honest diagnostic centers digitally to common man so that their services can be experienced by the one in need for all their diagnostic tests that costs more than Rs. 500, that too without taking any cuts or commissions either from a diagnostic center or from the patient! Also imagine a PET-CT available for Rs. 9999 and a 1.5 Tesla MRI for just Rs. 3999 and a 16-Slice CT for just Rs. 1499. Once it comes to digital, it becomes “Trusted, Truthful, Transparent” and the service providers would lower their rates some more to get an additional patient, if their machines do not have enough scans for the day. They would also declare like in a “hotel reservation page” what is included and what is not. More than anything else, a review – on their experiences “Good or Bad” is possible and it makes the system clean, just, democratic as well as “Rational”. What does bookmyscan bring to the industry? Lean costs for scans. No uncertainty of costs. More confidence on costs of Tesla. More options to choose without pressures. More scans for patients to make better diagnosis. More scans per machine per day. More machines per center to meet the demand. More entrepreneurs per city getting into diagnostic business. Industry becoming organized. Healthy healthcare industry. More than anything else, it would give a better outcome for the society than what Medical Services Amendment Bills dated August 8, 2014 can bring in. Rates should not be decided by diagnostic centers or patients or doctors or even government – it should be optimized by demand and supply by an Intelligent, Transparent, Empowered, Informed and Matured Market. Ache Dhin Aanewale hai! Mr. Modi said it often. It is a positive thinking and hopes of the 8 billion human on this earth since healthcare industry (which is said to be the most corrupt as of today) is going to be single largest industry in the world from 2030 onwards. Await a www.bookmyscans.com kind of diagnostic portal which does not demand money while booking or at any point of time and wins the trust of the common man. You may wonder what revenue is there for it if it does not demand booking money. I do not think Hotmail or Facebook or WhatsApp demanded any money from consumers or users (19 billion USD is what was paid to WhatsApp when it was acquired by Facebook). I keep telling money is a commodity which goes to those who do not demand it and avoids those who shamelessly chase it. In business, the one who wants to lose would get a lot of wealth and those who are scared of loss would certainly lose even their existing wealth. When in doubt, let us trust for all our needs “a click of a mouse or touch of an Android” – I am sure that both health and wealth would improve for next generation. The golden healthcare days are not far away!

I am apolitical. I have not found so far a need to be talking politically and hence remained away from politics. But if I say “Demonetisation” (DEMO) is good, I may be called Pro BJP or Pro Modi. I wish to only talk about this single act of our PM, on November 8th 2016. I saw a Whatsapp message glowing in the smart phone and then in eyes of Mr Vijay Shekar Sharma, Paytm Promoter was sitting, at Trident Hotel, Mumbai. Due to the advent of smart phones, I think 95% of the 500 people in that auditorium came to know the “Dhamaka” Mr Modi had announced. I sent a Whatsapp message to my family group “1000 people who where richer than me till 8.00 pm today, have become poorer than me by this single act of DEMO”. I came out of the event at 10.00 pm and when I sat in my seat, my driver – a simple guy from Uttar Pradesh – felt that he is breaking the news to me and said “Sir, Modi has done a great job. Those who have black money are gone”. I could see brightness in his face and I felt – Yes, that is the mood of middle class and lower middle class on this DEMO.  I did not know much (nor I know now) on what implications it would have on major economic indices like, Inflation, Interest rates, Dollar rates, FDI growth, Investor sentiments, Income tax rates and GDP. But one thing is certain, any change is for good, if we find it difficult to implement. Last 60 years we had been only talking the menace of ‘Black money, corruption and good for common man’ and we could not decide anything seriously for that. I have told by now, in last one year, in 100 talks across the country that culminates to the following, Discuss or Decide. You cannot do both. What is easy to do is not right to do and what is right to do is not easy to do. There is no good decision. There are decisions and they are made “Good” Not taking a decision is crime; Not taking wrong decisions. Risk, if not one cannot get rewards. Bigger the risk, bigger will be the impact. Change will be resisted but be brutal, if the change is for good. Security or Prosperity – one should choose wisely since there is nothing known as “secured prosperity” Like these many such punch lines I have used but this bold decision of Mr Modi makes me remember all of them for his one single act. Now people who have 1000s have no problem. Who have lakhs have some problem. Who have crores have most problems. They are gone for a toss if they had kept it as undeclared cash below the ground or bathroom or roof – just gone! For the first time may be in the history of this generation, all those who felt it is foolish to declare and pay tax, got it all wrong. I too run a business. Almost like any other businessman, in the first 5 years of business life, all advises came to me for decreasing official revenues and increasing potential expenditure to ensure that Tax is not paid. It looked like they were right because 90% of the businessmen appeared to be doing the same. But when the business was growing, it became a big challenge to work 10 hours and plan how to avoid tax for next 6 hours in a 24 hour day. When the business reached 10 crore per annum, it was 15 hours in a day planning to evade tax and thus time available for making revenues came down. Ironically “saving per hour” was running into only 1000s while “making per hour” was running in lakhs. Sleep got disturbed and it looked like undergoing hell in a pursuit to swim against the nature. Then I paid tax, full tax. Many ridiculed me, but it got a value for the company; because paying tax is the only way to earn value for the company. Because there was value in the company, Private Equity wanted my stock. Again my friends advised, do not go for PE, you will lose freedom. I went ahead and it brought the value of my company to 2000 plus crore. Then, I had an option to go for IPO or continue with PE. Many learned friends advised me, once IPO is done, you would lose all freedom. Against all their expectations, Thyrocare was listed on 9th May, 2016 at 3300 crores of Market Cap. In this journey, if today in Indian healthcare categories Thyrocare is in TOP 10 in market cap, it is only because we believe in 3 words – Trust, Truth and Transparency – with customers, doctors, franchisees, employees, vendors and investors. I did find it strange when I paid 250 plus crores tax in last 5 years but now when I see the value – I am happy that I demonetized me and company for unlocking the value in the business. In 2000, after when I intentionally demonetized me, I found many richer than me in healthcare  – but in 2016 once the script hit the NSE – hardly any company moved as fast as us in healthcare in India. Be Demonetized and Be Reenergized.

Anything simplified for common man’s comprehension and consumption becomes a Billion Dollar company; be it Facebook, WhatsApp, Uber, AirBnB, Paytm or any App that occupies a home page. And vise-versa anything complicated for common man’s comprehension and clarity struggles to survive and finally perishes. This is very much possible in healthcare too, which remains and becomes more complicated due to various vertices, technologies, specialization and expertise; more so is Radiology. It is not only complicated to common man but also to doctors to question or understand. I am a PhD having 35 long years of experience in diagnostics, and yet cannot understand why with same PET-CT we make a menu of 20 complicated tests with equally confusing rates. I have been in discussion with many Radiology centers, to explore “PET-CT in a franchisee model”. While alluding on various aspects I asked them in simple terms, what is MSR (Mean Scan Revenue) in 1.5 T MRI. Even those who have 5 plus machines with 10 plus years of experience got “Clean Bowled” for 15 minutes. A few intelligent answered well, while the rest bluntly said, ‘Such a number does not work in Radiology’. It is nothing but revenues in CT for the year divided by number of CT scans done in that year. The ones who do not understand argue that time taken is not same for all scans, or expertise of interpretation costs different for different scans. I am not confused or surprised at all since menu and rates are often cut pasted from neighbors or competitors thinking that they cannot be wrong. Are we medical professionals complicating it to consumers while Taxi drivers have simplified it? At Coimbatore station, I asked the rate of Taxi to a place which was at a distance of just 5 kms,  the driver said, “It is Rs. 300”; then I asked him, “Why so expensive?”. He clearly said – “Gate of the colony is only 5 kms but diameter of that colony is 10 kms. So it could either be 5 kms or even 15 kms based on which end of the colony your house is! We keep our rate to 10 kms average; in some we gain and in some we lose. This is convention here and all Taxis follow it.” It was that simple! Why not we as Radiologists find what is MST – Mean Scan Time and decide a MSR, is my contention. Patient is not going to choose based on the cost like a mobile phone. We have invested 100 crores in PET-CT, on one single technology! We ensured that it does only one test – FDG Whole Body Scan. We did not copy the neighbor and simplified it for doctors. We kept a single MSR based on MST, and also correcting for with or without Contrast at the same rate. We are seeing scans per day ‘Growing’, revenues per day ‘Growing’ and margins too in the shortest span of time. We do what doctors ask without any cost. It is simple now, till conventional diagnostic centers simplify or unclutter, machines will stand without adequate scans and patients will remain without essential scans. It is time to Uberify it. It can change the way in which Radiology is practiced in India; and even Globally!

