Managing the transition from one generation to another is not an easy matter. Six ophthalmologists of Aravind Eye Hospitals tell how they are carrying on the successful business model of their founder

This generation of eye doctors from Madurai’s famed Aravind family has worked under the shadow of their more famous uncle, Dr.G.Venkataswamy, the founder of the Aravind Eye Hospital.

Each of them is well accomplished and has a long CV that keeps on growing as they are involved in multiple activities and projects in the changing landscape of ophthalmology. But the challenge they face constantly is how to sustain the culture of their organisation that has grown from a 11-bed clinic to 10 eye care hospitals in its 37 years journey, seeing over four million out patients and doing close to 400,000 surgeries a year and also fetching returns by treating 60 per cent patients free.

Today the group is not just about being a role health care model. It is a financial success as well having diversified in the fields of research and education, resource and training, eye banking, community outreach and clinics, manufacturing and social service as a conglomerate, the Aravind Eye Care System.

“Achieving goals as a collective is of immense importance” -- each of them realises. “And being together is the recipe for further growth,” they say.

It is quite unthinkable to get six doctors out of their packed work schedules on a busy Monday afternoon for a joint chat. But when they do oblige it only explains their participatory, positive and enabling style of working. “Individually if you emulate the values that you would like the organisation to embrace,” they say, “then collectively, the values of accountability and respect are adapted at the work place.”

The place of pride where this second generation of doctors stands, the way forward is inevitable. Yet, looking into the future is as much difficult. As a team consisting of two dozen eye surgeons all related to each other, they are engaged in a whole scale approach to strategic planning while aligning to carry on the family tradition of excellence.

Aimed at improving patient care services, the Aravind 2020 Plan maps their growth over the next seven years.

“We plan to cover a population of 10 million through our existing network of hospitals and vision centres and also expand to new locations. An eye hospital in Chennai is on the anvil followed by one in Tirupati and near Thanjavur. Plans are also afoot to increase the number of vision centres three-fold from current 50 as these help in better market penetration,” says Dr.Aravind Srinivasan.

“The focus will be more on prevention and related research in years to come. Also our Aurolab, a major global supplier of Intra Ocular Lens, has a tremendous opportunity for growth as the number of cataract surgeries will increase significantly worldwide. Capacity is not a constraint, we can build it to meet the growing demand but need to explore sales further,” says Dr.Haripirya Aravind.

“We are a matured multi-dimensional organisation today. Earlier there was lot of raw energy available, but today the youth goes where there is money and growth. We have to ensure ethical patient care to maintain our edge,” says Dr.N.Venkatesh Prajna

“Our focus on eye camps is not lost but we still have to think on how to reach more people in underprivileged areas to treat preventable blindness. We are shifting focus to more comprehensive outreach services, such as Diabetic Retinopathy, glaucoma and refraction camps for better diagnosis and management of chronic diseases besides eye camps for children,” says Dr.R.Kim.

“We are extending our outreach services to include all speciality areas of eye care, focus on visual function and spread awareness on general health care. We have lot of people supporting us and not forget to acknowledge our paramedics who are more often appreciated by our patients,” says Dr.Usha Kim

“We have to help patients lead healthy and fulfilling lives. Majority of rural poor have no idea why they are blind and that a simple cataract surgery can restore their eyesight,” says Dr. Lalitha Prajna.

The Aravind Family’s ideas have gained national and international recognition. Hospitals copy their sustainable model of free patient care funded by the fees from paying patients. People come and observe the high volume work and learn about their strict quality norms, assembly-line efficiency and ruthless cost control that enables them to offer free, standardised and consistent service.

No one person has all the best ideas. And nobody has a personal agenda. Without shifting the focus from core values, frank discussions and assimilating thoughts of each other helps the team to give one voice. A case of tough love it may be for the pioneers of high quality, low cost service delivery. But like the proverb, the eyes have one language everywhere, these doctors too have one commitment – to deliver affordable eye care to the unreached and eliminate needless blindness among India’s poor.

Docs speak

Dr.R.Kim, Chief Medical Officer; Chief Consultant Vitreo Retinal Service; Director, Information Technology, AECS and Dr.Usha Kim, Chief Orbit, Oculoplasty and Oncology; Director-Training mid-level ophthalmic personnel

Dr.V and I: “He was a teacher first, demanding strict discipline, punctuality and adherence to rules. He had a way of bringing people to see his point.”

On Work: “Today’s system is very competitive. And we all are conscious and anxious not to break away from the culture and values that are at the heart of Aravind Family. Each of us undergoes personal growth. We also have to see how the third generation grows to the stature of previous two.” – Dr.R.Kim

Dr.V and I: “When I married into the family 22 years ago, I felt a bit claustrophobic. I watched him treat everybody equally, the family get-togethers were lot of fun. The feeling of togetherness he ushered in was overwhelming.”

On Work: “Whatever you do in a year elsewhere, you do in a week here. We rely on collective wisdom and whatever decision is taken is never countered given the process by which it is arrived at. Nobody questioned when Dr.V started the practice of 60 per cent charity. Lot of things have become structured and we have learnt to reach our destination slowly and together.” – Dr.Usha Kim

Dr.Aravind Srinivasan, Director-Projects, AECS and Administrator AEH and Dr.Haripriya Aravind Chief, Cataract and IOL Services

Dr.V and I: “To be a part of this organisation amplifies one’s life. Dr.V built a good fabric and helped each of us find our own strength. His vision was always way beyond what is possible. Nostalgia throws up fond memories and now I realise the importance of sacrifice, constantly educating ourselves and working for the people. He rewarded us by getting and giving us more opportunities.”

On Work: “We have to think big. As family doctors leading the group, we know we are being watched how and what we prioritise. Community outreach work is easiest to let go. Leadership is not about building and making a big organisation work. It is a quality that comes from empathizing with the community.” – Dr.Aravind Srinivasan

Dr.V and I: “He would be the last person to give a compliment. He would keep challenging me by asking me daily about the number of cases I did. Silently yet powerful, he would make you move in the right direction without you even realising it.”

On Work: “Volume of patients has increased but so has the cost of health care. High volume also drives cost control. To get professionals to stay excited about the way Aravind Hospitals work is no less a challenge.” – Dr.Haripriya Aravind

Dr.N.Venkatesh Prajna, Chief Cornea and Refractive Surgery; Director Medical Education and Dr.Lalitha Prajna, Chief Department of Ocular Microbiology

Dr.V and I: “He was obsessed with efficiency and a hard task master. I travelled with him a lot and donned various roles other than being a doctor. It was always best to say, ‘I don’t know’ to his questions to get coached by him at every step.

On Work: “We have to continuously guard ourselves against slipping into the comfort zone. It is a creative struggle of balancing what was Dr.V’s strength and the present day commercial operations in a sustainable non-profit organisation. Each of us is responsible for anything, big or small. If we enjoy the benefits, we should also share in the spoils.” -- Dr.Venkatesh Prajna

Dr.V and I: “He was always keen that the quest for knowledge never ceases. The concept of new age children where the younger members of the family assembled every Sunday to learn something new from him was something that struck me. He was so selfless in whatever he did.”

On Work: “In other places, seniors always have an overbearing presence. But he always encouraged and allowed us to grow.” – Dr.Lalitha Prajna