Marketing Those Who Came Back

Step into a hospital anywhere in the western world and you are in all likelihood to run into an Indian doctor sooner than later. The medical education system in India churns out doctors in large numbers and many of them choose to go abroad for advanced training and skills enhancement. Many of these settle down in the new country, which is more than happy to welcome highly educated and skilled doctors to its shores. It works well for the doctors too, they learn new things, train in some of the finest institutions in the world and than are able to make a decent living in their adopted country.

This is the way it was till recently.

Now with India making rapid strides in healthcare and even attracting patients from across the globe, many of these doctors are choosing to return to India. They are able to find employment in the new high tech hospitals, which have sprung up in the last 8-10 years. The reasons for this are not far to seek. Indian hospitals can now easily be compared with any that they might have worked in earlier, in the west, the standard of care is often superior, the financial rewards far better than what they were a few years ago, and life in upmarket urban India quite comfortable. Moreover, India is home for many with responsibilities for aging parents. Some are also not comfortable with their children growing up seeped in the ubiquitous and consumerist western culture.

All this is great, except for the fact that some find going in India quite tough. The hospitals that employ the returning prodigals, soon realise that these doctors will take time to settle down and find their feet in the changed Indian environment. Having been away for years they do not have a bank of patients, who can start patronising the hospital. Often their salaries are more than those hired from other Indian hospitals and with no patient base to speak off, these doctors are immediately under pressure to justify their high salaries. They usually need urgent Marketing support.  

Marketing these doctors wouldn’t be too difficult. However, marketers like me realise to our dismay that many are just not willing to make the effort, which is required to establish their credentials back home. Many believe that their foreign accents and fancy certificates will suffice to get them patients. Unfortunately, this never works.

Their are really no short cuts to building a practice. It requires painstaking engagement with the local doctors, establishing a rapport with the local communities around the hospital and delivering great experiences to patients who come in. Dr. Paramvir Singh a gastroenterologist, who returned from the US to join Artemis Health Institute in Gurgaon is a case in point. He decided early on that he will have to work closely with the marketing team and pestered each and every member of the team to take him out for meetings with local doctors, deliver talks in corporates and interact with the local community leaders. Dr. Singh also ensured that he called those referring patients to him, discussed the  case and politely thanked the doctor for his support. He also became friends with all the marketing executives, who found him very accessible and ready to go out with them on short notice. All this worked like a charm. Dr. Singh is today, about a year in pratcice in Gurgaon a very busy gastroenterologist indeed.

Sadly, many of those who returned find it hard to cope with the grind. Many carried a lot of baggage from the US, had an attitude which borders on arrogance and found it difficult to connect with the local doctors. Many confessed of not being comfortable interacting with some of these doctors, they questioned their practices and were just not able to treat them with respect. Not surprisingly the local doctors too turned up their noses at these ‘upstarts’. The hospital sales team just couldn’t make any headway.

Some of those who came back, found going out with the hospital sales team a chore well beneath their dignity, the heat and the grime of India beyond the air conditioned surroundings of the hospitals too much to bear. Others found it difficult to work long hours, 7 days a week, (which is the lot of most doctors in India) and cope with the relentless pressure of generating patients for the hospital.

No wonder many of them are contemplating returning back, others are holding on grimly, hoping with the passing of time patients will surly come. They may or may not, the struggle for these doctors is not ending anytime soon.

Pic courtesy

8 thoughts on “Marketing Those Who Came Back

  1. Great Post Anas.

    One thing is clear. It starts with the mind and what a person is looking for. No matter what one has done in the past, I think each situation or place means one starts afresh.

    Take the analogy of cricket, past reputations or scores count for little as a batsmen or a bowler has to get used to the conditions , focus on their skill and concentration and also work as a team for each new match.

  2. Dear Syamant,

    Thanks, you are right with the cricket analogy. India I reckon would be a very different pitch for these guys to bat on.Past scores on a vastly different track does not count for much.



  3. I liked your thoughts although I don’t necessarily buy all your arguments. I know pretty well the environment you are referring to. Well it is fair to say that the healthcare system is in transition moving from a more traditional style to a more formal western style corporate structure therefore there is an opportunity for exchange of ideas and perhaps retaining the best bits. I am sure you would appreciate that many senior Indian doctors also struggle to make the switch. The imminent expansion of healthcare in India further compounded by looming shortage of doctors (will become more and more apparent as the capacity expands) is bound to open up good opportunities for people looking at returning back. It is for the potential employer to understand this imminent trend and make the most out of it rather than forming any preconceived notions. Instead of waiting for people to turn up to their door they should define their needs (key problem in all organizations) hunt for the right people. They should be upfront with what their expectations are from individuals and what their KPIs (key performance indicators are) against the time lines. It does not always help to be always running into them with balance sheets. Understanding their needs and supporting them in the transition is the key to forming long term fruitful relations. It is these same certificates that they scramble for to get their hospitals accreditated. Just because few people did not click mean should not in any way be extrapolated to the whole breed of people that’s a dangerous assumption more so if made by an experienced professional.

  4. You are absolutely right when you say that hospitals who are hiring these doctors should be more patient, think beyond the bottomlines and handhold them during this transition.

    This unfortunately rarely happens.

    The pressure to deliver the goods starts mounting early and the relationship starts souring soon enough.

    I know of some surgeons who have been asked to accept pay cuts largely because they have not been able to deliver patient volumes.
    I also know of others who have returned and fit into the Indian system like they never left.

  5. These are early days in healthcare in India and the systems will mature with time. For we have an historic opportunity at our hands to usher in a new revolution in this field. But it must be remembered that Mayo, Harvard or John Hopkins did not happen overnight but it took years of mutual trust (patients/doctors/management) to build these brands and organizations. These would have never happened had they always limited their vision to next month balance sheets.
    It is for the organizations in India to decide and define their vision and hire appropriately the people with matching skills. But for that to happen we must first have people in the managements capable of managing the microenvironments without ever losing sight of the bigger picture.

  6. Its not just off shore professionals who find it difficult to settle in the country due to their attitudes and no client base , the other segment who faces more or less similar problems is the professionals hired from the government hospitals in delhi. These guys who have spent a significant amount of their lives practising non profit way are suddenly burdened to learn corporate ways overnight. Their major clientelle is low or middle income group whom corporate hospitals fail to deliver services to. They are suddenly expected to behave in a corporate way which they are not used to. Some of these doctors even bullies others to a level of insult because this is the way they have been doing it.I am not aware whether this group of people is given any special assistance to overcome these barriers or it is just assumed that they will do it.I think communication is the key to everything.

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