by Kavikrut  on Sun 12 Feb - 1 Comment
Categories: entrepreneurship, Health, International Development, Start-up

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Why did you decide to start Mobile Medics after undergrad?

A friend approached me with an idea to take doctors and paramedics on set routes to villages in India. 70% of India’s population is rural and has limited access to affordable high quality healthcare services and drugs. I was very excited by the social impact and business potential that the idea presented. If the idea could sustain financially, there seemed to be a huge opportunity to scale. We named the idea Mobile Medics, built a team and started to participate in business plan competitions in India and abroad. Very early in the process we built a global board of advisors with mentors who were passionate about the idea and were willing to invest time in helping us develop it. We won most of the competitions we participated in and started building confidence as well as a substantial pool of prize money. In 2006, we won the Global Social Venture Fund Competition. The social enterprise scene had just started developing globally and this placed us in a very favourable environment. We had amassed close to $30,000 prize money and were rated as one of the most popular social enterprise businesses plans globally.

I graduated in mid-2006 (other team members were in a year junior to me) and immediately asked myself if I wanted to take the idea to the next level - actual execution. On one hand I had a financial research analyst job and on the other there was this idea that experienced juries across the world thought had substantial potential. I knew that it would be difficult to not do anything about an idea that we were so passionate about and also that personally, I felt, there was not much risk in trying something like this right out of college. Also, my university, Birla Institute of Technology & Science, Pilani (BITS-Pilani) had just started their incubation centre and were very helpful in getting us off the ground. I setup our office on campus and set out to launch the company. Although it was a wholehearted decision, I had no clue what I was signing up for.

What was the experience like of getting acquired by Piramal health?

After a year of being hit by several barriers, we finally launched operations in 2007. By the end of 2008 we had treated over 2000 patients in 12 villages, established a considerably large loyal customer base and reached our operational break even patient number. Right from building trust amongst our target patients, pricing issues to supplier relationships, everything was tougher than what we had imagined. We had not anticipated how much hit and trial designing an efficient operational process would take. The biggest problem though for us was to find doctors who were willing to work on the van. We knew that we could never scale given the shortage of doctors. We were 3 months away from completely exhausting our cash reserves. My plan was to raise an additional $40,000 to experiment with new delivery models such as telemedicine.

The social venture capital space in India had just started to emerge so this gave me some hope of raising money but I found out after several pitches that early stage investing wasn’t on their agenda. I also approached several international and national non-profits and philanthropic organizations but with the lengthy proposals and impact measurement due diligence, 3 months looked like a difficult deadline to meet.

Between all these struggles, I happened to meet with the CEO of Piramal Foundation who later connected me to the Piramal Group. Piramal is one of India’s top conglomerates with over $1bn annual turnover. They had a significant interest in healthcare and one of their companies; Piramal Healthcare was India’s fourth largest pharmaceutical company in 2009 (acquired by Abbott India in 2010, making the new company India’s largest pharmaceutical player by market share). In their view, to improve healthcare in the country, it was necessary to not just manufacture drugs but also design service delivery channels that enabled access.  The rural healthcare opportunity was a natural interest. I met with Anand Piramal (HBS 2011) to pitch for fundraising but he instead offered to acquire our team and build a venture in-house. In his view, it was important to have the benefit of corporate resources to try bold experiments and come up with disruptive solutions for such a difficult problem. After some thought and discussions with our mentors, I decided to go ahead. It was a pseudo-exit that would enable our team to build on the Mobile Medics experience and design newer pilots with better backing. I had to give away entrepreneurial freedom but it was nothing in exchange to ensure that our employees kept their jobs.

How would you compare operating a social enterprise as start-up versus as apart of a large corporation?

They were two very different experiences. Mobile Medics was a bootstrapped startup and the overall limitation of resources limited our ability to innovate. I realized this only after moving to Piramal. I teamed up with a young entrepreneurial doctor from Piramal Healthcare and started a new venture, Piramal eSwasthya, incubated within the corporate. We both reported to Anand, but the three of us together, it was a young team passionate about a common idea. Our vision was to “democratize healthcare” with the goal of designing a for-profit rural healthcare delivery model that could provide access to quality affordable care to a hundred thousand villages. We had the freedom to operate as entrepreneurs, were granted quarterly budgets and reported every month to a highly experienced board.

To compare some differences of operating as a start-up with working within a corporate, here are a few instances. We started the first pilot at Mobile Medics with 5 villages and it took us an year to do so while at Piramal it was higher at 50, a more complex model and we launched in 6 months. At Piramal, we worked with an agency to incorporate our learnings from Mobile Medics and designed a marketing strategy to reach out to 20,000 households. Changing a specific strategy mid-way, seeking feedback from the board and then quickly fixing things was way faster. We had access to one of the best technology partners in India, Tata Consultancy Services. They were willing to innovate and experiment with us. Also, a very important difference was the Piramal brand. It helped us build relationships, build trust with customers and get things done in difficult business situations in the hinterland. The corporate environment, which includes expert advisors and managers willing to help, regulated access to a pool of funds, best in class partners and brand backing, helped us create innovations that have treated over 50,000 patients across 300 villages in just 3 years.

Why did you decide to go to business school? What’s next for you?

I was fortunate to have had the opportunity to gain entrepreneurial experience at such an early stage in my career. It helped start learning how to create businesses and build teams. I gained exposure to all business functions, learnt from mistakes made in the market, interacted with customers first-hand, learnt how to build relationships and had the chance to innovate in a very difficult operating environment. While the breadth of this experience was very wide, it was not deep. 

I loved what I did at Mobile Medics and Piramal. Healthcare was an interesting sector to work in but what excited me more than anything else was the bottom-of-the-pyramid market. Rural consumers played by their own set of rules, the opportunity to innovate was huge, there was an ability to impact at large while earning profits, best practices did not exits and there weren’t too many examples of businesses that had scaled. This was an interesting business environment with its own set of challenges.

My plan is to go back to India after business school and hopefully start a venture or work for a business focused on the BoP consumer. This sector needs radical business innovation, leadership and strong operating and general management skills. I decided to come to HBS to build these skills and because I thought it would be interesting to learn through a model that exposes a student to different global businesses and what they did in different operating situations. It’s been a very good experience so far in being able to do a diverse set of cases and relate them to what I have done before and draw my own set of takeaways. Also, I have not had a chance to work before in global teams and with diverse sets of peers. The HBS community has been way above my expectations on this front.

Kavi is a first year student who is from Hyderabad, India. Before HBS, Kavi spent 5 years working in the rural healthcare space in India. First, he founded Mobile Medics and later worked with the Piramal Group to launch Piramal eSwasthya. He graduated with a degree in Finance from Birla Institute of Technology & Science, Pilani, (BITS), India. Kavi loves photography and motorcycling. 

by Tarun on February 16, 2012 at 3:39am

Hi Kavikrut,

You have started an amazing journey. I also want to work with BoP communities in India and currently exploring where I can contribute. Is it possible for you to provide me a short volunteer/intern with the initiative?