For two decades now, Dr Rohit Madhav Sane (pronounced saa-ney) has been a practitioner in the morning and an entrepreneur by afternoon. He is proud that he has been able to don these roles. Sane, who has received a lot of accolades and awards, is known for integrating his learning in Allopathy and Ayurveda to develop an institution called Madhavbaug. Sane, the founder of Madhavbaug Clinics and Hospitals, talks to Jescilia Karayamparambil and R N Bhaskar about the need to combine techniques and practises of modern medicine to make Ayurveda more attractive.
Tell us about the journey of Madhavbaug?
Despite being the topper during my MBBS days, my father—head of department of Ayurvedic college in Sion, wanted me to finish my degree and practice Ayurveda. I was surprised by his decision, but I believed in my father I went ahead with it.
I started practising with him to understand Ayurvedic principles. We had good amount of conversations and debates on Allopathy and Ayurveda. We started looking at the same diseases from both aspects of Ayurveda and allopathy. During my time as student, I realised that we have been deriving so much from nature. This led me to believe that it would be possible to integrate both Allopathy and Ayurveda in the curriculum.
Did your father start this institution?
No, my father passed away in 2004. The company was formed in 1999. It became active only in 2006. After the demise of my father, I got involved with the company in 2005-06. In 2006, we started with the first hospital in Khopoli. The trigger in this journey was the death of my father. He died of a heart attack. I felt the pinch when I realised that I couldn’t save my father despite being a doctor in emergency medicine.
He suffered three heart attacks within a span of 17 days and I couldn’t not do anything. That made me realise that we have to do something before the attacks strike. We cannot prevent a heart attack but we can strengthen our heart muscles such a way that we can withstand the attack. This is more like a preventive technique.
Who does the job of standardisation of molecules in Ayurveda?
In 2006, when I started my hospital I used to search for such standardisations. At that time, getting such information was a difficult. But today there are many Ayurvedic colleges that do such research for us. We had a tie-up with Narsee Monjee Pharmacy College. Now, we are looking out for other pharmacy colleges to run such trials. We have done many animal trials. After the positive response for these trials, we run such trials on humans.
How big is the Ayurveda market?
As per CII report, it was estimated that Ayurveda market will be around USD 3 billion in 2016. But I am not convinced by the figures. I think it would be larger.
How big is insurance in Ayurveda?
Insurance companies say that they will be approving Ayurvedic treatment if it is an institute approved by the government. When the companies are asked what do they mean by that they say that we should be registered with government and when we ask the government for the procedure to register, they are unsure what that means. The government officials themselves do not know the procedure to get registered. Due to this hurdle, we didn’t go with the hospital model.
We shifted to the clinics model. Then the insurance companies told us that the clinics too had to be registered with the government. But the reality is that this registration process is only applicable to hospitals attached to an Ayurvedic college. Unfortunately, none of the Ayurvedic colleges that have hospitals function as hospitals. We all know that.
The second reason Ayurveda is not covered by insurance policies, is because there is no definitive protocol. There are no typical guidelines by any organisation. In case of Allopathy, there are typical protocols relating to types of drugs that are to be used for a specific ailment. But in case of Ayurveda such protocols are missing. There are protocols that are given in the text 5,000 years ago. Those are considered (the final word) for Ayurveda.
Till recently, the Central Council of Ayurveda did not have set protocols. But now there are such protocols for diabetics-related treatment (which was released four-five years ago). These have been published by the council and is available in public domain. The protocol was vague, but this is mainly because they came up with it for the first time. They are improvising on it. Going forward, penetration will increase and people will start understanding the processes involved.
How would Ayushman Bharat affect Ayurvedic industry?
We do not think it will affect us. The first reason is the class of people the scheme will be servicing. That class of people will want a quick treatment and will not opt for long treatment solutions like Ayurveda. As of now, we are not present among that class of people which is mainly living in rural India. The market for Madhavbaug will get bigger as Ayushman Bharat
allows for tertiary care and heart ailments come under it. Don’t you think so?
The market is bigger. Presently, we are trying to understand how Ayushman Bharat will fit in our scheme of things. This scheme will bring about an exponential growth. The only constraint will be that the Ayurvedic section in the Ayushman Bharat is unclear. The department of Ayush is still discussing the likely role of Ayurveda.
Do you think Ayushman Bharat will drive more people to Ayurveda?
Yes, it will. My understanding about Ayushman Bharat is that there will be wellness centres. The government is open for a Private Public Partnership (PPP) model. An individual player like us will be able to enter this scheme as we are organised. The government will be benefited by offering services under Ayushman Bharat and we will benefit by servicing people who will not be covered under this scheme.
There is a catch here. All the wellness centres today are termed as yoga centres. There is a change in definition now. This is where the whole problem lies. There is no clarity on what these wellness centres actually do. Now, the government is trying to recruit Ayurvedic doctors in these centres. The question is who will monitor these doctors.
Coming back to your company, are you looking at investors for expansion?
At present, we are a self-funded company. Normally, the clinics that we develop every year are self funded by way of bank loan or through profits generated. We have planned to set up 30 clinics every year in major cities. To establish a clinic, it costs us around Rs 20 lakh. Then we have to invest around Rs 50-60 lakh to market such centres. Then there are operational expenses.
Thus, we spend around Rs 7-8 crore to set up and market 30 clinics in a year. This is the investment that goes in.
We are looking at private equities. Right now, we are in discussion with few investors and that is going on in right direction. We are also looking at other instruments too like debentures etc.
How long does a clinic take to breakeven?
It takes 1.8 years to break even in terms of investment and in case of operational expense it is two-three months.