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| Super delux room at Beams Hospital |
Today, healthcare delivery within hospitals has gone beyond treating medical conditions. Hospitals now go out of the way to offer private rooms, catered meals, and round-the-clock private nurses. But healthcare delivery is taken to the next level by a unique fusion of clinical expertise, personally tailored medical services and brilliant hospitality with the concept of ‘concierge medical practice’ also called as ‘boutique healthcare’. With a look and feel of an five star hotel and its focus confined to few specialities, boutique hospitals cater to quality conscious affluent patients. By design, these hospitals have less number of bed strength in order to provide the requisite atmosphere to its patrons.
 “Privacy, comfort and comprehensive care are the basic principals followed in a boutique hospital.”Dr Dilpreet Brar Regional Director, Fortis Healthcare |
“Privacy, comfort and comprehensive care are the basic principals followed in a boutique hospital,” states Dr Dilpreet Brar, Regional Director – Fortis Healthcare. She further informs that boutique hospitals are manned by best in class doctors and supporting staff that provide exceptional care in a highly relaxing ambiance.
Amenities provided by these hospitals include:
- Restful, peaceful atmosphere for recuperating patients
- All private suites have spacious bathroom and in-room family area
- Large, spacious waiting rooms with multiple flat screen TVs
- Patients’ rooms are on one side of a floor to maintain their privacy
- Room service everyday— patients can order their own meals
- Patient entertainment centres in each room intended to enhance communication, education and entertainment options
- Wireless communications and Internet access
 “Keeping in view the economic concern, the concept creates a two-tiered system.”Rekha Dubey COO, Aditya Birla Memorial Hospital |
Elaborating further on the concept, Rekha Dubey, COO, Aditya Birla Memorial Hospital, explains, “It’s a concierge medical practice with a higher level of service. Functionally, the concierges would welcome patients to the hospital, orient them with their amenities, and walk them to the room, where the patients would be introduced to their personal nurse, who would take the time to discuss the stay and schedule the facial in between MRI and physical therapy.” With such luxurious amenities provided by boutique hospitals, certainly patients will be willing to pay for such hotel-like services, she feels. Dubey also points out that boutique healthcare centres bring in the wellness factor while providing medical care. She says, “Typically, worldwide such centres are focused on wellness and lifestyle, cosmetology, cosmetic surgery, delivery, rehabilitation and dental care. Some of the typical procedures carried out at such centres are laser treatments, botox treatment, acne treatment, acupuncture, tummy tuck, liposuction, facelift, weight loss, stress management, smile makeovers, dental implants, laser dentistry, silicone prosthesis etc.”
 “Technology wise boutique hospitals have all the required state-of-the-art healthcare technologies such as fully digital systems with electronic medical records.”Baldev Raj, Country Head, RG Stone Hospital |
Talking about the high tech medical technology and infrastructure in these hospitals, Baldev Raj, Country Head, RG Stone Hospital states, “Technology-wise boutique hospitals have all the required state-of-the-art healthcare technologies such as fully digital systems with electronic medical records, real-time access to patient results, radiology imaging systems that provide transcribed reports, telemetry monitoring in all patient rooms, easy registration, digital surveillance and many more.”
The concept of boutique healthcare originated in the US owing to the increasing demand for personalised medical care. Though the concept gained popularity in a short span of time; later a report published in the New York Times revealed that the concept did not gain sustainability as it created a “two-tiered” system in the US that exacerbated disparities in healthcare access.
Nevertheless, when applied in Asia, the concept blossomed well and countries like the UAE, Singapore, Malaysia and Thailand became well-known destinations for boutique hospitals. The reasons for its success in Asia were the growing demand for speciality institutes that cater to the elite class as well as the growth of medical tourism in this part of the world. India, of late, has joined the race.
The new wave in India
India is said to be emerging as a preferred healthcare destination for patients across the globe. Besides this demand for personalised care in India has also increased over the years. This makes the concept quite workable in the Indian context.
Currently, the country has around 6-8 well-known boutique hospitals across the country. Though the trend began with single speciality centres like Beams Hospital, Cradle by Apollo and La Femme by Fortis that focussed on mother and child care services, the concept is slowly being applied to other healthcare specialities as well, thus, giving rise to the concept of multi-speciality boutique hospitals in India. Neeraj Lal, Senior Vice President, Shalby Hospitals, citing an example of this transition says, “Beams Hospital, Mumbai the first boutique hospital in India was founded in 1994 with a focus on gynaecology and obstetrics. This phenomenon also helped in evolving the OBG sector which today holds a market share of about 13 per cent of the total healthcare industry in India. On the other hand, we have Hinduja Healthcare Surgical, Khar, Mumbai a well established group hospital which started of with a 103-bedded multispeciality boutique hospital early this year.” The transition from a single speciality to multi-speciality has not only evolved the boutique hospital concept in India, but also given hospitals the scope to think out of the box.
 “The emerging trend is to set up more compact, higher throughput healthcare facilities which focus on a limited number of synergistic clinical domains.”Dr Prakash Khubchandani Managing Director, Khubchandani Healthcare |
The concierge medical practice is a new booming concept which is attracting big corporate companies to invest in it, opines Lal. On the same lines, Dr Prakash Khubchandani, MD, Khubchandani Healthcare says, “The emerging trend is to set up more compact, higher throughput healthcare facilities which focus on a limited number of synergistic clinical domains. These not only translate to higher patient satisfaction and more effective clinical outcomes, but the operational efficiencies which can be built into such a model also result in lower overheads, more specialised manpower and higher operating margins.”
