Different strokes for different folks: Paras Hospitals' mantra for growth

For growth and expansion in smaller less-served towns and middle-income clientele

Practising medicine in the United Kingdom in the year 1998 showed Dharminder Nagar the way in more ways than one.

One, the 23-year-old, who had finished his MBBS from Mysore, had spent a year at Delhi’s Safdarjung Hospital, and had then moved to London for higher studies in his field, soon realised – while working as a junior doctor — that this was not for him. He wasn’t cut out to be a physician. Second, London wasn’t for him either. Whatever he had to do, he needed to do in his own country. 

The fourth of six sons of a dairy farmer (who started out with nothing but built a mini-empire in the 1980s), Nagar knew he wanted to remain in his chosen field of medicine and health care but he knew that diagnosis and treatment was not for him either. Moreover, coming as he did from the relatively backward and poor Gujjar community, he felt little empathy for the primarily well-heeled patients he typically came across in London.

He decided to do a degree in health-care management at the Imperial College in London, with very little idea of what to do next. After the degree, Nagar spent a year to set up a Lasik eye centre in London’s Richmond area. He spent a year planning and working on it but eventually, the project failed to take off. 

Nagar, now 47, got back to India in 2003 after having achieved very little except clarity on what he didn’t want. Pressure on him was building – he had no clue where he was headed but he was clear he wanted to be in the health care and hospital space. Noida was the natural ground for him to operate in (the family was from Ghaziabad) and he began to scout around for opportunities. 

It was then that one of his brothers – who manages the group’s real estate firm Paras Buildtech - suggested buying a large piece of land in Gurugram (in 2003-04) and building a hospital on it. Although Gurugram was still relatively quiet and sleepy, anyone watching closely could see the beginnings of the boom and the madness that would come to envelope Delhi’s most chaotic and crowded suburb. 

In 2006 – despite many warnings that Gurugram would never need a hospital of the size (250-bed) he was constructing – Paras opened its doors to patients – the first big hospital to come up in Gurugram.

Even as he realised what he wanted, Nagar knew what he didn’t want. He deliberately stayed away from glass and chrome structures that were typically coming up everywhere. He wanted a functional structure with costs kept in check. “No chandeliers, statutes, fancy fittings. A no-frills sort of facility was what I had in mind to serve the clientele I wanted to serve,” says he. “I need the connect. And I don’t feel for the rich and I can’t completely help or solve the problems of the poor. My universe lies in the middle,” says he. The hospital had cost around Rs 70 crore to build and broke even in the first year itself. Many people even approached him to buy his facility.

Nagar watched quietly in 2007-2015 as several competing hospitals in Gurugram came up all around him but he didn’t worry too much as all of the new ones seemed more focused on only the high-end of the market.

If the focus of competition is narrow, it is also restricted. Nagar says he wants to expand to areas where nobody else wants to go. “The day I opened in Gurugram, no one else wanted to open here back then,” says he.

Now, he is eyeing all of North India. In 2013, he opened the first 400-bed multi-speciality hospital in Patna (it also provides cancer care) and has now added a 100-bed hospital in an even more remote location in Bihar-Darbhanga. “I was pronounced a madman when I decided to go to Bihar,” he says.

But Nagar is firmly convinced that this is where his future lies. “Health care can be the biggest social agent for change. But for this, people have to look beyond their own noses.”  He’s in the process of building a 200-bedmulti-specialty facility in Panchkula at present that is expected to be operational by March 2018. He expects it to draw in patients from a wide catchment area including Ambala, Saharanpur, and Western Uttar Pradesh – all areas that are not served by private hospitals as of now. 

North India is where he sees the widest gap in provision of services, arguing that the South is well-served already. Further, he says he needs to understand the mindset of the patient he serves and this he can do only in the North. He reels off a list for the future: Kota, Gwalior, Bhopal, Jalandhar, Kanpur, Saharanpur, and Gaya, among others. Far from his radar are places like Mumbai and Ahmedabad. 

The future of the chain reflects closely the thinking of the promoter but his real challenge, he says, lies in practising ethical medicine, making money and not compromising quality. Doing any one of the three, he argues, is easy. It’s doing all three simultaneously wherein lies the challenge.