Friends, I heard the word, Thyroid in 1982 for the first time after reaching adulthood. I was asked in my BARC interview, where is Thyroid and I could not answer. However, I got a job because I answered majority of other questions asked; and was posted in RMC, a division of BARC that was specialising in diagnosis and treatment of Thyroid disorders, in Sept 1982. I got fascinated to read – Anatomy, physiology, biology, biochemistry, biotechnology – all for learning and understanding – Thyroid as an endocrine gland and its relationship with Pituitary and also all living cells in body. That institute permits, facilitates and promotes “Research in Thyroid” and that helped me to do MSc in Thyroid Biochemistry and PhD in Thyroid Pathophysiology – Both from Mumbai University. It says – in 1982 I did not know where is Thyroid, in 1992, I finished my PhD in Thyroid and in 2002, I run world’s Largest Thyroid testing laboratory. My entry into “Thyroid” as domain for learning science and technology while working, and my entry in “Thyroid” as focused business for learning business and growing – is all fortunately – Time and Timing. Let us analyse in what way Thyroid disorders and Thyroid testing technology were unique or demanding. Thyroid hormones were not easy to test in 1995 because it used Radioactivity in the technology (Radioimmunoassay, RIA) which demanded training, licensing and also manual, cumbersome procedures for a pathologist compared to autoanalysers for photometry tests or cell counter for hematology. Also, RIA is a quantitative test (not a qualitative test) that needs calibrators and controls to be run every time even if just 2 samples are to be tested. Without 50 samples in the same batch, testing was proved to be costly without compromising on quality. Problem was Thyroid testing was not as popular as Sugar testing – only 2 samples per day per 5 km radius needed Thyroid testing. Even awareness was too low for Thyroid disorders in 1990s. Thus, laboratory managers had to pool samples for a fortnight or a month – or give it to other laboratories who are pooling for the region. Thus, a support of 50 laboratories were needed for the 100 samples per day for RIA to be a cost-effective method. Instruments were cheaper to buy and maintain, so pooling for 50 labs proved to be viable. Then, came Chemiluminescence based Immunoassay – popularly known as CLIA – a fully automated analyser. This instrument is costly to buy – good and new machine costs around a crore, and to maintain it costs a fortune. It also has a capacity to produce 200 tests per hour. But a limitation now is, it needs 1000 tests per day to make it viable and that needs support of 200 labs without which it is a white elephant. India has as on today around 2500 CLIA analysers. Only 300 of them do more than 2000 tests a day (out of which 80 are with Thyrocare); remaining with national players and some regional players. Also, for hospitals one needs 500 beds to produce 1000 tests per day (if all are forced to undergo Thyroid tests) and hence 100 or less bedded hospitals find it difficult to justify. Thus, the technology is forcing to outsource them from “P” – a laboratory owner who is compelled to pool for producing the prosperity out of the asset. Now comes, where to outsource – Local P or Regional P or National P. Thyroid fortunately is not an acute illness. It is metabolic in nature and thus has enough time. Same day reporting was used as a tool to get a better load – against cost and quality issues. However, customer today has understood quality is more important than speed. There are around 5000 Thyroid testing laboratories in the country in 2016, (it was only 150 in 1995) in which 4000 of them have less than 50 tests per day, 400 of them have 500 tests per day, 40 of them have around 5000 tests per day and only 4 of them have around 50,000 tests per day. Thyrocare, since the focus is on Thyroid, processes in a night around 100,000 thyroid tests. All laboratories fight for Thyroid volumes so much, today TSH has becomes cheaper than blood sugar in many laboratories. In fact the definition goes like this:  “If TSH is single largest in volume” it is called as big laboratory – whereas if “Blood sugar is the single largest in volume” it is said to be a small laboratory. It is not only in India, be it any country – developed or developing – Asians or Americans – in all big laboratories single largest test is “TSH” and that makes – Thyroid as tall as Android. Why only laboratories study the Vendors for their Thyroid volumes – for Siemens or Abbott or Roche or