Visit to Aravind eyecare, Madurai Nov 22

With Dr. Kim, second from left, seating

 

After about 6 months of communication, planning etc, the MBA students and faculty of Alliance school of business Bangalore spent a busy 2 days visiting Aravind Madurai on 17 and 18th November 2022. We are back at our Bangalore campus and the 28 students from BBA, MBA sem1 and sem3 are back in hostels etc.

Madurai is an ancient temple town in South India on the banks of Vaigai river with a history that could be traced two thousand five hundred years back to the times when Ashoka ruled parts of India, and Homer, Greek philosophers and mathematicians were busy laying the foundations of the western civilisation.  Even Chennai, the capital city of Tamil Nadu does not have a history of more than three hundred and eighty years. 

The students learned a lot in this visit to Madurai. Prof. Ananth was a great help in our interactions with the employees and public in Madurai. Thanks a lot to Aravind for the terrific care and professional approach. Everything at Aravind went according to clockwork precision and that speaks why Aravind is world-class.

An engrossed and  captivated audience

Great hospitality, practical exposure to the hospital operations and great knowledge transfer was evident. We will treasure this visit throughout our lives. The following points are worth noting.

 

We really appreciate the way Aravind planned this visit by our business school and how they executed it with precision and finesse. Though we reached our Guest house rooms at 3 AM in the morning of 18 Nov, we immediately settled in our rooms, which were very clean, neat, quite spacious and available at very reasonable rates. Right from the word go, it was professionalism in the conduct of the session from 9 am on 18 November. Parallel to our session, there was another session, a 3 day workshop that was also being organised for health workers in another part of the building.

Inside the Madurai Meenakshi temple ..

Upto 11 am, we had interesting talks with the senior leaders of Aravind and immediately after coffee, we were divided into 4 groups and taken around the free and paying facility of the hospital. We were given a theme and had to move around the hospital  in the registration, paid and unpaid sections, paediatric section and the different departments to observe and make points for the post lunch discussions and presentation from 2 to 4 pm.

Management  Information Systems were implemented in Aravind in the early 90s. They were far ahead of the competition in data analysis. The in-house planning for the daily out patient consultation and surgeries for two months in advance at Aravind, enabled by excellent forecasting is a great help and support for Aravind planners, to plan for how many doctors to have each day in the OP division.

 

A good thing we observed at Aravind is the absence of an appointment booking system. In my visits to the country's second top medical college, CMC Vellore, the patient bookings are done at least 2 -3 months in advance. Any emergency patient has to beg, plead and make his or her way through the hospital bureaucracy to get to see the top doctors at other major hospitals. That is not the case at Aravind. Any patient who is in need of medical help, be he influential or not, can come to the hospital anytime between 8 and 6 pm on any day and he will be seen, irrespective of whether the doctors are busy or there are excessive patients and so on. The doctors take it as their bounden duty to attend to any needy patient whenever he/she arrives at the facility for help, even outside the office hours. This is a great step to ensure accessibility and reach even to the very poor and dispossessed in the society.

 

Inspiration Hostel, where we stayed

Another interesting observation we made was any person could go to either the paid or free sections at his will. Though the physical facilities at the free section are having less of frills, the doctors kept assuring us that the quality of the medical care that was administered to the patients at both the facilities was the exact same. One should not be surprised to find a patient arriving in a car and then joining the queue at the free counter or a poor patient coming and joining the paid counter. 

 

The story going around tells how the former Indian President, APJ Abdul Kalam when he came to Aravind in his younger days took the great Aravind medical care as a free patient and felt the warmth and professionalism of the Aravind system then.   

7 Principles of Aravind way ..

The other positive point we noticed was the very less throughput time for a patient to walk through the entire system for treatment. Though the patient screening and processing system was world class and very strictly adhered to,  to prevent the issue of patients getting lost or being delayed,  the patients were tagged to a guide, (who is a trained less skilled medical professional) to each patient in the paid section and to 3-4 patients in the free section. This saw that the throughput time for a patient who come to the hospital, register, meet the doctors, get medical advice and leave the system in about three to four hours, all this without the patient appointment system. A clear demonstration of the patient-centric (customer-centric) approach of Aravind. Jeff Bezos of Amazon would definitely have great takeaways from a visit here.

The other major point to be noted is the openness at Aravind. They have the best global systems in place and invite their competition from around the country and the world to come and see their facility and help improve service delivery to the patients. Over 46 years from the start in 1976, we feel,  Aravind never had any great competitor. Though it would be unfair to say, Aravind is its own competition as the ecosystem has not grown professional enough to catch up with the Aravind system, anywhere in the world. Empathy and compassion with the poor and an undeviating commitment to eliminate unwanted blindness from the earth is what drives the Aravind system to such exemplary levels of dedication and accomplishment. 

Dr. G. Venkataswamy, guiding light of Aravind

To see on a daily average 2500 outpatients and to carry out daily about a thousand surgeries in the paid and free sections, is not a small thing for any hospital. Aravind has mastered the famous assembly line, first propounded by the Ford Motor company, for carrying out the surgeries which reduces the theoretical time to carry out a surgery to about 4.5 minutes. The doctors are motivated to carry more and more of their skilled surgical practice than doing any of the less skilled activities like taking the patient vitals etc. They are thus able to improve the productive time for each doctor, improve his/her out by doing things to large volumes. 

 

The hospital, in spite of doing all such free service, generates returns at 35% EBITA (earnings before interest, taxes and amortization) by carrying out tasks at large scale. Last year even being a Covid year they carried out a lakh surgeries. After August of this year the numbers have all picked up as Covid fears have died down.

The inspiration behind Aravind is of compassion, empathy, non-exploitation and not sidelining the less fortunate or dispossessed in society, the principles espoused by the founder Dr. G. Venkataswamy in 1976. The whole story of Aravind is of bringing the sidelined to the mainstream .

The visit has deeply touched our hearts the way Aravind with empathy and without any exploitation is helping the needy sections of the society, the way it is trying to change lives and livelihoods for the blind across the world, from the present global 3% impact to 10% very soon. 

 

The simple man from the village ..

Dr. Kim, the medical director, gave an interesting session, very lively, interactive and highly informative. A big thanks Sir. He gave a very balanced view of the vision and mission of the hospital in the winding address. His balanced presentation and interaction was very timely, highly impressive and informative. 

It was heartening to understand that Google was collaborating with Aravind to perfect the Google lenses to help the partial and totally blind patients. Google collaboration to use AI based algorithms to detect the early onset of diabetic retinopathy is another great research work happening at Aravind. Click here for a 2018 Hindu report.  

 

Among other global accolades, Aravind is a winner of the 2008 Gates Award for Global Health, The António Champalimaud Vision Award in 2007, and the Conrad Hilton Humanitarian Prize in 2010. Click here for part 1 and part 2 of a write up on Aravind that shows how Aravind embarked on digital transformation and innovation much before competitiors had even heard of it.

 

In short, the learning was multi-dimensional and far-reaching. Aravind is the world's biggest business case for compassion. The students managed a visit to the Meenakshi temple in the evening after the visit before boarding the bus at 11 pm for our return journey to Bangalore.

 

George...