By the time Dharminder Nagar crossed 30, his family had begun to think he was using studies as an excuse to avoid working. Nagar says this with one of his frequent guffaws, but his family had good reason to suspect his intentions.
Five of Chaudhary VedRam Nagar’s six sons — Dharminder is the fourth — were well into their careers by 2004. The oldest had joined the father’s thriving dairy business, the second was doing well as a politician, the third and fifth, too, had joined the father, and the youngest had started a construction company. Dharminder Nagar till then had spent all his years studying medicine and health management systems, with a short stint as a doctor thrown in between.
“I was the only one not doing anything. Finally, father said I had wasted a lot of time on experiments. It was time to get serious,” says Nagar, now 45.
VedRam’s right to demand that of his son was unquestionable. He was born in poverty and, after his father’s death, left the family village in Uttar Pradesh as a young boy to look for livelihood in Delhi. He ran errands at various dairies in the big city. By the time he was in his thirties, he had enough learning and savings to start out on his own. Paras Dairy, which he set up in 1960, became so popular so fast it slowed down Amul’s march in north India.
“We are Gurjars. There is milk in our blood. But my father was perhaps the first entrepreneur in the community,” says Nagar.
Not the last, though. Nagar started Paras Healthcare, whose first hospital opened in Gurgaon in 2006. It now has five. “I have bets with my brothers that I am the tortoise who will overtake them all.”
He plans to do that by treating the middle class, which often gets denied good-quality healthcare, at times because it is too expensive, at other times because it is too far. “The middle is my goal. I can support the poor, but can’t serve them wholeheartedly through my business. The rich I don’t care about.” Nagar chooses his locations carefully, building his hospitals in places that have gaps in affordability, access, or quality.
That sounds good, and noble. But that’s also what one has heard from the other private sector hospital chains: Fortis, Apollo, Max.
“Actions speak louder than words,” says Nagar.
Let’s hear them. “My newest hospital is in Darbhanga.”
That is loud, especially because the Paras hospital in Darbhanga comes on the back of a large one in Patna. Both the towns are in Bihar, a fertile soil for medical practice, dotted with thousands of small nursing homes owned by doctors — none too large, none too modern. They do good business, because you don’t go to a government hospital in Bihar if you can avoid it.
But why won’t he build his business in and around Delhi, where Paras is a household name? “My aspirations are different. I want to go where there is a need. When you come to my hospital in Bihar, you will see a person clad in a dhoti, another in slippers, and a third in a suit and necktie all in the same queue.” These hospitals are full of doctors of Bihari origin who have come from all over the world.
He is walking the “need” talk in his expansion plans. All the six hospitals he plans to build in the next four years are to be in small towns. However, even the Paras hospital in Gurgaon, the city of rich executives and expatriates, has the same spirit. Its building has little glass, and a small facade. Nagar claims it costs 30% less on an average to get treated there instead of any of the ‘bigger’ hospitals. He has kept his costs low by being judicious in expenditure.
“Others complain that I am spoiling the ‘market’ in Gurgaon. A lot of the other hospitals buy technology that’s relevant to only 1% of the patients. But the other 99%, too, pay for it. I buy a technology if at least 70% of my patients benefit from it.”
He talks about a hospital in Gurgaon that spent Rs 10 crore on buying two catheterisation labs, used in cardiac procedures. “I bought just one. It does exactly the same job, and came for Rs 2.5 crore.”
Nagar won’t be deterred by the uniqueness of the market he has chosen. For instance, his Patna hospital applied a year ago for a licence to do transplants. The bureaucrats there are still trying to figure out how this licence is to be issued, and to whom. No one had applied for it so far.