Health and healthcare can be a field where failures carry fundamental, tangible repercussions. As Ashwin Naik chooses to regard it, “These are not just big social problems, these are issues of healthcare, community health and policy.” So does healthcare carry a greater onus to not fail? Are the stakes higher? Anjali Sastry feels that failures are inevitable in healthcare while Dr. Ravi Narayan feels that failures are natural but it is crucial for people in the field to pick apart every failure, without getting too complacent, and learn every step of the way, as he and a few peers had done
If It’s Not Broken, Fix It Anyway
Complacency can set itself in multifold ways, Thulasiraj of Aravind Eye Care, which began as a small unit and has now gone to command 40% of eyecare operations in the state of Tamil Nadu, relates their unique failure. “Our business model was such that for every paid eye treatment, we could provide two free treatments. But the market completely changed, with people who could afford treatment seeking out other places for their eyecare. We realised that we were giving more free operations than paid ones, and this is when we realised we had to improve and be competitive and provide eye care that could compete with the best. This is why I don’t necessarily believe in the saying that ‘If it’s not broken, why fix it?’. It’s an important thing to constantly keep questioning such processes even when things are going good, and that is why I think we must always have a strong sense of competition.”
What Does The User Value?
Dr. Prabir Chatterjee learnt that even with good health policy measures like Anganwadis, there lies a danger in centralization and not adapting to local dynamics in the remote areas that he was working in.
Prachi Shukla echoes the sentiment in recollecting her own taste of failure, “We believed that people in rural areas would pay for quality care we were offering at urban centers, but what we realised is that they were comfortable with their local informal care providers and were satisfied with the price point they offered. Medicines were also easy to come by for these informal networks, so they provided them with that too. What we realised soon was that if there was no value added to the services we were providing, people would simply not be interested regardless of us coming from a point of view where we wanted to deliver quality healthcare.”
Anjali Sastry also speaks of this disconnect between enterprises and their end-users,
“We started an AIDS program in Uganda and on paper, everything seemed ideal. We were gathering a lot of valuable data, but we soon realised that we hadn’t adequately trained locals on the field as to how to process the data, it was a major lapse on our part! Through conversation and experience, there’s a desperate need to hone our focus and stick it.”
The Issue With Grand Design
“We believe we are able to solve problems.” opines Naik “and in the late 90’s there was a renewed interest in Healthcare which meant we were getting a lot of money. We decided to go big and think about the grand picture of building a clinic in every village. But we realised that not all solutions to problems are solved with such a grand design. We had too much money, and just like most startups don’t die because of starvation but rather indigestion, we also went through the same process.”
Naik also elaborated on the issue of grand models, “Me and my partner thought we’d start a clinic in every single village with 200 people.” he said, adding, “But we realised this was not possible. We were making wrong selections in towns and partners. Solving a difficult problem like health is hard, moreover, we were not focussed on capacity building and scale.”
On the whole, the panel was engaged in providing many distinct experiences of failure stemming from personal experience. Perhaps the most important aspect to be gleaned was the sense of honesty with which the panelists discussed their respective failures, having left any sense of insecurity right at the door.
For more detailed insights on what ensued in the Failures in Healthcare panel at the Impact Failure Conclave 2018, watch the video below.
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