The boutique hospital concept eliminates the anxiety factor of a patient by introducing the system of surgical packages. This includes the pre-operative, intra-operative, and post-operative surgical services. Patients choose packages that suits their pocket and payment is done before or after the entire procedure. Surgical packages reducing excess billing work and helps in reducing billing errors. This, also enables the hospital to get cost settlements done more easily. Furthermore, what attracts private players to invest in boutique hospitals, is that this concept allows them to expand their range of services.
Market watch
Currently, the boutique hospital sector in India is witnessing a surge of activity. Beams, Apollo’s Cradle Hospital, Fortis La Femme, Hinduja Healthcare, Nova Medical Centres are few of the major players in this segment who are making it to the top. Other players like Lokmanya Hospital, a orthopedic boutique hospital, Diva Hospitals in Gujarat and Jupiter Lifeline are also slowly making their mark within the sector. On the other hand, Krimson Healthcare who will be soon entering the boutique healthcare space over the next 12-18 months has plans to launch a number of super-speciality boutique facilities in Mumbai, all focussing on the premium market segments across different clinical specialities like oncology, orthopaedics and aesthetics. Apart from this, there some private players who are exploring opportunities to start up buotique hospitals in Goa, Kerala and Gujarat. Analysing the current trend in the market, Khubchandani is of the opinion that speciality wise, a few brands have taken the lead in this field; but given the growth potential of the country we can expect more entrants over the next three to five years.
A concept for the metros
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| Delivery suite at Hinduja Surgical Centre in Khar |
However, as the concept of boutique healthcare is meant to provide luxurious service, it is certain that the corporates will be eyeing the metros rather than venturing into the Tier-II and Tier-III cities. “Majority of the elite population reside in the metros and regularly spend on luxury goods and services. They also don’t mind paying a premium in return for the ‘feel good’ factor that boutique set-ups offer. Therefore, boutique healthcare models are and will be concentrated in such cities,” says Dubey. “Mumbai, Delhi, Bangalore, Chennai, Hyderabad, Chennai are the major target areas for boutique hospitals,” updates Atul Kunwar, Director, Beams Hospitals. Also, it is important to note that setting up a boutique hospital needs a lot of top end infrastructure facilities and resources which will be best available in the metros.
Money matters
Establishing a luxurious set-up is not a cake walk. Experts feel that the total investment in a boutique hospital is high in comparison to other hospitals. According to Brar, a boutique hospital may spend around Rs 60-80 lakh per bed. Moreover, the total investment depends mainly on the number of beds within the hospital.
However, Khubchandani has a different viewpoint on this. He believes that investments in boutique hospitals are lower, area requirements are lower and return on investments are faster. He goes on to say, “Broadly, the ticket size per investment is smaller as the units themselves are usually less than a 100-bedded facility. In addition, the equipment required is more focussed and the specialised man power allow for a faster setup. One would typically see shorter gestation times at a project level, usually three to four years instead of the current 7-10 years for a larger multispeciality project”.
Stumbling blocks
Strategically and financially, the concept of boutique healthcare seems to be quite impressive for all stakeholders. The model is likely to have robust demand, but at the same time it also has certain road blocks that could crimp its growth. Khubchandani points out that the primary concern would be a slowdown of activity which can be financially difficult to bear through due to the single vertical nature of the model. Additionally, if a brand fall into the category of becoming known for one particular speciality of service offering, then brand perception may prove a challenge and your credibility as a specialist in one domain could hinder you when it comes to expansion or diversification. Kunwar, feels that the challenges associated with the poor coverage of health insurance in our country is detrimental to the growth of this sector. Dubey on the other hand speaks of the medico-legal issues that boutique hospitals may have to battle with. “High-end patients demand, high level of care and they also have access to legal resources. Slightest lacunae in treatment can lead to medico-legal cases with much higher settlements. So these hospitals have to be JCI/NABH certified with medico-legal experts on board,” she appeals.
All these are functional challenges that can be overcome over a period of time. But, the biggest worry is that like in the US, this concept can create a two-tiered system in India also wherein the “haves” get special service and the “have nots” don’t. Maybe yes or maybe no! This thought has received mixed reactions from experts. “Keeping in view the economic concern, the concept creates a two-tiered system. On one hand the customer is willing to pay for boutique services to make it worthwhile for hospitals to offer them and on the other hand catering to affluent patients will diminish the quality of care for those unable to pay more, ” states Dubey. Lal assumes that this concept may create a multi-tiered system. He claims that it would divide the population into groups, with elite class people preferring boutique hospital services where as the other classes would have to seek services from the corporate or smaller hospitals.
Keeping in mind the economic concerns, we shouldn’t forget the fact that boutique hospital are designed to serve the top-notch people of the society. “If one were to assume that all boutique hospitals are aimed at the premium market segment, then yes you could argue that this creates a two-tiered system. The ground reality however, is quite the opposite. Brands are focussing on different aspect like technology, interiors, hospitality serivces etc depending on their strategy and their pricing reflects this. We are also witnessing the emergence of a new game changer in the Indian healthcare landscape, as health insurance penetration grows at a phenomenal pace. With these coverage firms tying up with boutique healthcare centres, there will be something for everyone in this segment”, expresses Khubchandani.
In the years to come …
With increasing disposable incomes and growing demand for ‘branded’ healthcare there seems to be a lot of scope for boutique hospitals to thrive. However, there are few questions that still go unanswered. But will this concept flourish in India without creating a healthcare divide? Will this concept work for or against India’s dream of universal healthcare?
And what more would these players do to stay ahead in the race?
Only time will reaveal the answers to these questions.
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