HEART ART

Dr Devi Prasad Shetty, one of India's leading heart surgeons, is the stuff legends are made of. Radiating charm and compassion, he has a commanding presence in the operation theatre, a bedside manner to die for, and a mission to make quality heart care affordable to the poor. We had the honor of interviewing him, and to see first hand, some of the wonderful work he does, especially with kids. We were not only impressed with his professional side and his lighter side, but with the missionary zeal with which he moves government, private and corporate individuals / organisations to join him in the crusade to build heart hospitals in every state of India.


I understand that you and your team have perfected the art of assembly heart surgery - can you elaborate on it?
I wouldn't say perfected, we are still working on it. We have to reduce the cost of heart surgery from Rs 2 lakh to about Rs 65, 000, a sum that our patients can afford. If we want to reduce the cost of the product by 75% we have to change the way the product is delivered. There is so much of sophistication added to all the specialisations with which the mortality rate can be brought down significantly. Assembly line heart surgery aims at achieving ZERO mortality and reducing the cost by 75%. That is, we can manage a large number of procedures at lesser cost. Currently at Manipal Heart Foundation we do 14 to 16 operations a day.

The West is traditionally the place where people have been going for treatment. But since the inception of the Manipal Heart Foundation, more and more people are coming here for treatment. How has Manipal Heart Foundation changed this?
There is a slot and someone has to occupy this slot. At Manipal we have never created the market. There was a requirement for treatment and we have just filled in the slot.

Elaborate on your programs to make heart surgery affordable to poor people?
If I am given a choice I would like to treat only the poor patients. But unfortunately the economic reality will not allow me to do that. So instead what we do is, offer 25% of the beds for the rich people and 75% we leave for the poor. When I say Rs 65,000, (for a heart operation) not many can afford this sum. A person earning Rs 5,000 to
Rs 6,000 cannot afford this because the cost of living in Bangalore is high. So we organise various fund schemes. We have worked out a very interesting concept. In this society there are a large number of people who need help but do not know where help will be available. And there are a good number of people with money with the intention to help but don't know who requires it. We do that intermediary job. We are the brokers between those who need and those who have. We have occupied that slot.
If we tell people that we are going to charge one and a half lakh rupees for an operation, can you give us 30,000 rupees, does this make any sense? That person is not going to give us the money. So we tell him that we are going to operate on this child and offer our services free. Can you help us do it? This has worked. A lot of people have given money.
A good thing that has happened with information technology and with the opening of the economy is that good people have started earning money. Now we see people with honorable intentions becoming rich. We are getting more and more assistance. A Bangalore based software individual - for instance - I showed him around the hospital and he promised to help. Few hours later he called and offered a donation of Rs 6 crore (his laughter is that of pleasure, appreciation and gratitude.)
Not everybody who helps is necessarily rich. I don't remember spending even 5 minutes with this 60-year-old patient (a retired nurse) in Calcutta. Her lawyer calls me, just the other day, to inform me that she has willed her house in London to me.
Can you tell us more about your programs to help children with heart ailments?
We started an organisation called Kiddies Heart Foundation. (Pulls out the poster and points) - It will take 2 people to cure this 2-day-old baby's heart. We have the doctor. We don't have the resources. India conducts the largest number of heart operations on children in the world. This is so because India produces the largest number of children with heart disease in the world. One out of 100 children born anywhere in the world is born with a heart disease and we produce the largest number of children in the world. I operate free. But the associated costs are still high, so we have started many programmes.
(Click here for more on Kiddies Heart foundation)

Which other doctors are doing cutting edge research / application in your field?
The All India Institute of Medical Science in Delhi is a very good heart hospital. Research work is mainly done in Sri Chitra Tirunal Institute in Trivandrum, Kerala. Dr Velliathan, the Director of
Sri Chitra Thirunal is doing a good job.

What do you have to say about the fresh candidates thronging the medical colleges to make 'curing' their profession?

Here I would like to talk about job opportunities. The health care industry of the world is going to undergo a dramatic change. It is one of the most inefficient systems all over the world. Extremely disorganised and under utilised. And the doctors and the hospitals in India will do the transformation.

Let me explain - an experienced surgeon with years of experience behind him in a particular operation has good results because of the volume of surgeries he has done throughout his life. We already have a few young surgeons working with us who are in their 30s who have already done 2000 to 3000 surgeries. Now they have 20 or 30 years of active life before they retire. You cannot imagine where they will go in the next 10 years. Ultimately the result of whatever intervention is done depends on the expertise, and expertise depends on numbers, and in that number our youngsters are going to be overwhelming the others. This is because of the volume of patients this country has. With good administrative back up, we will be able to set up similar facilities in UK and US. Sounds hypothetical, but you have to realize that it is not mere national pride, it is economical reality. If we have a group of heart specialists who have 10 times more experience than the Americans, if we set up a hospital in America, it is just a matter of time before the Indian doctors overtake the medical professionals of the other countries.

How involved are you in management strategies? That is, managing growth, efficiency, and innovations, all of which your organizations are famous for? And how close are you towards fulfilling your dream of a heart hospital in every state of India?
Sitting right here in Bangalore, things are getting done. For instance, in Calcutta Mr Jyoti Basu granted us the land lease for the new Heart Institute within 45 days! It was inaugurated recently. This country has abundant talent. I don't think any other country can boast of such a talented workforce. There are people as clever as me and also people cleverer than me. I like to associate with people cleverer than me. People with the right attitude and...

Competence?
Compassion! Skills will follow. The single most important characteristic I require is compassion. There was this Iranian doctor. He was okay& but when I heard he used to shelter and feed nomads, you know, travelers, I said & I want that man!

What changes do you anticipate in heart surgery techniques in the near future? Any science-fiction type developments on the anvil?
No, no. I am happy with the current technology available to us, and the human resources. What is more important in this new millennium is reducing the cost and increasing the access of people to quality heart treatment.

Getting to Know Dr Shetty