Beckman – all have it leading from front. What makes it so tall is, there are “no” reports, I had read in last 30 years of focused Thyroid journey, that say people die because of Thyroid Dysfunction. Thyroid does a simple job of converting mass into energy in the body. Scientifically – it helps AMP (discharged battery) to become ATP (charged battery) by catalysing phosphorylation (charging). Thus, man becomes stamina less and energy less when Thyroid does not function adequately. In human population, 2% have Thyroid disorders and since the symptoms are vague, we need to screen 20% population to identify this 2% and also because once Thyroid deficiency is seen, there are 90% chances he/she will be lifelong deficient and therefore needs lifelong monitoring too. Any individual goes to a hospital with either metabolic illness, pregnancy, infertility or dozens of other reasons for Thyroid testing. And, Wellness testing means – without Thyroid testing, it is not at all a wellness testing, that is why it occupies an “Android” position. I did focus on Thyroid thinking, that I only know Thyroid, let me do it better – but today a 3300 crore brand in National stock exchange –

Sweet Heart, We did live together for a billion seconds happily. We must be one among the millions if we scale our happiness. I tried to make a list of things that you sacrificed for me, our children, your family, my family, our company, our staff, our franchisees, our vendors, our investors, our friends – the list is too long. Also, you did all of them without expecting back anything. You are one among the rare who considered that there is no world of your own, other than that of the spouse. You were an unending stamina pack, kept flying like a honey bee from floor to floor, building to building, table to table – touching thousands of people in and around Thyrocare with your smiles, files and mails. You did not consume even a 0.1% of wealth and 1% of my time from what you were entitled to. Though on our marriage day, I promised in front of your parents and hundreds of relatives that “we will share equally pains and pleasures”, you with such a broad mind, took vast majority of pains and literally none of the pleasures that we came across. You are the queen bee for Thyrocare still. Be around in floors and rooms, wish and bless hundreds of your children to enjoy their life in and around Thyrocare. Always yours, Velumani Friends, This is about Mrs. Sumathi Velumani. I lost her in Feb. 2016. I wanted to write about her in one of the Healthscreen, but I was not knowing how to start, write and end about such a “Noble Lady”. I, a village born boy, married her, a Mumbai born girl, in 1986, reluctantly. She worked for SBI, while I worked for BARC. We both quit together to start Thyrocare, when our children were of age 5 and 3. If today Thyrocare is a most intelligent laboratory concept in the entire world, for this child, I just gave the sperm and she mothered it – with all that a mother does for a child. Happy Life, Happy children, Happy company, Happy employees, Happy franchisees and our Happy investors and vendors – all enjoyed her warmth, love and affection only till 13.02.2016. She was diagnosed to have a pancreatic cancer on October 2nd, 2015. It just gave her less than 5 months. All the drama and turmoil between Oct. 2015 and Feb. 2016, if I write as a book, it would run into 300 pages, which will expose a lot in our medical oncology – innocence, complacence, arrogance, fallacies, greed, lies, politics, economy, claims, costs, frauds, failures, etc. I hope I would one day have time to write that book. All what I can say is she came up to my working table, while she was leaving for the surgery, and waited for 30 secs for me to take off my eyes from a file I was perusing, she looked at me, smiled and said a “bye”, I said – “Take care”- without knowing that it was her last “Bye”. She walked into a leading hospital in Bombay for a ‘whipple surgery’ and what I got back was only her body. Thyrocare was collapsed literally, but for only one day, that was Sunday 14th Feb to salute that ‘Mother’ of Thyrocare. But we all know, the mission is much bigger than the creators, and in this last 2 quarters we have done much better business than any time in the past. She taught us how to enjoy pains and frugality. We are now masters in that and we started enjoying both pains and frugality on our own, to give Thyrocare the ultimate position and height it deserves. I wish to thank all those who stood with me, with us, for the last 6 months, at our worst time of grief. Indebted.

