Skilling Health Care Managers

The Institute of Health Management Research (IIHMR) in Jaipur, now a university, may not be as popular as Indian Institute of Mangement-Ahmedabad (IIM-A) or IIM Calcutta (IIM-C), but it definitely beats the well-renowned B-Schools when it comes to talent placement in the healthcare industry. Interestingly, several premium B-Schools in South East Asia actually struggle to match the number of students as well as hiring companies that a handful of smaller but exclusive management institutes such as IIHMR attract in their healthcare management stream, which is in high demand now.

Healthcare is the new buzzword in India’s management education. The changing market profile for healthcare delivery and solutions has led to an increase in the demand for management professionals of late. The fast-evolving corporate and professional structure of India’s healthcare services industry, which is growing at an annual rate of at least 22 per cent, has turned the focus of many B-Schools on healthcare management education and training in the last few years. While the IIMs have just recently jumped on the bandwagon, healthcare management programmes at private schools including Indian School of Business in Hyderabad, Symbiosis Institute of Management in Pune and Tata Institute of Social Sciences in Mumbai among others, are gaining traction.

To provide a specially designed management programme for the healthcare sector considering its complex and unique nature, B-Schools are increasingly going for collaborations with popular healthcare institutions, including top hospital chains for practical classes.

It is the popular trend of corporatisation that brought about an all new management culture in the industry, which was till now predominantly led and managed by government or family and individual promoters.

Changing Scenario
India’s healthcare market is likely to witness a boom soon. The sector is expected to register an annual growth of 22.9 per cent between 2015 and 2020, and touch $280 billion at the end of the period. Rising income level, greater health awareness, increased precedence of lifestyle diseases and improved access to insurance are the key contributors to the sector’s growth. The private sector, which accounts for almost 74 per cent of the country’s total healthcare expenditure, has emerged as a vibrant force in India’s healthcare industry lending it both national and international repute. The country has seen a sudden surge in private sector investments in healthcare services and solutions by homegrown as well as foreign players. While there were only a handful of corporate hospital groups including Apollo Hospitals, Fortis Healthcare, Wockhardt and Manipal Group in the country until early 2000, the number of large and medium hospital chains focussing on multiple and single specialities entering the market has been substantial in the last decade.

A similar surge in investments has been witnessed in the diagnostics and other technology-led healthcare services as well. For instance, a fast-emerging trend in India now is telemedicine. Major hospital groups including Apollo, AIIMS, Narayana Hrudayalaya, have adopted telemedicine services, and have expanded the business through a number of public-private partnerships (PPP). The telemedicine market alone is valued at $7.5 million in India currently; it is expected to grow at an annual rate of over 20 per cent and reach about $18.7 million by 2020.

Besides investments, people from across the globe are are flowing into the country in search of better treatment. The presence of world-class hospitals and skilled medical professionals has strengthened India’s position as a preferred destination for medical tourism.

Some of the recent policy changes such as reduced excise and customs duty, and exemption in service tax, has also substantially aided the growth in healthcare secto in India. As a result, investment in both hard and soft healthcare infrastructure is set to rise, which will result in more hospitals, better research and development and quality education.

In Tandem
Early last year, two premium B-Schools in India unveiled their healthcare management programmes. IIM-Calcutta started its first healthcare management programme in February 2015 in association with US hospital CHI St. Luke’s Health, Houston TX, and Glocal Healthcare, a social venture providing healthcare at affordable prices to underserved India. IIM-C’s one-year MBA progamme, which began with 31 students — all working doctors on study break — is designed to provide management learning with built-in hands-on elements.

Next B-School to start a similar course in March 2015 was IIM-Ahmedabad. Although the first batch at both IIMs began with an all-doctors class, the schools said it is not essential to be a doctor to pursue this MBA programme and that any graduate with three years of experience in the healthcare sector can take classes.

The course curriculum mainly comprises training on how to solve hospital-specific issues. Every student has to go through real-life situations, crises and logjams that arise in hospitals.

According to Manish Thakur, the first healthcare programme director at IIM-C, candidates pursuing this programme will also go through the grind of financial and operation management. In addition, the programme would include classes on environment and clean energy. The healthcare management programme at IIM-C includes six months of field exposure, split into a five-month internship at one of Glocal’s hospitals across India, and a one-month externship at CHI St. Luke’s Health.

