MIOT: Not Your Average Hospital To Visit Under The Sun

The Madras Institute of Orthopaedics and Traumatology (MIOT) have shown strong interest in the Government’s proposed plan to convert Lautoka and Ba hospitals into a public-private partnership. If chosen as
31 Mar 2018 10:00
MIOT: Not Your Average Hospital To Visit Under The Sun
A MIOT doctor using the Revolution 750HD CT Scanner that can produce 4D images of the body’s blood vessels in less than 60 seconds at the Hospital in Suva. Photo: MIOT

The Madras Institute of Orthopaedics and Traumatology (MIOT) have shown strong interest in the Government’s proposed plan to convert Lautoka and Ba hospitals into a public-private partnership.

If chosen as a partner, the move will represent rapid expansion for a hospital with an end goal of revolutionising the Fijian health sector.

Details of the public-private partnership beyond a three-way agreement between Government, the Fiji National Provident Fund and an internationally certified hospital are scant.

But after a grand opening in the capital city to replace the Suva Private Hospital, Government’s confidence in MIOT seems to be assured and the hospital is a genuine contender.

The MIOT International’s 1000-bed sprawling hospital structure in Chennai, South India, is a medical hub for patients from more 129 countries around the world.

Since its humble ’70-bed’ beginning in 1999, the hospital, while providing award-winning medical treatment, has undergone notable growth.

With the vision of founder Dr Pakkiam Mohandas, the hospital began as a dedicated centre for treating road accident victims in India that, according to a 2013 World Health Organisation report, annually sees the death of 231,000 people on its roads.

MIOT International today specialises in 63 areas including joint replacement surgeries, interventional cardiology, orthopaedics and trauma.

In January, the hospital received an award from the Federation of Indian Export Organisations for being the best service provider in South India, reported Bangalore-based newspaper Deccan Chronicle.

Last October, the hospital officially opened for business in Suva, more than 11,000 kilometres from its headquarters, in partnership with 70 per cent shareholder, Bank South Pacific.

“I came here on my first visit in 2014, just before I became managing director of the hospital, and spoke to Investment Fiji,” said Dr Prithvi Mohandas.

“In some ways, Fiji was very developed and modern. But in other ways it still wasn’t. So, that was when I decided that Fiji was a place that needed what we could offer.”

A significant investment of $18 million to develop the hospital’s basement into an emergency unit meant plan of an expansion began immediately.

The unit contains a state-of-the-art Revolution 750HD CT Scanner, which can non-invasively produce a 4D image of the body’s bloody vessels in less than 60 seconds.

Another nifty piece of equiment is the Innova IGS 530 cath machine, capable of a sophisticated level of angiography – a blood vessel imaging technique.

Could, with the acquisition of hi-tech – and expensive – equipment and rapid epansion plans, Dr Mohandas’s bold plan to have better health care available in Fiji than Australia and New Zealand be materialising?


Who is the managing director?

Dr Mohandas joined MIOT in 2007 and is the son of the founder.

Administratively, he was given the role of developing overseas markets for MIOT.

He started first with exploring markets in East Africa and the Middle East.

“Now these countries, some of whom had oil rich wealth, I found, did not have the sort of zeal that we have in India to get through a high volume of ill patients,” he said.

His ascent to the managing director’s position coincided with his father’s retirement.

State-of-art medical care and ambitious plans for Fiji’s health sector aside, MIOT International is a “highly profitable” business – and like all businesses, wants to make money.

Its business model appears not just ideal for a developing country but is structured around Indian Prime Minister Narendra Modi’s view that Fiji can be a medical hub in the South Pacific.


Business Model

“Our business model works on the fact that the doctor does not bill every time he/she sees a patient,” said Dr Mohandas.

“Our business goal is that we reward the doctor adequately with a contract that has a base salary that is fixed yearly whether the doctor sees five or 10 patients today that does not allow him to bill extra for the patient.

“A result of that, based on the number of patients that come in, I can therefore have variable pricing depending on your financial capability so that you are not saying that it is too expensive and I cannot have the treatment.”

Fiji’s medical sector has been hit by a shortage of specialist doctors. Senior government officials, including health minister Rosy Akbar, have made numerous trips abroad in search of these doctors.

But, as recognised in MIOT’s business model, Dr Mohandas believes he may have found a long-term solution.

“Another goal is to provide post graduate medical education in Fiji,” he said.

“Presently, we have not been able to hire specialists in Fiji because the career pathway to make you a specialist is hardly available.

Dr Mohandas said the hospital planned to acquire accreditation – and a Government-issued licence – to train specialists in Fiji.

This plan is line with MIOT’s envisioned goal of having the hospital in Suva fully staffed by Fijians.

Its institute in Chennai offers medical and paramedical education and is recognised by the Government in India and approved by the National Board of Examination.

“We want a business model that will support flexible pricing and the access and availability of treatment,” Dr Mohandas said.

“The problem we have in a country like Fiji, which is so close to Australia and New Zealand, is that we try to follow their model – simply because they’re geographically close and our medical professionals are trained there.”

To deliver access and availability, MIOT enshrines in their staff and students a factory worker-like work ethic – but in a good way.

“Every day is a 13-hour work day – we start at 5AM and finish late in afternoon at 6,” he said.

“The philosophy of MIOT is to make sure that the doctor does as much as possible in one day.”

He believes this can reduce costs for patients because “if you are able to use your operating theatre (for example) through the day because your doctor is there for 13 hours then more can be done at a lower cost.”

This strategy is also commercially viable, Dr Mohandas said.

“As the number of patients increase, so will the usage of product,” he said.

“Purchasing more and more products will build supplier confidence, meaning products can be acquired at much lower prices.”

Dr Mohandas is currently holding talks with the hospital’s board to secure more land around the hospital and complete a planned expansion, an inidication that the business model is working.

With the formation of a link with BSP, insurance packages could feature prominently as a source of revenue.

It will be interesting to note how MIOT deals with competition should any present itself in Ba-Lautoka partnership plan.

For now though, the hospital has a firm footing in the country.


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