Dr Arvind Lal, Congratulations. Dr Lal Path Lab Limited, Delhi based pathology laboratory (LPL), the senior most player in the space, the most profitable in the laboratory industry has become a public listed company in December – 2015. In Indian healthcare industry, there was no listed company in Diagnostic space till date and hence LPL becomes the first Indian public listed company, with a value of approximately 1 Billion USD. The IPO which was made for giving exit to existing investors got over-subscribed 33 times.   For all in healthcare space that should come as happy news because this says how eager, keen and crazy are investing community in this space. Single factor that motivates is the multiples that a pathology laboratory has which is much more than that of a hospital. The valuation expectation by the company, though many say is in higher side, it is proved to be fair or under-valued by the company proved by the fact that share prices went up by 50% within 2 days after the opening day. What does this say – Dr Arvind Lal diluted the company in right time with right kind of investors who added value to board, a right CEO who added strategies for growth and in 5 years, it made every effort to retain its number 1 position and also chose a right time to come to market and en-cashed the best out of the industry to lead the industry for decades. I wish to congratulate the entire team in LPL for having reached there. No doubt, all was worth waiting for more than 7 decades to ring the bell at Stock Exchange. What is good about this space according to investors? ROCE – Return On Capital Employed is the most attractive in this space of healthcare (unlike Radiology or Hospital space) and it has great future. They see clearly what prosperity lies when the mean age moves from 28 to 38 in next 20 years in India.  Going to public in healthcare would become very motivating and we see two Bangalore based hospitals already there. Narayana Hirudhyalaya, inspite of an able and visionary leader could get only 3 times oversubscribed and is yet to ring the bell in stock exchange (while I write this). Another hospital, HCG Oncology run by a dynamic leader, Dr. Ajay Kumar is waiting for a new year to take the runway. Both are hospitals and when we discuss with investors, they say – multiples are less for hospitals compared to pathology laboratories. Again the reason is nature of business that demands a huge capex. ROCE is not impressive they say. What is now expected? Not in ours, in every industry, people follow successful models and strategies. Though it took many decades to see the first listed entity, there would be 10 listed companies in pathology space in just 5 years.  Even a small laboratory, with a CEO who can take risk can go ahead and create an impressive business model or agenda, with the right kind of “IT, HR and Logistics”. Once he is seen growing, investors would give funds to fuel growth and he can become a state player with a 20 to 30 crore turnover. Then next round of funding can take him to a national level. I personally see many with space, knowledge and capacity to become national, but almost all of them are risk averse. My Inputs for emerging CEOs of laboratories: “Jo Khona Chahta hai Woh khabhi Kuch Khota Nahi. Lekin, jo Khonese darta hai – Woh kuch Paata nahi.” In English – “Those who want to lose will never lose but those who are afraid of loss will never gain”. And also I want to say, “Romance with Risk – it pays; but if you “Risk with Romance – it would be costly” Focus, Learn, Grow and Enjoy. I wish all a very Happy and Prosperous 2016.

Dear Friends, Recently a colleague of mine passed on to me a You tube link which was about a sting operation conducted by a TV channel, in the name of “Operation Jonk”. It had 4 to 6 “live” episodes each spanning to 20-30 minutes and more thrilling to watch, than many stunt movies! The prime focus was to throw light on namely four or five, big diagnostic centres (that do PET-CT in Delhi) as to how they operate. No shame! No reluctance! It is open! Not only that, they assure the doctor, “You do not worry. We have a perfect system in place. We have thousands of doctors in our list. All are safe”. The height is, the doctor is also advised, “you can reject our competitors’ scans as substandard and ask them to come to us only”. It is this “hurricane” that ate many more lives than the diseases or nature could. In my last 19 years of business, not less than 80% of our franchisees and 5% of patients have complained to me, verbally or through mails that, “Consultant has thrown the report on the face of the patient, as soon as our “Logo” is seen. It means even before looking at the numbers in the report, it was rejected”. I knew what it meant. Obviously innocent patients, who consider doctor as God, cannot imagine that God could be biased to a brand due to commissions. This was happening in Thyroid Testing reports from 1996 till 2005. Though slowly over the years, percentages of such complaints have reduced. Like how 3.0 Tesla MRI is demanding an unjustified premium, Chemiluminescence (CLIA) was demanding a premium and the Noble Prize winning (in 1959) Radioimmunoassay(RIA) Technology was belittled and also ridiculed. In the year 2003, in frustration, I gave up