The Managerial Excellence in Healthcare Management programme at IIM-A is designed for middle and senior level managers who are responsible for managing healthcare institutions and programmes. The programme includes training on management of large hospitals, clinics, and public health systems. Classes on critical issues relating to people management, quality management, finance and costing, and information system are also part of the curriculum.

Recently, IIM-Bangalore too started a general management programme for healthcare executives. It is a part-time certificate course aimed at high-performing individuals in the healthcare domain, who are looking to transition from a functional role to a managerial role. The program, which follows the model of its highly successful Executive General Management Program (EGMP) offered under IIM-B’s executive education programs, has been designed and developed in partnership with Apollo MedSkills, the management-skill-development arm of Apollo Hospitals. While the academic content of the programme is delivered by IIM-B faculty, there are frequent interactions with clinicians and administrators are from leading hospitals; and practioners from allied disciplines such as pharmaceuticals and insurance, which play an important role in determining the success of healthcare delivery models.

The Pioneer
Founded in 1984 in Jaipur, IIHMR is the first management school in the country to focus solely on healthcare management programmes. The institution, which became a university in 2014, is accredited to International Hospital Federation and Association of University Programs in Health Administration. Specialised in management research, postgraduate education and training exclusively in the health sector, this research university currently aims to create more knowledge and new technologies.

According to S. D. Gupta, chairman, IIHMR, the institution works as a WHO Collaborating Centre for District Health Systems. It has been designated an Institute of Excellence by India’s ministry of health and family welfare, which played a major role in promoting and conducting health policy and program management research over the last 30 years.

“The Institute has been instrumental in causing a paradigm shift in the management of healthcare and hospitals in India. It has produced a substantially large base of professionally trained health and hospital managers in South East Asia,” says Gupta, adding that it has by now become a major destination for training and capacity development in leadership and strategic management, hospital management, disaster management, quality management, project management, health management information systems, and health economics and finance.

IIHMR, which now has branches in New Delhi, Kolkata and Bangalore, has also commenced MBA programmes in pharmaceutical management and rural management as part of an integrated approach on its healthcare focus.

Managing Health
The term ‘healthcare administration’ that India was so far familiar with has been nearly replaced by the term ‘healthcare management’, say industry experts.

“This is a much needed change that India’s healthcare sector wanted in its journey towards professionalism,” says Vishal Bali, co-founder and chairman of Medwell Ventures, and a veteran healthcare management professional in India.

Bali, who headed India’s two large corporate hospital groups — Wockhardt and Fortis — before setting up his own homecare venture, also believes that this high-growth sector, which involves a lot of critically important segments such as healthcare delivery, technology, research, pharmaceuticals, insurance and even social development, badly needs the same professional management set-up as that which exists in any other industry.

So the rationale behind added thrust on healthcare management education is to be able to develop a greater bandwidth of highly skilled professional managers in this complex sector. As the sector ultimately targets the well-being of people, it requires coordinated participation of hospitals and healthcare institutions, pharmaceutical firms and diagnostic services, healthcare technologies, informatics, insurance providers, entrepreneurs and finally, the community of healthcare recipients.

The other rationale is to expand the economy. Expenditure on healthcare is on the rise in India. It reached the $100-billion mark in 2015, and is set to triple over the next five years, according to government and industry data. Consequently, there will be a humongous requirement for trained management professionals in healthcare.

In hospitals, so far, senior doctors and nurses were charged with responsibilities of administration, something they had never been trained for. But with the market becoming more competitive and challenging, the need for a professional management structure is strongly felt in the sector.

“India’s healthcare sector, which was predominantly driven by families or individual doctors in the private sector, totally lacked a professional management culture,” says Bali.

“No business school really looked at this area as a potential segment for offering management programmes until recently. And now, the sector is emerging as one of the most potential segments for management schools due to the complex nature of this fast growing services sector,” he adds.

As the industry grows, the gap between the demand and supply for professional managers in the sector grows as well.

“The country’s more than Rs 50,000-crore healthcare sector is projected to grow at minimum 15 per cent annually. Despite its size and growth projection, the healthcare sector lacks an adequate pool of human resources with management skills. The new thrust on healthcare management education will certainly help bridge the gap,” says Sabahat S. Azim, CEO of Glocal Healthcare.

î unni@businessworld.in; @unni_BW