The entry of well-funded PE/VC investors who want to create a national chain of corporate IVF clinics to maximise their profits is going to hurt individual IVF clinicians and their patients.
Capitalism rewards winners, which is why everyone wants to become larger and bigger , so they can get a bigger slice of the pie. And corporates are very good at this , because they specialize in advertising , selling, marketing and attracting patients.
30 years ago , IVF was considered to be a medical treatment which was offered to infertile couples to help them to have a family , and medical professionals were proud of their ability to create joy and give these couples babies who were so deeply loved. Today however, VCs and PEs who only care about money and the ROI ( return on investment) they get on their capital, think of this as an “ infertility industry “. They treat it like a business where they can make a lot of money , and talk in terms of business jargon, such as TAM ( total addressable market ) – how many infertile couples there are who require IVF ; how many more IVF cycles can be done in India; and untapped demand which can be exploited to generate income. They are big picture thinkers, because they really don’t care about individual patients and their pain.
Doctors, on the other hand, look at everything from a bottom-up perspective , because we treat one couple at a time. Investors have a top-down approach, and are extremely competitive . They want to grab as much market share as they can , and they know that while one way of growing is to establish new clinics , an easier way to expand is to acquire existing IVF clinics . This is their standard modus operandi , and it’s very easy for them to take individual doctors for a ride .
Doctors think they’re very smart because they did so well academically, and always topped their exams, but they’re actually very naive and don’t have any business acumen at all . These large corporates hire the best lawyers , and they provide a standard agreement that doctors sign , without even understanding what they’re signing up for , or what the clauses mean , because they don’t understand the fine print, and don’t bother to decipher this.
This is how these chains operate. When they enter a new town, they will target one or two of the busiest gynecologists, and offer them a sweetheart deal , so that they sign them up as “partners”. They rebrand the clinic , launch a marketing and advertising blitz campaign to drive patients to the clinic ( by offering “free” consultations). They use these senior doctors as their brand ambassadors , to get other doctors to sign up as well. When they have enough clinics, they switch from the carrot to the stick. They bully the other doctors , and threaten them that if they don’t sign up , they will lose all their patients, because they will then start discounting their rates to lure patients away. They can spend big bucks on advertising and holding camps , and because they are a business, they can get away with this. Individual doctors can’t , because they’re bound down by the National Medical Council Code of Ethics , as a result of which it becomes a very unlevel playing field . These chains spend tons of money on advertising (online as well as offline billboards ) , and it’s very hard for individual doctors to be able to stand up to this onslaught , and they are scared of losing their income. Some senior doctors at some point will just retire, whereas junior doctors will feel trapped , and conclude that the only way they can survive is by joining them ( by getting merged or acquired ). However, they will end up getting the short end of the stick ! Initially , the contract will be very sweet , but as time goes by , these doctors will gradually get squeezed year after year , as a result of which at the end of a few years, the cream will be taken away by these corporate players , who only care about how many cycles they do , and will treat the individual doctor as a small cog in a large business enterprise which hires hundreds of doctors.
Not only will doctors lose their income , they lose their professional pride and autonomy as well, because he will have a corporate manager over him as his boss, who will tell him exactly how many cycles he needs to do . If the doctor doesn’t obey these orders and he doesn’t meet the quota which is set for him by the corporate manager , he will lose his job , because he will now be considered to be a replaceable widget.
Doctors will no longer be able to respect themselves, because they have to dance to the tune of junior MBAs ! It’s very sad that the medical profession has come to this pass , but it’s partly because we doctors don’t stand up for our rights or for our patients , and don’t cooperate with each other , that we have allowed this to happen to us. We are very competitive , and this classical Indian crab mentality means junior doctors will continue getting trapped and ensnared by these commercial chains. It’s already happened in the US, and it’s just a matter of time, than IVF specialists in India also become salaried employees of their business masters.
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