RIA (with great pain) and brought in CLIA. Though costlier, I did not increase the cost and got out of that “stigma” created by “hurricane” community. Hence, I can understand what this TV channel says, means and communicates on MRI or PET-CT scans or Vitamin D mania! I do not know where I got the courage to declare countrywide, in 1996, that the Thyroid Testing is only Rs. 250 when all players evolving around this “hurricane” (intentionally or accidentally or unknowingly or by miscalculation), were charging anywhere between Rs. 600 and Rs. 1000. Against all propaganda against me by those who felt insecure (I called it as marketing done for me) I made it as world’s largest Thyroid Testing laboratory in just 10 years, simply because this country has still 33% doctors who are absolutely honest. Be it Punjab or Kerala, Gujarat or Assam, this 33% of honest doctors want all benefits going to their patients. You must be wondering about the remaining 67%. It is unfortunate that, 33% do not sleep if they do not get their promised share in their pockets, even if it is from their kith and kin! That leaves the remaining 34% who would take if given a small percentage or in kind, only if given, but would never demand. Thus, it is this 33% who are in this “hurricane,” spoiling the reputation of the entire fraternity. The diagnostic centers who have seen it working dared to send TDS cut cheques to innocent consultants too. A few months back one diagnostic center in Mumbai got cornered, when the concerned honest and courageous consultant forwarded the cheque sent by them to MCI to explain or understand or act. In the year 2013, I again had to decide, this time, the price for my PET-CT scan. When everyone was charging anywhere between Rs. 18,000 and Rs. 30,000, I thought, I can make a decent business even if I charge Rs. 9999. (Knowing fully well it is costly because like MRI, PET-CT is also in the next “hurricane”). Predictably, I started getting complaints, “consultants are throwing the reports on the face at the sight of the logo”. I did not get discouraged because it is the same PET-CT machine they are also using. In fact, the quality cannot be spoilt, even if I intended to, technology is such. My heart and family said “Lage Raho”. Within 5 months of launching our Delhi center, we have crossed already 30 scans per day, whilst majority of those in the core of this “hurricane” surprisingly do only 4 to 6 scans/day even after 5 years of starting! If my Delhi operations in PET-CT is more successful than our Mumbai, it says either Delhi patients are affected more by real cancer or artificial cancer. Fortunately, things are changing and it should change faster in the years to come. It definitely has to be cleansed but would not happen over night. It is just not in India, but the world over too. At this rate it would take nothing less than 99 years to bring down this 33% to 3%. I do not know, whether this evil (like dowry) it is created by the giver or taker, but it would certainly be undone. Have a look at these atrocities by looking up “Operation Jonk” on You tube. I only hope that they do not pay crores to remove it before you even have a chance look at it. Again I say “Thrilling”!

After an enriching and exciting trip to Japan, I have a breather to write about my visit to Sysmex, head quartered in Kobe renowned worldwide for the finest in quality, innovative diagnostic equipment and reagents in Hematology for four decades. I landed at Kasai International Airport Japan, from where Kobe was an hour’s drive. We visited its Kakogawa Factory for Tour. Largely ladies, employed from a radius of 10 kms, the work force had a headset, which was guiding them to do the steps one by one in assembling a 3 or 5 part analyzers. Large floors, huge resources and organized assembling in that building is now reaching its fifth decade. After the tour of an hour understanding the factory we headed our way from the Solution Center, which was a huge facility. From the presentation that was done, I understood that, in US, Sysmex was in number two position, three years back, currently, they lead the table. For Sysmex, hematology is core business accounts for 80% of their total business and is present in most countries across the world. In India, Sysmex hematology analyzers has been present for more than 25 years, through Transasia headed by Mr. Suresh Vazirani and I am given to understand that reagents for India are made in India by Sysmex. We have in our floor 7 machines (XN–1000) and are happy about their performances. In Kobe Japan, we were taken to Sysmex Techno Park, their their core R&D division established on the 40th anniversary of the company with the state of art facilities to curate their rich technological heritage and the future advancements. I was amazed to see their ability to keep books and posters for 30 different scientific disciplines in 20 different languages. I picked up books (weighing 10 kgs) from that display (any visitor is given a bag and asked to choose what they would like to take). Highlight of the trip was the team which went together to Japan. Mr. Anil Prabhakaran, the MD of Sysmex India, tried for first time that no one in this industry tried in the past. He invited heads of all the four big laboratories (head on competitors) to come together for the visit. In this Dr. Arvind Lal, the veteran could not join since he had some domestic commitments. But other three Dr. Sushil Shah, Chairman of Metropolis, Dr. Avinash Phadke Director SRL and myself together were in this trip for four days. Since big laboratory players from emerging market like India were in their premises, they asked us to make a presentation of 20 minutes each to their employees on what works in India and in some emerging markets where Indian laboratories are active. Post lecture, the elaborate, customary, Tea Ceremony was a new learning for me. After an intellectually stimulating session we were taken for a tour through the Techno Park that offers a platform for all the scientists and engineers all over the world to exchange knowledge for further advancements in the technology. Dinner was hosted by Chairman, Board of Directors of Sysmex, at Minato Ijin-kan, Kobe which in Japanese means foreigners abode a beautiful wooden house of Sysmex to host special visitors little away from the main land. During dinner, the communication to decision makers in Sysmex was, India is a: Cost conscious market. Quality conscious market Volume generating market. Patient pays 95% from his pocket, a non-insurance market No support from government, as an industry. Sysmex understands and acknowledged the complexities of Indian market and has commitment to continue to be leader in India and world wide. We were taken to Kyoto since we wanted to visit a couple of the big Japanese Laboratories to understand how they work. We first visited FALCO Bio Systems. They have a laboratory of around 1,00,000 sq. feet, with more machines and less men, fully automated commercial laboratory, working in similar lines of how Thyrocare does, but has all laboratory disciplines from microbiology to molecular biology. It does in a day around 50,000 specimens and 2,00,000 investigations and interestingly TSH is the single largest test for them too! The second visit was to Kyoto Hospital yet another large customer of Sysmex. FALCO Bio Systems did not have a track while this one had a good track system supported by high end analyzers. Obviously automations and track systems were far ahead of that in India. In other words, mean age of Japan is 15 years more than India while their technologies are 10 years ahead of us. (Considering an average Indian laboratory). Interesting fact to be noted from the diagnostics world is, be it in vitro or in vivo, 50% comes from Europe, 22% comes from America, 20% comes from Japan, 8% is contributed by rest of the world. In other words, 10% of population supplying to 90% of the world and it is now 50 years. Mindray, the Chinese fast growing brand is latest in this domain but their aggression rd brings them to 3rd position in hematology. What is interesting, only Hematology is the fastest growing discipline in a laboratory and R & D in this field by the players is motivating while the race is on, between the three main players globally, Sysmex, Coulter and Mindray.

Dear Friends, Understanding the HR capabilities is a challenge for all Employers. Also understanding what the company needs is a challenge for all the employees. I will give a simple way of analysing the above two things. Man has many attributes and let us first see what all he can do: Think   – Think different to make execution of challenges error free and stress free. Teach   – Teach on a subject, with clarity in English and emotions in words. Work   – Physical work – Coding or pasting or testing – and pursue till it is completed. Write  – Write on paper, stories about test or technologies or companies or concepts   or personalities. Walk   – Walk hours and kilometers – to meet people who need our services. Analyze – Analyse a situation or mail or a file or an excel data – to explain blocks, bottle- necks, needs and can diagnose failures and success. Compile – Compiling the needed, relevant and crisp data for studying about success    or failures or projects or purchase or complaints. Watch – Watching what or why or how – people or process or machines – function   and suggest ways of improving them for better productivity. Listen  – Listen patiently for 500 secs to know which 10 secs are communicating the exact problem and solve or pacify or explain for distress or complain. Lead    – Lead a given team for a given task with clarity on what is needed and within the given time frame. Follow – Follow the team leader without questioning, obediently, disciplined with an objective to end the task with more contribution than the peers in the team. Speak  – Speak confidently with limited knowledge, with clarity to a visitor or stranger or vendor- where  you  sound  like  you  only  created  the  entire organisation. Thus there are dozen things an employee can do. But one can do 1 or 2 or 3 only. Also an organisation needs all the dozen things but not all the 12 from the same man. You could study or assess or analyse your strengths. Or discuss with your friends or superiors. Are you doing what you are capable of or good at or enjoy with? Think. Who knows you may be Mr Chetan Bhagat if you can write or may become Mr. Shiv Khera if you can teach. “Keep thinking till you grow better than your peers.”